Possible to Go for Invisalign Without Tooth Extraction?

This is a GREAT question. It is clear (based on the records you have provided) that you have a LOT of crowding of your teeth. Let me say right from the start that you have made a wise choice to straighten your teeth. Straight teeth not only make a more beautiful smile but also create a healthier mouth. 

Typically, with Invisalign (and with traditional forms of orthodontics as well) it is easier and requires less time to treat a patient using extractions than it would without taking teeth out. Because you have excessive crowding you either have to take teeth out, expand the space your teeth occupy and/or make your teeth more narrow.

I would ALWAYS recommend treating a case without taking teeth out if possible. NOT extracting teeth will give you a broader smile, better lip and face support and be less-potentially damaging to your TMJ. BEFORE removing any teeth you must always consider how extracting teeth will affect the look of your face and the health of your jaw joint. If the dentist tells you there is no possibility of a negative affect...seek another opinion or two. 

Good luck!

I see that you have crowded teeth.

However you should try invisalign treatment. It might work. I have had a case similar to this and it worked really well without any extraction. I am not saying that this might aply to your case as well but you have a good chance to achieve your goal without extracting any tooth 

Good question and many answers.

My advice woudl be as follows:

You have a slighty convex upper lip which is being pushed out by the 2 front teeth. The profile is nice and should not be flattened too much. Your chin point is slightly forward as well so again moving the upper teeth into extraction spaces may flatten the upper lip and make your chin look slightly long. The front teeth may also have an open bite as well.

The crowding is quite severe and yes you need lots of space. Your upper canines are in class 1 and that is quite stable. To remove 2 upper and 2 lower premolars would create too much space. The dentist may then spend half the time in closing these spaces by moving the molar teeth forward; not easy with Invisalign.

My advice would be to create space in th eupper arch by expanding the dental arch and even moving the molars back 2-3mm. There might be some fine interdental stripping as well. The front teeth can then be tipped back into the dental arch. I have already done a similar case with a twisted upper arch.

Invisalign can provide attachments and now even power ridges on the front teeth to help the aligners to move the roots of the upper incisors.

The anterior open bite should not be closed by pulling down the upper incisors as you show too much of your teeth already.

The dentist should take impressions and create an Invisalign scan and then see what movements he can make. It is then possible to add extractions if really necessary ( I dont think they are) to the scan and then you will be able to use Invisalign.

Sorry for the long explanation but I only extract teeth in the upper arch when the upper jaw is very far forward from the lower arch.

please see my cases

Dr R Kumar BDSLDSRCS

I would not advocate