Invisalign fabricates trays but the orthodontist is the one who determines the treatment course. Remember that the aligners are like any other appliance. They are used as tools by the doctor, to help move teeth, just like braces, an expander, or using elastics. Invisalign is a mass-made 100% customizable appliance. Impressions are sent in and scanned in Mexico. The digital images are sent to Costa Rica where the models are dissected digitally. There are over 500 techs with little to no dental background who are responsible for putting together the course of treatment. They are extremely talented with using the software, but do not know how much about orthodontics at all. It is up to the doctor to decide on which teeth move, when they move, how they move, which attachments should be used, where they should be placed, whether IPR is required, and the rate of movement. Failed Invisalign treatment is usually due to one of two reasons. The first is a lack of compliance with wearing the trays. The second is poor or inadequate planning by the treating doctor. An experienced Invisalign provider goes a long way in maximizing the chance of successful treatment. Good luck!