The 1st premolars 4/4 are usually removed, but sometimes the 5/5 may be heavily filled and are better candidates for removal.

The problem however is that the 5/5 are further away from the anterior crowding and so it takes much longer to carry out treatment.

The patient had severe upper crowding. With a deep bite. We agreed to remove the 5/5 and provide Invisalign to close the gaps and correct the crowding. The aligners were changed every 2 weeks.

The patient wore the aligners mostly 20 hrs a day.

Treatment time was 18 months in total and patient was travelling across Asia, so he attended every 3 months.

The back teeth were moved forward whilst the from teeth were moved backwards.

The patient could not travel back, so he had the attachments removed, 3D scans taken and sent to us. We ordered 6 retainers and posted them to Hong Kong. Job well done.

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Having braces as a teenager is no guarantee that the smile will be acceptable in your early adulthood. Retainers given after orthodontic treatment are not designed to last too more than 1-2 years, and as a teenager you may still be growing.

This patient was 22 years old with moderate upper and lower crowding, centre line shift, premolar rotation and some tooth wear of the incisors.

The 2 lower incisors were forward, which was causing the upper 2 front incisors to drift forward. The 2 upper lateral or side incisors then started to fall behind the front incisors.

All in all, an unstable situation.

We agreed Invisalign aligner treatment. It took 13 months with no teeth extractions. The patient attended every 6-8 weeks for review appointments.

The patient received 6 retainers that will last 5-10 years. #invisalign #clear braces # braces # crooked teeth

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Dental development involves the replacement of the baby teeth (from the age of 6) by the fuller set of adult teeth.

Adult teeth are greater in number and are greater in size.

The canines are usually in there correct position by 12 years of age, but not in all patients.

Sometimes the canines (fangs) do not develop at the correct position, or are delayed in coming down, or their space is closed by an early extraction of a baby tooth.

In any case the crowded canines look odd, although some societies actually want that teenage look way in to their mid 30’s.

In this case, we were seeing a 28 year old female who wanted her smile improved.

The canines were so way out that the RHS canine actually had no space whatsoever.

We offered 3 options with Invisalign:

1 remove the canines and no Invisalign treatment

2 remove the 1st premolars with a shorter Invisalign treatment

3 remove the 2nd premolars with much longer Invisalign treatment, as these 2 teeth are further away from the canine problem.

The patient chose the last option because the 2nd premolar on the RHS was root filled and may fail one day.

So we agreed and took impressions/scans.

The Invisalign Clincheck came back with a favourable treatment plan and time line, 18 months.

We agreed and removed the upper 5/5 and fitted the aligners.

The patient came to see us every 8 weeks for a review and after 18 months we did some refinement aligners.

The change was dramatic and the patient was extremely happy with our planning and execution.

Invisalign is a brand and product, but we would always recommend a dentist with many years of experience.

#invisalign#clear braces# aligners# crooked teeth

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