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Robert Passamano, DDS

Orthodontist

4200 Barranca, Irvine, California

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24 Questions Answered

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QUESTIONS ANSWERED

Invisalign over-correctors? They made my teeth crooked after they were straight, I got retainers while they were crooked?(photo)

Asked By:AnonymousANSWERS (1)

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.

Robert Passamano, DDS

Orthodontist

Recent Invisalign IPR over spec. 5mm measured at .75mm. What can I do about it? (Photo)

Asked By:AnonymousANSWERS (1)

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!

Robert Passamano, DDS

Orthodontist

My orthodontist decided to put my attachments on 3 trays late. Will my treatment be flawed? (photo)

Asked By:AnonymousANSWERS (1)

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!

Robert Passamano, DDS

Orthodontist

I have had Invisalign for about 3 months ago, and I just had a button (1 out of 16) come off. Is this normal? (photo)

Asked By:AnonymousANSWERS (1)

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!

Robert Passamano, DDS

Orthodontist

I was wondering if getting my premolars was required for getting braces? (photos)

Asked By:AnonymousANSWERS (1)

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.

Robert Passamano, DDS

Orthodontist

Crowded teeth: Is it necessary to extract before Invisalign? (photo)

Asked By:AnonymousANSWERS (1)

Hey NE2244, Removing teeth, especially four teeth should only be done if it's absolutely necessary. In my orthodontic practice, we generally remove 4 teeth for severe crowding (which you do not have) or changes in profile (which I cannot see). Just based on the photos, it does not look like extracting teeth is absolutely necessary. I find that you can easily add 1 year of treatment time by extracting 4 teeth especially in Invisalign. It is very difficult to do removal of 4 teeth with Invisalign and I hope you have an experienced Invisalign doctor for that situation. Good luck!

Robert Passamano, DDS

Orthodontist

Damon Clear Braces Vs Invisalign for an Open Bite? (photo)

Asked By:AnonymousANSWERS (1)

There's usually only one scenario where I recommend Invisalign over braces (almost every time in adults) and that's Invisalign. Braces can make your open bite worse based on pure biomechanics. Invisalign has intrusive effect and likely to improve any open bite without making it worse. In this case, I chose Invisalign over braces.

BTW: Damon Braces is just a fancy marketing term for self-ligating braces. There's over 60 types of those braces on the market. The magic is in the wires, not brackets.

Robert Passamano, DDS

Orthodontist

Should I Get Braces or Porcelain Veneers? (photo)

Asked By:AnonymousANSWERS (1)

Your gap is fairly large and if you closed that space with porcelain crowns, then the teeth will have uneven proportions. Teeth should be a certain height and width and if you choose to go with crowns now, then your width will be too large for the height and look weird.

Hope that helps. Good luck!

Robert Passamano, DDS

Orthodontist

Why Are Invisalign Using New Materials? Mine Now Say Made in Mexico and Feel Very Different.

Asked By:AnonymousANSWERS (1)

Yes, the Invisalign aligners now feel different and you are correct. It is a different material as of January 2013. All aligners now are made with a different material that is not as stiff but moves your teeth with a gently force with the same (if not better) movements.

PS: They always said Made in Mexico since 1999. They have been making them across the border in the same place that most medical manufacturers are located near Mexicali.

Robert Passamano, DDS

Orthodontist

Is It Better to Do Braces First and then Crowns or Vice Versa?

Asked By:AnonymousANSWERS (1)

Orthodontics first, then crowns is the general rule for most people. There are exceptions to the rule, but generally it is better to line teeth up in their proper angulations and locations then do crowns afterwards. This method will allow your crowns to have minimal reduction of your natural tooth and will look closer to a normal tooth because the dentist will not have to overbulk to make teeth look 'right'. Good luck!

Robert Passamano, DDS

Orthodontist