Reconstructive Orthodontics - Troy
Late Better Than Never
The issues of how serious certain types of orthodontic treatment delays can develop into are discussed in a College Student treatment example and also in a Businessman Case History example involving an executive who chose to control his own treatment program.
Because severely maligned or poorly erupted teeth can wreak havoc on our other, healthier teeth by creating lateral or "sideways" forces that further move teeth where they shouldn't be .... the idea of getting treatment sooner rather than later makes sense.
Getting Past the Normal Delays
High school, post secondary technical schools and college life commonly interfere with traditonal orthodontic treatment plans mainly because of the inconvenience many patients associate with long treatment times, (18 - 24 months or more) discomfort and perceived cosmetic effects of wearing braces.
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Management
High Visibility Position |
Treatment plans for a college student catching up on treatment was shown to be quite efficient that didn't require extensive use of restorative products while the "catch up" case for the Businessman involved the creative use of veneer portcelain and other services to treat orthodontic needs that were greater, due chiefly to the longer delay of treatment.
Moderate Treatment Delay
The 30-ish young woman presented here represents an adult orthodontic treatment case where untreated alignment and eruption issues have caused bite changes that exceed what a college student may expect but are not as cumulative or severe as someone who delays treatment even longer, as reflected in the businessman example.
Canine guidance in particular was becoming more disturbed for the patient. Tooth movement was occuring that had the net effect of causing some of her teeth to become even more crowded, resulting in rotations of teeth.
Unusual Symmetrical Teeth Crowding
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Orthodontics and Restorative Dentistry
Procedure Combinations |
Our patient had an expected, but yet still unusal event of having tooth crowding events occur almost simultaneously in the upper and lower anterior areas of the jaw.
Because of the canine guidance problem that was causing lateral forces on opposing teeth, four (4) tooth structures in particular were moving lingually, or toward the inside of the mouth.
The distortion to the patient's natural arch was more severe on the lower jaw. To create an idealized occlusal match for the upper and lower jaws, it was decided to remove a single displaced anterior tooth that enabled Dr. Nazarian to create, for the first time, a normal bite plane for the patient that was symmetrical.
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| Mandible Alignment - Teeth Crowding |
Certain types of tooth movements can be accelerate for some adult patients, depending upon the type of tooth and location within the jaw. Careful attention is focused on maintaining an appropriate rate of movement to assure good root health.
Tooth movements that are too fast are known to make tooth roots resorb to some extent. Unfortunately there are occassional reports of patients requesting the fastest movement possible that creates an outcome where all root structures within a given arch are compromised which can affect overall long term oral health.
Dr. Nazarian's proprietary monitoring of orthodontic movement during a patient's treatment plan assures optimal root and bone tissue health.
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| Occlusal Plane Optimization |
Establishing Canine Guidance
The adjacent pictures show how the lower arch has been modified to create the mandibular component of healthy canine guidance. Gone are the elements that caused years of anterior malocclusion that created the lateral forces that repositioned the patient's lower teeth in a haphazard fashion.
Notice how the patient's lower arch is wider and now has the healthy "U" shape, as opposed to the narrower shape before treatment. The width and contour of the upper and lower arches are modified uniformly throughout treatment to assure the best occlusal outcome.
Upper Arch Realignment
The patient's upper jaw had a stronger "V" shape characteristic, compared to the lower jaw.
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| Maxillary Alignment - Minor Teeth Crowding |
The unusual placement of brackets and wires placed on the patient's upper and lower teeth were done in a fashion to create different types of tooth movement where the arches would be modified differently yet produce the biting surface that would be natural for her teeth.
Although orthodontic treatment was delayed until the patient reached 30 years of age or so, the malocclusion did not cause damage to the enamel surfaces nor, more importantly, to the root structures.
Tooth eruptions were not an issue although a minor amount of eruption was facilitated to correct some uneveness across all biting (or inscisal) surfaces.
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Eliminating V Shape
Central Incisor Contour |
Porcelain restoratives, therefore, were not required to compensate for or to correct differences in tooth shape or height.
The use of tooth colored fillings (composite resins) were used as needed to treat minor cavities.
Final Cosmetics
Tooth whitening products in the form of a home teeth bleaching kit complete with bleaching trays and a specific whitening formulation was self administered by the patient.
Minor polishing was provided to remove residuals of bracket cements as needed.
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Successful Adult Bite Repair
Function and Cosmetic |
Function and Esthetics
Nothing looks better nor functions better than what Mother Nature can usually provide when there aren't any unusual influences. But, for many of us... getting that perfect natural look and feel can take a little extra effort.
Unusual bite issues that affect a vast number of patients can be now be successfully treated at nearly any age. As our happy patient pictured here shows.... getting the "right" ortho treatment later, is better than not getting it at all.
She has a normal bite, great looking natural teeth and a smile that is the broadest ever. The years and years of cumulative malocclusion and bite damage has come to an end.
(See more adult ortho pictures here)
Adult Bite Questions?
Contact Dr. Nazarian at (248) 457-0500 to arrange a consultation for determining whether you would be a good candidate for Rapid Ortho or traditional braces.
Or, you can use our on-line Ask The Troy Dentist form to send any specific questions regarding concepts discussed on this page (or any other concerns) directly to the Dr. Nazarian. He will respond to you directly with the answers you are seeking.
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