it's dr amanda with straight smile solutions straightsmilesolutions.com and
today we're going to talk about the biggest mistake that doctors often make when they
are repositioning brackets and i have a ton of content about bracket positioning and about when
to repo and why no repo and how to repo if you want to watch that you'll want to go to my youtube
channel so you just go to your youtube channel put in the search bar street smile solutions it'll
take you to my youtube channel which has a green banner once you're there scroll down on that home
page until you find the street wire playlist which is the braces playlist there's over 100 videos
and you can find all those ones that you want to watch i recommend checking them all out you know
this is free orthodontic education a lot of people pay a lot of money for these classes
we make it available for free all we ask is that you like comment and share so um anyways but this
is one thing i just want to clarify because i'm finding a lot of doctors don't understand this so
just a friendly reminder of course you won't have bracket repositioning if you use indirect bonding
and even orthodontists who know how to place brackets ideally use indirect bonding why because
sometimes it's hard for us to get things perfect when we have to stand on our head it also makes
it so we can approve the black bracket placement ahead of time so that our team member or assistant
can place the brackets because we've already approved the bracket placement then all we have to
do is be in the room while we do it depending on the state that you're in and verify the placement
before you put the wire in but should be all good to go it just saves you so much time and i can
tell you i've been working with general dennis on straight wire for well over 10 years i mean i've
been orthodontists for 20 but i've worked with general dentists for 10 years and the ones that do
indirect bonding for at least their first 100 cases just end up being way happier you're going
to just be frustrated if you're trying to direct bond don't bother okay so let's say you did have
some direct bonding cases because your indirect bonding paces shouldn't have repos and you're like
shoot i need to fix this okay so let's talk about this obviously you want to take your pano x-ray
you want to take a full set of photos good idea to work with an orthodontist to make sure you're
putting the brackets on right that's something that we do we'll help you mark up your photos
tell you where to put the brackets um it's really bad just take them all off and do indirect bonding
instead you know even in the middle of treatment but the main thing you want to do is after you've
finished your repose is you need to go back to a later night wire usually my go-to wire would
be 18 night tie after the repos and then i'm going to figure eight all the repos that means
you take that little o-ring and you do a little twist if you don't know what a figure eight is
you can use a stainless steel tie and ligature tie it you don't want to just put on a regular o-ring
because it's not going to be tight enough to fully express that bracket if your repos are so severe
that the wire isn't sitting fully into the slot with the figure eight or steel tie then you need
to go back one more wire go back to the 16 nine tie that's really really important other thing
that's important the biggest mistake i see doctors make is they throw power chain on after they do
repost cannot do that first of all you should never be power chaining on an 18 or 16 night tie
only on heavy rectangular wires or you're just going to dump the teeth and i know that there's
some classes that teach otherwise but trust me it doesn't work out you're going to regret it
don't do steel ties don't do long leg ties don't do chain just figure eights that's it you can use
individual steel ties but not long lace under ties like this okay and no power chain yes that means
that you maybe you had a space and maybe you closed it and now it's going to open up again
yeah it will that's why we like to do things in a certain order so that's why i recommend
the sequence of order of appointments for wires and you know straight wire in general
how does that work well there's no power chain until you get to heavy wires it's that simple
and you're not getting the heavy wires until you've checked your brackets and done your repos
so it's really not an issue yes spaces are there yes patients like to close spaces but if you
explain to the patient that you don't close the spaces until you get into the heavier wires and
there's a sequence of appointments and there's a way to do things they won't bug you about it
tell them up front i see you have spaces or i know that in initial lighter wires spaces that
are there might get bigger or spaces that were never there might present don't worry about it
that's just part of straightening teeth as we straighten teeth more spaces happen even spaces
that were never there happen but that's okay we're going to go ahead and close them later
once we get into heavier heavier wires closing space is easy that's the easiest part about ortho
so you just really really have to have patience and stick to your guns and try not to skip those
steps no power chain until you get to heavy wires if you do that you will finish these cases way
faster with less chair time patients will be happier your team will be less frustrated and
you'll get way better outcomes using less overhead if you use this method alright thanks so much