Problems with Pre-molar rotations?

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#1 Post by **Wireless** » Fri Dec 11, 2009 11:19 am

Is anyone else experiencing problems with having pre-molars rotated? I'm on the second attempt to do this - my first was 20 years ago with regular braces. If I remember correctly, a proper rotation wasn't achieved then and there have been problems with current treatment. My ortho has decided enough rotation has taken place to be ok and filed the attachments on these teeth off.

Another concern is how relapse after treatment can be avoided and are special retainers needed.

I've been in treatment a year with several months left to go. I'm hoping this won't be a problem that needs refinements or cause problems later. My ortho has told me I'll have retainers similar to my Invisalign trays.

#2 Post by **melandy** » Sat Dec 12, 2009 1:23 am

hiya this is my first time having my teeth straightened and I am on my second trays which are killing me but hey ho hopefully all worth it in the end I have 34 trays to go on Upper and 16 on lowers I have 7 attachements on the top and 6 on the lower so I think my teeth have a lot of work to do !! I have been told that night time retainers will be needed after my treatment for the rest of my life and I assume the same would be for everyone as my Dentist said your teeth naturally move throughout your life so a retainer is required - I do envy you only having a few months to go - good luck

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#3 Post by **drrick** » Sat Dec 12, 2009 9:07 am

Personally I am a fan of fiberotomies on rotated teeth (not all docs are) Granted I use them more on anterior teeth than premolars.

the doc could probably use some auxillaries (buttons and powerchains) to keep those PM' rotating if you are not yet pleased.

#4 Post by **Wireless** » Sat Dec 12, 2009 6:24 pm

drrick, thanks for your comments. I'm really not concerned about the tooth rotation unless it causes other problems. My biggest concern is correcting the deep bite that resulted in my lower front teeth hitting my gums behind my uppers. My gums had become inflamed so I had to get this fixed.

This has been an ongoing problem and I've had braces twice before. My last treatment involved extruding my molars, which worked ok for a while until normal forces pushed them back down into their sockets. My present treatment includes intruding my front teeth. I was told my case would be hard to hold correction due to the curvature of my jaws.

Melandy, I've been told the same thing you have about retainers at night for life. It sounds like this is becoming more commonplace now as it is understood how much adult teeth move. My wife has had problems with tooth movement although she has never had braces. She has a partial that acts as a retainer on some teeth causing the others to crowd and make it difficult to floss.

It also appears some problems relapse quicker than others. My doc mentioned my deep bite had a high probability of coming back and I read tooth rotations didn't hold well either. I'm hoping that the right retainers will keep all of this from happening again.

With 34 trays and 13 attachments, it sounds like you also have an involved case. Good luck!!! It does get easier after a while.

#5 Post by **drrick** » Thu Dec 17, 2009 3:01 pm

As long as the rotated teeth arent creating some type of occlusal interference things should be ok.

You may want to ask if addian and anterior bite plane to your retainer is a good in your case.

SOunds like you are a brachycephalic face tyoe and probably a clencher (wheter you know it or not) and this situation def helps reintrude extruded molars deepening a bite. The ant bite plane can keep the back teeth separated so even if you do clench there isnt pressure on the back teeth to intrude more (which is still possible)

#6 Post by **Wireless** » Sat Dec 19, 2009 2:55 pm

Drrick,

Thanks for your comments. I think clenching along with jaw shape are probably factors involved with the problem. Until a couple of years ago, I had a very high stress job. Even though I have moved on, this probably had impact. One of my more recent symptoms was ocassional ear ache when waking up. Since I've been in treatment about a year, this problem, along with others such as clearing my ears have all but disappeared.

For me, the biggest surprise was having symptoms start in my late 50's. Problems started with minor irritation to the gums behind my front uppers. I did some web searches and found it would be necessary to do a full correction for this type of problem, so I put off telling my dentist what was going on and thinking if a major problem started, it would show up on a six month checkup. I also thought that because I was in my late 50s, my teeth wouldn't move enough to cause more than minor problems. I was surprised on both assumptions - my dentist and hygenist thought the gum irritation was a coffee burn, and the gum inflamation became bad enough that it kept me awake at night, I assume from clenching in my sleep. At that point, I complained to my dentist who sent me to my kids' orthodontist.

My doctor has an advanced degree in Orthodontics and has been explaining a lot about my specific case and why it will be very hard to keep a correction. He also spent a lot of time initially going through my X-rays showing problems, as I was reluctant to start treatment at first.

For both dentists and former (??) ortho patients, it's a good idea to keep check on tooth movement, even when patients are in their 50s / 60s. New patients should also give written histories to their dentists. I'm not sure how often this type of problem occurs in older people. I have met two other invisalign patients in their 60s since I started. One, like me had braces earlier.

I put the ??s behind the word former - after my experience, I'm not sure there are any "former" ortho patients!