Can Invisalign close extraction gaps?

Doctor's Answers 1

Invisalign can close extraction gaps but in my experience, this requires either additional treatment with fixed braces to ensure the teeth on either side of the gap end up in correct alignment or additional tools (such as power arms) during space closure.

What tends to happen when aligners are used to close spaces, is that the crowns of the teeth tend to tip towards the gap instead of moving towards each other in an upright alignment (bodily movement). Even with fixed braces, this can be difficult to achieve. This tipping is accentuated further when patients do not wear their aligners enough.

Power arms are either metal/plastic pieces that are glued to the teeth on either side of the gap and elastics are used to squeeze the arms together as the space closes. This tries to counteract the tipping of the crowns towards the extraction space. If the aligners are not worn as prescribed, the opposite problem may happen: the roots of the teeth come closer together than the crowns, instead of both being parallel.

Performing extraction space closure with aligners is challenging, and a lot depends on patient compliance. Despite ideal patient compliance, finishing with fixed braces (or several sets of refinement aligners) so that a proper bite and alignment is achieved at the end of treatment, is almost mandatory.

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Braces and Invisalign are all tools an orthodontist uses to treat patients. There are many factors which may lead to the decision of selecting one system over the other, such as cost, complexity of case, preference of the dentist for one system over the other (based on experience), etc. To be honest, the majority of my Asian patients are treated with extractions due to our facial profile and lip prominence. Rest assured, a case requiring extractions does not necessarily mean the case is complex.

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It depends on how severe the underbite is and the underlying cause. Underbites can be caused by: 1) Jaw size discrepancy If your lower jaw is too large in proportion to the upper jaw, or the reverse, then a skeletal underbite is the result. This results when the developing skeletal issue was not addressed when you were still in your growing years (before puberty). Normally, your dentist or orthodontist can detect this in a growing child, usually around the age of 7-10 years old. If the discrepancy is mild, you may be able to camouflage it with extractions.

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