Dr. Mayank Khandelwal
Orthodontist
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
As I am planning to undergo orthodontic treatment with invisalign aligners for which my dentist advised me to take cone-beam computed tomography (CBCT). I do not understand what they meant by radiolucency. So, it would be great if you can simply explain the term radiolucency. I will be asking the question to my orthodontist but my appointment is at least a few weeks away and I need some answers at this moment. So, it would be great if you could help. Thank you.
Hello,
Welcome to icliniq.com.
Congratulations on your decision to go ahead with invisalign. The report says radiolucency around the tooth root of 36. There is a white cap seen on the third tooth from the left in the lower region, which suggests tooth number 36 has previously undergone root canal treatment, and the restoration is incomplete. And if you notice near the tooth root area of 36, you can see small black spots or areas. That is called radiolucency. And any area which appears more whitish than the other areas, we expect it to be radiolucent. It simply means that the previous root canal has failed, and the tooth is re-infected and needs treatment again. The canine tooth is impacted in the cone beam computed tomography (CBCT). Impaction means any tooth which has failed to erupt in the mouth beyond its normal eruption time due to any reason. Three of your wisdom teeth, the one at the extreme end of your jaws, first in the upper (left in the X-ray), and second in the lower are impacted. Apart from this, you have an impacted canine. This means, there is insufficient space for the canine to erupt and now, it is stuck in the bone. Thank you.
Patient's Query
Hello doctor,
I know about impacted canines. One of my canine tooth is placed higher than usual which prompted me to get checked as it was affecting my aesthetics. I did not know there were so many problems with other teeth before taking cone-beam computed tomography (CBCT). I just wanted that highly placed canine to come down and align my teeth. I spoke about that impacted canine during iTero scan with my orthodontist. He said the decision to make space for it will be taken in accordance with the condition of root and bone in that area and how it could affect the neighboring teeth if not treated. I am trying to avoid extraction but at this point, I am not sure if invisalign could help with all the problems. Thank you.
Hello,
Welcome back to icliniq.com.
It looks like your upper right canine is highly placed. It needs to be leveled. Regarding impacted canine, it has tilted the other teeth as well. Yes, we do assess bone of that particular area and the overall tooth health status. If everything seems fine, we need to assess if there will be sufficient space to align all teeth as desired as well as accommodate the canine in the area. So, there are many things to look for before we decide on how to go ahead with the canine. Invisalign is a good option when the case is mild to moderate. You case seems towards a severe category. Unless the treatment plan is well designed, invisalign would not be able to give you 100 percent results. Other factors to consider would be the cost of the appliance and the time taken for correction. Thank you.
Patient's Query
Hello doctor,
What do you mean by timing? So, do you think traditional braces will be more effective in my case? I know there are so many other problems apart from aesthetics. Cost is not a concern. I wanted to be more comfortable during the treatment. So, I opted for invisalign aligners. Thank you.
Hello,
Welcome back to icliniq.com.
Timing means the total duration required to treat the case till the end. Each aligner tray of invisalign should be worn for ten days. So, if a patient has 15 tray plan, his treatment time is 150 days. But in your case, there is a highly placed canine, tilted teeth, impacted canine. It will definitely require big tray sets to get a good finish result and will take more time than the traditional braces. However, this all depends on the position of other teeth and amount of correction required. Braces with some additional methods can be implied here as an option, which you can consider. Hope this helps. Thank you.
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