Premolars Pushed out of Buccal Plate with Invisalign

[1holycow]

While under Invisalign treatment to create an overbite and overjet where I was edge to edge, my maxillary 1st (birooted) and maxillary 2nd premolars were pushed out of the buccal plate. After allowing them to relapse for a year, they haven't budged much and I have chronic pain on one tooth with half the root out of the buccal plate. Currently only my maxillary 1st premolars are in contact during lateral excursions.

My orthodontist wants to place me in permanent retainers and end my treatment.

Are there any orthodontics options for me? Has this happened to others with Invisalign treatment? I've seen periodontists who've recommended implants. Endodontics is going to be risky given the root apex might have little to no bone overlying it.

[DrJasonKTam]

The treatment pushing the teeth out of the buccal plate can happen with any treatment modality and is not unique to Invisalign. There is a certain amount of movement where the teeth will still be in the jaw bone. It may be a consideration to try to move the teeth back in orthodontically, but that depends on the amount of room and if the tooth is still viable. There is a chance the tooth may already be or may become non-vital, requiring a root canal, but as you mentioned, there is little reason to perform the procedure if the tooth is not viable long term. Good luck!
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