Crowding and open bite: options for treatment? (photos)

I want to straighten my teeth. I don't have any functional problems, only aesthetic. I went to several orthos and got as many opinions as docs: 1) to extract 4 premolars and use braces 2) not extract any and use Damon, but I don't get how they are going to make space. 3) not extract, but use invisalign and do filing. Which option do you think is the best and why? Of course I don't want to extract teeth, but if extraction will give much better result I am ready. What about incognito?

Doctor Answers 1

The DNA Appliances create Orthopedic Growth along with Orthodontic tooth movement

I would strongly suggest maxillary expansion with a DNA appliance to orthopedically grow your maxilla.  It is also possible to do Surgically Assisted Rapid Palatal Expansion or SARPE procedure.  This will create the space to fit all your teeth, fill the buccal corridorsand will provide better function. 

A myofunctional therapy consult and exercises may give better results as well.


I would divide treatment into two phases orthopedic growth and pneumpedic growth (airway) first along with oral and myofunctional therapy if indicated (probable) followed by E-cligner therapy 


Web reference is a youtube video of a patient.


Ira L Shapira DDS, D,ABDSM, D,AAPM, FICCMO
Chair, Alliance of TMD Organizations
Diplomat, American Academy of Pain Management
Diplomat, American Board of Dental Sleep Medicine
Regent & Fellow, International College of CranioMandibular Orthopedics
Board Eligible, American Academy of CranioFacial Pain
Dental Section Editor, Sleep & Health Journal

Member, American Equilibration Society

Member, Academy of Applied Myofunctional Sciences

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.