When is enough enough??

[cazzie]

Hi

I have been using Invisalign since Nov 2007 and originally had 17L and 40U. I posted on here a few months back that my treatment went off track in Dec of last year and i had to go and have refinements made in early Jan, I eventually received my new sets of aligners and had 6L and 8U. I am currently in set 4U/L and due to see the dentist next week. My question is that i am having real trouble getting my lateral incisor to move, it was really tipped back at the beginning of treatment and although it has moved significantly it never seems to fit the aligner correctly, there is always a slight gap. I just wondered if anyone had any experience of when to say that maybe the aligners wont perform the movement your teeth require and maybe think about conventional braces? Will Invisalign provide more than one set of 'refiner aligners'? is it a case of they will just continue to make them until you are finally happy or do they say 'this is as good as it gets'. Also obviously getting worried about price seen as this has cost so much already and i may have to face paying out more? Has anyone got any experience of these issues?

[John37]

The only comment I can make is that one of my upper lateral incisors had to rotate a lot and it ended up moving up (intruding) instead of rotating completely. With my refinements, they put an attachment on it and that has helped keep it moving the way it's supposed to move.

Do you have an attachment on that tooth? If not, you should ask about that and make sure you point out that that is a concern of yours.

[Wobblydeb]

Sorry to hijack the thread, but what shape attachment have they given you on that incisor John?

I had a circular attachment on a lower incisor and that has stopped fitting too. I was wondering why it was circular rather than oblong (like the ones I've got on my posterior teeth) and whether it would have moved the tooth better if it was oblong...

[John37]

Sorry to hijack the thread, but what shape attachment have they given you on that incisor John?

It is rectangular, longer left to right.

[Wireless]

I am starting to have the same problem Wobblydeb noted. One of my attachments (vertical rectangle) is starting to not fit the aligner. It looks like one of my bicuspids is tilting inwards when it shouldn't be. Initially, I noticed it was much easier to remove my lower aligner. I can now see the "bubble" for the attachment looks empty and there is a small gap between the bottom of the aligner and my tooth. I'm on tray 9 of U14/L21.

This week, I had an ortho appointment and it was unusual in that my ortho looked at my teeth, then asked the assistant to get my molds. He was paying alot of attention to the movement of my teeth, but didn't say anything was wrong. Before the end of the appointment though, he took back the third set of aligners I was supposed to take with me and set my next appointment for 4 weeks instead of 6.

I was told up front I may require regular braces if results could not be obtained by Invisalign. If Cazzie or Wobblydeb have any new info about how you are progressing with your issues, I would appreciate anything you are willing to share. This morning I felt discouraged enough to keep my aligners out for a second cup of coffee!!

[cazzie]

I think its good us 'experienced' Invisalign users can all comment on how treatment is going as most of the posts on here are from new users. I too am getting a little discouraged as i went to the dentist this week to pick up the final batch of my refinement aligners and when i moved into the 5U set out of 8 they provided it was really clear that my lateral incisor just isnt fitting right. I have a kind of 'bubble' where the oblong attachment on that tooth doesnt fit the gap for the attachment on the aligner. The space at the bottom between my tooth and the aligner is also getting bigger so the tooth isnt moving out or down which i think are the hardest movements for the Invisalign aligners to make. The dentist said i should apply pressure to the aligner to try to get it to fit and also consider going back to the 3rd refinement aligner and then progressing up through the series again, but i'm not sure about this as surely all the pressure from that aligner that i have already worn for 2 weeks will be wrong for the position that my teeth have now moved to?? He also commented that i could have bonding or an elastic band to try and pull that tooth down but how do you wear an elastic on one of the front teeth and still talk??! I just dont get it! So we decided to plow on for the next month and see how things go and then maybe go back and see about a conventional brace. The thing is when i asked how long a fixed brace would take to shift the tooth he said about 4 weeks! So i am thinking i have been using Invisalign for 18 months and surely it would be better just to put up with being a metal mouth for a short time than maybe spending the next 6 months messing around with resubmitting moulds to Invisalign and waiting for aligners to arrive so on...Although i do work in a hospital and speak face to face to patients nearly every day and my vanity is stopping me from having a brace at 32, what do others think?? should i just quit -eek!!!!!

[Wireless]

Cazzie, thanks for your response!! You have a lot of the same concerns I do about refinements. I'm concerned that if I'm having problems now, I may require refinements now and at the end. My first set of aligners took over seven weeks to deliver and if the refinements take the same length, thats 15 weeks (almost 4 months of additional treatment time) waiting for aligners alone - not to mention the time wearing the additional aligners!!

I'm in a position where I can't just quit - my deep overbite was causing gum damage and considerable pain. My original assessment was braces for 18 months and Invisalign wasn't mentioned until I was told if had regular braces, a resorbed tooth root would have to be X-rayed frequently and there may have to be periodic "stop treatments" if problems came up.

When I found out I would have 21 trays (about 10 months) of Invisalign, this sounded really good!! I marked my calendar with the dates thinking this was going to be great - much better than the original 18 months! Now I am not so sure as I'm finding out about Invisalign's refinements which are probably as bad as the stop treatments I was told for the other route. I wished I had paid more attention to the refinement topic before signing up!!

Regarding wearing braces as an adult, I did in my late 30's and previously as a teenager. This is a whole different story. As for what other thought about it - there were friends and strangers. The friends basically ignored my braces after the first time they saw them. The strangers I really didn't concern myself - although now they are also called customers!

I haven't called my ortho yet - I want to see if going to the next tray on schedule helps. I did try the next tray and the earlier one and they all now fit the same as present one with the problem. I'll post if I find out anything new.

[Wobblydeb]

Well I have had my last lower tray in for nearly 4 weeks now - and it has definitely stopped moving the teeth!

As with you guys, the bubble for the attachment is actually sitting above the attachment, and there is a gap between the bottom of the tray and my tooth.

I am seeing my dentist on Wednesday, and am hoping that he will agree to take moulds for a lower refinement then. On the plus side, that tooth has definitely moved around and up - just not far enough. It's not completely tight against the adjoining teeth either, so I think there is potential for refinements to work *fingers crossed* I am going to mention that I am happy with an oblong attachment (lower teeth so not particularly seen) if he thinks that will help...

I am keeping my fingers crossed, because this is a dentist, and I don't have a fixed braces option!

I don't know why, but I've got in my mind that Invisalign provides up to 3 refinements with the "Full" treatment. I'll try and see where I've got that from, if its anything official....

[Wireless]

Wobblydeb,

Thanks for your comments! Good luck on your dentist visit Wednesday.

While I do have a fixed braces option now, its not a good one. I don't have enough vertical clearance for brackets on my lower teeth, which is where I need the most correction. I was told I would have to wear a removable bite plate as well as braces to correct. I'll probably go with a refinement this time and see how much progress I can make.

I'm changing trays next week so I hope that helps. If not, I'll call in to see what my ortho suggests. The bottom of my lower tray is irritating the inside of my cheeks, but I do have dental wax left over from my last ortho encounter.

I think they do provide more than one refinement. I'm not sure I want to wait through three given how long it takes for Invisalign to process them.

[Wireless]

I just switched to the next set of trays and these appear to be ok. The attachments on my right side don't seem to hold as well, but they look like the are in the bubbles in the tray. I've got one more set after these before I go back in.

[Wobblydeb]

Well, I had my dentists appointment last night, and these were the possible solutions to my lower teeth not being quite where they should:

- A mid-course correction. Unfortunately Invisalign charges for this, and would do both upper and lower arches. Or I could wait until the uppers are finished at tray 31 which makes it a refinement, so would be included in the cost.
- Wait to see if the tooth erupts naturally into the space waiting for it. Even a small movement would enable the attachment to click in better and help the process.
- Use another manufacturer of trays to create 2-3 trays to try and improve the alignment. Again, this would have a cost implication.

So........ I'm waiting another 8 weeks and seeing how I get on. Considering the options above I think I'll be hanging onto lower tray 17 until October (its already getting a bit discoloured!) and then getting refinements.

In the meantime (as predicted!) Invisalign is struggling to rotate my upper canine. I can see the early signs of the attachment struggling to fit. My dentist says if it has stopped fitting next time, it will be time for elastics.....

[cazzie]

So thought i would just update on my happenings, just had an appointment this morning and it looks like this is the end of the road for Invisalign for me My lateral incisor just will not move and the attachment on that tooth hasn't fitted into any of my refinement aligners bar the first one. So i was told that i could have moulds taken again and my problem explained to Invisalign and that they might be able to make new aligners with different shaped attachment bubbles and that a larger attachment might work to extrude the tooth, but then again i have had this problem since Dec last year and i'm not confident that waiting for more aligners is the right thing to do. So a metal mouth fixed brace is the way forward - to be worn for how long who knows. Bit disappointed in my treatment, as i said in earlier posts my treatment notes with my Clincheck mentioned the use of elastics and all sorts of complex terms about my teeth but not once has this been read through with me and my options discussed. My appointments just feel as though they have been 'here take these new sets of aligners and see you in 2 months' and for the near £3000 i have paid for this i am feeling a bit let down. I know Invisalign isn't a miracle cure but i have seen before and after pics of people whose problems looked far worse than mine and they don't say that they resorted to fixed braces. Sorry this isn't very informative and is just a bit of a general moan, but after 48 aligners for my upper teeth i'm just a bit hacked off. Oh and today is the 8th may and i can't have the brace appointment til 5th June, so i am sat wearing trays for a month for nothing. If i get any interesting happenings after moving into the brace i will let you all know, i won't defect to the other message board for fixed brace users just yet!!

[DrJasonKTam]

Sorry to hijack the thread, but what shape attachment have they given you on that incisor John?

I had a circular attachment on a lower incisor and that has stopped fitting too. I was wondering why it was circular rather than oblong (like the ones I've got on my posterior teeth) and whether it would have moved the tooth better if it was oblong... :?:

Fantastic observation. Invisalign is an ever-evolving technique. I can say that many experienced providers no longer use the ovoid or ellipsoid attachments and have moved to rectangular beveled attachments as described by John37.

[lyra silvertongue]

Thanks for the update cazzie. I'll be interested to hear how the fixed brace goes for you. My lateral incisor is the tooth that needs most movement but doesn't have an attachment. I hate the idea of refinements with Invisalign - all that waiting around with nothing happening. I'm on my last tray for my lowers & my teeth aren't where they should be and I have big gaps between the top of my teeth and the end of the tray. I'd much rather go straight to fixed braces and skip refinements if my top teeth don't move how they're supposed to either. I'm not sure if my ortho will allow that though. He said it was an option if Invisalign don't work but I might have to go through the refinement process first - I hope not.

Unlike most people here it seems, the invisibility of Invisalign wasn't why I chose them. I intended getting fixed braces but then my ortho recommended Invisalign and promised they'd give the same results so I went for it. Of course, it's only after I got them that I've read all the stories of them not working & not giving as good a result as fixed braces. I hope I don't regret not going with my original plan!

Anyway, don't worry too much about getting the new braces. Hopefully they work quickly. And just think, you won't have the annoyance of taking Invisalign in and out and will be able to eat whenever you want now!

[Wireless]

Lyra and Cazzie, thanks for posting your concerns. I have similar where I was first told regular braces and then the ortho switched to Invisalign at the records review because of a resorbed tooth root. In my case, I would have a similar problem with "stop treatments" and extra X-rays with regular braces, so it looks like problems either way until my upper arch is aligned.

I'm having trouble with my lower aligners not fitting correctly over my attachments on one side. I can pull my aligner out on the poorly fitting side almost as though there are no attachments and the other side the aligner latches so tightly I have a lot of trouble getting it out. I'm also not seeing much vertical change for my overbite and I'm on trays 11 of 14U / 21L. I plan to ask my ortho on Tuesday about the progress on the vertical correction and is Invisalign still the best approach. I'll post if there are any interesting comments.

I would rather wear regular braces and get it over with than to deal with repeated delays for refinements. I'm also finding Invisalign doesn't work well with my lifestyle and travelling. This week, I had to watch a co-worker devour a chocolate donut and drink coffee during a seminar while I drank my bottle of water, not to mention eating on an airplane. Tommorrow, I'm doing a 50 mile bicycle ride with friends and there is no where to deal with my aligners discretely at a refreshment stop. If I take them out for the ride, my attachments cause sore spots inside my cheeks. I'm getting very weary of the lifestyle restrictions and starting to feel like a guinea pig!!