Jaw Surgery for Midline? Orthodontist Says Impossible with Invisalign, True?

Question

I've been using Invisaligns for about a year. Long story short, my orthodontist says my upper midline can only be fixed by jaw surgery. My midline is off by only 2mm. I've been reading online that it is more than possible. My orthodontist completely dismisses it by saying, not everyone's teeth are perfect and if you want to fix it, you need surgery. Should I have a consultation with another orthodontist? Would they need xrays to tell me for sure?

Rob van den Berg, DDS, MS · Answer

To truly fix the upper midline all the upper teeth have to move by 2 mm, also correcting any molar bite asymmetry. This can be done by combining Invisalign with:

	
		elastics or TADs anchorage
	
		attachments on the front teeth to control root angle
	
		additional treatment time 12-15 months


	A common compromise approach is to keep the back molars in place and to move just the front teeth. This compromise involves:

	
		recontouring/reshaping of the teeth in the upper and lower arches
	
		may need new restorations on the upper to close space created
	
		attachments on the front teeth to control root angle
	
		additional treatment time 6-9 months


	For your second opinion use the Invisalign doctor locator to find an orthodontist. Bring your beginning x-rays and photo's to this consultation appointment.

Kent Lauson, DDS, MS · Answer

It is hard to speak about an individual's problem without seeing pictures of the teeth.  There are a number of reasons that the midline could be off, but only a 2 mm discrepancy should be able to be handled with Invisalign treatment.  It may be that elastics (rubber bands) in conjunction with Invisalign may be necessary for the correction.  It is highly unlikely that surgery would be the best option, however.  It sounds like another opinion may be necessary for you to achieve satisfaction.  I hope this is helpful.

Jay Neuhaus, DDS · Answer

Yes you should definitely seek out another orthodontic opinion. I would NOT recommend surgery to anyone to correct a 2mm midline shift. The orthodontist would most likely need to see your X-rays. Perhaps the shift that you require would need to be done with conventional orthodontics, as opposed to Invisalign. Alternatively, the midline correction might be able to be corrected with porcelain veneers.

Jaw Surgery for Midline? Orthodontist Says Impossible with Invisalign, True?

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Jaw Surgery for Midline? Orthodontist Says Impossible with Invisalign, True?

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