Can my midline be corrected with Invisalign? (Photo)

Question

As you can see from my pictures my midline is off and and I have a overbite. One of my cuspids never came down. On xrays you can see that its embedded in my gums. Can I remove a tooth on the opposite side for symmetry and close it up with orthodontics? Can I use aligners to close the space? Can I cover the space from the extracted tooth by filling the aligners with composite? PS my bottom teeth are off center as well because of tooth removal but they dont bother me as much.

Robert L. Knudson, DDS · Answer

Middline shift of that magnitude is very difficult, braces or invisalign.  Took Tom Cruise something like three years in braces. ( Check Top Gun vs. now).  To do that will require  something like braces with headgear (Yuck!), extraction of a tooth or two ( Double yuck) or  what are knows as TADS ( an orthodontic form of implants used to pull on to rotate the entire upper arch) and invisalign.  Some IMPROVEMENT can be made without that.  The question that shoud be answered first is "does any one notice this other that you?"  Most folks have no idea about their midline.  Just having them be straight up and down with a little movement towards the middle might give you a 90% improvement.

Mark Weiser, DDS · Answer

In an ideal world, we want the canines in the mouth and in their correct position--just like your molar teeth.  So, my goal would be to get the midline where it belongs and open a space for the right canine that is impacted.  If you are game, an orthodontist/surgical consult would be needed if you want to try to bring the impacted canine into the mouth.  Another option is to remove the impacted canine and place an implant. All of this would be done after the ortho treatment.  Now, we need to know how far off the midline is. If it is off 5 mm, for example, then we will need 5mm on the left side to move everything around. We can expand and idealize your upper teeth position to create space.  If that isn't enough, we can do IPR (interproximal reduction--remove some tooth structure between the left canine and back teeth without endangering those teeth).  If that isn't enough, then an extraction would be needed.  All depends on the relation of the molars on the left side.  I bit complex.  The key is that you do not want to make your condition worse with Ortho.

Can my midline be corrected with Invisalign? (Photo)

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Can my midline be corrected with Invisalign? (Photo)

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