Crown Came off While Making Invisalign Molds - Will That Happen with Trays?

Yesterday I had my molds for Invisalign done. I have a crown on the upper left molar (tooth next to the wisdom...wisdom tooth was pulled years ago). When they pulled the hardened mold off, my crown came out with it. Went to my dentist (not the same dentist who did the crown) to glue the crown back. He said I will probably pop that tooth off every time I pop out the invisalign trays. I can't go everyday with that happening are there any other options? Is invisalign not an option for me? Please any advice, I just paid yesterday.

Doctor Answers 8

Change the crown first

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

If the crown came out with an impression it obviously does not have enough retention. I would have your dentist remake the crown PRIOR to making the Invisalign trays. Invisalign will tell all dentists to make sure all dentistry in done prior to taking impressions.

Patient with loose crown undergoing Invisalign treatment

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It concerns me that your dentist thinks the crown is going to continue coming off. I never expect my restorations to come off...and when they do, there is an underlying problem that needs to be fixed.

Are you seeing an orthodontist for Invisalign? It may be a good idea to find a skilled dentist and get a second opinion about that crown and your mouth/smile in general. Make sure the dentist is experienced and is up to date with technology.

Crown needs to be secured before Invisalign

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is definitely an issue that your crown comes off every time you change an aligner. It is practically impossible to have it put back in the exact same place, and this may compromise the fit of the aligner.

In a more global dental view, the crown should not come off that easily. This show an underlying problem with either the crown, the cementation process, or the preparation of the tooth. It's a good idea to have this issue corrected before moving onto more "elective" orthodontic treatment.

Jason K. Tam, DDS
Toronto Orthodontist

Invisalign and crown

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You can cut the Invisalign tray where it fits over the crown. This will allow you to seat the Invisalign tray even if there is a new crown.

David Cheng, DDS
Toronto Dentist

Invisalign does not create suction similar to impressions

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You likely will experience nothing like when the crown came off, so I would not worry too much.  Unless the dentist that feels it will continue to come off knows something about this specific tooth that is not being shared here, I would not anticipate a problem with the Invisalign treatment.

Shouldnt be a problem

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

For one thing when your Invisalign dentist does the treatment online he can actually exclude that tooth from your aligners, or even cut the aligners each time from that crown area and not loosen your crown. Also the aligners will probably not pull the crown off...just doesnt seem likely to me.

Michael J. Thomas, DDS
Los Angeles Dentist

Crowns shouldn't come off with alignment trays

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Impressions have much more "suction" or grab on the crown. I would anticipate that if it is a simple recementation you shouldn't have to worry about the crown coming off with the aligners. That said, if I were to do an examination of your mouth I may come to a different conclusion.

There may be good reasons to wait until Invisalign treatment is completed to finalize a new crown. For example if it is a front tooth, you may expose the margins of the crown if there is significant movement. You also may want to bleach your teeth before a new crown is done. For back teeth, I feel it is easier to control the the "bite" with a crown than it is with aligners, therefore, multiple crowns may be better to wait until treatment is finalized.

M. Andrew Atwood, DDS
Bellevue Dentist

Invisalign and crowns

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is hard to say whether your crown coming off during the invisalign impression is a one-time thing or if it will happen repeatedly, (since I have not examined your mouth).

I would speak with your invisalign doctor about your dilemna as there are a few options. It may be that the crown is not a good fit and needs to be redone. Permanently cemented crowns that fit right should not come off during the invisalign impression or when removing the invisalign trays. It may happen once, but if if happens repeatedly then there is a problem with the fit of the crown.

Alternatively, your invisalign dentist may be able to section the invisalign so that the aligner does not fit over this tooth (as it is a 2nd molar and the last tooth in the tray). This may be an option if you are not moving that tooth with the aligner although there may be a chance of supra-eruption of that tooth due to lack of the aligner covering it. Your invisalign dentist will be able to determine what is best for you.

I hope this is helpful!!

Gabriela Hricko, DDS
New York Orthodontist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.