Explained | Inman
Aligners | Invisalign |
Retainers | Orthognathics in Cosmetic
Dentistry | Orthognathic
COSMETICS & ORTHODONTICS (INMAN ALIGNERS, BRACES,
INVISALIGN) AND ORTHOGNATHICS (BONE REPOSITIONING
Cosmetic dentistry many times
involves a combination of therapeutic treatments. In combination
with the most talented specialists in the region, Dr. Prus will
offer you every and any treatment modality you may need to
successfully remake your smile, rebuild your mouth or redesign your
facial appearance. There are many novel orthodontic products on the
market such as Six Month Smiles, Inman Aligners, Invisalign, and
traditional braces with standard or porcelain brackets. These can
and should be used in combination with orthognathic (dental
orthopedic) surgery when the malposition is due to more than teeth
being out of position but also the jaws are not properly aligned
for a variety of reasons. Review the casework
below and perhaps you will find just the solution
you are looking for.
Orthodontics is a vital component to many aesthetic treatment
plans. Orthodontics adds these benefits to cosmetic dentistry
- places the teeth and their supporting structures in visual and
- allows for more uniform restorations, if needed. Uniform shapes
are more beautiful and natural looking.
- allows for more natural and more cleansable tooth/crown
contours helping maintain optimal oral, gingival health
- creates more harmonious gingival contours. Visual harmony is
the essence of a beautiful smile.
Adults often experience a loss of
front tooth aesthetics due to shifting and crowding over time. This
even occurs after they have had full mouth orthodontics as a child.
This is a natural process but it can be corrected in many instances
with a simple, easy and more affordable 2-4 month treatment
sequence using the Inman Aligner (Inmanaligner.com ). This is an
exciting new dimension of care that Dr. Prus has brought to the
Center for Dental Excellence. It avoids the more lengthy standard
orthodontic protocols and provides for a major improvement in your
smile without the extensive involvement of orthodontics.
Both Inman aligner cases above, supplied by Inman Aligners, were
completed in under 4 months with additional whitening and
recontouring of tooth edges with bonded composite fillings.
For a full description
of the Inman Aligner (click here)
today and ask how we may be able to help you improve
your smile easily and affordably.
ClearCorrect, or aesthetic ceramic
braces (see photos below) are used for full mouth orthodontic
treatment. Invisalign clear aligner trays are becoming
a standard of care for most patients. No one product can solve all
orthodontic problems. Often combinations of therapies are needed to
create a beautiful smile, at any age, that will last a
Dr. Prus will refer you to one of
our preferred specialists to ensure you receive the best
orthodontic care. Dr. Prus firmly believes in preventive therapy.
In orthodontics that means he wants to treat any tooth positioning
problems at the earliest possible opportunity. Your young child may
exhibit strong tendencies for tooth mal-positioning and if the
growth patterns of the young jaws are guided properly these can be
minimized with such guided intervention. This lessens later
Invisalign case from
treatment performed after orthodontic care is more beautiful and
sustainable . Uniformly spaced and positioned teeth are
easier to keep optimally healthy as well.
Every day a patient will walk into
CDE with crooked and crowded lower front teeth. These patients very
often mention that they had worn braces years ago and the teeth
collapsed in the front over a period of years. It is easy to
conclude that whenever you wish to straighten your teeth as part of
aesthetic improvement of your smile YOU MUST ASSUME A
POST-TREATMENT RETAINER MUST BECOME A PART OF YOUR LIFE FOR MANY
YEARS IF NOT FOREVER if you want them to stay as beautiful as they
are just after treatment. Retainers can be fixed or removable as
each case requires.
Orthognathics in Cosmetic
The most advanced treatment that is used to create a
balanced, properly functioning mouth is orthognathic
dentistry. Orthognathic dentistry (aka dental
orthopedic surgery)is used when the bones of the mouth are too far
out of position to allow for proper function of a smile by any of
the preceding techniques. The bones of the maxilla and
mandible are repositioned to maximize proper position and
function . Repositioning of the bones is performed by a
highly trained oral-maxillofacial surgeon. At this point
standard orthodontic and cosmetic dentistry can be successfully
performed with excellent results.
Dr. Prus has been fortunate to work with some of the finest
surgeons in the world, including Dr. Andrew Hauser, (NewYorkoms.com) during his tenure in
Manhattan. These surgeons are now available to you should your
dental situation call for such care. Please talk with Dr. Prus
about your special needs. It would be his pleasure to help you.
When orthognathic dentistry is necessary, but not
used, it is likely the final cosmetic results will be less
appealing and may not last as long.
Orthognathics is also a key component in reconstructive
dentistry where both the bone and teeth may have moved out of
position (see orthognathics).
gallery images are shown below. These cases are almost
always associated with orthodontic treatment. Orthodontics, by
itself, could never affect the facial structural
Case 1: 'short' lower jaw and chin
Case 2: anterior open bite, excessive
chin. Realign bones and teeth with ortho
Case 3: significant chin and facial
regression. Upper and lower surgery put face in greater aesthetic
balance with a positive result.
Case 4: anterior open bite due to bony
misalignment surgery + ortho
Case 5: restricted chin and facial profile
corrected by surgery
Case 6: Full facial deficiency corrected by surgery and conjunctive
When the proper protocols are applied
to facial aesthetics the outcomes can be dramatic in appearance and
equally as dramatic in the beauty and comfort of a properly
functioning mouth. It is all about creating harmony is appearance
and function. Call Dr.
Prus and ask him what he and his extraordinary team of
specialists can do for you.
Inman Aligner Full Story
THE INMAN ALIGNER
Why do the front teeth become crooked?
Many patients suffer from crooked front teeth even if they have
had orthodontics as youngsters; then, over time, the natural
process of forward migration of teeth created sufficient pressure
of the front teeth to have them buckle and shift. If this is you
and if nothing is done to alter this state, it will slowly and
progressively continue to worsen making your smile les and less
attractive. In many cases the front teeth overlap, some pushing to
the front and others backward. There may also be some tooth
rotation of these teeth in the process of pushing forward or
Then, suddenly one day, you look at a photo and realize your teeth
and your smile does not look good at all. This misalignment is seen
mostly on the lower front teeth but occurs on the upper, maxillary,
anterior teeth also. In fact the lower teeth are often the reason
the upper teeth may look worn, chipped or crooked because a
normally functioning chewing arrangement does not exist and
excessive forces from below damage the upper teeth.
What is an Inman Aligner (IA)?
The Inman Aligner is a low intensity orthodontic device created
specifically to deal with the very common problem of crowded, out
of position, front teeth (central and lateral inscisors, canines
(cuspids)). It is capable of reestablishing a harmonious
realignment of the front six teeth in just a matter of weeks as
long as the misalignment falls under certain parameters.
To learn more about the following question on the Inman Aligner
follow the link.
What Can the IA do?
How does the IA Work?
How long does treatment take and how much does it cost?
What happens to the damaged teeth after using the IA?
How long will the teeth stay in position?
What can an IA NOT do?
What is considered a ‘Normal Bite’?
What Can the IA do?
The Inman Aligner was designed to straighten out irregularities
in the front six teeth as a result of being pushed forward,
backward or rotated slightly by quickly and affordably arranging
the front teeth so they function properly and look harmonious for a
better working and looking smile.
How does the IA Work?
The IA does so by applying simple vector (directed forces)
physics to the teeth. Through specific points of pressure the teeth
are guided into a balanced position, mostly with forward or
backward pressure. Think of it this way. If you push on the front
or back of a person in the center of the body, they will move
straight back or forward. If you push on a shoulder, you will
rotate them. By carefully selecting the exact points of contact in
the front and back of teeth, the teeth are moved carefully into
position. It does not bodily move teeth through bone as with full
orthodontics as much as it tilts teeth back/forward toward a more
ideal position. Thus the limits to its function. Besides pushing
forward and backward, the IA can extrude (pull) a tooth down (upper
teeth) or up (lower teeth) to a small degree. Fortunately this
covers most of the problems of front tooth crowding. Functional
misalignments beyond the scope of the IA are better handled by full
The entire process is done through computer analysis so the process
eliminates guesswork, creating the best possible result. In the
more severe cases of crowding that an IA ca handle an ideal
position may not be possible to achieve, but the result will be
significantly better in appearance and function.
In reality very few people, including movie stars and other
celebrities, have perfectly straight teeth and perfectly balanced
smiles (unless they are all veneers or caps) yet they are beautiful
to look at. Perfection rarely occurs in nature, but you can get it
in a dental office if you so choose.
How long does treatment take and how much does it
These are the two best features of the IA. The course of
treatment from the easiest to more challenging cases is between
4-13 weeks. Worst case scenarios may take up to 16 weeks, but that
is a far faster treatment span than with routine orthodontics.
Again, the IA works within a limited perspective of dental
alignment issues and does not tackle major orthodontic
mal-alignments, even in the front of the mouth. The computer
analysis will determine if your teeth are appropriate for
As a result the fees for IA therapy are a fraction of that for
routine orthodontics. Every case is unique but, as an example, the
least involved cases only cost between $1,200-$1,500. Any dental
insurance coverage may also affect your out of pocket fees.
What happens to the damaged teeth after using the
In addition to the IA treatment there may be need for further
cosmetic enhancements. When discussing such treatments with my
patients this is what I refer to as “The Next Worst Case
Syndrome”. In dentalspeak that means the teeth will look better
at first because they are straight, and initially that one glaring
front tooth out of position was the only could see every time you
saw your face in the mirror. What your eyes may not have seen was
the chip on the corner of another tooth or the discoloration of yet
another. In the end each patient will decide for themselves what
needs correcting but it is a natural instinct to want to fix up the
smile so it looks harmonious and balanced. You want your smile to
match your style. These add on procedures can be discussed in the
beginning before IA treatment starts, and you can know the bundled
costs before you begin. Dr. Prus will guide you in this decision
How long will the teeth stay in
This is a most important question. The teeth will stay in the
position you put them as long as you regularly use a retainer.
Dentists now agree a retainer is a lifetime requirement. In years
past dentists used to think that patients only had to use retainers
until the ‘memory’ was eliminated in the bone (bone really does
have a type of elastic memory), perhaps a few years at most; not
any more. As stated above, teeth are always on the move toward the
front of the mouth. A retainer prevents that from
What can an IA NOT do?
• It will not affect any other teeth in the mouth except
for the front teeth.
• It will not push teeth down into the bone; it can pull
straight up slightly.
• It cannot move teeth laterally except by tipping that occurs
from a forward or backward pushing which engages an adjacent tooth
and slightly tilts it.
• It cannot treat severe anterior tooth displacement. These
cases are best handled with orthodontics (see orthodontics in
• It cannot treat children or adolescents who do not have full
adult dentition and jaw growth.
Realize the Inman Aligner is a localized application of forces on
teeth and while it can do wonderful aesthetic things for a smile,
it cannot do major orthodontic processes for anterior teeth.
Because the treatment is all computer driven, it will diagnose,
analyze and program the course of action to be taken down to the
finest detail, as well as eliminate inappropriate cases.
What is considered a ‘Normal Bite’?
A normal bite functions this way: when the lower jaw moves forward
the lower teeth should strike and slide down the back (palatal)
side of the upper teeth. That functional relationship is called
incisal guidance. It should be smooth in transition between each
tooth. When lateral movements are brought in, the same process
should continue smoothly, transferring the biting forces evenly
from tooth to tooth. When the lower jaw moves strongly to the left
or right, in most mouths the canine (cuspid) teeth are contacted on
the palatal surface and they will ‘open’ the bite because of
their length (try sliding the lower jaw left or right with the
teeth in contact while looking in the mirror and you will
understand). In adjusting incisal guidance a dentist will put
marking (articulator) paper between the upper and lower teeth and
observe the marks left on the teeth when the jaw functions as
above. The marks should be evenly distributed. If not ‘occlusal
adjustments’ are made to make it more balanced.
When teeth are crooked and out of place and occlusal adjustments
are not sufficient to correct the bad bite, tooth movement is
appropriate. The adverse forces of teeth grinding improperly wear
down the contacting surfaces causing visible attrition and damaging
the smile. Any and all cosmetic based services including an Inman
Aligner are available to correct this.