Could Invisalign rotate a tooth 90 degrees off ideal or are braces absolutely required? (Photo)

The bottom line is "yes", you CAN rotate a tooth 90 degrees with Invisalign.  HOWEVER (and this IS a big deal), it will require buttons and tools to get the job done.  The usual reason to do Invisalign is to be "invisible" or "discreet".  With these attachments, it is as obvious as brackets and wires, which are MUCH more predictable.  Usually, rotations like this require mid course refinements and a LOT of extra time.CAN you?  Yes.  SHOULD you?  Up to you.

Invisalign could probably do the trick, however it won't be as simple as an invisible tray. Buttons and other elements would have to be used to get your tooth moved. Often these things eliminate the 'invisible' aspect of Invisalign. Certainly, it would be a lot less noticeable than traditional braces, but braces would take care of the move much faster. The question may come down to, you can see the treatment, but have it over faster or something less noticeable, but that takes longer to complete.
Good luck!

Thank for sending your question and pictures. Invisalign can help with these movements. I have treated many individuals with this type of movement and have seen incredible results. We treated many individuals in our Los Angeles office with Invisalign clear aligners successfully. Feel free to come in for a comprehensive evaluation. All the best.

I have used both braces and Invisalign to rotate teeth and I will have to say that rotating teeth is one of the more difficult movements to accomplish using Invisalign.  This is because the aligner needs to place force on the tooth in a way to rotate the tooth, and round-shaped teeth such as lower premolars (the one you need rotated) are the most difficult to rotate.  Attachments on the tooth are required, and even with attachments on, moving the tooth can be unpredictable and frustrating.  I have found that using fixed appliances (brackets and wires) to rotate a tooth is very predictable and much faster than Invisalign.  
My advise would be to use a limited number of braces on the lower teeth to get the tooth rotated and then switch to Invisalign.  Rotating the tooth should only take a few months.

I have rotated teeth like this into proper position using Invisalign. I generally prefer to use a vertical high profile attachment and recommend a circumferential fiberotomy once it is in place. It looks look tooth 20 not 28 though unless this is a reversed photo. Be sure to wear your aligners exactly as instructed!Doug Jopling, DDS