Invisalign ® clear braces: Before-and-after treatment simulations.

A) Using the Invisalign ® system to close relatively small tooth spacings.

Clear braces are typically considered to be an appropriate treatment choice for closing relatively small tooth gaps. As a general rule of thumb, the total amount of spacing involved, cumulatively, should measure no more than 6mm per arch.

B) Crowded teeth are sometimes narrowed first and then realigned using clear braces.

Some cases that involve tooth crowding can be transformed into and then treated as a case where the bulk of the tooth movement involves space closure.

In this type of instance, the dentist will "strip" (narrow) the crowded teeth just slightly (either with their dental drill or a diamond-coated finishing strip). Invisible braces are then used to realign the narrowed teeth to a more perfect arrangement in the same amount of space that already exists.

C) Tooth crowding can sometimes be resolved with invisible braces by expanding the patient's dental arch. Another approach that is sometimes used to correct tooth crowding with invisible braces is to expand (flare out) the patient's dental arches just a small amount. In this type of situation, this slight arch expansion (typically no more than 2 to 4 mm) provides the space that is needed to realign the teeth.

D) The space needed for realigning a patient's teeth is sometimes created by extracting teeth. One way to create the space that is needed to realign a patient's teeth is by tooth extraction. "Extraction" cases are commonplace in the orthodontic world, however, they usually involve the extraction of back teeth (bicuspids). A way to create the space needed for realigning crowded front teeth can be to remove one of them. While philosophically this technique might seem to stray from the ideal, from a practical standpoint it is sometimes chosen. When this approach is selected, it almost always involves the realignment of lower front teeth. And yes, the patient will end up only having three lower incisors positioned in a space that is normally occupied by four. However, the vast majority of people with whom the patient will have contact with will never notice this discrepancy.

E) Rotated teeth can be realigned using invisible braces. Cases involving minor tooth rotations are often good candidates for Invisalign ® treatment. Especially in the case of canine and bicuspid teeth, clear braces are probably most appropriate for correcting tooth rotations that are less than 20 degrees from normal position.

F) Invisalign ® dental braces might be use for just a portion of a person's total orthodontic treatment.

It is possible that a decision might be made to utilize Invisalign ® for only a portion of the patient's total orthodontic treatment plan. Treatment might be initiated using traditional braces, so to create those orthodontic tooth movements that can be difficult for removable tooth aligners to produce. Then, once these tooth movements have been accomplished, the case can be finished using invisible braces. Since both types of braces are involved, the total cost for this type of treatment plan would be expected to be greater than if the case was treated with traditional braces only.