hey it's dr amanda with straight smile solutions straightsmilesolutions.com and today we're going
to talk about lace backs under ties tie backs uh what else there's a bunch of synonyms for this
procedure and the why behind it but whatever you want to call this whatever this is
it's a pretty awesome thing to do in orthodontics and there's a lot of power between it so let's
talk about the why and i've made a few other demo videos on this but i did not type it on and
i think people couldn't quite visualize exactly how it works so i actually had a graphic artist
create this for me um because there is like nothing even on google images that shows
really detailed on how to do this so you get the idea here we've got some a molar you might even
want to have a second molar as well you know um premolars or maybe a canine maybe this was
an extraction case and you're just trying to consolidate the case the idea is that you're
trying to create maximum anchorage by pitting four or three really big teeth with lots of roots
against a couple front teeth you know or ideally just canines if you just had canines to retract
and then once you do that once you retract that tooth against these which are all tied together
then you redo the under tie okay including that other tooth and then you do the rest of the teeth
does that make sense almost like beads on on a string one tooth at a time it's like playing
a tug or you know the more people you have on one side the more that side is gonna win and you
won't slip anchorage so let's talk a little bit more about that about how that works in braces
so whoever has the mouth is gonna win so anytime you're using power chain you know everything's
just gonna consolidate kind of smoosh up so if you're power chaining the whole arch you know
and you've got some space in the middle or in the front well the back teeth are going to move
forward and the front teeth are going to move back right but what if you don't want your back teeth
to move forward what if you want them to stay exactly where they are well you could put in
some type of anchorage some people would put in maybe a tpa or a nance or some type of cemented
fixed anchorage you can do that that's fine you could use elastics then you may or may not have
compliance issues that come with that you could do a tad but that's always the very bottom of my list
because first of all who wants that second of all they're painful third of all they might
cost more money um fourth of all there's could be liability numbness risks that's my very very
bottom of my list listen this might be old school but it works really really really well and i find
when you do this and do it right you often don't need pads they're really not necessary people like
them because they're blingy and cool and they feel like they can charge more for treatment
but nine times out of ten when i see a case with tats i'm like i could have done this without tats
just as well so just saying so anytime someone tells you you need tads it may not be necessary
so anyways just an upsell sometimes but i digress so what this is is you're using a long
stainless steel tie here okay you can buy from any orthodontic store you're going to loop it around
the hook on the molar if you've got two molars then you're probably going to loop around the
terminal hook and then do your twists in between and then go around here and then twist twist
twist twist twist twist twist and then go around here and then twist twist twist twist twist okay
if you do not do these multiple twists in between it will not work you have to do the multiple
twists it's just not as strong and then terminally you're gonna twist twist twist twist twist cut a
little bitty piggy tie and tuck it under that's why you can't see it and then like i said
you're going to retract your canine or whatever you're going to do and if you've got more teeth
retract then you're going to redo this under tie long tie tie back whatever you want to call
it to include the next tooth in it that's it it's pretty simple hopefully that was helpful thank you