What Can I Do About "Black Triangles" Caused by Invisalign Treatment?

Question

I started invisalign treatment in Feb. 08 for crooked teeth. I'm wearing the last tray for bottom teeth and the result is not nearly satisfying. Before I had only one slightly crooked tooth at bottom and it's still crooked.
What makes it WORSE is the black triangles. I didn't have them before. At the beginning I thought it was part of the process of moving teeth around and it will eventually go away. My ortho told me last week that they will be permanet and there won't be any fix! my smile looks worse than before. I'm really desperate.
Can someone tell me if there is any fix? I wish I knew this before I started. My Ortho didn't warn me about this at all. I still have 6 more trays to go for upper teeth. I see more black triangles start forming between upper teeth. I can't stop wearing the trays since my biting is not corrected yet. I'm stuck. Can someone help???

Lance Timmerman, DMD, MAGD · Answer

Bioclear method is likely the best option.  Material is adhered and shaped to fill in the spaces.  Dermal fillers work very well as a simple solution to black triangles.  In a few short minutes the material can be placed and the space is closed.  Usually.

Whether direct bonded composite veneers (similar to a diastema, or gap, closure) or indirect porcelain veneers, the spaces can be closed. Often movement of teeth reveal periodontal issues. Sometimes the black triangles are temporary, but more often than not, when doing adult orthodontics the triangles are permanent.

Sometimes simply making the teeth slightly thinner (interproximal reduction) and continued orthodontic care can minimize the spaces, but veneers should be considered as well.

Zach Casagrande, DDS, MS · Answer

Invisalign treatment does not cause black
triangles. Black triangles are a result of alleviating crowding (where the gum
tissue did not form properly between the teeth). It is possible to correct or
at least improve them by having your doctor prescribe IPR (interproximal reduction)
followed by space closure.

Raj Kumar, BDS, LDSRCS · Answer

These triangles are due to your triangular shaped teeth meeting at the top due to their flair and hence a space opens up between. The dentist could create some small spaces by stripping the enamel at the top between the teeth, this will make the teeth less flared and traingular. He/she could then use Invisalign to bring the teeth closer together.

	Sometimes closer teeth can get the gum to grow up a bit further reducing these triangles.

	Hope this helps

	Dr R Kumar BDSLDSRCS

R. William McNeill, DDS, MS · Answer

Chances are that your Invislaign treatment did not "cause" the black triangles. It is common for gum tissue between severely rotated teeth to be less bulky than between properly aligner teeth. Then when the rotated teeth are corrected, the gum tissue is not bulky enough to fill the space. This is particularly true with adults. In adolescents, we typicaly see that the gum tissue will adapt to the space that is created by rotation correction. ( Good argument for early bite correction!)

	When this problem arises there are generally two solutions. one is to narrow the teeth a bit so they can be movedcloser together. This should be done very carefully to be certain that there is not a tendency for tooth contacts to remain open. The second solution is to have your dentist build the teeth up in width with composite filling material. These materials have been much improved in recent years so such build-ups have good longevity. Follow your orthodontists recommendation as to which of these alternatives will best suit your needs.

Jason K. Tam, DDS · Answer

Suggest additional Invisalign aligners to correct the rotated teeth.  Attachments and interproximal reduction may be needed.
Interproximal reduction may also be an option to change the contact point of the two teeth, reshaping them to reduce the black triangles.  You may require additional Invisalign refinement aligners in order to close any residual space.
The good news is that once new contact points are formed following your Invisalign, there may be some reestablishment of your papillae (gums near the black triangle) over time.
Good Luck!

What Can I Do About "Black Triangles" Caused by Invisalign Treatment?

Answers (7)

Answer: "Black Triangles" can be corrected after Invisalign treatment.

Answer: "Black Triangles" can be corrected after Invisalign treatment.

Answer: Additional Invisalign aligners may be needed

Answer: Additional Invisalign aligners may be needed

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What Can I Do About "Black Triangles" Caused by Invisalign Treatment?

Answers (7)

Answer: "Black Triangles" can be corrected after Invisalign treatment.

Answer: "Black Triangles" can be corrected after Invisalign treatment.

Answer: Additional Invisalign aligners may be needed

Answer: Additional Invisalign aligners may be needed

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Recommended reading

Everything you need to know about Invisalign

Our mission is to create a world where every investment in modern beauty is Worth It.