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Author Topic: My Journey to Removable Braces  (Read 21323 times)

Offline foobar

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Re: My Journey to Removable Braces
« Reply #90 on: 11. September 2022, 19:39:51 PM »
Just looked at pictures of your braces again. They really are epic. How are you getting on with them?

The removable braces I had were all absolutely amazing and I enjoyed every last single bit with them. Unfortunately, I can't wear them anymore. Since I have the lower fixed retainer the bottom plate doesn't fit anymore. And I now have a button on my upper left first molar where the adams clasp of the upper removable plate is located, due to which it doesn't fit…


The ortho said that I could skip the last appointment if I still notice my bite actively settling. However, during the last week before the appointment I didn't notice any further major changes, so I went in.
After a short inspection and wax foil to check the bite, she decided that we should try out the next idea for fixing my bite: elastics. She placed a plastic button on my upper left first molar for elastics to my lower left first molar to close the vertical gap between those teeth of >1mm.
Standard procedure with cleaning, etching, cementing and curing. Etching hurt like hell as my teeth are very acid-sensitive. In fact that tooth is still sensitive to warmth and cold and I'll ask for fluoride varnish during my next appointment.
I was given a pack of 100 light elastics 3/16" (4.8mm) 2 OZ (60 g / cN) and told to wear them 18 hours per day between 26 and 36, switching them out daily.

All of which is to say: I'm now wearing elastics (well, technically just one elastic).

It feels weird. Whenever I put it back on, it feels weird all over again. First, it's as if my teeth are being forced together. After a few minutes, I feel my muscles starting to work against that force. A few more minutes later, I stop noticing the elastic as my muscles are fully compensating the additional force.

The first few days the elastic pinched my cheek and a blood blister developed. I started hanging the elastic twisting it 180°, making it cross in the middle. That helped and soon my check got used to it at which point I was able to put in the elastic normally again.
I didn't have much of a problem with the button. Its edges are a bit rough, but I only notice that when not wearing the elastic.
Especially during the first two weeks, I had an elastic snap pretty much daily on me. It's gotten better now, probably because my tongue plays less with them.
Due to the different force between my left and right muscles, and a slightly shifted lower jaw position, my TMJs are acting up again and are clicking every now and again.

The button and elastic are practically invisible, being so far back, even when I laugh. Though if the plan is to move forward with more elastics to close the gaps between all my premolars as well, the buttons on those will be quite visible even when just talking.

I've been wearing the elastic diligently. The ortho said that if I notice the gap being closed I can stop wearing the elastics. I took that as a good sign that things should be moving quickly. Of course, why would I be that lucky? In the last 5 weeks, the gap only got a little smaller, now being at around 0.9mm. However, I can't feel the teeth actually being extruded. Instead, I think they just tipped lingually which improved contact between them a little. I don't know if that was the plan or if it's just my luck again. Guess I'll find out during the next appointment in two days.
I also notice that my lower jaw is pulled a bit to the left, which affects my bite on the right slightly. Either that, or it's the way my left molars are lining up differently now. My left canines push into each other a bit now, which makes the upper one move out, opening up the gap between my upper canine and first premolar again. There's also more contact between my lower incisors and my upper left lateral incisor.

I can definitely say that the brackets, button and elastic don't have as much an effect on me as the removable braces. Here, it's more of a love-hate-relationship. It's still fun to experience quite a lot of different orthodontic appliances and measures, which most people won't all experience during a single treatment.

Last week was the 1.5 year mark since getting braces, which initially was the predicted latest point at which I should have finished treatment. Instead, we're still dabbling around trying to fix something which wasn't even a problem before beginning treatment. One friend suggested that the treatment might be considered malpractice. Although I don't think that's the case as the complications weren't due to anything the ortho directly or indirectly influenced, that statement started creating some small doubts for me. On the other hand it's not like I'm suffering. Quite contrary, I'm still enjoying every minute of the treatment and don't even want to think about the time where I'll be braces-free.

Offline foobar

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Re: My Journey to Removable Braces
« Reply #91 on: 04. October 2022, 00:52:14 AM »
My next appointment is tomorrow, so it's time to give an update an update about the last one.

Last appointment was uneventful. While I didn't notice much progress, the ortho was satisfied. The gap between my left first molars closed down significantly such that she couldn't see through them anymore. However, while the gap is closed distally, mesially it's still there. As I only tested the size of the gap using different gauge wires mesially, I didn't realize the progress distally.
She noted down all the complications I experienced and said that we'll tackle those later.
For now she wanted me to continue wearing the elastic to close the mesial space. If it closes before the next appointment, I can try not wearing the elastic for a few days to see if the result is stable.

Unfortunately, not much happened. The mesial gap was about 0.9mm and went down to about 0.8mm over 2.5 weeks. Three days ago I noticed that my bite was starting to become very off and I wasn't able to bite properly on the right side anymore. So I stopped wearing the elastic. The gap has now opened back up to 0.9mm. However, My jaw pain and clicking decreased significantly since I stopped wearing the elastic.

Let's see what tomorrow brings. I won't be surprised if a few more brackets are added.

Offline bracessd

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Re: My Journey to Removable Braces
« Reply #92 on: 04. October 2022, 17:19:41 PM »
Tanks for the update. Will you post post new pics?

Offline foobar

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Re: My Journey to Removable Braces
« Reply #93 on: 19. November 2022, 12:36:31 PM »
Last appointment the ortho checked my bite again with wax foil. She was happy, stating that my bite is improving. She said that where I'm testing the size of the gap, I'm testing a horizontal gap where two crowns meet, not any vertical gap. Folding the tape and testing my bite again, she concluded that there's less than 0.08mm of a gap left vertically.
She decided to let everything settle again for seven weeks and continue from there.

My left upper lateral incisor moved back and started to interfere with my bite. The ortho modified the upper plate to push it out. To reduce the effects on my bite from the no longer well fitting plate, she shortened it. Then she spent half an hour trying to adjust the clasps so that it only exerts pressure to the to-be-moved incisor. In the end it still didn't fit well. Wearing it, my bite still feels off afterwards. I shall wear it as little as possible, only as much as needed so that the incisor isn't blocking my bite. Which for me equated to one to two hours every few days.

Even without wearing any elastics or removable braces, my TMJ acted up again a few weeks ago. For a few days I couldn't even chewing properly because it hurt so much. Since then everything was fine and I didn't experience any further problems.

Next appointment will be on Thursday. I don't even know what to expect. I don't think my bite improved much, it definitely doesn't feel stable.


Will you post new pics?
There isn't really much new to show, apart from maybe the shortened upper plate.

https://dereferer.me/?https://cdn.discordapp.com/attachments/863502137362743399/1043457867858071642/1.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/863502137362743399/1043457868352983040/2.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/863502137362743399/1043457868785000488/3.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/863502137362743399/1043457869263163402/4.jpg

Offline bracessd

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Re: My Journey to Removable Braces
« Reply #94 on: 21. November 2022, 18:05:53 PM »
@foobar Right on!

Offline foobar

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Re: My Journey to Removable Braces
« Reply #95 on: 23. January 2023, 01:40:06 AM »
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://dereferer.me/?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://dereferer.me/?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.

Offline bracessd

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Re: My Journey to Removable Braces
« Reply #96 on: 23. January 2023, 18:13:38 PM »
Thanks for the update! Looking forward to seeing some progress pics...