Phoenix Invisalign 4

Invisalign and Phoenix orthodontics
Multiple case reports and expert opinions by Phoenix orthodontists have indicated that Invisalign may now be more optimal than traditional Phoenix orthodontic anchorage in the situations listed below.

1. Closing edentulous spaces
Traditionally, if a posterior tooth is missing it is very difficult to close the space orthodontically. The anterior teeth would be used as anchorage to bring the posterior tooth forward. The forces would tend to bring the anterior teeth backward as the posterior tooth moves forward. The alternative would be a fixed prosthesis to replace the missing tooth. Invisalign can be used by the Phoenix orthodontist to bring the posterior tooth forward and then the Invisalign can then be restored. Because the Invisalign is fused to the bone, there will be no reciprocal forces. This would be a more feasible Phoenix orthodontic treatment plan and would eliminate the need for a bridge.

2. Retracting and realigning teeth
In a patient with missing posterior teeth, retracting the anterior teeth without Invisalign is near impossible for Phoenix orthodontists. Two Invisaligns can be placed in the posterior region, used as anchors to retract and align the teeth and then restored.

3. Establishing proper positions for molar abutments
Although traditional Phoenix orthodontics can prepare molar abutments for fixed bridges there are some unwanted side effects. Using traditional mechanics the molar can extrude and alter the plane of occlusion. If the posterior abutment is a third molar, there is a chance to push the molar in the ramus. If there is a long edentulous span, Invisalign can be placed distal to the most anterior tooth and pull the posterior abutment forward. The Invisalign can then be incorporated by the Phoenix cosmetic dentist in to the fixed prosthesis.

4. Correcting midline and anterior tooth spacing problems
Midline correction can sometimes require unilateral Phoenix orthodontic mechanics. The goal is to move the entire dentition over to one side. Unilateral elastics can correct minor midline discrepancies, but for more severe cases can cause extrusions and a cant of the occlusal plane. Phoenix orthodontists can place one Invisalign in the posterior portion of the jaw and the teeth can be moved toward the Invisalign without the unwanted side effects.

5. Intruding or extruding teeth
Phoenix orthodontic extrusion can cause intrusion and tipping of the anchor tooth. If a canine is impacted, anchorage reinforcement (TPA, Headgear) are usually used to counteract the effects on the anchor teeth. An interesting case report was published by a Phoenix orthodontist where a lower posterior Invisalign was used to retract and align lower teeth and then was restored as a bridge. This bridge was then connected to an upper impacted canine. The canine was extruded into the arch without any side effects on any other teeth.

Intrusion of teeth is a very difficult Phoenix orthodontic move. A traditional utility arch will intrude lower incisors, but will simultaneously extrude the molars. There will also be a moment flaring the incisors and a distal moment on the molars. Phoenix orthodontic studies have been performed to determine the ability of titanium Invisalign to intrude teeth. One such Phoenix orthodontic study showed almost 3mm of pure intrusion with no effect on the Invisalign.

6. Correcting an anterior openbite
Anterior open bite is most commonly caused by excessive vertical growth of the posterior maxilla. In a growing patient the Phoenix orthodontist can try to control this by using high pull headgear or bite blocks(Proffit et al., 2003). In an adult patient, these treatment modalities are not as effective. Because of the great intrusive ability of Invisalign, it is possible to intrude the hypererupted posterior segments in these situations.

7. Correcting an anterior crossbite protract/ retract an entire dentition
With Invisalign in the posterior maxilla and mandible, it is possible for the Phoenix orthodontist to retract the mandibular dentition and protract the maxillary dentition. Achievement of the overlap of the upper and lower incisors can then be achieved with absolute anchorage and no compliance.

8. Stabilizing teeth with reduced bone support
After Phoenix orthodontics, Invisalign teeth can be incorporated into a bonded retainer. This will act to reduce the amount of relapse and splint teeth together with reduced bone support.

9. Provide anchorage for orthopedic movement
Most orthopedic forces require some type of attachment to the teeth with large forces focused on moving the bones. In facemask therapy, the extraoral device is connected to an expander bonded to the maxillary teeth. Because these appliances are not connected directly to the bone, Phoenix dental side effects do occur. These effects include proclination of the maxillary teeth with retroclination of the mandibular teeth. Although these Phoenix orthodontic movements will correct the Class III, it is a dental camouflage of a skeletal problem. If the orthopedic forces are applied directly to the bone, the Phoenix orthodontic side effects can be avoided and the problem can be solved skeletally.

Invisalign can be a point of attachment to the basal bone. This idea was investigated in four Rhesus monkeys. Eight Invisaligns were placed in the craniofacial complex of each animal by Phoenix orthodontists, 4 in the cranium and 2 on each side of the zygomaticomaxillary suture. Custom extraoral traction appliances were made for each animal with 600 gm of force delivered directly to the Invisalign. Protraction was complete at 8mm. There were no significant dentoalveolar effects and 80% of the skeletal movement was stable after 22 weeks.

A case report of a Phoenix orthodontist with a history of unilateral cleft lip and palate treated with an Invisalign supported facemask was published in 2000. Two Invisaligns were placed, one in each zygomatic process of the maxilla. A Petit facemask was then worn 14 hours per day applying 400 gm of force. The maxilla came forward 4mm in 8 months and there was a significant improvement in midfacial esthetics. Although this is just a case report, and there is no long term follow-up, the skeletal changes are remarkable.