Bite has not been fixed

[momof1]

I posted this in the retainer forum, but thought I should post here as well. After 3+ years of invisalign + elastics, I am now considered done. I originally had a significant anterior open bite( >8mm) and was considered a difficult case. It's a long story, but I was wearing a nightguard for a number of years and my ortho thinks it caused my open bite. The nightguard did not fit well. In addition, I have some bone loss which may be due to my open bite, but also the clenching and grinding I was doing at night. It was suggested that I have orthodontia to straighten out my bite. Because of the bone loss, invisalign was recommended since it was slower and gentler than wire braces. Unfortunately, although I now have straight teeth, my bite has not been fixed! I have a class 1 occlusion, but I am still only contacting on my back molars. My bite feels really off, and I keep banging into teeth. My ortho does not want to put me in wire braces to finish since he thinks it will be too risky with the bone loss I have. My dentist thinks he can fix my bite by adding composite to my teeth, since some of them are close to touching. He would then like to fit me with a nightguard for my upper teeth and a removable wire retainer for the bottom lowers.

My question for those of you that clench and grind - what does your ortho plan to do post braces to address your night time grinding/clenching problem? I am in Vivera retainers (similar to essix), but I don't really feel it's protecting me. I wore them full time for six months, and now I am only wearing them when I go to bed. Yes, it's protecting the tooth structure, but in the mornings I can really feel pain in my teeth going into my jaw. This leads me to believe that I am still clenching down at night. For some unexplained reason, my ortho does not want me in wire retainers. I'm assuming wire retainers are Hawley retainers? He said that the wire retainers will only hold the front 6 teeth in place and not the teeth in the rest of the arch. Does anyone know if this is true? My ortho also think my open bite will come back, if I do not stick with the Vivera retainers.

[Advocate]

What causes the grinding? If it's stress, then maybe Yoga or meditation would help? Would a sedative like Lunesta reduce grinding?

[momof1]

It's not just the grinding. My bite is just very uncomfortable. The kicker is that in many cases it's the teeth not fitting well that causes the grinding. I suspect for me, it is the combination of stress and the malocclusion that sets off the clenching/grinding.

[drrick]

full arch retainers with a discluding element (ala an NTI) could prove helpful.

Also perhaps consider some botox in the massetters and temporalis muscles

[momof1]

What do you mean by full arch retainers? - Hawleys? Also, I've read that NTI can cause open bites. Is this true?

[drrick]

Like an essix , only heavier, with the NTI discluding element.

NTI can open the bite if your condyles are not seated but after all of that invisalign it is probably already seated.