Describes the parts of a bracket, NiTi vs. SS vs. TMA wires, the three phases of orthodontic treatment, and our typical archwire sequence to align the teeth and correct the occlusion (bite). Worksheet: drive.google.com/file/d/1nfXP...
Great video. I'm 44 years old and I began Orthodontic treatment 6 months ago. This helped me more than any of the answers I received from my Orthodontist.
I'm glad this helped! Ortho is part science and part art so your orthodontist might not do it exactly like this but the idea will be the same. Good luck with your great, new smile!
I remember I heard my ortho asked his assistant to bring him a "0.018 lower" and I searched it in the internet like crazy and found your vid! Well informative! This is the 1st wire replacement I got which means this is the 2nd wire.
Best video about orthodontics for patients! Really, really informative, with simple language that everyone can understand, and precise explanations! Thank you so much!
This is so informative, thank you! I was able to distinguish exactly where I am in my braces journey based on this video. Also explains why there are two months between my last and next appointments, which I was curious about!
i got 4 teeth missing and i was told to use elastics with a round wire while i have still some unresolved alignment and spacing issues. i dont remember we've ever used rectangular ones before. my whole body crunched in stress, so many problems showed up, needed a root canal for one teeth and we gave up on elastics. i've experienced narrow skewed arch, too much closed space for the missing incisor with tmj problems and with all that at least 7 seemingly unrelated physical problems from postural, neurological to dermatological ones and of course its psychological traumatic effects. i needed to learn dental stuff instead of my profession, gave a break to my job 2 years ago, and still no clear sight ahead. this treatment is not a joke but somehow some orthodontists are not aware of the consequences of what they are doing. i wish every ortho would be a clear communicator like you. thanks for the videos, these explanations has given me clear understanding of its technicality. if you have any suggestions, i'd also be appreciated.
You are the best, i have seen a lot of orthodontic trt vdos but you have the most simple affective and understandable way of learning and explaining Ps i liked the sound effects keep using them 💙💙💙
In braces. Great lesson. Enjoy the sound effects too! Update: I had my 24-month visit today. Still in phase II. I got thicker arch wires and am still wearing bands to close space. Can't wait to phase III and out of these braces. Although wearing a retainer doesn't sound like much fun either.
What a freaking awesome video!!! The rectangular wires are super neat!! With their work they do on teeth. I can’t wait to see the difference in my treatment once I get my 3rd set of wires!!!
Based on the preceprorship I attended,.016x.22 is a contraction wire while.017x.025 is the final wire but it all depend on your school of thought..Great video indeed❤
This is super helpful, thank you! My orthodontist couldn't really explain anything he did, and i couldn't live not knowing how it all works. Im already on retainers, i didn't have to wear elastics and it took about a year and a half, thankfully. Also before braces i wore something that looked like a plastic retainer but it moved my teeth away from each other and created gaps between them to uncrowd. I never heard of that thing before.
Interesting. I was always wondering how braces work. I have an interesting case. I have 9 front teeth and 10 bottom front teeth. I have bad crowding and a cross bite. I had braces put on two weeks ago,. The ortho said they can straighten these monsters out and ready me for some nicely fitting partial or if i can afford it some implants/bridges. 18 months to go to see if it'll work.
Can patients be given elastics as soon as they start a rectangular wire? Or does the rectangular wire first have to work on its own for a few months until you're put on wearing elastics?
Hello- I am making ortho videos to help my ortho assistants--I have included some excerpts from your videos in my course and have given you credit---great job--Is that okay? Would love to see more content. Thank you!
Correct. Those help to level the lower arch of a straight wire isn't getting the job done. Some orthodontists use them a lot, some a little, and some not at all.
How if my doctor using the same wires with all of the ortho treatment? Like he using the same wire to do the alignment, space closing & elastics, and also for the detailing..
When I started I asked my ortho how long he believed I needed braces for and he was just like “Yes”. It will take more than two years. Like what? That said I guess the phases can take a different amount of time depending on your condition. I had impacted Canines. I spent 8 months wearing an appliance just to make space for the tooth to come in. Then it has been little over a year getting the tooth down into the arch and It just now got to a point where they can put a bracket on. Lol thought I was getting close and now I find out I’m not even done with phase one and that’s not even the longest part lol fml.
Hello. My incisors on my lower jaw are protruded. Is it really ok to use Stainless steel wire? Ive beem wearing my braces using SS in my lower teeth, but I haven't notice any changes. Incisors are still protruded.
As crowded teeth align they have to go somewhere and where they go is forward onto a larger arc so that they can be lined up. The only way to tip them back is to either pull them back using extra-oral anchorage (like with a headgear that pulls from the back of the head or neck) or, more commonly, by extracting certain teeth and closing that space. As the space closes, the protruded teeth can move backward into those extraction spaces. A small amount of backward movement/tipping can also be achieved by inter proximal reduction (IPR), which is selective removal of tooth enamel between the teeth with an abrasive disc then closing those small spaces to bring the teeth back. You get less tip back than with extractions but it’s better than nothing. If you’re concerned about the position of your teeth you should definitely bring this up to your orthodontist so he/she can review the options available to you to fix it. 👍
For .022 slot brackets, a .019 x .025 SS wire would be ideal. That is what I used to close space on when I used .022 slot brackets at a previous office. Closing spaces with large rectangular SS wires is the norm. I.e., it's unusual that we close space on NiTi wires but we've found that it works well for us. I hope that helps! 👍
If the patient's arch is narrower than the arch form of the wire, rectangular NiTi and/or rectangular SS wires can expand the arch to match the size and shape of the arch form of the wire. It seems like most of that "expansion" though is dental tipping rather than skeletal expansion like you'd get from an expander.
Great question! When closing spaces you need a wire that is rigid enough to stay straight while the spaces are closing. Traditionally this is done on a SS wire when closing space with sliding mechanics (elastic chain or closing springs to make the braces slide along the wire) because SS is naturally more rigid than NiTi. However, if your NiTi wire is thick enough (.017" x .025", for example) it should be rigid enough to stay straight while closing spaces with sliding mechanics as long as you keep your closing forces relatively light. We use NiTi closing coil springs for light, continuous force and we haven't had any trouble using NiTi wires with that system. However, when closing space with closing loops you would need a wire material that allows you to bend closing loops into the wire (SS or TMA).
And what do you do if your patient has a nickel allergy? I have a bad nickel allergy and a few orthodontists at consults have wanted to try a metal containing it anyway. I'm also type 1 diabetic, only one cared enough to ask if my a1c was good or not.
If you think you might be allergic to the braces your orthodontist could bond one to a tooth and check you later that day or the next day. If you're allergic you'd know within that time because the part of the cheek/lip touching the brace would have a noticeable allergic reaction. That said, in 13 years of doing orthodontics I've only ever seen one person who was allergic to the braces and they knew within 1 hour and there was no mistaking it. The inside of their cheeks were very red and swollen. Lots of people have nickel allergies but it's extremely rare to have an allergic reaction to the metal in braces.
Hi Dr. you meant we can use a power chain to close spaces on rectangular 17*25 NiTi? If so , Is this going to cause a roller coaster effect on the teeth?
I was always taught that it would but my partner and I have been closing spaces with power chain and sentiloy springs on 17x25 Niti wires for the last 4 years with little to no roller coaster effect. Closing spaces on stainless steel wires is the more traditional way to do it, though, and does have less risk of getting roller coaster effect (assuming you're using the same size wire in SS vs NiTi).
Hello, doctor I have a question about the wire is the top wire the same as the bottom wire in shape? For instance, the top and bottom wires are nickel titanium so would the shape be the same or not? Thanks in advance.
Arch wires come in many shapes and you can order the arch shape that you prefer. In addition, each arch shape has a maxillary arch wire and a mandibular arch wire. The difference is that the maxillary arch wire is the same shape but just slightly broader or larger than the mandibular arch wire such that if you set the mandibular arch wire on the table inside the maxillary arch wire, there would be a uniform gap of 1-2 mm between the two arch wires all the way around. Most orthodontists use maxillary and mandibular arch wires in their respective arches to keep the arches and the occlusion coordinated.
I was explaining that the round NiTi wire will correct the rotation and height of the tooth but cannot correct the torque (what I show with my hands at 7:00). A rectangular wire that's large enough to fill the bracket slot is needed to correct the torque.
Very nicely explained. Please advise the 0.17 x 0.25 Niti wires are round or rectangular and the detailing wire 0.16 x 0.22 SS is round or rectangular. Please advise the duration of wear for space closing and detailing wire
Both of those wires are rectangular, thus the two numbers to describe the wire’s dimensions. Those wires are used for as long as you need to get all the spaces closed and all the detailing done. Usually that’s about 6 months each but it can vary depending on the needs of the patient.
I would recommend following the recommendation of your orthodontist because they know what’s going on in your particular situation. Usually one elastic on each side, if worn 24 hours per day, will be sufficient to correct the occlusion. If you want to wear two elastic, I would check with your orthodontist before doing so.
At which phase I can expect widening the arches, I am 9 months in and my ortho said once the gap is closed they will start widening my arch(no expander)
Treatment methods that try to widen the arch with arch wires instead of using an expander (usually Damon) will usually do this with the larger, rectangular archwires, though some claim that the arch widening starts with the initial round wires. Doctors who use that treatment method will usually use archwires whose arch firm is significantly wider than that of a standard archwire. For specifics I would ask your orthodontist, as orthodontics is part science and part art and each doctor has their way that they like to do things. I hope that helps!
The Ortho could either remove some tooth structure to flatten the edge or the dentist could add some composite to flatten the edge. The dentist could also do a porcelain veneer to change the size and shape of the tooth. You could also leave the rounded edge of its appearance doesn't bother you.
The most widely used textbook for Ortho is Contemporary Orthodontics by Profitt. Excellent book. It’s not even close to a replacement for attending an orthodontic residency program after dental school, though, so please keep that in mind when deciding if you’re going to start doing Ortho cases in your dental practice. It’s very easy to get in over your head if you’re not extremely careful. 👍
