Surgical Orthodontics with Invisalign Treatment

  1. Barriers to orthognathic surgery with Invisalign:


  1. Traditional surgeon requests for orthognathic surgery patients:
    • Brackets must be placed, all orthodontic tooth movement must be completed, and arch wires must be rigid and passive
    • Wire ties throughout
    • Banded molars
    • Hooks on all brackets


  1. Invisalign/surgery challenges:


Arch Bars

Eyelet wires – Caplan stems/hooks

Direct bonded arch bars or archwires


Hybrid arch bars


Secure maxillomandibular fixation during surgery

Use of elastics will not cause tooth mobility/extrusion

Minimal soft issue irritation

Can begin refinement of occlusion with aligners sooner because

nothing is ok to the teeth


Segments must be sufficiently mobile to be completely passive

Establish the final occlusion precisely

Robust rigid internal fixation

Bony buttressing, grafting, and strategic placement of fixation


Bonded tension band with stress breaker across interdental

osteotomy sites

Bonded lingual archwires

Custom fabricated trays

Early mobilization and start of refinement


Retain occlusion with custom tray until ready to refine with aligners

Take advantage of RAP and allow vertical occlusal refinement

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