Crossbite, bone loss, and periodontal disease questions...

[toothlessinCO]

I'd appreciate any opinions or feedback on my situation.

I've had 3 teeth extracted due to excessive bone loss in the last year or so. I need to move my teeth so there is enough room for dental implants. I also have a history of periodontal disease which is arrested for now, but needs to be taken into consideration.

I have visited four orthodontists and I'm trying to decide between two of them.

Ortho A was the first ortho I visited and with whom I had my records and consultation. She recommended Invisalign treatment for 20 months. She has a lot of experience treating difficult cases with Invisalign and believes that with my bone loss and periodontal history, using Invisalign is the best approach since the moving forces are applied to the entire tooth rather than concentrated on a bracket. She normally will offer either Invisalign or braces, but feels strongly that Invisalign is the only way to treat my case.

Ortho B has the opposite approach and suggests that the best way to tackle my challenges is to "get in and out of there as quickly as possible". So he suggested 14 - 16 months in braces. I have a crossbite with my left molars and they might try to correct it, but if it doesn't look like anything's going to happen, they won't push it. I am currently wearing a flipper (retainer with fake teeth) and I guess they'll use it with the braces at first, and then incorporate the fake teeth into the braces.

So here are my questions:

1. I have a crossbite in my left molars. Three of those four molars are crowned and the fourth molar has a resin filling, all of which were made with the crossbite. I'm concerned that if we correct the crossbites, the way the biting surfaces interact will change dramatically and maybe have to redo the crowns/fillings which is never a good thing. So, what is the lesser of two evils? Leaving my left molars in crossbite with biting surfaces that itneract well, or trying to correct the crossbite?

2. Treatment time. From what I've read on the internet (which you can't believe everything you read) it seems like root resorption might be correlated to treatment time, ie the longer you're in braces the more likely you'll have root resorption. Does anyone have any experience with how bone loss is related to treatment time?

3. Invisalign versus braces. Does anyone have an opinion/experience on the two technologies when dealing with bone loss/perio? I talked to my periodontist and he thought whatever method was the gentlest is the best. Is Invisalign really that much gentler than braces?

4. Last of all...I realize that ultimately I need to decide which ortho to go with, but based on the information which I've given you which admittedly is very little, who would you go with? I have a lot of faith in Ortho A, I'm just not sure about Invisalign (and having to remove the aligners and therefore my fake front teeth when I eat). Ortho B actually has dental implants himself.

Thanks for any and all opinions, etc.

[Joanna20]

Hi! I can only relate to one thing: I currently have no second molar in the lower jaw, but the space is needed in the front so I'm still trying to find out what they're going to do with that. I suppose that when you have extracted teeth it becomes easier to correct crowding. I create cavities quite easily so getting fixed braces for me is going to be a chalenge. I wish I could do Invisalign. Plus I have full lips and my teeth pop up, I'm gonna look funny.
Good Luck to you.
Joe

[SueFromNJ]

I can help abit on the bone loss issue. I currently have braces for just about three years, with no ending in site yet. Unfortunately, I have bone loss on most of my upper teeth (root reabsorption), and this was diagnosed on x-rays taken at 21 months. So I wasn't even two years into treatment and already had enough bone loss to make my ortho very concerned. He said all my teeth have to be splinted together after I get my braces off, as the only way to keep them stabile.

The sad thing is, my teeth were perfectly healthy when they were horribly crooked, but now they aren't. The bone loss is permanent. But still, unhealthy straight teeth is far better than crooked healthy teeth - and I am not kidding! No regrets at all.