so before we begin I want to make sure that you know how to get ahold of me how
to ask questions after this show please do go to my website straight smile
solutions comment want to show you a couple of new features that are on there
that maybe you didn't know about if you go to the homepage and this is this I'm
gonna start with number one if you see number one up there there is a button
for a free 20 minute consultation now we're not gonna be going over in any
cases in that um we're just going to be talking about your practice how we can
optimize it finding ways to be more efficient just talking about different
orthodontic systems you can utilize that 20 minute consultation however you want
for every dentist in the world I know that's a big big stretch and dental labs
to a free 20 minute consultation just jump on there and you can schedule it's
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little as like one session we can go over like one case or you can have an
unlimited subscription listen if you're just doing like one case every three
months it pretty much covers it but we help you with depending on your level of
service pretty much everything that you need help on so you probably don't know
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definitely sign up today we do take only a limited amount of concierge doctors at
a time not gonna tell you how many I do have a few other or that do work with me
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concierge provider um but it is limited so um I would highly recommend that you
start there I do visit our FAQ session if you have any questions okay number
three bottom left a little camera this is called smile snap so smile Snap is a
virtual consultation tool listen I'm not saying patients but they were super cool
and they let me use it for a few months and you guys can play with it so I
installed it it was so easy the code just drops right in sold it on my
computer you can go ahead and play with it you can change the verbage so I was
kind of using it um if you guys want to communicate with me about a case but you
can use it in your own way so you should totally check it out for
now feel free to play with it and just do whatever and then on the other end
there's a dashboard so um theoretically I could probably show it to you if you
want to do a screen share but anyways they'll be glad to do a demo if you want
introduction let me know alright and lastly number four you may not be able
to see that up on the top right there's a portal this is our HIPAA compliant
portal if you are client you'll have access to this every client gets access
to their own HIPAA compliant portal that's how we submit our cases if you
want really fast responsiveness in a couple other ways but there's about
thirty different ways that we can use to communicate so we'll find the right way
for you and we'll go over all the options with you okay and then don't
forget don't forget we are launching our digital education series not only
digital but we have like hands on like destination where you can go someplace
and learn we have hands on you can do it on your own time digital but you will
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orthodontic movements and education this is totally customized for you this is
new we literally launched this officially to last week but you can go
to our website if you want information it's because it's customized the price
points also customize so if you're interested let me know what parts you're
interested in and I'll go ahead and send you that information they here with
straight smile solutions straight smile solutions comm don't forget to go to our
website check out all other other blogs and vlogs and go to our YouTube site and
subscribe as well but today we're gonna be talking about post ear open bites and
aligners what to do how to prevent them from happening will give you a bunch of
options for correcting this some are free some will cost some money but yeah
let's just dig into it and I just want to let you know that this is like first
of all don't freak out if you see this happening on a patient this just happens
it's just part of aligners it's just one of those things that at the end could be
a little bit tedious but it shouldn't be anything you're stressing out about and
neither should your patient so just be prepared for it when it happens so this
is kind of a very exaggerated example of a posterior overbite it may not be like
that it might be here it might be here you know it might be very subtle it
might be bilateral it might be unilateral so just be prepared
my suggestion just to kind of document it is to go ahead and get that
articulating paper I like the horseshoe-shaped one but go ahead mark
all around if you're not already utilizing intraoral and just general
dental photography to capture progress on your aligner patients you should be
and of course dental monitoring is one of my favorite systems it's already
streamlined it's already in there for you it's a no-brainer another great idea
I like to partner up with dental photography made easy my friend Bill
Moore he's fantastic and going to set up the systems for you but it's an amazing
risk management tool hey if you're not already attending we are having a great
symposium and online webinar it's free it's going to be on Friday April the 5th
so stay tuned or connect with me if you want to get invited mr. Mohr and I will
be presenting this anyways I digress let's get back to how to fix these
posterior open mites so mark it with articulating paper all over make sure
you get the X curse extrusive movements as well all the different right left
front back kind of movements make sure there's no see OCR shift and then take
pictures of the occlusion both upper and lower you should be doing this every
appointment if you have some concerns about the bite and then capturing it and
documenting it and archiving it beyond that let's go ahead and talk about the
first of my three suggestions sure there might be four suggestions for fixing
this but we'll see what comes out of this presentation so number one is going
to be okay let's make it easy let's go ahead and just get rid of those aligners
take the buttons off you know or attachments or whatever you're doing
tell the patient they're done and let's make some wraparound holly retainers now
this is not the perfect example of actually what a wraparound holly attaint
retainer I would recommend this is a stock image I need to probably get you
exactly what I want so and hey my favorite lab I'm gonna give props to
them is the orthodontic lab comm they're super awesome they're in Phoenix Arizona
I'm gonna be visiting them in March but anyways that's my buddy you can contact
them at the orthodontic lab at gmail.com but just a little shout out to them for
always giving me cool demos when I ask form for my videos but yes
ask them for quote and I'm gonna write this down at the top you can just copy
it on your prescription okay so it should be
please fabricate upper and lower wrap around Holley retainers with no occlusal
wires Inter occlusal wires over the occlusion whatever you want to call it
so see here how there's these little wires that are right here and here here
in here there's four of them you don't want those all you want is this okay
now you're a lab person might be like well you can't do that well yes you can
cuz I actually I have a retainer myself that's like that and I've had it for
twenty years almost a long time if it's just fine never got bent and I never
ever had to adjust it but the key is you really need to have a super accurate
impression this can't be no like junky alginate impression we really like to
have a scan because it really needs to be scalloped and you have very thick
wire I don't know the gauge of the wire but it needs to be extremely stable wire
and nowadays they do so much cool things with these retainers and hey if you're
from a lab and you're doing cool things with retainers like with Holly's that
aren't like traditional Holly's and I've seen ones with clear bows and cast bows
and 3d printed bows I want samples send them to me in message me email me info
at the straight smile solutions com info at street smile solutions comm and I
will get a little video going about your appliance but anyways yes fabricate
these upper and lower Holly's patient is to wear them 24/7 yes that means they
went from aligners to wearing Holly retainers 24/7 for at least three months
at least three months so if they're not committed to wearing these 24/7 and I'm
guessing if there are liner patients they like clear you need to make it very
clear if they do not wear them 24/7 not only is their bite not gonna fix ideally
but their teeth are gonna move so you're gonna need to have some type of major
compliance contract if you're going to do this but it does work if you do it it
does work it does work it just takes time have the co memory come in every
maybe four to six weeks document with articulating paper a little bit more the
bite settling could even take up to six months to
settle so they're going to wear these until every single tooth is touching
ideally in a balanced way and then you can move them into traditional Essex
retainers alright so that was suggested number one the wraparound Hawley
retainer no inter occlusal guide wires all right suggestion number two is going
to be actually I'm gonna do this one first so let me let me go to slide
number seven this is suggestion number two which is going to be and thank you
so much to TP orthodontics again another shout out to them because they sent me a
huge box of samples and I love it when people send me samples they are so nice
and I'm so excited by the way if you're going to Chicago med winter be sure to
connect with them I don't think they have a booth but they're gonna be there
so they're based in Indiana but anyways they actually have a solution for this
already it's called the pre finisher this is a semi custom positioner system
it comes in all kinds of different sizes and all you have to do it's not look at
that all you have to do is measure yourself there's a little ruler measure
the size of the teeth and you can actually keep these in stock I don't
have a price point exactly on them so I think you can buy them in bulk they do
all sorts of cool things but yes you can just go ahead and dispense this pre
finisher to your patient they bite around it on it for a few
weeks I would wear it 24/7 but I know it's probably not gonna happen so why
don't you wear it like 16 hours maybe not at work you have to actively bite on
it though that's the key okay again do the same thing we call the patient every
four to six weeks check it with articulating paper until they fully
settled and once they've fully settled hold them there for at least two to
three weeks and then you can make their essex retainers yay and this is what it
looks like up close it's basically just a semi custom positioner so make custom
means and yes this is a class to medical grade device so semi custom just means
that it's already in stock so you can stock various sizes you don't have to
wait if you want a custom position there are tons of lab to make that to that's
going to involve upper and lower impression possible face bow mounting it
it's probably gonna cost a little bit more but yes that's option number two
the positioner and is the tipi orthodontics one okay we're
jumping all over the place let's go to option number three so this is kind of a
very crude example of a post ear open bite this is not a very severe one but
this is probably commonly what you're gonna see so number three is gonna be
take the last aligners or whatever aligners they're in and trim them to
still to the 3s just to the canines so just gonna have anterior alignment and
then you can go ahead and place buttons on the posterior teeth one two three
four five six at least every posterior tooth should get a button so it means
premolars and molars bilaterally so put those buttons on you can get them
unclear or mad all the patients probably gonna want you to have clear and then
like hear them and then you're gonna go ahead and dispense elastics okay you
don't need to probably stock a variety of sizes of elastics I'd get one eight
medium and heavy I'd get 3/16 medium heavy and I get one quarter medium heavy
that's six different types I would always keep in stop and then you'll need
to go ahead and have them run elastics in triangular patterns overlapping
triangles it doesn't matter if they're upside-down how you do it bilaterally
there should be probably about three elastics on each side they need to wear
those 24/7 along with their aligners on their front teeth and for a couple weeks
they can come back I would say every week to ten days come back this happens
pretty aggressively and once you get them stabilized and you have a good bite
again retain it at night for at least two to three weeks and then you can put
them in their essex retainers and that's my three solutions for you for closing a
posterior open bite any questions please please go to straight smile solutions
comm ping me or info at straight smile solutions comm don't forget to like us
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