Pics from the end of my first round of trays!

**lemon tree** · 10-07-2009, 11:03 PM

So after 20U/21L, my teeth are a lot straighter but I think that there's probably a bit more tweaking that can be done with my teeth during the refinement process. I can't believe it - but despite going in just humbly wanting straighter teeth, I can't seem to embrace my teeth just as they are at the moment.

Pictures are attached (see my blog link for before pictures!) I'd really love some feedback on what sorts of things I might want to discuss with my doc when I see him next week. I'd like to come in as prepared as possible so that I can properly articulate the final changes I'd like to see.

Anyhow here's my list so far:
- can the top front right incisor be rotated a little further to the right and right lateral incisor brought out (or both)?
- can something be done with my top right lateral incisor that seems to be at an angle (not perpendicular to the gumline?
- will my top and lower finally meet again?
- will my attachments be coming off? when? what can be done about the staining?
- would it be possible to get both fixed and removable retainers for top and bottom? (he recommends, top removable and bottom fixed I think)
- can my teeth be shaved a bit? it seem like one incisor is longer than the other...
- is there anything that can be done about my uneven gumline?

**havingitdoneintheuk** · 10-08-2009, 02:58 AM

You've got this far so if you can see more changes you would like, go for it, you are paying good money for it! They look great to me but I have done the same having refinements

**Sunny** · 10-08-2009, 05:34 AM

Your teeth look outstanding lemon tree and I reckon you have your questions organised, so use them to get your ortho's opinion about what else can be done to make your teeth more as you'd like them.

Good luck with your next appointment!

**anewsmile** · 10-08-2009, 11:47 AM

I dream of the day when my teeth look like yours. Good job!

**kezzakattami** · 10-08-2009, 05:30 PM

They look great Lemon Tree!!

**Rosieee** · 10-08-2009, 05:53 PM

Maybe a bit of shaving as the edges of your teeth aren't straight?

**lemon tree** · 10-09-2009, 02:36 PM

Thanks everyone

Rosie - I asked about it early on but it looks like he won't shape the bottoms of my teeth until the end of my treatment as my teeth may be at a different by the time I'm finished.

**MCOMarkhamOrthodontist** · 10-10-2009, 02:46 PM

Originally Posted by lemon tree

Thanks everyone

Rosie - I asked about it early on but it looks like he won't shape the bottoms of my teeth until the end of my treatment as my teeth may be at a different by the time I'm finished.

This is generally a good idea to make sure the angulation of the tooth is correct before doing any cosmetic recontouring. Keep in mind that the uneven edges may be shaved, but one aspect of smile design is to have a symmetrical gingival contour also. Even incisal edges with matching gum levels will lead to the most aesthetic result.

Good luck!

**myhollywoodsmile** · 10-11-2009, 03:33 AM

How do you achieve the right gum levels? Is that a surgical thing?

**MCOMarkhamOrthodontist** · 10-11-2009, 09:55 AM

The correct gum levels can be achieved to a certain degree with intrusion/extrusion of teeth. Most people look at treatment to line up the incisal edges of the teeth, but for the best results, the gum levels should be at the ideal position after orthodontics, with incisal edges restored or shaved down later.

Surgical intervention may also help, but it depends on the location of the cementoenamel junction (where the crown meets the root) and the bone level.

Not that the symmetry of the gingiva becomes less important if the smile line is low (ie, the lips cover the gingival margins in the widest range of smile movement).

**lemon tree** · 10-11-2009, 03:52 PM

^thanks Dr. Tam.

i've heard that invisalign is far more effective at extrusion than intrusion. are you able to confirm this?

Also, do gums ever 'grow' back on their own? For instance, in places where teeth were previously overlapped?

**Rosieee** · 10-11-2009, 04:32 PM

I meant the sides of your teeth oops!

**MCOMarkhamOrthodontist** · 10-11-2009, 05:38 PM

Originally Posted by lemon tree

^thanks Dr. Tam.

i've heard that invisalign is far more effective at extrusion than intrusion. are you able to confirm this?

Also, do gums ever 'grow' back on their own? For instance, in places where teeth were previously overlapped?

Extrusion of any teeth is difficult with aligners. I won't get into it here, but there is relative and absolute extrusion, with the former being much more predictable than the latter.

Invisalign 1.5 has new optimized attachments that are supposed to improve the likelihood of extrusion of anterior teeth. Previously, the default was ellipsoid attachments, though by our own experience, we have been using an attachment almost exactly like the optimized attachment for a few years. Otherwise, the use of adjuncts like elastics and buttons for single tooth extrusion is necessary.

Intrusion of posterior teeth and anterior teeth can be achieved quite readily with aligners.

The areas between the teeth are known as the dental papillae. When missing, it creates space referred to as a black triangle. Overtime, they can reorganize depending on the bone level and contact point of the teeth. IPR between the teeth will improve the contact point remove these "spaces".

Best of luck and look forward to seeing how your treatment continues

.

**myhollywoodsmile** · 10-12-2009, 05:51 AM

Interestingly extrusion of one of my teeth has been too successful, I want it pushed back in a bit! One of the things that my refinements will be addressing is that problem

**lemon tree** · 10-12-2009, 04:31 PM

^^^ oh, ok. I was assuming they would take that into account when they create my refinement trays.

^^ I wonder if I just mixed up the two initially. this is all good information though. thanks for the explanation.

will update after my appointment tomorrow!

**lemon tree** · 10-13-2009, 02:07 PM

So my appointment this morning took forever.

Get this, they had to take 3 attempts at doing mold of my bottom teeth and about 7 of my top teeth! Something about the either the room being too warm or the putty being a bit old I recall. According to my doc's latest estimates, I'll need at least 10 more aligners which is a bit longer than I would have liked but confirms my suspicions in terms of where I was at in terms of my treatment. But oh well, might as well get this done properly!

My poor lips are so chapped

Stay posted, will write more when I get home...

**Sunny** · 10-14-2009, 04:46 AM

Shame about the moulds and you needing more aligners, but I think you've got the right attitude about doing this properly! You're nearly there ... that's the best news!

**myhollywoodsmile** · 10-19-2009, 06:15 PM

hi there lemon tree. I just went and got my refinements for my top arch and I have 9 including overcorrection, so you are not alone! Bit disappointing though, I think I was hoping for 2 or 3. Still, after all this, I want to get it right. Another couple of months or so doesn't really bother me at this point...

**mommamorin** · 10-20-2009, 04:27 PM

Hi hollywood, whats "overcorrection"??

**lemon tree** · 10-20-2009, 10:32 PM

^^ thanks, it's a bit disheartening but I'm trying to look at the positive side being that hopefully at the end of this next round, I'll be done and finally be happy with my teeth! your teeth are already looking so good that I am sure by the time you are done they will be just perfect!

^ I've heard two explanations, one being that it is an overadjustment to compensate for difficult to move teeth and the other, to bring teeth closer together after they have been aligned. The latter one was from my doc.

**lemon tree** · 11-02-2009, 11:43 AM

just got a call from Dr. A's office.

23 more trays - yikes!

more on Wednesday, when I go to pick them up.

kind of annoyed but trying hard to focus on what my teeth will look like when finished.

**myhollywoodsmile** · 11-02-2009, 08:16 PM

Hi mommomarin,
Sorry I didn't see your question before. My orthos explanation is that it's where they move a tooth further than they think it needs to go. So in my case the front tooth needs to rotate and move back. The aligners are now made so that the 6th is where they think it should end up, but as it didn't work last time there is also a 7th, 8th and 9th so that it can keep going further if it's not in line. My only problem is that fact that we are working on two areas, so if one needs overcorrecting but not the other I wonder what happens. I'll ask next visit.

Hi lemon Tree, sorry to hear that you have so many refinements, BUT at least you know that they should really be perfect at the end of all this. I think they look fantastic already so I will be very interested to see your new clincheck. I had read somewhere that invisalign are moving teeth slower now as they think it works better, so that may be it.

**MCOMarkhamOrthodontist** · 11-02-2009, 09:36 PM

Interesting to have more trays in refinement than in your first set of trays...

Hopefully these 23 trays get you to where you need without more refinement!

Originally Posted by lemon tree

just got a call from Dr. A's office.

23 more trays - yikes!

more on Wednesday, when I go to pick them up.

kind of annoyed but trying hard to focus on what my teeth will look like when finished.

**lemon tree** · 11-02-2009, 09:59 PM

Thanks ^ and ^^.

I'm trying to stay positive though I did also find it very 'interesting' too that I have so many more trays than my initial run. I suppose now that I'm so used to the routine, it's not the end of the world. I'll post my clincheck once Dr. A's office uploads it - they're usually pretty speedy.

**kezzakattami** · 11-03-2009, 06:05 AM

Sorry to hear about the number of refinement trays, the time wil go soooooooo quickly though. It is very much worth the wait when you get to the end-point, good luck..you will soon see the trays counting down

**lemon tree** · 11-03-2009, 01:56 PM

^ thanks kezza. hope you are enjoying your brace free teeth! how is life in retainers?

**kezzakattami** · 11-03-2009, 03:36 PM

I get my retainers next Tuesday and I'm looking forward to not wearing my trays after then, but also I know I will miss the comfort of them in a really strange kind of way (never thought I would hear myself say that!)

Once im in a routine with the retainers I will be fine (i think!)

**havingitdoneintheuk** · 11-04-2009, 03:21 AM

Haha know what you mean, feel naked without them! Also, I used to get sensitive teeth in the cold wind and with these on it stops that!

Thread: Pics from the end of my first round of trays!

LinkBack

Thread Tools

Display

Pics from the end of my first round of trays!

Similar Threads

Pics progress so far

Second Round

Getting second round - teeth pulled?

Braces round 3!

Posting Permissions