Waiting for refinement trays...

[ChicagoB]

Here's an update. I was initially told I would have 25U/L aligners and about a month ago, I found out I would only have 24L, uppers remain 25. Two weeks ago, I went to pick up my last 2U and 1L aligners and spoke to my dentist about refinements. He told me to return in 2 weeks when new impressions will be taken. He said it could take about 2-3 weeks to get the new aligners.

Prior to my last pick-up, I normally picked them up on Fridays and change into the new set Friday night. Due to the thanksgiving holiday, I picked them up on Saturday and switched that evening.

On Saturday, I had the impressions done and the assistant told me not to wear the last set because - of course - wearing the last set will change my teeth positions and the refinements may not fit. I guess this brings me down to 24U/L.

I was also hoping my attachments would be removed that day, but that will be done when the new trays come in. My dentist also mentioned I would get some whitening solution I can use to whiten my teeth. Definite plus - I guess I'll save the crest whitestrips I just purchased for another time.

Here's something interesting. When I'm done with refinements, I'm getting the vivera retainers. She told me I would only need to wear those retainers at night. I was surprised because I read that you get 4 sets of vivera retainers - the first 2 sets are worn 24/7, the third set is worn at night and the last set is worn every 2-3 days at night. Can anyone confirm this? I even asked if going without them all day won't revert, and she said no because the last set of aligners are worn for 6 weeks and that's enough time. I'll have to ask the dentist about this.

Anyway, so here I am still with aligner 24 and would have these for a few more weeks. I hope they hold up.

[nightship538]

I am also waiting to see if I want to go through with refinements. I completed 14/14 U and my teeth look marvelous! I also completed 10/10 L and there is just the slightest bit of crowding in the two middle lower teeth. I had impressions taken a week ago-- with the attachments removed-- and am waiting to see how long I will need to do the refinements and determine if I want to commit the time and $ to continue. In the meantime I am wearing the my last trays without the attachments and also hope they hold up until I get some sort of new tray or retainer. My teeth also look a bit dingy but I have heard that whitening procedures can cause sensitivity, so I will wait until my regular cleaning. (They are not as white as they usually are, but I have pretty white teeth naturally). I am excited to be (almost) at the end!

[GoofyGG]

While I'm waiting for my refinements I only have to wear my last trays at night. It does seem odd and i keep putting them back in mid-day for a couple of hours 'cos I'm scared they'll move back to where they were So, I am guessing that when i'm all done with invisalign I'll just have night time retention - forever...

[GoofyGG]

How come they took impressions of your teeth with your old attachements on? Surely that means that your new trays will have bubbles in those places whether you need those attachments or not?

[ChicagoB]

How come they took impressions of your teeth with your old attachements on? Surely that means that your new trays will have bubbles in those places whether you need those attachments or not?

I have no idea and hope it was done right. Now, you're getting me worried. Hope Dr. Tam can chime in.

[GoofyGG]

Oops, sorry!!

[ChicagoB]

No worries...better to know now, than later.

[MCOMarkhamOrthodontist]

If they take the impressions with the attachments, the new sets will have to have them on them in the aligners, unless there is something that I haven't heard of before (thought I doubt it!). We always remove attachments before going to refinement because the attachments do wear down over time, and if I needed new ones, I would want a new template and fresh attachments.

In terms of your Vivera retention protocol, it is going to depend on each person, the way their teeth started off, how quickly the teeth were moved, etc. We start off with about a month of F/T wear and taper down to nights after that. Some patients go F/T longer than others but we let our patients know how to titrate their retainer wear-time.

[ChicagoB]

You guys scared me. For a minute there, I thought the office had messed something up. I just called them and they said it's fine having the attachments there for the impressions. When the new aligners come in, they'll remove the current attachments and put new ones - if invisalign calls for it.

Attachments go on the surface of the teeth which is why I initially wasn't worried... then I got scared after the earlier response.

[MCOMarkhamOrthodontist]

You guys scared me. For a minute there, I thought the office had messed something up. I just called them and they said it's fine having the attachments there for the impressions. When the new aligners come in, they'll remove the current attachments and put new ones - if invisalign calls for it.

Attachments go on the surface of the teeth which is why I initially wasn't worried... then I got scared after the earlier response.

To be honest, I still do not understand this response. Either the attachments are removed before impressions, and the refinement aligners are made with attachments to be placed, or the impressions are taken with attachments and you leave them on during your refinement.

The attachments are on the surface of the teeth, but the aligners have to be shaped to fit the attachments, so they go hand in hand...

Why would one take the impressions with attachments, remove them, and replace them?

[ChicagoB]

OMG!!! Why???

[ChicagoB]

So what's the normal process? I have the last aligner on and of course they have the bubbles for the attachments. If they remove the attachments, I will have the aligners on for a few weeks without attachments. Should I call their office and request that my aligners be removed for the impressions?


Update:
I've called the office and once again they've assured me the new aligners will not have pockets for the old attachments. I hope they're right because it would be so frustrating to wait weeks for new aligners only to have them wrong.

[GoofyGG]

Update:
I've called the office and once again they've assured me the new aligners will not have pockets for the old attachments. I hope they're right because it would be so frustrating to wait weeks for new aligners only to have them wrong.

Keep us posted, would love to know the outcome of this!

[MCOMarkhamOrthodontist]

I'm interested to hear how this works out also. If you think about it, why not remove the attachments before the impressions since the impression is supposed to accurately capture how your teeth are in their current position, and the attachments need to be removed at some point anyways.

I have not heard of anyone removing attachments at the first visit of refinement, but perhaps the computer software can remove them virtually based upon the previous shape of your teeth. It would still require your doctor to remove the attachments exactly the way the software did in the simulation.

[hannahbanana]

I had refinements and like ChicagoB, they left the original attachments on to take the impressions for the refinements. The new aligners came and had different bubbles for different attachments. The dentist took the old attachments off and put the new ones on at my first refinement appointment. It didn't make much sense to me either, especially because it would have been nice to have the attachments completely off while waiting for refinements. But it didn't seem to matter in the end.

[MCOMarkhamOrthodontist]

I had refinements and like ChicagoB, they left the original attachments on to take the impressions for the refinements. The new aligners came and had different bubbles for different attachments. The dentist took the old attachments off and put the new ones on at my first refinement appointment. It didn't make much sense to me either, especially because it would have been nice to have the attachments completely off while waiting for refinements. But it didn't seem to matter in the end.

In the refinement aligners, did the teeth that previously had attachments on them have attachments wells on them or did they conform to the teeth as if there were never attachments on the teeth?

[hannahbanana]

In the refinement aligners, did the teeth that previously had attachments on them have attachments wells on them or did they conform to the teeth as if there were never attachments on the teeth?

The refinement aligners had one less attachment well for attachments - I originally had six attachments and the refinement aligners only had bubbles (wells) for five attachments. The five attachments for the refinement aligners were for the same teeth as the original aligners, but my dentist took the old attachments off and put new attachments on.

[MCOMarkhamOrthodontist]

The refinement aligners had one less attachment well for attachments - I originally had six attachments and the refinement aligners only had bubbles (wells) for five attachments. The five attachments for the refinement aligners were for the same teeth as the original aligners, but my dentist took the old attachments off and put new attachments on.

Sounds like the attachments were removed virtually by the technicians and replaced. I do wonder about the accuracy of this method, but apparently you have not had any issues. If they are to be removed anyways, it would still make more sense to have them taken off earlier. Thanks for letting us know!

[cp41981]

In about a month, I'll be going in for my refinement impressions. My Ortho explained how the process would work, and it's on par with Dr. Tams explanation.

They will remove my attachments after my 19/20 tray, and then take new impressions without the attachements. I will continue wearing aligners 19/20 (without attachments on teeth) until my new set of refinement trays comes in.

The one thing he did mention to me is that the new attachments will be a different... He explained that instead of having one larger attachment on each tooth, there is technology used where 2 smaller attachments are placed on a single tooth to give the aligners better grip..

Dr. Tam, are you familiar with this?

[hannahbanana]

Sounds like the attachments were removed virtually by the technicians and replaced. I do wonder about the accuracy of this method, but apparently you have not had any issues. If they are to be removed anyways, it would still make more sense to have them taken off earlier. Thanks for letting us know!

I wouldn't say I didn't have any issues - no MAJOR issues but my teeth didn't turn out perfectly and I had to finish with ceramics on top. My dentist was pretty new to invisalign and after all I've read on this site I don't know that she always knew what she was talking about. If I had it to do over again I would insist they take the attachments off before taking new impressions just based on your opinion about the accuracy of this method. (and common sense)

[robin8]

Back in April, my orthodontist gave me a set of removable retainers to wear while waiting for the refinement trays to arrive in about 3 weeks.

Basically, after removing my attachments and taking the impressions for the Invisalign trays, the ortho’s staff made another mould (an easier one) for the retainers. My ortho can make the retainers in-house in about an hour or get an outside lab to do it in a few days.

He has since acquired an iOC intraoral scanner so the wait time is reduced and he may not do the retainers any more.

[MCOMarkhamOrthodontist]

In about a month, I'll be going in for my refinement impressions. My Ortho explained how the process would work, and it's on par with Dr. Tams explanation.

They will remove my attachments after my 19/20 tray, and then take new impressions without the attachements. I will continue wearing aligners 19/20 (without attachments on teeth) until my new set of refinement trays comes in.

The one thing he did mention to me is that the new attachments will be a different... He explained that instead of having one larger attachment on each tooth, there is technology used where 2 smaller attachments are placed on a single tooth to give the aligners better grip..

Dr. Tam, are you familiar with this?

I just answered this question in another thread. It is about G4 attachments. They are two attachments on the mesial and distal parts of the tooth to allow the aligner to have contact in two different parts of the tooth. I haven't personally had many problems with moving teeth prior to all of these "optimized" attachments and found that the odd shapes of the new attachments are actually very difficult to match up to the template, meaning less than perfect fit. Imagine needing to trim a rectangular attachment vs a tear drop (and now it will be two small ellipsoids).

The bench testing has been done in the lab and theoretically it sounds fantastic. I will wait until I hear that the clinical results back up the bench tests before I decide to "experiment" on my patients. I know what I can do with the original attachments. I don't know how these ones will work out.

[MCOMarkhamOrthodontist]

Back in April, my orthodontist gave me a set of removable retainers to wear while waiting for the refinement trays to arrive in about 3 weeks.

Basically, after removing my attachments and taking the impressions for the Invisalign trays, the ortho’s staff made another mould (an easier one) for the retainers. My ortho can make the retainers in-house in about an hour or get an outside lab to do it in a few days.

He has since acquired an iOC intraoral scanner so the wait time is reduced and he may not do the retainers any more.

All of our patients get an aligner/retainer with no attachments on it while waiting for refinement. The iOC scanner will remove the one way shipping and production of the 3-D model in Mexico, but the bottleneck occurs with how long the doctor takes to review the ClinCheck and how many revisions are required. I have received the ClinCheck back within the same day with the iOC scanner, approved the ClinCheck on the same day, but it still takes more than 10 days to get the aligners into the office in the Toronto area. This is way too long to go without holding the teeth in place.

[robin8]

... but it still takes more than 10 days to get the aligners into the office in the Toronto area. This is way too long to go without holding the teeth in place.

I didn’t mean that I would have no retention at all. I meant if the turnaround time was reduced to just a couple of weeks, my ortho might not make the retainers and instead would ask me to wear the last trays with empty attachment wells.

Dr. Tam, thank you for taking the time out of your busy schedules to help and educate us on the various aspects of Invisalign treatment. I’m sure your efforts are greatly appreciated by everyone here. Wish you and your family a Happy Holiday Season!

[MCOMarkhamOrthodontist]

I didn’t mean that I would have no retention at all. I meant if the turnaround time was reduced to just a couple of weeks, my ortho might not make the retainers and instead would ask me to wear the last trays with empty attachment wells.

Dr. Tam, thank you for taking the time out of your busy schedules to help and educate us on the various aspects of Invisalign treatment. I’m sure your efforts are greatly appreciated by everyone here. Wish you and your family a Happy Holiday Season!

I think using the last set of aligners with the wells is just fine for retention while waiting for refinement. While we ask patients to change the trays every 2 weeks, they last far longer than that.

My pleasure for helping out here. I really enjoy my job and enjoy reading about experiences of other people all over the world. Wishing everyone all the best during this holiday season and into 2012!

[ChicagoB]

Here's an update. After several weeks, I finally got my refinement trays this Saturday; I have 7U and 3L.

I guess I was worried over nothing because the new aligners were fine - no bubbles or whatever. I'm also down to 3 attachments from 11! One tooth has one and other other tooth - one of the front teeth has 2. These are much smaller than the standard attachments. So small I lost the lone ranger attachment yesterday and I'm scheduled to have it replaced this Friday.

When I put on the new tray, I was surprised that I did not feel the usual discomfort associated with new trays. I was told the discomfort level is a lot less at this point - we'll see.

[ChicagoB]

I also got a whitening solution - it comes in a syringe-type dispenser - to use. This is used with the aligner for an hour each day. Since I have sensitive teeth, I was told to use it every other day. I also got a desensitizing solution in case I get the zaps .

[nightship538]

I am getting my refinement trays on Feb. 1. I was a little surprised because the initial trays were 14 upper and 10 lower. Now, I have 16 trays upper and lower! There will only be the two attachments on one of my front upper teeth. My dentist has said we can shorten the time by going 10 days per tray instead of the 14 days.

In the meantime I've been wearing the last trays from the first set of trays since November, and cannot wait to get some fresh and clean trays in my mouth.

[GoofyGG]

Here's an update. After several weeks, I finally got my refinement trays this Saturday; I have 7U and 3L..

WOW, lucky you!!! I picked mine up yesterday and won't be done until Setpember I'm quite happy with my teeth now, I can't believe there's so much more movement to be done!
I've got a few new attachments - one of my teeth has 2 of those tiny ones on. Wierd.

[LeslieKnope]

Congrats on the refinements! What was the process for removing attachments? Do your teeth feel like there's still glue stuck on them?

[GoofyGG]

What was the process for removing attachments? Do your teeth feel like there's still glue stuck on them?

My Ortho cracked them off with a tool and then ground the bigger bits of cement off before polishing the tooth. Not a particularly pleasant process but not painful. I did still feel some cement left on a couple of teeth but I'll make sure they're completely dealt with after my refinements are done.