Okay, I'm starting with the disclaimer that I know next to nothing about orthodontics, other than I would rather have my orthodontist move teeth for my patients than subject them to unnecessary tooth preparation whenever possible.
The above photos are of a patient I am currently seeing who has agreed to comprehensive orthodontic treatment. She is very resistant to conventional appliances and is interested in Invisalign.
The goals orthodontically are to rotate the canines in the upper arch, distribute the spaces in order to slightly widen the laterals and to reduce the crowding and align the canine in the lower arch.
My orthodontist, Dr. Cheryl DeWood is extremely competent with both traditonal and Insivalign appliances so this is not an issue.
Here are the clinical realities:
1. Completion time for conventional appliances is six to eight months and the time required for Invisalign could be three to six months longer.
2. Conventional appliances allow the orthodontist to have complete control of the movements, especially if the treatment plan changes because of unexpected circumstances. If we need to change the treatment plan with Invisalign it might mean prolonging the case for new aligners to be fabricated.
3. My patient, while absolutely committed to the process, can get annoyed with the aligners and take them out whenever she likes; this prolongs the process. Invisalign works when the patient wears the aligners 24/7.
4. The cost for traditional appliances is usually less than Invisalign.
5. Traditional appliances may create a greater degree of self-consciousness and discomfort in adults, resulting in failed treatment because they bail before completion.
In this case, I have strongly suggested conventional appliances. It will be faster and ultimately more predicatable. Don't get me wrong, I like Invisalign. I have had patients who got better care because they did Invisalign after adamantly refusing conentional braces.
What do you think? What would you recommend?
The concept of Facially Generated Treatment Planning can greatly simplify treatment planning for wear patients. You can find more information about treatment planning, esthetics and occlusion within the Spear Digital Suite. Download the free resource:
The 8 Steps Checklist-Facially Generated Treatment Planning.