Orthodontist here to help

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#46 Post by **jonesortho** » Mon Oct 08, 2007 2:34 pm

I don't think that bonded retainers have to go past extraction sites, but there is a risk of space relapsing if they don't. I almost never carry a retainer past the canines, so I don't necessarily follow my own advice. I tend to prefer spring retainers or clear retainers in extraction cases even if I bond a retainer (I'll make a spring or clear that will fit on top of the bonded retainer that can be worn in case space starts to crack open between teeth). I know lots of orthodontists who will just use the bonded retainer, even in extraction cases, and they don't seem to have much of a problem. The spaces that do open (if they open) are usually small and no big issue in terms of esthetics or function. But patients who have been paying very close attention to everything tend to point the microscopic spaces out, so I like to hedge my bet

#47 Post by **oceanblue** » Mon Oct 08, 2007 3:11 pm

Hi Dr. Jones and thank you for answering questions!

I got my braces off about two weeks ago. Do you think my two front teeth are a little too far out? I feel like my smile is really "round" and not more straight and flat looking like I was hoping for! Is it something that could be (or needs to be) fixed with Hawley retainers? I'm using an essix on top and a bonded wire on bottom right now.

Here is a link to my post braces pictures:

viewtopic.php?t=21444

Thanks!

#48 Post by **jonesortho** » Mon Oct 08, 2007 3:16 pm

Hi Ocean,
I think your smile looks great! It takes a bit of time to get used to your smile. Everyone has slightly different arches and the muscles and shape of your mouth all play a role in how the shape of your smile appears. I think everything looks super and your orthodontist did a great job. Congratulations!

#49 Post by **Higgy** » Mon Oct 08, 2007 5:37 pm

Is there any certain rule about bonded retainers and teeth that have had RCT? My orthodontist has mentioned bonded on the bottom becuase of how much crowding there was in the beginning. I've had one tooth that they have rotated 85 degrees during treatment. The concern for me is that my lower left canine tooth has had RCT, and as of right now, does not have a crown....could they just make it go one tooth further or wait till the crown is put in (which may be a considerable amount of time since my dentist is 2000 miles away).?

Mon Oct 08, 2007 6:32 pm

That tooth is pushing back why? i noticed it pushing back this past week, and its really tender there. It only started now out of the 8 months in braces.

#51 Post by **jonesortho** » Mon Oct 08, 2007 7:04 pm

Higgy, there aren't any reasons to not do a bonded retainer to a root canal treated tooth, although if you are getting a crown on that tooth down the line, your dentist and orthodontist should coordinate. It's really their call, as there are lots of options for retention in your case. Make sure your orthodontist know that the canine has a crown planned on it in the near future.

Chillin- it's hard for me to see what's going on in your picture and I don't knkow what adjustments your orthodontist made, so it's really hard for me to answer your question. Hopefully you have an adjustment appointment soon for your doctor to answer your question. Sorry I can't be more help!

Mon Oct 08, 2007 7:18 pm

Not till november 21st, the tooth is just pushing back behind the rest of the teeth. i have the same lower wire for 3 months now.

#53 Post by **belle** » Fri Oct 12, 2007 7:44 pm

hi dr jones..my uppers are getting braced this 26th and i have mixed emotions about it...happy..excited..nervous...my question though concerns my lowers..i only have 1 molar left on my right lower standing by himself.i lost my other molar several years ago.now my ortho says she cannot make this molar move and join the rest of the teeth because of bone loss that has already occured and she can oly straighten the rest..i just wanna ask your opinion on how true is this bone loss thing that makes it impossible for my ortho to move my tooth.than you

Fri Oct 12, 2007 11:03 pm

sad news, the tooth is now pushed even further in, i cant see seing the rotho just for that one tooth, i think i will wait until my next appointment and see if he says anything, if not i will point it out, i am getting new lowers so it might reverse it and close gaps not sure,

#55 Post by **jonesortho** » Fri Oct 12, 2007 11:15 pm

Chillin--sorry to hear about your frustrations with that tooth. Remember it's a process and sometimes it appears that things are getting out of whack. Something like a tooth slipping a little bit will probably not effect the length or quality of your treatment. Things like that happen all of the time and it is usually an easy fix that can be accomplished while other improvements are being made.

Belle--as far as moving a molar through a previous extraction site...that can be a very difficult and lengthy process, especially if there has been significant atrophy of the bone. The narrow bone that is left over can be very dense, thus difficult to move a tooth through in a predictable and timely fashion. You want your teeth straightened, but you also want your braces off within a decade, so if your orthodontist is recommending keeping that spot open for a bridge or implant, it's probably good advice. It's a lot different situation moving a tooth through an older extraction site that has had time to atrophy and moving a tooth through a fresh extaction site, where healing is working in our favor.

Fri Oct 12, 2007 11:17 pm

wouldnt power chains work? i got a small one on my upper right gap and the gap is closing, and its only been 2 weeks.i just dont understand why did they remove those 2 lower teeth, wouldnt that make my jaw smaller more narrower?

#57 Post by **jonesortho** » Fri Oct 12, 2007 11:41 pm

Chillin--sorry, I wasn't referring to your spaces in my previous post, I was talking to Belle. I edited my post to make more sense. Powerchain does work well to close spaces. Extracting teeth does not make the jaw narrower. The jaw stays the same width, it's the position of the teeth within the jaw that changes. Imagine your jaw like an actual horse-shoe, with your teeth like marbles on top. Taking away a couple of the marbles won't narrow the horse shoe. If the marbles didn't have enough room in the first place, taking a couple away gives the rest of them room to align properly and gives them a better chance of staying straight in the long run.

Fri Oct 12, 2007 11:46 pm

oooo ok, so do you think i will get powerchains on the lowers?

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