Assessing and treating crowding in the 6 month braces patient

Crowding in orthodontic terms is defined as mild moderate or severe. There are a number of methods of relieving crowding

1)IPR or enamel stripping.

2)Tooth extraction.

3)Arch expansion.

The primary method of relieving crowding for six month braces is enamel stripping. This involves using .2/.3 or .5 mm round discs in the straight handpeice at a high torque and low speed (1000rpm). The discs are passed between parrallel sided anterior teeth. Thin diamond burs are helpful to strip contacts between the posteior premolars and molars and also distal to the canines. In my experience no more than .6 mm gap should be made between the teeth as sensitivity can occur (.3mm stripped from each tooth). Its important that the contact points are brocken and the dentist feels a drop between the teeth otherwise the contact point will impede any relief of crowding.

Tooth extraction is a more traditional method of relieving crowding. To consolidate spaces takes well over 1 year so would suggest referal to an orthodontist in any case that you think needs extraction, apart from a lower incisor extraction in a crowded lower arch or in a mild skeletal 111 pattern. ( more on this later)

Arch development and expansion are the methods employed by self ligating orthodontic brackets that have a non extraction philosophy. The Damon braces system is a favourite of our practice. When combined with IPR it can be a very powerful tool and produces amazing results. Anterior torque in the damon braces system is the only downside.

Next we will go through how to bond your six month braces both directly and indirectly.

Dr Huw Anthony. BDS Cert ortho

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