New Posts
Hi I’m new to this site and this is my first post. In 48 hours I will be getting my upper and lower fixed metal braces fitted again. It’s a long story but I recently got my money back for my first treatment. Looking forward to wearing braces again but I’m also very anxious about what other people will say. I think I will enjoy it more 2nd time round and I have already ordered some other items to have some fun with. I wanted to get molar bands in the hope that they had headgear tubes but the Ortho didn’t want to put bands. I will try face masks and j hooks and might need some advice or suggestions to try some other things. I will go for silver ligatures on the first fitting but might get a bit more adventurous at the first adjustment.
Hallo Leinad! Ich bin von meinem betont biologisch arbeitenden KfO vom Akti auf den Bionator umgestellt worden. Gut 1 Jahr her, wollte ich erst nicht, aber war goldrichtig. Im Juni auf mein Bitten noch mal einen Labo für unten angebaut.
Seitdem geht es mir so gut wie ewig nicht mehr. Jetzt ist das perfekt. Mein Bio und ich sind kaum noch zu trennen. Sogar meine Frau findet das toll. ;-)
Wie sind Deine Erfolge?
>>>Habt ihr Tipps, was man alles benötigt für die lose Spange??<<<
Besorge Dir aus dem Internet ein paar Spangendosen (die coolen), ein paar Reinigungsdosen (coole) und Kukis-Zahnspangenreiniger. Alles *nicht* aus der Seniorenabteilung substituieren. Wir sind eben *immer noch* Generation Zahnspange, nicht Generation Haftpulver. Kukis kosten im Netz bei guter Abnahme die Hälfte.
Was braucht man noch? MUT. ;-)
VG!
Seitdem geht es mir so gut wie ewig nicht mehr. Jetzt ist das perfekt. Mein Bio und ich sind kaum noch zu trennen. Sogar meine Frau findet das toll. ;-)
Wie sind Deine Erfolge?
>>>Habt ihr Tipps, was man alles benötigt für die lose Spange??<<<
Besorge Dir aus dem Internet ein paar Spangendosen (die coolen), ein paar Reinigungsdosen (coole) und Kukis-Zahnspangenreiniger. Alles *nicht* aus der Seniorenabteilung substituieren. Wir sind eben *immer noch* Generation Zahnspange, nicht Generation Haftpulver. Kukis kosten im Netz bei guter Abnahme die Hälfte.
Was braucht man noch? MUT. ;-)
VG!
TrainTrack said:
At my consultation, they said it was the “most efficient” way to get the movement we want, and didn’t really go into detail beyond that.
From what I’ve looked up online, the results the Carriere gets isn’t really much different different than elastics with braces. There are some small differences, but I didn’t fully understand what I read of those differences. I did find something that said that the Carriere tends to correct class 2 to class 1 more quickly than elastics with braces, but then the time in braces after the Carriere makes total treatment take a little bit longer (less time just in braces after having the Carriere, but Carriere + braces is longer than treatment that is braces and elastics).
From what I’ve seen online, it seems like the protocol for the Carriere uses higher-force elastics than normally used for class 2 elastics with braces. I don’t know know if that’s because the Carriere is marketed around taking less time than braces and they want to back that up and so they use stronger elastics than ideal, or if it’s because the archwire for full braces isn’t stiff enough when using those strength elastics but they’re still safe/healthy/etc to use. I’ve seen comments from an ortho on the braces subreddit whose against the Carriere because he says the forces of the elastics are too high. That’s just one opinion, though, and I’m reassured by the fact that the best orthodontist in my city uses the Carriere on some patients. (I haven’t worked up to those strongest elastics yet; I’m curious how they’ll feel.)
From my personal experience with braces and the Carriere, hygiene is easier with the Carriere than with braces, so the shorter time in full braces should be advantageous for the health of the patient’s teeth. The marketing for the Carriere doesn’t touch on that, but fewer things glued to fewer teeth will be good for preventing cavities and such. The marketing more plays up the angle that you can correct the bite “before braces”. Which I feel like is a half-truth. People will be able to see it and the elastics (if it’s bonded to the canines), but it will be a lot more discreet than brackets across all your front teeth.
So sorta faster than just braces, but not depending on how you measure. More discreet than full braces. And from what I can tell more hygienic than full braces.
TrainTrack
Platinum Member
One question about the Carriere. How is it different from regular elastics connected to brackets? It seems the same to me, and as you said, it isn’t the most widespread used appliance.
A few notes after a week of the Carriere:
The upper bars of the Carriere are really comfortable themselves. They are really smooth, and cause no irritation at all.
The LLHA doesn't cause any lisp, and it didn't take too long to get pretty used to. Sometimes I can kinda forget it's there and not notice it. However, food gets stuck between it and my teeth really easily, and it's really hard to get it out sometimes.
I can already see small gaps that have opened up in front of my upper canines. They are only about the width of a sheet of paper, but it makes me curious to see how big it gets by my next appointment, and by the time I get the Carriere removed (if my upper incisors don't move at all, which I would guess they will some, the gap on the right will have to get to be as wide as half a tooth in order for that side to get to a class 1 bite).
Also, this is from a few weeks back but forgot to mention it and it's kind of funny. This is about when I got the brackets removed from my canines and first premolars (the week before I got the Carriere), and so I just had the four brackets on my upper incisors and nothing else. Later that night, my wife said that when I got home she could tell something looked different but wasn't sure what. She did recall that I was supposed to get more stuff added at some point, so she just figured the top braces were added. Yeah, she tends not to notice small details. And, I suppose, it's verification that she doesn't secretly have any sort of interest in braces (though I was basically already 99.99% sure of that.)
The upper bars of the Carriere are really comfortable themselves. They are really smooth, and cause no irritation at all.
The LLHA doesn't cause any lisp, and it didn't take too long to get pretty used to. Sometimes I can kinda forget it's there and not notice it. However, food gets stuck between it and my teeth really easily, and it's really hard to get it out sometimes.
I can already see small gaps that have opened up in front of my upper canines. They are only about the width of a sheet of paper, but it makes me curious to see how big it gets by my next appointment, and by the time I get the Carriere removed (if my upper incisors don't move at all, which I would guess they will some, the gap on the right will have to get to be as wide as half a tooth in order for that side to get to a class 1 bite).
Also, this is from a few weeks back but forgot to mention it and it's kind of funny. This is about when I got the brackets removed from my canines and first premolars (the week before I got the Carriere), and so I just had the four brackets on my upper incisors and nothing else. Later that night, my wife said that when I got home she could tell something looked different but wasn't sure what. She did recall that I was supposed to get more stuff added at some point, so she just figured the top braces were added. Yeah, she tends not to notice small details. And, I suppose, it's verification that she doesn't secretly have any sort of interest in braces (though I was basically already 99.99% sure of that.)
I have the Carriere and lower lingual holding arch (LLHA)! I had the appointment to have it placed this past week.
At the appointment, they first started with placing the LLHA. The assistant had a hard time getting the bands to fit on my molars, despite having test-fit them the week before. She said the issue was that the lab used a lot of solder attaching the arch, and that made them not fit easily (maybe the bands needed to flex a little to fit, and the solder was preventing that?). Eventually she got it seated enough, though I don't think quite as far down on the teeth as when they were test-fit. The assistant ground down some of the metal a little because my upper molars were hitting it. I could tell that the hooks on the molar bands would irritate my cheeks easily, so the assistant bent them inwards a little bit, but I don't know if it made a difference.
The assistant then prepped my upper canines and first molars, and then the orthodontist came over to bond the bars of the Carriere to those teeth.. This was pretty simple and straightforward (they had already measured what size they needed the week before). Then the assistant had me watch her place an elastic on one side and place the other myself (hooked from the lower first molar (hook on molar band) to the upper canine (hook on front of Carriere bar) on each side. I am to wear Ormco "Zebra" (5/16' 4.5oz) elastics for the first two weeks, and then Carriere Force 1 (1/4" 6oz) elastics after that (at least until my next appointment; there are also Force 2 elastics, which are 3/16" 8oz, and I suspect I'll have to wear those on the right side at some point, as the other ortho I got a consult from even said that as part of his treatment plan).
They left the brackets on my upper incisors and the wire that runs through them alone.
After the appointment, it felt like there was so much in my mouth compared to right before. I had one of those "What did I get myself into?" moments.
The LLHA is higher up and further away from my teeth than I expected, so my tongue is constantly hitting it while talking. Luckily, it doesn't seem to give me a lisp in spite of this. Food gets stuck between it and my teeth fairly easily. When the elastics are on, the hooks don't bother me, but when I take them off the molar band hooks poke my cheeks while eating. Unfortunately, wax on them doesn't work great while eating since those are the teeth I'm chewing with, so the wax gets knocked off almost immediately. I'm just doing without using any wax on them. I don't think it's visible when I talk.
The bars of the Carriere have been really comfortable. They are very smoothed, and the hook on the front is very low-profile. Food does get stuck between them and my teeth. They kind of help make it look like I have braces across all my upper teeth.
The elastics aren't too difficult to put on, but it takes a little practice to do easily without a mirror. I was told by the assistant at the appointment to change them twice a day (morning and bedtime), but the info sheet said four times a day (after each meal and bedtime), which is also what I was told at my consultation. I emailed them after a couple days to check which is correct, and it's four times a day. When I take the elastics off, it almost feels like there is a slight force on my teeth in the opposite direction that the elastic pulls. After just a couple days, I can tell when flossing between my canines and lateral incisors that there's already been a very small amount of movement.
I didn't have any soreness for the first several hours after the appointment. Even with taking Tylenol, though, my teeth were pretty sore the next day and somewhat into the day after that. There's been more soreness on the left side than the right (I find this a little interesting, because the left side doesn't have to move as much to reach class 1).
It's nice having something going on that is going to produce more significant results. And, in a way, it's nice having a more in my mouth and stuff both on top and bottom. Makes the braces feel more complete and full.
Here's a photo from the front where you can see the Carriere and the elastics:
https://www.flickr.com/gp/189082961@N04/ip936a1r56
And here's a photo of the LLHA (and elastics):
https://www.flickr.com/gp/189082961@N04/0329ZFk0u0
Feel free to ask me any questions about the appliances! I may have left something out, and I know the Carriere is not as common as some appliances. I'll probably take a photo where one of the bars of the Carriere is more fully visible later.
I suspect my next appointment in several weeks will just be the ortho checking my progress and potentially changing what size/strength elastics I'm wearing.
At the appointment, they first started with placing the LLHA. The assistant had a hard time getting the bands to fit on my molars, despite having test-fit them the week before. She said the issue was that the lab used a lot of solder attaching the arch, and that made them not fit easily (maybe the bands needed to flex a little to fit, and the solder was preventing that?). Eventually she got it seated enough, though I don't think quite as far down on the teeth as when they were test-fit. The assistant ground down some of the metal a little because my upper molars were hitting it. I could tell that the hooks on the molar bands would irritate my cheeks easily, so the assistant bent them inwards a little bit, but I don't know if it made a difference.
The assistant then prepped my upper canines and first molars, and then the orthodontist came over to bond the bars of the Carriere to those teeth.. This was pretty simple and straightforward (they had already measured what size they needed the week before). Then the assistant had me watch her place an elastic on one side and place the other myself (hooked from the lower first molar (hook on molar band) to the upper canine (hook on front of Carriere bar) on each side. I am to wear Ormco "Zebra" (5/16' 4.5oz) elastics for the first two weeks, and then Carriere Force 1 (1/4" 6oz) elastics after that (at least until my next appointment; there are also Force 2 elastics, which are 3/16" 8oz, and I suspect I'll have to wear those on the right side at some point, as the other ortho I got a consult from even said that as part of his treatment plan).
They left the brackets on my upper incisors and the wire that runs through them alone.
After the appointment, it felt like there was so much in my mouth compared to right before. I had one of those "What did I get myself into?" moments.
The LLHA is higher up and further away from my teeth than I expected, so my tongue is constantly hitting it while talking. Luckily, it doesn't seem to give me a lisp in spite of this. Food gets stuck between it and my teeth fairly easily. When the elastics are on, the hooks don't bother me, but when I take them off the molar band hooks poke my cheeks while eating. Unfortunately, wax on them doesn't work great while eating since those are the teeth I'm chewing with, so the wax gets knocked off almost immediately. I'm just doing without using any wax on them. I don't think it's visible when I talk.
The bars of the Carriere have been really comfortable. They are very smoothed, and the hook on the front is very low-profile. Food does get stuck between them and my teeth. They kind of help make it look like I have braces across all my upper teeth.
The elastics aren't too difficult to put on, but it takes a little practice to do easily without a mirror. I was told by the assistant at the appointment to change them twice a day (morning and bedtime), but the info sheet said four times a day (after each meal and bedtime), which is also what I was told at my consultation. I emailed them after a couple days to check which is correct, and it's four times a day. When I take the elastics off, it almost feels like there is a slight force on my teeth in the opposite direction that the elastic pulls. After just a couple days, I can tell when flossing between my canines and lateral incisors that there's already been a very small amount of movement.
I didn't have any soreness for the first several hours after the appointment. Even with taking Tylenol, though, my teeth were pretty sore the next day and somewhat into the day after that. There's been more soreness on the left side than the right (I find this a little interesting, because the left side doesn't have to move as much to reach class 1).
It's nice having something going on that is going to produce more significant results. And, in a way, it's nice having a more in my mouth and stuff both on top and bottom. Makes the braces feel more complete and full.
Here's a photo from the front where you can see the Carriere and the elastics:
https://www.flickr.com/gp/189082961@N04/ip936a1r56
And here's a photo of the LLHA (and elastics):
https://www.flickr.com/gp/189082961@N04/0329ZFk0u0
Feel free to ask me any questions about the appliances! I may have left something out, and I know the Carriere is not as common as some appliances. I'll probably take a photo where one of the bars of the Carriere is more fully visible later.
I suspect my next appointment in several weeks will just be the ortho checking my progress and potentially changing what size/strength elastics I'm wearing.
joerider
Gold Member
Hallo wieder einmal.
Heute war wieder ein Kontrolltermin. Derzeit ist der Doc etwas unschlüssig, wie er weitermachen soll. Einerseits müssen die Schneidezähne ohne Rotation weiter nach hinten geschoben werden, andererseits passt die Verzahnung oben hinten noch nicht. Um das festzustellen haben wir diesmal Röntgenbilder gemacht.
Diesmal hat er Bedenken gehabt, dass die unteren Weisheitszähne nach vorne schieben und später wieder alles verschieben können. Nach derzeitigem Stand möchte ich diese jedoch nicht verlieren. Er hat sie leicht angeschliffen, um zu sehen, ob sie wirklich wandern... Ich hoffe es bleibt alles wie es ist.
Die Verblockung wurde entfernt, ich muss wieder Gummis tragen. Diesmal von unten 3 nach oben 6 oder 7, je nachdem, ob es zu stark schmerzt.
Der Termin dauerte knapp 30 Minuten, der nächste wird in 8 Wochen stattfinden.
Bis dann oder früher
Joe
Heute war wieder ein Kontrolltermin. Derzeit ist der Doc etwas unschlüssig, wie er weitermachen soll. Einerseits müssen die Schneidezähne ohne Rotation weiter nach hinten geschoben werden, andererseits passt die Verzahnung oben hinten noch nicht. Um das festzustellen haben wir diesmal Röntgenbilder gemacht.
Diesmal hat er Bedenken gehabt, dass die unteren Weisheitszähne nach vorne schieben und später wieder alles verschieben können. Nach derzeitigem Stand möchte ich diese jedoch nicht verlieren. Er hat sie leicht angeschliffen, um zu sehen, ob sie wirklich wandern... Ich hoffe es bleibt alles wie es ist.
Die Verblockung wurde entfernt, ich muss wieder Gummis tragen. Diesmal von unten 3 nach oben 6 oder 7, je nachdem, ob es zu stark schmerzt.
Der Termin dauerte knapp 30 Minuten, der nächste wird in 8 Wochen stattfinden.
Bis dann oder früher
Joe
Here's a picture of my spacers:
https://www.flickr.com/gp/189082961@N04/71Z99GFC9i
They weren’t as bad as I remember having as a kid as far as soreness goes, but maybe that’s just because I was good about taking Tylenol for the first two days after this time?
At the beginning of this week, I had the ortho appointment to get the impression for the lower lingual holding arch (LLHA).
First thing they did, actually, is remove the brackets from my upper canines and first premolars. My guess as to why they did it at that appointment and not the appointment where the Carriere is placed is just to not take up that time at that appointment. Brackets popped off easily, but the grinding off the glue was even worse than when they replaced my front four brackets, despite the teeth not being as sore this time. They then just trimmed the existing archwire to fit just the front four teeth. I chose teal for the ligatures behind the wire.
After that, the assistant test-fit some bands on my lower first molars. Once a band was seated on each of those molars, she took an impression of my lower teeth. This will be used for a lab to make the LLHA that I'll be getting next week (it will be anchorage for the Carriere). They use digital iTero scans for records and creating retainers, but use impressions for these kinds of lab-made appliances because they are more accurate, I guess. My ortho's office has a whole list of flavors for this, where it seems like the assistant adds some drops of flavoring to the impression material as it's being mixed. I chose chocolate, but it was so slight I could barely notice it, and it was that fake chocolate flavor/smell that Tootsie Rolls have. The assistant let be rinse out my mouth really quick after the impression, to rinse out any bits of impression material left behind. I got to see the bands on my molars (but didn't think at the time to take a quick picture), and and it was a little weird seeing bands on my molars again (I had molar bands on all of my first molars when I had braces the first time). I could also tell that the part on the cheek-side of the bands that has the hook will irritate my cheeks, and I'll probably need to use wax for a while once I actually have the bands on.
The assistant then removed the bands and put spacers back in, and I was on my way.
The archwire didn’t get quite centered in the same place as before, so my front teeth were fairly sore for the first couple days after this appointment. Those teeth also don’t have the canines and premolars anchoring them, so pretty quickly I noticed them starting to tilt back inward (even though my ortho said the wire would keep the torque on them). We’ll see goes much that really matters next week or after.
It has looked weird to me to see just the front four teeth in braces. I’m glad it’ll just be for a week, because it’s a little awkward explaining to someone that I have fewer brackets on now because we’re getting ready for the next step of my treatment (I admit, it’s not intuitive to me).
Here’s a picture of what they look like this week, with the teal ligatures:
https://www.flickr.com/gp/189082961@N04/C7s3H1zp73
My appointment to get the Carriere and LLHA is next week; I will be sure to post about it and post some photos.
https://www.flickr.com/gp/189082961@N04/71Z99GFC9i
They weren’t as bad as I remember having as a kid as far as soreness goes, but maybe that’s just because I was good about taking Tylenol for the first two days after this time?
At the beginning of this week, I had the ortho appointment to get the impression for the lower lingual holding arch (LLHA).
First thing they did, actually, is remove the brackets from my upper canines and first premolars. My guess as to why they did it at that appointment and not the appointment where the Carriere is placed is just to not take up that time at that appointment. Brackets popped off easily, but the grinding off the glue was even worse than when they replaced my front four brackets, despite the teeth not being as sore this time. They then just trimmed the existing archwire to fit just the front four teeth. I chose teal for the ligatures behind the wire.
After that, the assistant test-fit some bands on my lower first molars. Once a band was seated on each of those molars, she took an impression of my lower teeth. This will be used for a lab to make the LLHA that I'll be getting next week (it will be anchorage for the Carriere). They use digital iTero scans for records and creating retainers, but use impressions for these kinds of lab-made appliances because they are more accurate, I guess. My ortho's office has a whole list of flavors for this, where it seems like the assistant adds some drops of flavoring to the impression material as it's being mixed. I chose chocolate, but it was so slight I could barely notice it, and it was that fake chocolate flavor/smell that Tootsie Rolls have. The assistant let be rinse out my mouth really quick after the impression, to rinse out any bits of impression material left behind. I got to see the bands on my molars (but didn't think at the time to take a quick picture), and and it was a little weird seeing bands on my molars again (I had molar bands on all of my first molars when I had braces the first time). I could also tell that the part on the cheek-side of the bands that has the hook will irritate my cheeks, and I'll probably need to use wax for a while once I actually have the bands on.
The assistant then removed the bands and put spacers back in, and I was on my way.
The archwire didn’t get quite centered in the same place as before, so my front teeth were fairly sore for the first couple days after this appointment. Those teeth also don’t have the canines and premolars anchoring them, so pretty quickly I noticed them starting to tilt back inward (even though my ortho said the wire would keep the torque on them). We’ll see goes much that really matters next week or after.
It has looked weird to me to see just the front four teeth in braces. I’m glad it’ll just be for a week, because it’s a little awkward explaining to someone that I have fewer brackets on now because we’re getting ready for the next step of my treatment (I admit, it’s not intuitive to me).
Here’s a picture of what they look like this week, with the teal ligatures:
https://www.flickr.com/gp/189082961@N04/C7s3H1zp73
My appointment to get the Carriere and LLHA is next week; I will be sure to post about it and post some photos.
Long time no update. Since the last update I had two appointments and the next one is to follow on Tuesday.
When we last left off, I spent 7 weeks doing nothing and letting my bite settle. I didn't notice much improvement. Neither did the ortho. There was still just barely contact between my left first molars. She asked me if I'd like to try elastics again, possibly making my tmj act up again. I accepted as I don't really know what other option there would be. Also the pain usually started after 5 weeks, so trying them again for 4 weeks might just be enough.
She gave me a wax marking paper to take home. She said that I can test myself if the bite improved. Once I'm satisfied, I should continue wearing the elastic for about a week for retention but could then stop.
I told the ortho about me wearing the upper plate a few hours every few days, trying to wear it as little as possible, which made my left upper lateral incisor move outwards and back again. She stated that it's not healthy for the tooth to move back and forth all the time.
She suggested that I could wear it during one night, come to her office in the morning and she'll bond a permanent retainer for my upper jaw. However, as I'm not satisfied with the upper incisors yet, especially since the gaps behind the canines opened up again, I rejected.
Over the next four weeks, I tested around with some wear times.
When I use the removable plate during the night, my bite feels off a bit in the morning, which gets better after breakfast.
Wearing the removable plate while actively thinking not to suck negative pressure I don't notice adverse effects.
However, if I didn't concentrate on not sucking, it gets worse again. For example when working from home, just 2 hours affect my bite more than the 8 hours of weartime during the night.
I also tested reducing the time using the elastic. In the end I settled on wearing the elastic 12-14 hours during the day but not during the night. During the night I put in the removable plate.
This seems to resolve the tmj issues, as I didn't notice any tmj pain or problems anymore since switching from full-time wear to just during the day.
My bite not feeling much better during the 7 weeks of settlement may be due to the incisor. Wearing the plate every night moved it further out of the way and my bite in general felt way better.
Unfortunately, after about 3 weeks, I noticed that my premolars started to lose contact. I checked with the wax foil the ortho gave me, which proved it. The contact of the first molars improved distally, but still lacked mesially towards the front.
There was one more complication though: the elastic between the two molars tilted them inward. It even reached a point where contact started to deteriorate.
Thus, I stopped using both the elastics and removable plate a week before the next appointment. Both the molars and premolars got better again, but the incisor moved back. Luckily it didn't affect my bite just yet during the appointment.
That next appointment was 4 weeks after the previous one. The ortho checked the bite and confirmed the same improvements I was seeing. Distally the molars touch well, but mesially it's still lacking just a bit. Also contact between the premolars did suffer a little.
To fix the molar contact mesially, she suggested removing the button on top and the bracket from the lower first molar and replacing them with elastic hooks mesially on the tooth. That ensures the elastic force is focused in the front and should also reduce inward tipping of the molars.
Removing the glue from my upper molar was pretty painful as that tooth is extremely sensitive. The rest was quick and uneventful. She used metal buttons with loops (https://www.gcorthonline.com/wp-content/uploads/2019/02/42-0030-0000.jpg). The upper one is pretty visible when I smile wide, though I don't expect most non-braces-affectionate people to notice.
My lower left wisdom tooth rotated back quite a bit since the wire through the three brackets was removed, which is something we need to tackle again. I'm not sure what she is planning in that regard. Maybe also using elastics as she suggested during one of the first consultations? I guess I'll see when we get there.
I asked the ortho what she thinks about a case study I found where the holding clasps of a retainer resulted in a degradation of bite, so they switched to a modified wraparound hawley (https://moroortodontia.com.br/leitura/wraparound.pdf). I asked her if she thinks something like that might work in my case.
She thought about it a bit before discussing that it could work and we might as well just try it. She said for me it would require the full palate to be covered in acrylic as otherwise I'd have the slightly painful impressions of the plate in my palate again. But before tackling the upper jaw again, she first wants to finish fixing my occlusion.
I mentioned that this might be one of the last possibility to spare me of a fixed upper retainer. She agreed that if we can get such an appliance to work without (or at least with controllable) side-effects, it could be used as retainer.
This means that I'll get another quite hefty removable upper brace some time in the future with some nice pictures
Since that appointment, I stuck with wearing the elastic during the day and the upper brace during nights. So far no major tmj issues, although my right jaw joint is starting to crack a little.
The contact between my left first molars feels pretty much perfect, so the new elastic hooks definitely helped. Apart from that, the incisor is still nagging, and due to wearing the upper brace the contact between the premolars is lacking slightly.
I'll wait and see what the ortho will do on Tuesday and how we're going to proceed.
When we last left off, I spent 7 weeks doing nothing and letting my bite settle. I didn't notice much improvement. Neither did the ortho. There was still just barely contact between my left first molars. She asked me if I'd like to try elastics again, possibly making my tmj act up again. I accepted as I don't really know what other option there would be. Also the pain usually started after 5 weeks, so trying them again for 4 weeks might just be enough.
She gave me a wax marking paper to take home. She said that I can test myself if the bite improved. Once I'm satisfied, I should continue wearing the elastic for about a week for retention but could then stop.
I told the ortho about me wearing the upper plate a few hours every few days, trying to wear it as little as possible, which made my left upper lateral incisor move outwards and back again. She stated that it's not healthy for the tooth to move back and forth all the time.
She suggested that I could wear it during one night, come to her office in the morning and she'll bond a permanent retainer for my upper jaw. However, as I'm not satisfied with the upper incisors yet, especially since the gaps behind the canines opened up again, I rejected.
Over the next four weeks, I tested around with some wear times.
When I use the removable plate during the night, my bite feels off a bit in the morning, which gets better after breakfast.
Wearing the removable plate while actively thinking not to suck negative pressure I don't notice adverse effects.
However, if I didn't concentrate on not sucking, it gets worse again. For example when working from home, just 2 hours affect my bite more than the 8 hours of weartime during the night.
I also tested reducing the time using the elastic. In the end I settled on wearing the elastic 12-14 hours during the day but not during the night. During the night I put in the removable plate.
This seems to resolve the tmj issues, as I didn't notice any tmj pain or problems anymore since switching from full-time wear to just during the day.
My bite not feeling much better during the 7 weeks of settlement may be due to the incisor. Wearing the plate every night moved it further out of the way and my bite in general felt way better.
Unfortunately, after about 3 weeks, I noticed that my premolars started to lose contact. I checked with the wax foil the ortho gave me, which proved it. The contact of the first molars improved distally, but still lacked mesially towards the front.
There was one more complication though: the elastic between the two molars tilted them inward. It even reached a point where contact started to deteriorate.
Thus, I stopped using both the elastics and removable plate a week before the next appointment. Both the molars and premolars got better again, but the incisor moved back. Luckily it didn't affect my bite just yet during the appointment.
That next appointment was 4 weeks after the previous one. The ortho checked the bite and confirmed the same improvements I was seeing. Distally the molars touch well, but mesially it's still lacking just a bit. Also contact between the premolars did suffer a little.
To fix the molar contact mesially, she suggested removing the button on top and the bracket from the lower first molar and replacing them with elastic hooks mesially on the tooth. That ensures the elastic force is focused in the front and should also reduce inward tipping of the molars.
Removing the glue from my upper molar was pretty painful as that tooth is extremely sensitive. The rest was quick and uneventful. She used metal buttons with loops (https://www.gcorthonline.com/wp-content/uploads/2019/02/42-0030-0000.jpg). The upper one is pretty visible when I smile wide, though I don't expect most non-braces-affectionate people to notice.
My lower left wisdom tooth rotated back quite a bit since the wire through the three brackets was removed, which is something we need to tackle again. I'm not sure what she is planning in that regard. Maybe also using elastics as she suggested during one of the first consultations? I guess I'll see when we get there.
I asked the ortho what she thinks about a case study I found where the holding clasps of a retainer resulted in a degradation of bite, so they switched to a modified wraparound hawley (https://moroortodontia.com.br/leitura/wraparound.pdf). I asked her if she thinks something like that might work in my case.
She thought about it a bit before discussing that it could work and we might as well just try it. She said for me it would require the full palate to be covered in acrylic as otherwise I'd have the slightly painful impressions of the plate in my palate again. But before tackling the upper jaw again, she first wants to finish fixing my occlusion.
I mentioned that this might be one of the last possibility to spare me of a fixed upper retainer. She agreed that if we can get such an appliance to work without (or at least with controllable) side-effects, it could be used as retainer.
This means that I'll get another quite hefty removable upper brace some time in the future with some nice pictures
Since that appointment, I stuck with wearing the elastic during the day and the upper brace during nights. So far no major tmj issues, although my right jaw joint is starting to crack a little.
The contact between my left first molars feels pretty much perfect, so the new elastic hooks definitely helped. Apart from that, the incisor is still nagging, and due to wearing the upper brace the contact between the premolars is lacking slightly.
I'll wait and see what the ortho will do on Tuesday and how we're going to proceed.
Thelog
Platinum Member
I'm now pretty set on the hawley style, I didn't like the idea of an essix retainer covering her teeth, though her prescribed essixes are completely invisible
I'm not interested in bulky, mouth-filling active appliances - she had fixed braces for many years and that's what I really like
I've been discussing with the bracesshop stainless steel ligature wires, laced around the brackets - there's a couple of options tk decide between for that
I'm not interested in bulky, mouth-filling active appliances - she had fixed braces for many years and that's what I really like
I've been discussing with the bracesshop stainless steel ligature wires, laced around the brackets - there's a couple of options tk decide between for that