Are your brackets "perfectly" positioned?

Message

#1 Post by **Koolmama** » Thu Aug 16, 2007 11:48 am

Hi guys,

i've been wearing my lowers for about 5 months now and uppers for less than 3 days... Something has been bothering me but i'm not sure if it's just me... or... it's my ortho...

When i compare the brackets on my left lower molars to those on my right lower molars for example, i don't find them positioned in exactly the same way. E.g. the brackets on the left are much lower down the tooth (touching the gum) than those on the right (which don't touch the gum but are more like in the middle of the tooth)

When i brought this up to my ortho, however, he didn't seem too bothered by it and just said that there was no way he could have placed ALL the brackets in exactly the same way for every tooth. Furthermore, there are many other factors affecting the final position of the teeth (e.g. top molars hitting against lower molars) so i shouldn't worry too much about it. But i AM worried! What if i end up with teeth which are higher on one end than the other end? Shouldn't all the brackets be positioned in a "perfect" or symmetrical manner?

Also, when i look at the brackets on my canines, they look strange to me. It's as though they weren't placed straight along the tooth, but rather more at a slant/angle. Is this just an optical illusion or a deliberate act by the ortho or does he simply have very bad/shaky hands??

Can anyone pls enlighten me and/or share your experience please... thank you!!!

#2 Post by **SandraJones** » Thu Aug 16, 2007 12:11 pm

Someone correct me if I'm wrong, but I think the brackets are supposed to be placed in such a way that when there is total alignment the archwire is straight and the brackets are all oriented the same way.

Koolmama, imagine your teeth fully aligned and torqued properly ... does it seem like the brackets will all be lined up then ?

I would think any other positioning would cause undesirable forces to be exerted on the teeth.

#3 Post by **SandraJones** » Thu Aug 16, 2007 1:11 pm

Here's a bracket positioning document:

http://multimedia.mmm.com/mws/mediawebs ... l5gsWWWW7-

#4 Post by **SnowSara** » Thu Aug 16, 2007 1:58 pm

Mine are getting more aligned as time goes on, but they didn't start out that way. They are placed in such a way to move each individual tooth to where it needs to be relative to teh teeth around it. My brackets were placed with OrthoCAD, which is a system that helps the orthodontist figure out where to place them in the beginning of treatment so they end up aligned in the end (he won't have to reposition them later in treatment, that is).

#5 Post by **oceanblue** » Thu Aug 16, 2007 2:06 pm

Yeah I'm almost done with treatment and my brackets don't line up perfectly. My ortho moves the teeth with bends in the archwire. I don't know how many bends are in my top wire, but I know there is a lot! My brackets on my two front teeth don't line up with each other, but the bends my ortho puts in my wire make up for it. That's how it was explained to me anyway . . . he said my teeth would look more straight once the brackets were off.

#6 Post by **ghostmyimag3** » Thu Aug 16, 2007 4:03 pm

My brackets were centered on my teeth however he is having to readjust two on my lower canines, no biggie i guess it happens. I still have pencil marks on my teeth due to the adhesive used when they were put on but im told that its alright and when he polishes them and whiten's them they wont exist although im scared of yellow dots on my teeth from where they used to be so icky.

#7 Post by **Koolmama** » Fri Aug 17, 2007 11:00 am

Thanks everyone for all your feedback... i don't know whether to feel more or less worried now... ha

Sandra, that's what i thought initially too - i guess as a layman, i would have expected all my brackets to be positioned like you described, that's why i was so nervous when i realised my brackets weren't all placed the same way...

Thinking back, my ortho was super-quick at putting on the brackets for me - there was no marking, no hesitation, just a quick paste-paste-paste and that was it! Finished in a matter of minutes. He didn't even use the light curing technique! (which Sandra's bracket positioning document pointed out to be better in that it allows more time for the ortho to adjust a bracket before it sets) At that time i simply thought my ortho must have been really, really experienced to be able to place the brackets so quickly!!

But...now that Oceanblue has mentioned the wire-bending technique that his ortho uses, i am really, really hoping and PRAYING that my ortho has something like this in mind... otherwise... i am going to look for a new dentist!

Does anyone else have more info to share? Many TIA

#8 Post by **Koolmama** » Fri Aug 17, 2007 11:18 am

Btw, can anyone pls enlighten me as to whether these brackets are supposed to last us thru to the end of treatment, or are they usually changed when the wire is changed or when the powerchains are put on, etc? Thanks

#9 Post by **SnowSara** » Fri Aug 17, 2007 11:20 am

Don't worry, he probably is skilled enough to do it quickly (think of how many times he must have done this!) and each ortho uses what ever technique they prefer for getting the job done. I've heard about all of the above techniques and all that matters is that teeth look great when finished, right?

Wires and ligs and other appliances might get changed out but you'll keep your brackets the whole time, the only exception I can think of is if one pops off on you or if he does indeed need to reposition a few to tweak a tooth's final position.

#10 Post by **SandraJones** » Fri Aug 17, 2007 11:41 am

My orthodontist told me that she thinks she's got the positioning of the brackets right, but as my teeth move she said she might need to pop one or more off and put new ones on in different positions.

Even though some people have bends in their wires up til the very end, I do think the goal is to have a straight wire running through all of the brackets. Depending on the amount of correction required, it could be very difficult to get the brackets positioned just so at the very beginning.

Koolmama, you could find another orthodontist and schedule a 2nd opinion consultation. Do not tell the 2nd orthodontist who your current orthodontist is, just in case they are buddies !

I'm really interested in seeing your brackets on your teeth, would you be willing to post a pic, even just temporarily ? I will update mine this weekend and you can see how mine are placed. I have bends in my wires now but as my teeth straighten out I will have few if any bends.

#11 Post by **platinum** » Fri Aug 17, 2007 11:53 am

I think a barcket on my second lateral is not positioned right. There is propably a explanation for it... I guess tehre is not enough space to turn it right at the moment.

#12 Post by **SandraJones** » Fri Aug 17, 2007 12:14 pm

Are you talking about your lateral incisor, the tooth next to your front tooth (central incisor) ? I think it looks good.

#13 Post by **pumpkinpatch** » Fri Aug 17, 2007 12:49 pm

Relating to this question, I have also noticed that sometimes brackets are positioned more toward the bottom of the teeth, whereas sometimes they are more toward the top or more in the center. Is there a reason for this, or is it just the way different orthodontists position brackets?

#14 Post by **platinum** » Fri Aug 17, 2007 1:06 pm

Are you talking about your lateral incisor, the tooth next to your front tooth (central incisor) ? I think it looks good.

I would like to have the teeth straighter and not to overlap the central incissor. For me it looks that it is not correctly positioned.

#15 Post by **SandraJones** » Fri Aug 17, 2007 1:56 pm

platinum, it looks like the bracket on your lateral incisor is correct with respect to the tooth, it is in good position horizontally and vertically. Imagine the tooth completely straight as you want it, will the bracket be nicely straight with respect to horizontal and vertical too ? It looks like it will be. Of course it's kind of hard to tell from just that one photo.

pumpkinpatch, in that bracket positioning document linked to in my earlier post, it appears the goal is to get the bracket on the anterior cusp of the tooth. I suppose on some people that cusp is lower than on others. My upper central incisor brackets seem too low to me, but when I consider the cusp I think they are right on. I'm guessing that's done because the tooth is thickest there so it's the best spot to handle forces.