What You Can Expect During Invisalign Treatment

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So if you come in and we determine you are candidate for Invisalign, what we do is have to take special impressions of your teeth. We mail those impressions to Invisalign, and based on the treatment plan that I came up with from you from our clinical exam, and from the photos and X-rays, I will sit down and type up a detailed treatment plan of exactly how I want your teeth to move.
Invisalign will create digital models and that's what you see here on screen. Nothing has been done. This is the initial model the way you came into our office. I will scroll through this case with a patient. And I can rotate this to the side; and you will notice the bite is off. I can spin it around to the other side and look at it this way. I can also spin it around from the back and look at the bite from the back. I can look at the upper arch independently and you can see how significant the crowding is in the upper arch. I can do the same by looking at the lower arch and flipping that down.
These are how your teeth look initially. You'll see the progression of treatment, as well as the end result. And you can see the teeth aligning. The bite is starting to open up, if you just look at the front. Then in the end, if I pan to the side, and I'll show you how her teeth fit together, and they fit together beautifully on the side. You can look at it from the frontal view. The midlines are corrected and even, as we like to see. The bite relationship here in the front is perfect. And if we look at the other side, her bite relationship is normal and corrected as well, so everything fits well.
So what you see a lot of times on the computer is not really exactly what's taking place inside the mouth. There is some variation. The thing I can tell you today about Invisalign, is it is much more accurate than what it was back in 2002 when I was first trained on it.
Typically, in an Invisalign case there are attachments that go on the teeth, and what attachments are, are little tooth colored composite buttons, I call them, or bumps, that we put on the teeth; and those bumps are determined by movements that we need to place in those teeth when we do the treatment plan. Not all teeth get them but some do.
One thing that's interesting about Invisalign, is it works by pushing teeth. So we can't really pull teeth, or move teeth in any other dimension other than by pushing them. So these attachments that go on the teeth have flat plains and the aligners push against those planes, and cause the movements that we need in those teeth. I rarely do attachments on the first aligner. I'll often do on aligner number four. Initially, I want patients to get used to wearing the aligners, taking them in and out, get used to the comfort at the aligner, and just dealing with that on a daily basis. Once the attachments go on on aligner four, oftentimes they're little harder to take on and off and they fit a little bit snugger. Teeth tend to be a little more sore at that time because teeth are moving a little bit more, and you know just a little more to get used to, so I don't want to overwhelm anybody at the beginning.
I tell all of our patients that many cases have to have at least one to two refinements, and a refinement is where we kind of detail and finish the case. At refinements, we will take all the little bumps off the teeth, take new impressions of the teeth, send it back in to Invisalign, and tell them exactly what we want to detail in the finish. Fortunately, I've had some cases that never need a refinement and they finish beautifully. But, especially in severe rotations and other movements that are more difficult, things may not be together exactly the way you want them, and those cases would require a refinement.
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