Invisalign question (I have Clear Image Aligners) (photos)

Question

Does most movement occur only when you first change your trays, or are teeth constantly moving? My trays are always loose a few days after receiving a new tray, and they are only sensitive for a few days. Also, does IPR help move teeth faster? Or is it just a necessity if you have tight teeth? I have pretty significant gaps on my problem areas. after recent IPR. My dentist used a mini saw-like drill, looked like a little disc. Does this wear off enamel?

Marlon Moldez, DMD, MSc, PhD · Answer

Invisalign trays delivers light pressure on ligaments, vessels and tissues surrounding your teeth. Thus, fluid is squeezed out, tissues are compressed. This cascade of events happens immediately within seconds of tray insertion. Within minutes of insertion, inflammatory mediators are activated, hence pain is felt. 2 days after, the cells that remove (osteoclast) and deposit (osteoblasts) bone around your teeth are activated, thus tooth mobility/movement occurs in the following days. You should allow 14 days before you go on to the next tray to allow bone remodelling to take place. Insertion of a new tray before remodelling is complete will cause undermining resorption and excessive tooth mobility and pain.Interproximal reduction (IPR) is required to create space to move teeth into for alignment. It also increases tooth contact areas that helps in stability after braces. Your enamel around your teeth is about 2-3mm. The ideal IPR removes 0.25 to .5mm of enamel and is within safe limits.Best regards,Dr. Marlon Moldez

Oleg Drut, DDS · Answer

IPR sometimes is necessary to make space for the crowded teeth and to improve the bite. From your photos, I do not see that you have space issues. The gaps are large. IPR will not make the teeth to move faster. The trays should not feel loose at all during treatment. Should fit like a glove but should not hurt. I would be very careful to use so called Clear Image company since the delivery and materials is different when compared to the industry leader Invisalign and the doctor has much less control over the case comparing to when using Invisalign. When Clear Image can be used to treat easy cases, some more complicated could be treated with the help of Invisalign

Mark Weiser, DDS · Answer

Typically new aligners are tighter. Then they loosen as time goes on. As long as there is force on a tooth, it is moving. And there are intrinsic and extrinsic forces always in play. Proper IPR procedures remove minimal amounts of enamel. Not enough to cause a decay risk. If the dentist feels it is a close call, he can have you use Fluoride inside your aligner (like a fluoride treatment in the office).  I use ClearCorrect, and the company provides a kit for IPR. It is similar to what you describe. Gauges are included so the dentist can measure the amount of IPR accomplished.

Invisalign question (I have Clear Image Aligners) (photos)

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Invisalign question (I have Clear Image Aligners) (photos)

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