Manhattan Cosmetic Dentists

Braces Vs. Invisalign for Overbite/overjet

I am 21 years old and in college and have never worn braces before but have a big overbite and overjet. Based on these pictures, do you think I could benefit from braces? If so, is it possible to tell what kind of treatment I would be looking at? Would I be able to wear invisalign or do I probably need regular braces?

Generally speaking, overbites are difficult to treat using any types of orthodontics especially in adults. Time and patience are needed simply because we are intruding anterior teeth (pushing front teeth back into dense bone) and extruding posterior teeth (pulling back teeth out of the bone) – Furthermore, not all overbite cases are simple teeth problems and could be of skeletal problems as well which refer to irregular amount and angulation of skeletal bone.  We take digital panoramic and cephalometric x-rays to determine much info before starting treatment.

What I have found when treating overbite cases with invisalign is as follows:  Typically, the results we see on invisalign computer modeling called clincheck, looks better with more of the overbite gone by the end of treatment.  Although this seems to be a bad thing, we have learned over the years and thousands of cases that in order to battle this issue, we perform what is called an over-correction.  Basically, if we want to reduce 50 to 60% overbite which seems to be the case here, we NOT only reduce overbite to ideal on the computer model but we continue ordering more aligners beyond ideal final results and purposely create a virtual open bite of about 1mm on the computer model.  More happens in clincheck and less in the mouth so we will still end up where we want and we simply stop treatment once ideal overbite has been achieved!

Keep in mind the key to successful orthodontic treatment is anchorage and compliance. Anchorage comes from tiny little composite resin buttons called attachments.  We at our office place good number of both facial and lingual attachments to insure proper anchorage especially in overbite cases.  Patient compliance and wear is very important in achieving successful results.

Also from your photos, it seems you have what is called a class II bite meaning uppers are more forward than they should be.  We use tiny invisible circular elastics just as used in braces to pull uppers back and lowers forward into ideal class I bite.

Proper diagnosis and treatment planning along with great attachments and use of elastics and great compliance on your part will give you ideal results with invisalign.  If you think, you will not wear aligners properly, you may as well go for braces which would require much less compliance on part of the patient.

The clincheck computer modeling below is an example of how overbite is corrected. Please note overbite video.

***Online Answers should NEVER be substituted for a complete clinical exam and following advice of your treating doctors based on proper and full diagnosis and treatment planning.   There is no way anyone can properly diagnose and treatment plan a patient online without an in office exam.

Daniel Noor, DMD, PC

Manhattan Cosmetic Dentist

Are All Veneers Made of Porcelain, or Are There Other Options?

Most veneers are made of porcelain.

Some are made of plastic or resin, but porcelain is stronger and more esthetic.  I don’t provide plastic, and don’t know any cosmetic dentists that do.

I would say the options to porcelain for veneers are not existent, but there may be options to veneers themselves  depending on the condition of your teeth and what you are trying to achieve.

Steve Alper, DMD

New York Cosmetic Dentist

Veneer or Crown for Chipped Teeth?

The other day, I fell and chipped my #7, 8, 9 teeth. There's no pain, just a little temperature sensitivity in one of them, and my initial x-ray shows no cracks in the root. I'm in my early 30's. Which restoration option would you recommend in my case, and why?

Hi Chipped, Good Question:

3 Veneers would certainly work to restore the teeth, but when placing porcelain on the front teeth I recommend a symmetrical approach from the center line.  In your case this means veneering teeth 7, 8, 9 and 10. 

You will not only get a better result immediately, but you can also expect it to look better than only 3 veneers as time passes. This is because the porcelain veneered teeth have much more shade stability than those without a veneer.  The tooth without a veneer will change shade over time and become more and more obvious to others. 

Steve Alper, DMD

New York Cosmetic Dentist