It is rare that palatal expansion is possible in an adult because of the maturation of the upper jaw. If one is used after the palate has matured beyond a certain point, instead of the palate expanding, the teerth are moved. This may or may not be acceptable. In many, if not most, patients such movement has the potential to cause recession of supporting gum tissue and bone on the outer surfaces. Given what you have described, it might be a good idea to get a second opinon to be certain your goals for orthodontic treatment will be met without any untoward side-effects.
This is a common observation and usually indicates that tooth movement is occurring more slowly than originally projected. The solution is to take new impressions and plan a new aligner series (mid-course correction or refinement). Check with your orthodontist, but I am quite sure that is what will be recommended.
The amount of dental crowding you have can certainly be eliminated with Invisalign, without extraction. However, in doing so it is probable your teeth and lip profile will become more protrusive. Thus if your goal is to reduce protrusion, this is probably not the best treatment choice. The question is not, "can it be done withourt extraction", but rather "is it appropriate to do it without extraction if the goal is to reduce protrusion". Extraction does not simplify treatment. In fact treatment of an "extraction case" with Invisalign is one of the more challenging corrections that we face. I suggest that you clearly define your objectives and use them as a guide to the appropriate treatment choice.
Well, yes and no! If there is sufficient gum and bone support to permit the movement, yes the back teeth can be moved outward to create a broader smile. On the other hand, there often is a limited ability to move just the teeth because of insufficient bone support and gum tissue converage. In such cases, meeting the objective of broadening the smile in adults may require a combination of surgery and orthodontics. Up until the mid-teenage years, while the face is still developing, another alternative is to do orthopedic expansion of the upper jaw with a palatal expander. I recommend that you consult with an orthodontist to learn of the options that will best meet your needs..
It appears likely that the asymmetry you observe is more a matter of difference in upper and lower jaw development than merely malposition of the teeth. If that is the case, it may not be correctable with braces. I suggest you speak with your orthodontist about that and determine if it is realistic to expect the upper dental midline to be coincident with your philtrum. If it cannot be done orthodontically, and it is really important to you to have it corrected, it may equire jaw surgery. Or it may be possible to differentially modify the width of the upper front teeth to get things a bit closer to the symmetry you are seeking. In any event, prolonging your time in braces - three years is a long time - pursuing an unrealistic objective may not be in your best interest.
