Severe misalignment but qualified for Invisalign?

[nhyn]

Hi all,
I was wondering if any of you has a case that was/is classified as "severe", and yet has successful treatment with Invisalign?
I have a 9mm (!) overjet (mostly just one tooth), an overbite (not completely, but significant), crossbite on one side, and overcrowding on both upper and lower jaws. The first orthodontist - who was great (and has great reviews)- after a full diagnostics session (with mold, Xray etc.), decided that I'd need braces for 2 years, with two extractions from the upper jaw.
Just to get a second opinion, I found another orthodontist with also good reviews, and also seemed great in person. His office does more things than the other office (Damon, lingual), besides Invisalign and traditional braces. This orthodontist said I can do Invisalign with no extractions!

I was very skeptical and thanks to all the posts and advice here on this forum, I was armed with knowledge and I asked again and again what if this or that happened, what if my teeth flared out etc. and he showed me examples from other patients (but none as severe as mine) and explained to me that Invisalign would still widen my arch enough to make space to pull back my front teeth (along with some pushing of the lower teeth) to close the overbite. This seems believable because I do have some back molars that can be pulled more outward to make the arch more round and wider. I asked straight up that I know it won't be perfect without extraction and asked how much of the overjet they would reduce, they said since it's mostly one tooth that jutted out, they can definitely close the overbite to a normal range (no number specified, and I get it - orthodontics is not an exact science etc.). Anyway, point is, I even said I would be willing to do lingual, which was much more expensive, and they said lingual wouldn't be too comfortable and were set on Invisalign. Considering that the cost of the Invisalign and traditional braces (from the other office, with ceramic upper) are the same, I feel like maybe they're not trying to scam me out of my money?

I decided to go with it anyway because of other factors from this office (their experience with patients moving away, their hi-tech approach with pre-filled medical information online as opposed to papers like the previous office, their very very clean facilities and spacious office, ipads for patients while they are in the chair having their braces tightened, etc. - I know, totally extraneous stuff, but it seems to me that this office is careful and thorough when they care about this kind of stuff).
But just out of curiosity, has anyone ever had success with Invisalign even though their case was considered "severe"? I feel like if this doesn't work out, they will put me on braces for the last few months or something, which is fine - I really didn't want to do traditional braces but if I have to cross that bridge I will. I just still find it hard to believe that I don't need to have any extractions, AND can do Invisalign Any opinion is appreciated! Thank you!

[newbite]

It sounds like your ortho is very confident about their ability with Invisalign. My ortho is a top Invisalign provider and he was surprised I chose Damon braces over Invisalign. I had a 3mm underbite, crossbite, crowding, etc, and I felt he probably could have fixed my teeth with Invisalign but I didn't want to mess around. I wanted them on and off as soon as possible with as little fuss as possible.

Do you know anything about using elastics with Invisalign, or what kind of attachments you'll need? Personally, I feel like if you have a complex case, just get regular braces and get it over with. Or at least make sure you know what you'll be dealing with since I seriously doubt you could get through treatment without elastics at least.

Also, if you have sensitive teeth at all you would probably regret getting Invisalign if you had to get braces put on at the end. They would have to grind off all of the Invisalign attachments, glue on the brackets, and then you have to go through it all over again at the end with grinding off the bracket glue.

I sound like such a naysayer, but not because I doubt it can be done. If he's highly rated (check with Invisalign) then go for it. It just might take longer and be less convenient and possibly not be as good of an outcome as with braces.

Hopefully someone who went through Invisalign with a complex case will chime in!

[DrJasonKTam]

Being qualified for Invisalign is dependent on:

1. the severity of the malocclusion
2. the experience and ability of your treating doctor

We see many patients every week that have been told they are not candidates for Invisalign where we see absolutely no issue at all using aligners to produce excellent results. We have had patients remove 4 teeth and close space, corrected crossbites, overbites, open bites, underbites, and even used Invisalign with jaw surgery. Below are links to two videos we've made of various types of Invisalign treatment that many people would have previously thought impossible with aligners. Good luck!

https://www.youtube.com/watch?v=cNTVxoTQqR8

https://www.youtube.com/watch?v=ywcwlyL-sg8

[lilyflower]

I'm not sure if I'm severe but I qualified with a 60% overbite and a lot of lower crowding. Pics in my diary in the link. I ended up with 21 attachments but no IPR and so far (4 months in) my case is tracking nicely. Lower arch is widening and lower molars were bumped back to where my (erupted) wisdom teeth were. Front crowding has lessened and my upper canine is starting to slowly rotate. I won't need rubber bands or anything much beyond some refinements towards the end.

I've found this to be a pretty good experience so far, not having had braces as a kid but hearing the horror stories. If you trust your provider then I'd say go for it.

[FixMyOpenBitePlz]

Thanks for asking this so we can know more!

[golcarlilly]

Hi there, I think I am probably classed as a severe case as I have 35 top trays and 58 bottom and my treatment will take over 2 years, I have a very narrow smile, severe lower crowding and an occlusion at the top, my dentist said I was a great candidate for Invisalign. Have a look at this video on You Tube, it inspired me so much to think that such a fantastic transformation was down to Invisalign!

https://www.youtube.com/watch?v=v4HEikEHKCc

[nhyn]

just want to update that I have 38 trays for each jaw, no attachment so far (in the last 3 months 4 will be put in in the back teeth for the rubber band) and everything has gone very well. I have Acceledent so will finish in a yeat (unsure about the retainer phase though). So looks like Invisalign might work after all!

[DrJasonKTam]

Qualification for Invisalign depends on two factors:

1. The condition of your teeth.
2. The experience and skill of your doctor.

Our office is one of the top Invisalign offices in North America, having had our work recognized by Align Technology, and we have taught doctors across North America how to use Invisalign, but there are some cases where by the nature of the condition of the teeth, braces might work better or be faster. This is a small subset of the treatments that walk in our door as we have worked with patients who require extractions, expansion, etc. Keep us posted!