Robert Passamano, DDS

If you are unhappy with the position of your teeth following orthodontic treatment, then go back to your orthodontist to see what they can do.  Usually the orthodontic retainer is made based on a straight position of your actual teeth, not a computer simulation.  If it wasn't straight then maybe you needed to continue with Invisalign until they were straight.  I'd go back to your orthodontist or ortho-dentist to get them straight.  That's what you paid for.    

Hey LeakyBrain ... Nice Catch!!  The current set of Invisalign is only set to close a space of .5 mm so you'll be left with a .25 mm space at the end of the Invisalign set.  You'll then need what we call a 'Case Refinement' which is another 1 or 2 sets of Invisalign to continue the treatment.  [There are overcorrection aligners, but it won't close .25 mm ... sorry] In my office (which is down the road from you), we generally do 2-3 sets of Invisalign orthodontics to make sure everything is perfect and all the spaces are closed.  That's the whole 1.5-2 year process.  Good luck!

Hi Jayk18,  You definitely have an interesting story.  The Invisalign Orthodontic treatment simulation is designed to move sequentially from aligner tray to aligner tray with the attachments in mind.  If the desired tooth movement for that specific Invisalign Orthodontic tray is not achieved (like trays 4,5,6), then those specific movements may or may not have been achieved.  I can't speak on behalf of another case since I don't  know the specifics, but ideally, those 'bubbles' , 'buttons', 'attachments' should be filled when your Invisalign Orthodontic tray has a void for them.  

Invisalign Orthodontic treatment is a journey and usually never finishes in 1 set of Invisalign trays.  You will likely have the opportunity at 1, 2 or 3 case refinements and/or a mid-course correction to fix any problems that come along.  Almost all Invisalign Orthodontists use multiple sets of Invisalign to achieve the desired orthodontic outcome.  Good luck with your treatment!

Hi JSenne,

That's unfortunate that one of the buttons / Invisalign attachments came off.  The Invisalign Orthodontic attachments coming off rarely happens, but it happens.  It sometimes happens by the method used to remove and put in your Invisalign Orthodontic trays.  Each attachment has a specific movement, so we generally recommend holding in your current Invisalign Orthodontic tray until the 'button' is replaced.  

I'm sure you can call around to other Invisalign Orthodontists in the area and one of them can do it for a small office visit fee.  

Good luck!

Since there's no profile photo or lateral cephalometric x-ray displayed here, it is impossible to assume that removing bicuspids will  "adversely affect your facial aesthetics" or even "narrow your arch" or even "adversely affect your TMJ."  I have extracted bicuspids on hundreds of patients, while actually improving TMJ and broadening the smile and arch.  It really depends on what type of mechanics your orthodontist does.  Anyway ....

Based on just your repose (relaxed lips) photo you have, it looks like you have protruding teeth.  I cannot say that for certain without the profile photo or cephalometric x-ray, but that is my guess just on one photo.  I would agree with your orthodontist that removing bicuspids would be the correct course of treatment. 

Good luck.