Orthodontic Tips September 12, 2014


“My bottom teeth are loose Doctor. What should I do?”

You need braces and a TMJ splint at the same time.

Give your patients the option of saving their teeth even though the future looks bleak.

This picture is an anterior view of a healthy 59 year old woman with a deep bite, TMJ dysfunction and lower incisor crowding and mobility. In fact, all of the lower incisors have only 5mm of bone around their roots and tooth 31 had mobility of 3. Her bruxing habit was

causing the bone loss and mobility. The solution is to use braces to open the bite and correct the malocclusion with a maxillary split at the same time. This is done by designing the splint to only touch the tips of the tooth cusps, which allows tooth movement to occur. Retention is from molar clasps that attach to the molar braces.

This technique changes a hopeless situation into teeth for a lifetime. If the occlusal trauma is removed, teeth can last for a very long time with minimal bone support.

Currently this patient is free from TMJ symptoms and all of the lower incisors have firmed up. When her braces are removed she will wear upper and lower TMJ splints at night time for ever. I am expecting an excellent and long lasting result.


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