Are you starting an extraction case with Invisalign? You will be faced with many challenges during the treatment. I was there. before.
I was sweating when I was treating my first and 2nd Invisalign extraction cases. Before starting the extraction case, I had attended as many Invisalign lecture courses as possible. I went to lectures by Dr.Ojima Kenzi and Dr.Sandra Tai and many others. I thought I knew how to deal with the extraction case. But It didn’t work as I wished.
I could clearly see the bowing effect. Canines were tipped distally, and 2nd premolars, 1st and 2nd molars tipped mesially. 2nd premolars were intruded and were not occluded with opposing teeth.
You can see more dramatic bowing effects in this case. My patients didn’t have this much bowing effect. This was a transfer case. Original Clincheck plan was this. Her doctor didn’t change anything when he got the plan from the Invisalign technician and just approved it. After the first round of Invisalign treatment, the results are like this.
Let’s compare the plan and the actual results. Not good. One bowing effect occurs, it is more difficult to fix. Prevention is the key.
How can we prevent them?
Most important thing is over-correction. If you think molars can be tipped mesially, prescribe distal crown tip on the molars.
What to over-correct?
- Crown tipping toward extraction space- mesial crown tipping of 2nd premolars, 1st and 2nd molars
- Intrusion of premolars and 1st molars
- Extrusion of canines
- Posterior open bite, only anterior teeth are occluding
Here are another Invisalign extraction case. I prescribed the setup with over-correction.
