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Face changes with Invisalign extractions

Many of our patients want to have their teeth straightened especially when the teeth affect the lips or profile. Sometimes the lips are full and flaccid allowing tooth drift, or the patient could be a mouth breather allowing tongue thrust movements and tooth drift.

In cases like these, the patients are looking for a dramatic improvement of both the teeth and face.

Take this teenager, her upper and lower lips are protruding. The nasolabial angle is an acceptable 90 degrees, but this is because the nose is upturned and the upper lip sticks out.

She had mildly proclined upper and lower teeth and her lip seal was strained due to hyperactivity of the Mentalis chin muscle.

We agreed to remove the UR4, UL4, LR4 and LL4. This would allow retraction of the front upper and lower 6 teeth and allow the lips to become more relaxed.

The teenager was at boarding school and so the teeth were extracted over 2 visits during the school holidays. Attachments were bonded and she went off to her studies.

She was told to wear the aligners 20 hrs a day and to change them every 10 days. No elastics, TADS or aligner cut out were required.

We did a single review at half term.

Approximately 11 months she returned for a review at the end of the aligners.

There were some minor refinements to do to the occlusion. So we carried out a new Itero scan and took photographs.

Refinement aligners were ordered and fitted 2 weeks later.

Treatment time would be 1.25 years in total with only 2-3 review appointments in-between.

The facial changes were dramatic however.

The face is slimmer, the lips are more relaxed, with the lower lip more so. She will complete the refinements and we will then provide her with 3 upper and 3 lower retainers to retain the occlusion. #invisalign #clear braces