- 17 Gerard St, Cremorne, Sydney, NSW, 2090
- I Mon to Fri: 8:00AM-6:00PM Sat: 8:00AM-12:00PM
AVOIDING EXTRATIONS IN ADULTS FOR TOOTH ALIGNMENT AND LEVELLING
Chief concerns: improving the aesthetic apperance of her smile:
Severe upper and lower crowding was a concern for Ms L. Main concern was: crowding severe maxillary/mandibular crowding. In the past, this patient was advised extraction of all four premolar teeth (this was not an option for the patient preferring different less invasive approach.
Our Aim: to improve the aesthetics: arch shape, teeth alignment and levelling. Provide optimal lip and facial support using minimal intervention.
We agreed to consider the best option: maxillary (upper jaw) arch expansion in combination with PAOO, TAD to create adequate space to level and align the teeth in both arches.
Therefore, I would like to set out the treatment I feel appropriate in this case.
We agreed to consider the best option: maxillary (upper jaw) arch expansion in combination with PAOO, TAD to create adequate space to level and align the teeth in both arches.
Therefore, I would like to set out the treatment I feel appropriate in this case.
This study will show;
11 May 2017
Crowded lower arch with spacing & wear. Note the blocked out upper left lateral incisor and lower right lateral incisor. The uneven gum levels and discrepancy between the dental and facial midline is quite obvious
Treatment Plan.
Levelling and alignment with an orthodontic treatment. The primary aim is to correct the dental/facial midline, create space using small interproximal refinementsr canines for retracting canines and anterior crossbite 22/33 using TADs ( temporary anchorage device-miniimplant to be removed once the orthodontic treatment is completed).
The treatment will involve placement of clear orthodontic brackets, followed by forthnightly adjustment.
To “speed up the orthodontic treatment, the procedure is PAOO: Periodontally Accelerated Osteogenic Orthodontics is advised, which involved selective incisions on the bone between the teeth being moved orthodontically (selective alveolar decortications).
This concept is well tested. It improves the speed and result of orthodontic levelling and alignment.
Treatment time less than one year but usually in severe crowding we need up to 18 months
When orthodontic treatment is complete we place permanent retention wire on the palatal aspect of upper front teeth as well as back of the lower front teeth, since we have better control with fixed compared to wearing removable retainers. Latest research suggests that retention should be as long as possible.
17 Gerard St, Cremorne, Sydney, NSW, 2090
Mon to Fri: 8:00AM-6:00PM
Sat: 8:00AM-12:00PM
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