4 Months of Braces Followed by 9 Months of Invisalign - Good Plan?

Hi. Sometimes there is too much crowding or rotations for invisalign to correct successfully, and thus braces first and then invisalign are good. In other cases, I start with invisalign, as many of my patients do not want braces, and I advise them that we will see how much correction we can achieve with invisalign and will most likely need to put braces on for a short period of time at the end to get the full corrrection. It depends on the case as well as the patient's comfort level. I think combo cases are great and work out well if done right!

SInce you asked your initial question 12 months ago, I'm curious how things turned out for you. Please do share!

Adding some braces for a few months before, during or after the Invisalign can boost the speed of treatment. For example if teeth are rotated more than 45 degrees. Ask your doctor what specific goals he or she has for the braces phase of the treatment, so you both know when you will be set free. If the idea is just to get you in braces to sway you from Invisalign without a clear justification I would advise against that.

If you are going to do four months of braces and that is enough to get significant changes, which in my office using Damon braces it probably would be for some mild Class I crowding,  you would probably be better off and get a more precise final result if you just go ahead and do a few more months in the braces and be done with it. You might also be able to do it faster.    It is likely to be a good bit more cost effective and probably a more precise result at the end.  It doesn't sound like a difficult or long term case.   Once you are into the process most patients just want "whatever will get me done the quickest".  Talk to your orthodontist about the treatment time goals that you want to shoot for.

I think this can be a very good solution.  When the teeth are rotated 20 degrees or more, it is a challenge to correct them with Invisalign.  It makes very good sense to correct any major rotations with braces before transitioning to Invisalign for the final correction of your bite.  This approach tends to simplify the correction and make it more efficient and predictable in outcome.

Invisalign struggles with "extruding"  and "rotating" round teeth.

As such, partial metal braces may be used first to accomplish some of the tooth movements that are difficult for Invisalign to do.

It sounds like your orthodontist is trying to get rotation of teeth using conventional braces before finishing the case with Invisalign. Using Invisaling to rotate teeth, especially canines, used to be a very difficult proposition but the company has developed newer attachments that make this movement somewhat more predictable. I would suggest trying Invisalign first (with the newer attachments of course) and see if you can't complete the entire case with only Invisalign. If treatment objectives are not realized at the completion of Invisalign then brackets and wires can easily be used at the end.

In some cases (perhaps yours) using Invisalign in conjunction with braces can achieve more than just Invisalign alone.  This is true because there are many tooth movements that braces accomplish better than Invisalign.  Putting the two together is more costly and complicated, but if you are willing to bear the extra cost and spend the extra time to get more work done you will probably get a better result than just using Invisalign alone.  One thing I often notice about patients who get braces is that after several months they don't seem to mind them as much as they thought they would.  So maybe you'd decide to skip the Invisalign.

In my practice I rarely treat with a combination of braces and Invisalign. If i do it would be to use braces on a limited # of teeth to correct rotations at the end of treatment. If a case required braces from the start I would complete the case in braces to avoid an extended treatment time for my patients. Most cases of crowding can be treated with Invisalign alone so I do not usually have to use braces with Invisalign.

While what you suggest will likely work just fine, the complexity of it all would increase the fee in my office.  You would likely save both time and money by just sticking to the braces and skipping Invisalign completely.