Orthodontic Tips May 20, 2014
Can Orthodontic treatment be sped up?
Yes it can.
If the patient is motivated and has the extra cash there are choices available to speed up orthodontic tooth movement.
AcceleDent is a vibration platform with claims of accelerated tooth movement. Their best evidence is testimonial. The science behind the product is based on mouse studies; however, the product seems incapable of causing harm (if not a slight headache). Continue reading
Orthodontic Tips May 12, 2014
Do you have a mentor?
They say that when the student is ready the teacher will appear.
Choose a mentor to help you stay challenged but out of trouble.
This past week one of my patients came to see me with a pressing question. I had been treating him for TMJ and Sleep Apnea. He asked me if he needed orthodontic treatment for the spaces between his teeth. Continue reading
Orthodontic Tips April 29, 2014
What is the difference between the occlusally positioned gingival margins on the maxillary centrals in these two pictures?
The picture on the left shows tooth 1.1 with a lower than normal gingival margin. The reason for this is because the 1.1 has been worn away from occlusal wear and it has over-erupted.
Treatment for this is to orthodontically intrude the 1.1 to move the gingival margin apically and then restore the incisal edge to create a tooth of ideal length and gingival position.
The picture on the right shows both the 1.1 and 2.1 with a lower than normal gingival margin. The reason for this is thicker than normal alveolar bone on the Continue reading
Orthodontic Tips April 24, 2014
Facial asymmetry can be a distressing event. Often the asymmetry occurs after braces have been removed. The mandible is the last bone in the body to stop growing. If a patient is prognathic, the asymmetry can be pronounced.
The treatment is braces and Orthognathic surgery to re-establish the facial asymmetry.
Orthodontic Tips April 7, 2014
This is a new patient I saw today.
1. Notice the 31 is displaced labially in the dental arch in the picture on the left.
2. Notice the loss of attached gingival on the labial of the 31 in the picture on the right.
The history of this event is that the lingual wire was detached several years ago from the 31 and was rebonded without moving the 31 back to its proper position.
That’s why it lost labial bone and needs a gingival graft at this point. Continue reading
Peg Lateral incisors!
When I am doing the orthodontics for a case like this one, I like to have the peg lateral incisor temporarily bonded before the braces go on.
Then, I can be sure that I will please the restorative operator in the final positioning of the tooth for its permanent restoration.
Here is what I am looking for in the temporary bonding procedure. Continue reading
Orthodontic Tips March 25, 2014
I went to lunch with a dental colleague last week. He asked me “Can you tell me when a two splint system is necessary instead of a one splint? Can you tell me when I should be doing the TMJ care and when should I refer it?”
Here are the answers.
A two splint system is necessary when there are bite marks or grinding marks on the single splint. The reason for this is as follows. If there are marks on the splint then the patient will Continue reading
This is a CT scan of a mandibular second molar. Notice the buccal shelf of bone. That is where I place a TAD to retract the mandibular teeth “en mass”. The molar teeth slide distally past the TAD as the lower teeth move back.
This is one of the exciting things that I do with orthodontic TAD’s.
Placement of the TAD’s is done with local anesthetic infiltration to numb the mucosa and periostium. Bone doesn’t have nerve fibers so a block in not necessary. If the TAD touches the root, the patient will let me know since the tooth is anesthetized. There is very little postoperative pain. The patient will brush the TAD to keep it clean and rinse with Listerine once a day. I can load the TAD immediately to start to move the teeth.
Stan Continue reading
img class=”alignleft size-medium wp-image-129″ src=”https://www.drstanwaese.com/wp-content/uploads/2014/08/Adult-Ortho-needs-Perio-300×163.jpg” alt=”Adult Ortho needs Perio” width=”300″ height=”163″ />
This is an anterior view of a 51 year old female who came for a consultation last week.
Her chief complaint was protruding teeth. We can see other issues as well: crowding, deep bite, tooth brush trauma. But the most significant issue is periodontal disease. Upon probing there were only minor bleeding points in the lower anterior. However, there has been bone loss and recession. This causes tipping forward of the posterior teeth and proclination of the incisors. We call that vertical collapse of the lower face height. Continue reading
Orthodontic Tips March 4, 2014
“God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.”
This is the Serenity Prayer.
I was talking to several dentists this week about the state of the economy. Apparently everyone is experiencing a slow down. It is easiest to think that when things don’t go the way we want them to that it is our fault. Well apparently it is not so. That’s when the Continue reading