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

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?

Doctor Answers 3

Invisalign to center upper midline

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.

San Ramon Orthodontist

Minor midline corrections can be made using Invisalign

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.

Kent Lauson, DDS, MS
Denver Orthodontist

Jaw surgery to correct a midline problem

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.

Jay Neuhaus, DDS
New York Dentist

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.