After just 4 weeks of brackets, I'm already on a rectangular wire.

During my last appointment three weeks ago my round wire was replaced with a rectangular one. The ortho said that it's way easier to insert than two weeks earlier where she struggled a bit. She was satisfied with how my molars are moving even though I still don't have better contact as the bite seems to be closing little by little.

When checking the rest of my mouth, she said that she wants to strip away a bit more from my bottom incisors. I said that a space has started to open up behind my lower left canine as my lower incisors are starting to crowd again. She looked at it and I had the feeling that she isn't fully convinced if that's enough space, but decided not to perform IPR at that time. Since then, a small space also started to open up behind my lower right canine. I guess with the plan of first fixing the bite, then the bottom incisors, then the top incisors, we can pretty much start back at square one with my bottom incisors.

We had a discussion about my top left lateral incisor which is blocking the bite for which I'd been wearing the upper brace partially again. I had been wearing it 6 hours per day before going to bed. While sleeping my bite settled again. However, my incisor also went back rather quickly touching the bottom canine again. Wearing it through the night moves the incisor to be out of the way for most of the day but it takes my bite three hours to settle. She explained that this is all due to my suction which might be a variation on a tongue sucking habit. She's never seen it that strongly in any other patient. She presented several options:
First, she suggested that I could wear the plate during the night and come back the day after at which time she can place a permanent retainer in the top jaw. The teeth are sitting well and could be finished up that way. But I'm not satisfied yet. The spaces between the canines have started to open back up very slightly. I'm also a bit worried that when my bottom incisors are moved back again the contact in the front could be a bit off. Additionally, if possible I'd like the upper left canine to be moved lingually a bit more. This also sparked another discussion surrounding permanent retainers which I'm not too keen on.
The second option is that she could cut away the back part of the upper brace starting from the second premolar. That way the holding clasps wouldn't affect the molars anymore with my suction, only the premolars.
I asked if there was a third option of somehow breaking the tongue sucking habit. She said that usually when she notices such behaviour it's in way younger patients. In these cases she usually suggests trying to become aware of and trying to avoid it in addition to doing some muscle relaxation exercises. But she doesn't have much faith in me succeeding as the habit is very pronounced in my case. I still wanted to try this option. She said that I should try to wear it more during the day, closer to 12 hours or as much as I need for the incisor not to block my canine.

I've tried being more aware of it for two weeks but ultimately failed. Whenever I take out the upper plate after wearing it, my bite feels off. Even after just one hour. I wasn't able to bite properly during any meal as I wore the brace a lot during the day. In the end I decided to wear it during the night again. That way the incisor is under control and my bite settles until lunch such that I can at least properly bite during the rest of the meals.
If the habit results in problems later on (which I wasn't aware of before starting treatment; heck I wasn't even aware that I was doing anything unusual), I'd really like to get rid of it, but I'm not sure how.

The wire turning during every meal solved itself as that's just not possible anymore with the square wire. Funnily enough the wire now started to move forwards a few millimeters while I'm eating. At least that's easily fixed by just pushing it back with a finger instead of requiring tweezers and a mirror.

Tomorrow is my next adjustment and I have no idea what to expect. I'll definitely bring up the retainer topic again to finally reach a solution. I'll state my case that I don't see a need for permanent retainers as I'll wear my removable retainers diligently every single night due to needing a bite-plate anyway. But if she still insists on permanent retainers, I'll give in and at least try them for half a year or so.

Just so you know, I have top and bottom permanent retainers and they're really cool!!!

Not to derail foobar's thread, but out of curiosity why do you think that permanent retainers are cool? I've never been really thrilled about mine, though part of that might be that I was told I'd get it removed and replaced with a removable retainer after a handful of years but that never happened.

One one hand, I'm glad the six teeth it's attached to haven't moved, but on the other hand it did nothing to stop the teeth behind those (bicuspids and molars) from shifting some. If I were to ever get braces again, I'm not sure if I'd want permanent retainers or not.

Last appointment quite a lot happened. Initially the ortho said that she wants to remove the wire from the brackets, letting the molars settle by themselves. She doesn't want to remove the brackets just yet in case they'll be needed again later on.
I said that I feel like my bite is still quite a bit off on the left site. She got marking foil and inspected my bite and contact points. While the second molar uprighted well, the opposite force tilted my first molar a bit. Usually such force is distributed among all other teeth when all teeth have brackets. Due to the tilting, instead of removing the wire, she took it out, added a bend and reinserted it.
She asked how I got along with my top plate. I explained to her that I tried different wear times and finally settled on wearing it through the night for the reasons laid out in my last update. She seemed to be fine with it as an interim solution.

Next came the expected discussion about retainers. After stating my point of view I got the feeling that she hopes that I won't need removable retainers with the fixed retainers considering all the complications I had with my removable braces. When I mentioned that I'll need a bruxism guard anyway, she mentioned a possible compromise of having a fixed retainer in the bottom where people have less problems with it and the bruxism guard in the top jaw. However, so far in my bottom jar during treatment spaces developed between my canines and first premolars, and the first premolars and second premolars. Even if the permanent retainer would include all four premolars (which would be pretty extreme), there's no guarantee that no space between my premolars and molars would open up. I don't think the retainer discussion is finished yet…

Then came the lower plate. As discussed during the previous appointment, we are sticking to the plan of finishing up the bite, then the lower teeth and finally the upper ones. While the bite isn't fully fixed yet, we're getting close enough to start with the lower incisors and canines again. The ortho inserted the lower plate and checked how it fit. Surprisingly the triangle holding clasps didn't interfere with the brackets and wire at all. They fit perfectly in between. But I felt pressure everywhere. She decided to cut away everything going back further than the first molars on both sides. The wisdom teeth derotation springs aren't needed anymore and she feared that the holding clasps between my molars might wreck more havoc than they're worth at this point. After spending quite some time bending the holding clasps, letting me check, and bending again, the lower plate fit well enough. We tried minimizing the pressure from the holding clasps.
To move the canines distally, she applied inwards pressure with the labial bow. She explained that usually it also moves them distally if there's space. If that doesn't work in my case, the plate will need to be modified to add springs similar to the ones in my top plate to move the canines backwards.
I asked how long I should wear the lower plate. Her response was to wear them as long as possible without my bite becoming worse again. Similar to what I did with my top plate I need to figure out how long I can wear it and when I should keep it out to let my bite go back to normal. But 12 hours are needed at minimum to properly move the other teeth. In addition I should continue wearing the top plate as long as needed to keep the lower canine and top lateral incisor from interfering with each other.

And with that, I now have top and bottom removable braces and bottom brackets (albeit "only" 3) all at the same time. Probably a dream treatment for many here.

Already on the day after my appointment the gap between my lower canines and premolars was closed. With the lower left canine back, it stopped interfering with my upper incisor. While having all the braces and plates at the same time is quite an experience, I quickly stopped wearing the upper plate. It isn't necessary for its current purpose anymore but still changes my bite quite a bit.
The lower plate isn't perfect and has similar problems, but not nearly as strongly as the upper brace. When I take out the lower brace, it takes about an hour for my top and bottom premolars to fit together again. I'm wearing it for about 16 hours each day. The 8 hours off seem to be enough to keep the bite stable.
Interestingly, the small gap that reopened behind my upper left canine has closed completely.
Not having an anterior bite plate or posterior bite plane, my joints are aching a bit in the morning as I'm primarily biting down on the holding clasp wires when clenching / grinding. Also every morning I have pretty deep imprints in my cheeks from the brackets.

It's interesting how the mouth adapts to talking with braces. Some months ago when I had the long bottom plate and the thick upper bite plate, after a few weeks I was able to talk with them without too much of a noticeable lisp (although I feel like there'll always be a rest-lisp with a bite-plate). Not having any plate in my mouth for a few weeks completely reset everything that I'd learned about talking with them in. After getting back the top plate two appointments ago I was struggling to pronounce everything correctly again, even though the bite plate was shaved down significantly which should have helped significantly. But again, after a week or so I was able to talk with them in okayly. Now with just the bottom brace I've adapted to speak pretty much perfectly, so much so that even some family doesn't notice. But putting it the top plate again, I can barely be understood. Apparently it only takes few weeks to learn and unlearn everything.

My next appointment will be on Tuesday.

Just so you know, I have top and bottom permanent retainers and they're really cool!!!

That's interesting. What do you like about them? Don't they just interfere with everything? For example doesn't flossing take ages?

I haven't moved away from removable braces. However, for one tooth to be fixed, my lower left wisdom tooth and molars needed brackets as that kind of movement isn't possible with removable braces. I'm still using removable upper and lower braces.

The last appointment wasn't too exciting. The wire was removed from the three brackets to see if the bite improves by itself again. The ortho wants to keep the brackets on for now. To prevent them digging into my cheeks during the night, she suggested to put elastic ligatures on them. They probably won't stay for long, but hopefully my cheeks will get used to the brackets until the. First she tried thick ligatures, but they didn't fit firmly. I was able to push them from the buccal tubes with my tongue. Then she tried thinner ones which did fit and made the brackets less sharp-edged helping quite a bit. Two of the ligatures fell off after 5 days. One is still in place but feels roughened compared to its smoothness directly after the appointment.
She stripped my lower teeth again and adjusted the labial bow and springs of the lower plate to derotate my 32 and 41 and push my 31 inwards.
And that was the whole adjustment.

During the first week I tried wearing the lower plate 12 hours per day as before. I didn't notice any improvements to my bite on the left. I went down to 8h/d for another week with the same results. Then I tried out 16 hours. The bite didn't improve but also didn't get worse. But the longer wear time helped the incisors significantly. Thus I wore the braces for 14-16 hours for the last two weeks.
My left second molars make good contact, but the premolars and first molar don't. For example in that area my teeth don't cut through pizza. On the right side everything is good enough.
I went to the office one day (usually I do home-office) and didn't wear the braces for about 14 continuous hours. I noticed that I clench quite strongly at work. In the evening all of my teeth felt pretty sore, but I did feel like my bite improved a bit. Unfortunately it didn't last when I wore the braces again.
The incisors got better, but don't feel stable. If I don't have the braces in for 8 hours, they are moving back to where they were quite a bit.

Regarding my bite, I'm interesting in what the ortho will recommend during my next appointment tomorrow. Personally I see two options. Add brackets to my lower and upper left molars and premolars and somehow try to close the bite with elastics (which will most likely result in yet some other complications considering how my treatment went so far). Or, fix the lower incisors, then the upper incisors, put in fixed retainers and then tackle the bite again. However, if the upper fixed retainer includes the first premolars to keep the gap between them and the canines from opening up again, this won't work. But as it is, I'm definitely not satisfied with the situation. I'll wait and see what the ortho suggests, but I may need to make up my mind about the possibility of something like that happening.

The situation with my TMJ without the bite plane / bite plate is worsening. I had two times where the joint clicked and hurt for a few minutes. I tried wearing the upper bite plate again during the night, but it doesn't fit well and affects my bite negatively. I'm going to ask the ortho to make it fit for the night again.

All in all I still enjoy the treatment, but am a bit torn. After over a year I had expected to be in the finishing touches phase and not have new problems to tackle every appointment.

A week after the last appointment I went back to the ortho for the gel splint fitting. She ordered an AquaSplint, which doesn't really need much fitting. As such, it took only a few minutes. It had a sharp edge in one place which the ortho smoothened. She explained that I should wear it if I feel the need, but try to use it as little as possible to prevent further premolar intrusion as that's where the gel pads are located.
Afterwards, she checked the lower removable plate and adjusted the labial bow and springs a little. And with that I was on my way for 4 further weeks until my next appointment tomorrow.

I've worn the gel splint three times, each for 1-2 hours either when I woke up with jaw pain, or when I noticed that I clenched while doing stressful work. It helped in both occasions by relaxing my muscles.

Regarding tooth movement, the lower left outer incisor improved a bit, but isn't moved back quite enough yet. At the same time the lower left central incisor moved a bit outwards and the right central incisor moved inwards a bit. I think another round with slight adjustments will be needed. I feel like the lower left wisdom tooth moved back with the wire through the brackets again.

As it would be boring if that was it and there were no further complications, my lower left first molar intruded quite significantly, I'd guess about 1mm. I only noticed a few days ago because food was getting stuck between the elastic hook and my gum as the bracket is now lower, which didn't happen before. Before, it was always stuck between the hook and my tooth with a little more space for me to get it out with my tongue. I remember the ortho already saying that the wires resting on top of both lower first molars may result in some intrusion, but she hoped that won't happen. It also didn't happen when I didn't have the wire through the brackets (though I don't know if that's related).
When I ate some sticky stuff which sticks to the teeth, I noticed that quite a lot was stuck on the occlusal surfaces of my molars and premolars on both sides. As such I think the bite will need some fixing on both sides. Even though the right side feels okay, I think it could be improved quite a bit still. If we're tackling the bite, possibly on both sides, I want to ask the ortho if my wisdom teeth could also be moved into better occlusion. Currently they are on top of each other but with a gap between them, not touching properly. That was even worse before treatment, before the wisdom teeth were derotated and moved inwards more, but if it could be fixed easily, why not do it as well.

With all the side effects for my case I wonder when the ortho will be at wits end and just suggest full metal brackets on all teeth for a few months to finish everything. I hope that won't happen as I really don't want brackets on my social 12 (don't try to convince me otherwise, I have tried to convince myself and failed, that reluctance comes from way further down somewhere).
If I'd guess, I'd say that the ortho may carry out the option of putting buttons on my upper molars / premolars and pull the teeth together with triangle elastics starting from tomorrow already? Maybe she may also put brackets on the lower left premolars and try to pull it back up with a wire that way.

At this point I'm a bit torn. On one hand side, after 15 months of treatment I would have expected to be either finished already or at least in the finishing stages. Instead, every time we think we have a working plan, there is some complication pushing the treatment back a few weeks. On the other hand side, these complications let me experience lots of stuff I wouldn't have otherwise. First the anterior bite plate, then the three brackets, and now buttons and elastics (which I'm pretty sure I'll get at some point or another). Without the complications, I wouldn't have any of those. I'd also most likely already be done…

Let's see what tomorrow holds.

Exciting news that your bottom teeth are now corrected.  I understand that bottom incisors are particularly prone to relapse, so a bonded retainer will be essential.  But a bonded retainer is only likely to be on your front 6 teeth. Perhaps you could ask for a bottom hawley as well in order to keep the whole bottom arch aligned?

If your bite permits, you might also get a bonded retainer on your top 6 front teeth. Again, a hawley in addition would help maintain the whole upper arch and the hawleys in combination should maintain your bite.

This way, whilst you will have lost both your removable braces, you will have something similar in the hawleys on an indefinite basis. And perhaps you might have some input into the design and colour of the hawleys to make them interesting.

 Good luck at your next appointment.

Just looked at pictures of your braces again. They really are epic. How are you getting on with them? You have not posted for a while.