Re: invisaline referral

From: Mark & Steven Bornfeld DDS (bornfeldmung_at_dentaltwins.com)
Date: 07/15/04 

Date: Thu, 15 Jul 2004 12:40:11 -0400

Steven Bornfeld wrote:

>
>
> Poyntman wrote:
>
>> another reason? what is wrong with invisaline? or is it just that you
>> dr's make less off of them vs traditional braces?
>
>
> I'll give you my perspective (as a general dentist and Invisalign
> patient) tomorrow if/when I get a chance--you deserve and answer.
>
> Steve

Briefly:

        Invisalign, like any other legitimate technique, is not "good" or
"bad". It may be appropriate, or inappropriate, depending upon when and
how it is applied.
        Invisalign is best suited to adults who desire correction of relatively
minor crowding, tipping and malposition of teeth. For major orthodontic
problems with arch relationship problems it is less versatile than
traditional orthodontic treatment with bands and wires.
        It has a number of advantages and disadvantages. Besides the obvious
advantage of esthetics, it has others which may not be readily apparent.
  Chief among these is the fact that it is removable. This means that
oral hygiene procedures are not effective. One must be careful to keep
the appliance as clean as your teeth however, as any dirt on the
appliance is going to be held against the tooth for an extended period
of time. The removability also means that your general dentist will
have an easier time cleaning your teeth during treatment, as well as
rendering any necessary restorative treatment.
        There are a number of disadvantages. The most obvious one is the
expense of the appliance itself. For the orthodontist, this sword cuts
two ways--there is far less chair time involved, since there are no
brackets, wires, bands, springs etc. to attach, fall off or adjust.
However, the lab fee is hugh. How this plays out in terms of a fair fee
to the patient I don't know--maybe some orthodontists could comment.
        Besides the fact that Invisalign is not as versatile as traditional
orthodontic treatment, it has one important flaw which is never
explained to patients and really, really should be. It has been
commented on by Charlie Ruff and me in this space. The appliance is
only as good as the impressions and the clincheck--the treatment plan
developed by the orthodontist and the lab.
        If there are any miscalculations at either end, you can be truly and
well screwed. The appliances are made, and you go from #1 to #2 to #3
etc. In traditional orthodontic treatment, if things aren't going
totally according to Hoyle he/she can adjust, tweak, or even change
appliances. If the patient using Invisalign loses an aligner and can't
get it replaced soon enough, or leaves it out a few days and the teeth
relapse and the aligner can't be put in again, you are out of luck.
        In my case, some correction of crowding was accomplished. In the upper
jaw, the space was gained by what I believe they call
"reapproximation"--grinding between the teeth. Because there was a
fairly large amount of grinding to do, my dentist (my brother) chose to
do it in stages, continuing as the spaces closed. But as we approched
the end of treatment my spaces hadn't completely closed. Apparently
someone miscalculated in formulating my treatment plan. My brother and
I were astute (and lucky) enough to recognize this and not complete the
reapproximation.
        I recall at least one patient posting to this newsgroup that the teeth
did not "track" properly when he got to one of the aligners. Since the
whole series of aligners are made before treatment starts, the treament
likely would have had to be repeated.
        I wonder if any of the orthodontists can report on how liberal the
invisilab is about accommodating new appliances where there is a problem
like this.
        My result was pretty good--not least because I didn't have aggressive
goals for my own treatment. My class II malocclusion (jaw relationship)
was not corrected, but crowding was.
        Overall, I think it is a good technology if it is used mindful of its
limitations.

Steve
>
>>
>> aaron
>> "Joel M. Eichen, D.D.S." <joeleichen@yahoo.com> wrote in message
>> news:<02l8f0dnv57s8q9onjkt7d24qcsgi6vt74@4ax.com>...
>>
>>> Another reason not to like Invisalign ........
>>>
>>>
>>>
>>>
>>> On 13 Jul 2004 14:20:21 -0700, poyntman@hotmail.com (Poyntman) wrote:
>>>
>>>
>>>> I'm thinking about getting invisaline.... there is a referral program
>>>> and I'm looking for someone who has invisaline to refer me. I get a
>>>> $100 coupon and you'll get a $50 gift certificate. E-mail me at
>>>> poyntman@hotmail.com
>>>>
>>>> Thanks
>>>> Aaron
>>>
>>>
>

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