13 May INDICATION AND CONTRAINDICATION OF INVISALIGN
Invisalign is not for everyone. Generally, Invisalign is recommended to patients beyond 13 years of age with orthodontic concerns with Invisalign treatment prescribed by a dentist. It is important to note that it is the dentist or the orthodontist that will do the prescription and design of the custom-made aligner.
INDICATION
The following are ideal case types to be treated according to the practitioner’s level of familiarity with the Invisalign system.
Level I: (Minimum 1 to 10 cases treated per year)
- Angle Class I occlusion
- Anterior spacing
Level II: (Minimum 10 to 30 cases treated per year)
- Mild angle Class II malocclusion: Class II, Division 1 and Class II, division 2 (treated by distalization and interproximal reduction [IPR])
- Anterior crossbite and single posterior crossbite
- Mild angle Class III malocclusion
- Prosthetic and implant preparations (eg, space reopening)
- Slight periodontal attachment loss from periodontitis
- Severe crowding (treated by extraction, IPR)
Level III: (Minimum 30 to 80 cases treated per year)
- Treatment with extraction
- Impacted canines
- Mixed dentition (retained primary teeth, ageneses)
- Treatment in adolescents
- Unilateral complete posterior crossbites
- Angle class II malocclusion with intermaxillary elastic traction
- Angle class III malocclusion with intermaxillary elastic traction
- Orthosurgical preparation
Level IV: (Minimum 80 or more cases treated per year)
- Extreme movements such as rotation and severe tooth wear
- Severe periodontal attachment loss from periodontitis
- Extremely complicated cases
CONTRAINDICATION
Patient factors
- Age: Patients with primary or mixed dentition are too young for Invisalign treatment. However, a new Invisalign system called “Teen,” which is specifically designed for adolescents is now available. The Invisalign Teen system is designed for children age 10 or older if the first premolars have completely erupted, while canines and second premolars can still be in the course of an eruption.
- General health contradicting the treatment.
- Psychologic profile, eg, depression due to recent loss of job or divorce.
- Patients with hypodivergent facial profile, ie, deep overbite
- Growth abnormalities: hypodivergent facial morphology and mandibular retrusion, which requires an initial orthopedic intervention.
Tooth factors
- Teeth with anatomy unfavorable to force transmission from aligners, eg, short, round, or peg-shaped teeth
- Teeth requiring dental treatment
- Impacted teeth
Occlusion factors
- Severe extrusion or intrusion
- Deep overbite
- Anterior or posterior open bite
- Need for combined treatments (eg, pretreatment, mini-implant placement, surgery)
What about the cost?
The cost of Invisalign treatment depends on the clinical situation of each patient. Invisalign is not cheap. It can be quite expensive for most people. Before proceeding with treatment, the cost of the procedure will be introduced after determining the clinical condition or diagnosis of the patient. The cost of the whole treatment will be broken down and discussed with the patient during the initial consultation. It is worthy to check with your health fund if the dental office you have chosen is covered in your health insurance and if a part of the Invisalign treatment can be covered.
Conclusion
Invisalign is an invisible orthodontic treatment device that is custom-made for each patient. The dentist will design the clear aligner to match the patient’s clinical requirement for treatment. The patient’s orthodontic concerns must match with the clinical situations required to qualify for the Invisalign treatment. The dentist must be qualified and have exceptional skills with the Invisalign procedures to prescribe an exceptional, surprising, and not disappointing aligner. The patient needs to be discerning when it comes to who will do the design as Invisalign is not cheap; a qualified and reputable doctor is worth looking for. Invisalign is not for everyone. With the cost depending on the clinical situation or condition, most will be wary of proceeding to the actual treatment. While it is expensive, Invisalign can be considered a long-term investment where you can save time, money, and discomfort in the future as it offers some advantages that are quite attractive for people who don’t want to experience the discomfort of having to wear braces or metal aligners. As clear aligners are removable and can be easily cleaned while braces is cannot be removed and are challenging to clean.
