orthodontic complications: Open-bite w/ receeded chin

[cheeze21]

I am about 6 months into orthodontic treatment using Invisalign. I have an open-bite and receeded chin which causes me to have mild lip and chin strain when closing my mouth.  After about a month wearing the aligners I realized they just added too much more strain to my lips and chin when closing my mouth. However in this time it appears the muscles of my lower lip and chin have altered to compensate for the added thickness of the plastic aligners over my teeth and there is now more strain and added "rippling" of my lower lip and chin.  I have been told by the orthodontist that regular treatment with braces cannot pull the front teeth back in order to relieve some of the strain i feel in my lips and chin.  I have looked into having a chin advancement done to correct the recessed chin and hopefully relieve some of the strain i see and feel in my lips and chin.  Is this a reasonable expectation of this type of surgery?  And I know invisalign would correct spacing of my teeth, but is it possible to switch to either regular braces or "lingual" braces that go behind the teeth to help pull the front teeth back. Thanks so much. I greatly appreciate any advice i can get.

[Ramin Mehregan, DMD]

Dear cheeze21
It sounds like you are a Class II with an open bite. I suggest you find a Neuromuscular Orthodontist and an Ear Nose Throat specialist evaluation. There is no way you can close the anterior open bite with either conventional braces or Invisalign. And if successful you will have a relapse in a short time. Here is the problem: An anterior open bite is usually due to tongue trusting or airway problems, such as deviated septum, enlarged turbinate bones, tonsils and or adenoids.
This situation could be easily corrected non surgically via orthopedic advancement of the lower jaw after the etiology of the open bite has been identified.
Sincerely,
Dr. Mehregan

[Sam Delfino]

Hi,
Sorry to hear this. The problem with invisalign is its limitations and most often a thorough orthodontic work up is not done because invisalign does not require it. It is great for some basic instances, but it has much limitations in my opinion. If you do have chin and orthopedic issues, you must see a dentist who has training in orthopedic orthodontics. You may not need chin advancement surgery.
See the cases in this link http://www.top3dentists.com/pages/neuro_dentistry
But this is what you really need and if there were no dentists in your area, email and they will help to find someone for you. http://www.top3dentists.com/pages/neuro_ortho
Keep me informed of the progress