Dr. Bhargav Reddy Gutha
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
Hi doctor,
I was about to start my Invisalign treatment and completed my iTero and other tests. I have some questions related to my CBCT (cone- beam computed tomography) reports. I have an impacted canine that is stuck under two teeth due to insufficient space in the arch. With Invisalign, enough space for the same is created, and extraction can be avoided. I have attached my OPG (Orthopantamogram), CBCT, and x-ray. CBCT consists of a lot of films. Let me know if you need all of them to judge the situation better. Please let me know.
Thank you.
Hi,
Welcome to icliniq.com.
I understand your concern.I have reviewed your reports (attachments removed to protect the patient's identity). Upon review, these were the findings. You have impacted 43 (lower right canine) and buccally placed 13 (upper right canine). The space-gaining procedure requires fixed orthodontics. The provisional diagnosis is Angle's malocclusion with buccally placed 13 and impacted 43. I suggest you go for orthodontic fixed mechanotherapy. The prognosis is fair. I hope this information will be helpful.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply. What is mechanotherapy? Also, will braces work better than Invisalign? I prefer Invisalign for its aesthetics as well as for its convenience. Also, what do you mean by fair prognosis?
Thank you.
Hi,
Welcome back to icliniq.com.
I understand your concern. Mechanotherapy means using braces. You need a clinical visit.
Patient's Query
Hi doctor,
Thank you for the reply. So Invisalign will only be able to solve some of the problems? Invisalign is sufficient to pull down the higher canine and align the crooked teeth. Honestly, I did not even know about impacted canine because my bottom tooth used to look all good. What concerned me is that higher canine was causing the cosmetic issue. I did not know the canine was impacted until I did an OPG and X-ray. Can we leave the impacted canine as it is? Or it will cause complications in the future. At my age and in professional life I prefer Invisalign because of cosmetics reason as it is visually invisible and also for its convenience.
Hi,
Welcome back to icliniq.com.
I understand your concern. Clear aligners help in minor malocclusion and mild derotations with some spaces too. In your case, it is space gaining procedure. During braces treatment for teeth movement impacted canine has to be addressed as it affects movement.
Thank you.
Patient's Query
Hi,
Welcome back to icliniq.com.
I understand your concern.
I was recommended braces a few years back, but I ignored them. Kindly let me know if the impacted canine affects nearby teeth too. I also need to address that there is radiolucency in root canal treated teeth, which needs to be re-treated. I may get braces later in life. Hopefully few years after when my professional life is not similar to what it is now. I cannot deal with all the pain and cosmetic appearance with braces for more than two years, considering the situation is not mild.
Thank you.
Hi,
Welcome back to icliniq.com.
I understand your concern. You are welcome.
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Orthodontist
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