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Can I avoid extraction with Invisalign treatment if metal braces require extraction?

Braces & Invisalign Invisalign

I have overcrowding and overbite/overjet. With traditional metal braces treatment, I was informed that 4 premolars must be extracted as expanding to create more space will not work well for an adult patient. Will Invisalign treatment require the same?

DOCTOR’S ANSWER (1)

Your teeth DO NOT know what type of orthodontic appliance is being used on them. All the tooth will be aware of is force: magnitude and direction.

Remember that Invisalign is just a different type of orthodontic appliance. ALL orthodontic appliances have to exert forces on to the teeth to cause tooth movement.

Invisalign CANNOT overcome the limits of biology, such as how much bone is available in the jaws for safe expansion of the arches. In adults, since there is negligible skeletal growth and the suture lines are fused (where 2 different bone plates meet usually in the midline, such as the midline of the hard palate and the mental symphysis), arch expansion at the skeletal level tends to be unsuccessful even if surgery is performed.

The decision to use extractions for space creation and for profile improvement would be THE SAME for any type of orthodontic appliance (fixed braces, be it metal or ceramic; Invisalign or any other clear aligner system). Different appliances may have different features that may be useful during treatment but the planning and execution of the treatment plan by the clinician is the most important in determining the final result.

Other options for space creation without extractions include distalization and interdental reduction (IPR).

Having an overbite and overjet is IDEAL at the end of any orthodontic case, so each case has to be judged individually. The aim of orthodontic treatment is NOT to eliminate overbite and overjet but to optimise it.

196 views 20 Mar 2019
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