Invisalign is a popular way to straighten teeth. But not all providers are equal. The best ones ensure smoother, more predictable treatment.
How? By nailing the treatment planning. Let’s dive in.
The rise of Invisalign over the last 20 years has been phenomenal. It started as an outcast in the dental world and was scorned by orthodontists but with 100s of millions spent on research the system is a powerhouse.
Now you may think that Invisalign is Invisalign so there’s no difference between practices or dentists offering it. But did you know that a dentist only needs to go on a weekend course and they are let loose on your teeth?
It’s like being given the keys to a jumbo jet after playing on a flight simulator for a couple of hours.
One issue with an untrained dentist is at best treatment takes a lot longer and at worst roots can be damaged and you have an uncomfortable bite.
What Are Refinement Aligners?
Refinement aligners are extra sets of aligners. They fix issues when teeth don’t move as planned. They close gaps in tooth tracking. They fine-tune alignment for the best results.
So why Are They Needed?
Sometimes teeth are stubborn. They don’t move as expected.
This can be due to
- – Biology -> the starting point and amount of movement required increase the degree of difficulty. There are a number of other factors which make movement harder which we list below.
- – Patient habits -> if aligners aren’t worn for the 20-22hrs per day they don’t have the time to move the teeth. No matter how good the planning or dentist it’s not going to work well.
- – Poor Planning -> inexperienced providers let the software do all the work. This leads to overambitious or inaccurate plans. Which means treatment takes a lot longer and can lead to complications.
Difficult Movements Which Need More Refinement Aligners
Certain types of tooth movements are more challenging to achieve with Invisalign aligners due to the limitations of the aligner material and the biomechanics involved. Here’s a breakdown of the most difficult movements:
Invisalign for Rotations of Rounded Teeth
Problem:
Rotating teeth, especially canines and premolars, is difficult because the aligner’s grip on these teeth is less secure due to their rounded surfaces.
Invisalign for extrusion (Pulling Teeth Out of the Gums)
Problem:
Aligners are less effective at pulling teeth vertically out of the gumline because they rely on pushing forces.
Invisalign for Severe Rotations of Molars
Problem:
Molars have larger surface areas, making them harder to grip and rotate effectively with aligners.
Intrusion (Pushing Teeth Into the Gums)
Problem:
Invisalign struggles to create sufficient force to intrude teeth, especially in cases involving multiple teeth.
Invisalign for Correction of Severe Deep Bites
Problem:
Aligners can struggle to open deep bites effectively, as this often requires significant vertical adjustments.
Invisalign for Closure of Large Gaps
Problem:
Invisalign can struggle to close larger diastemas (spaces between teeth) predictably because of the difficulty in controlling adjacent teeth.
Invisalign for Complex Malocclusions
Problem:
Problem:
Aligners are less predictable in correcting certain severe malocclusions, such as:
– Class III malocclusions (underbites).
– Open bites.
Invisalign for Crossbites
Problem:
Problem:
Correcting crossbites requires significant lateral movement, which aligners find difficult to achieve predictably.
Here’s an excellent illustration from Dr Kevin O’Brien’s blog that shows the type of movements and how easy/hard they are to achieve
Treatment Planning Is Key
Good planning is crucial. It ensures teeth move predictably. It makes aligners fit well. It reduces the need for refinements. Expert providers analyse cases in detail. They use digital scans, photos, and patient history. They work with Invisalign tools to simulate realistic outcomes.
After the clinical consultation when I’ve gathered all the information I use this checklist to assess the issues in details.
This didactic approach minimizes the risk of missing issues and covers all bases.
How Often Are Refinements Used?
Research has found on average, patients need 2.5 refinement scans. Only 6% finish without any. Long treatments often stem from poor planning.
The Refinement Process
It starts with a progress check. Then new digital scans adjust the treatment. New aligners are made. Treatment continues with these refinements. Each cycle can add weeks to treatment time.
Provider Expertise Matters
Many providers start offering Invisalign after short courses. They lack deep orthodontic knowledge. But providers with advanced training know more. They understand tooth movement better. They plan treatments digitally. They handle complex cases well.
A good Invisalign provider will have a comprehensive planning document. This document outlines every step of your treatment. It includes:
- Your initial condition documented with photos and scans.
- Your treatment objectives, such as closing gaps or correcting crowding.
- A step-by-step plan for how your teeth will move.
- Potential challenges and strategies to overcome them.
- Reminders about patient compliance and key milestones in your treatment.
Choosing the Right Provider
Ask about certifications and training. Look at before-and-after photos. Ask how they plan and monitor treatments. Well-trained providers mean fewer refinements, faster results, and lower costs over time.
To ensure a thorough and effective Invisalign treatment plan:
- Choose an experienced dentist who have undergone extra training in tooth movement and can create more precise treatment plans.
- Look for a provider who uses digital scanning technology like Trios or Itero for accurate impressions. This leads to better-fitting aligners and more effective treatment.
- Ensure your orthodontist creates a personalized plan addressing your specific needs, facial structure, and anticipated changes. Avoid providers who rely solely on default software-generated plans.
- Ask about the process for monitoring progress and making adjustments. Regular check-ups every 8-12 weeks allow for necessary modifications.
- Discuss how complex movements will be handled. Experienced providers anticipate challenges like rotations or deep bites.
- Inquire about the use of attachments, which can improve the effectiveness of tooth movement.
- Request to see the provider’s planning document, which should include initial conditions, treatment objectives, and anticipated challenges.
- Ask about their refinement policy. While skilled providers aim to minimize refinements, it’s important to understand how they’re handled if needed.
By following these steps, you can ensure a more thorough and effective Invisalign treatment plan, potentially reducing treatment time and improving outcomes.
Invisalign Success Starts with Expert Planning
Refinements often show poor initial planning or inexperience. An expert provider with thorough planning avoids unnecessary delays. They achieve predictable results.
Want the best Invisalign experience? Choose a skilled provider. Book a consultation for tailored, expert care. Your smile deserves the best!
Further Reading