hey it's Dr Amanda with streets math Solutions streetsmouthsolutions.com and can't believe I
don't have a video on this I just realized it today I've been telling you guys about this for
seven years now and I'm finally making a video so let's talk about bracket repositioning and forced
eruption so from time to time y'all send me cases where you know we've gotten to that and I'm hoping
before you listen to this video that you take a step back hit pause go to my wire sequencing
videos if you don't know how to do that go to my YouTube channel straight smile Solutions it
has a green Banner if you go on the top headings with all the tabs and scroll if you're on a phone
or on an iPad or on a laptop you might have to navigate and scroll over to the very last tab on
the right and it looks like a little magnifying glass once you hit that magnifying glass put in
wire sequence in my channel it'll bring up all my wire sequencing videos make sure you watch these
first before listening to the rest of this video or it's not going to make sense so once you get to
the 18 nighttime stage and your wire is passive then what I want you to do is use articulating
paper and take a progress panel I also want you to take a full set of bracket repositioning photos if
you don't know what bracket repositioning photos are or anything else I just said make sure you
also use that keyword feature to look those up or this video is not going to make sense
once you do that if you find out that you have some teeth that are not in occlusion and your wire
is passive and you've double checked the panel and the bracket repositioning photos which are
different than regular photos and you see that all the teeth are straight all the roots are
parallel and aligned no tipped Roots everything is done the only funky thing that's going on is that
maybe you don't have occlusion on a canine or a premolar obviously these premolars look seated but
the canines remember canine should be longer than premolars it is a little bit here but this stuff
this one definitely is not I mean this is like not worn three not worn canine it should be definitely
definitely more erupted than the adjacent premolar perhaps this premolar is bracketed too low but
anyways I'm just giving you an example and you're like shoot everything looks really great you know
everything's aligned the wire's passive the roots are vertical the only issue that I have is that
these aren't seated a lot of you will start like putting in like triangle elastics or posterior box
elastic and that's not going to work because the wire is passive all you're doing is force erupting
and it's just going to bounce back so easiest way to do this is one of two different things
yes some people will do step bends and that's not wrong it's just you know if I if I knew I was 100
done and I knew my arches were coordinated and that's the very only less stop I have to do then
maybe I would do that maybe I would go into a 1925 nightie finish leveling and then do my step bends
and that's totally not wrong but what I prefer you guys do as general and pediatric dentists is for
syrup them or I mean if you see if you see enamel more gingival and you can just you know scooch it
up a bit gingival or scooch it down a bit gingival on the lower Arch a half millimeter that's great
but sometimes you know the gums are inflamed or sometimes you just right at the gum line and you
can't so then what you do is you take that 18 night tie okay that you already had in and you
know tie it in like normal tie it in like normal tie it in like normal on this one I want you to
take the tie off and loop it under the bracket the key is you have to take the tie off so obviously
this is not a great example I don't have a great example of this because it's y'all's photos
because I'm not doing braces in my our offices right now I just we do all removables it's just
our Theory but you guys are doing braces so I want to give you tricks and tips so take the tie off so
there's you know when you take the tie off there's a little lip under this under these things and
you've run the 18 nighttime over the bracket or run the 18 night tie under the bracket no tie okay
and then tie it in here tie it in here tie it you know run it through this the tube same thing here
no tie under the bracket tie and tying through the tube okay now you're right it's not ligated
here I don't want you to like 80 here I just want you to sling it over the top sling it under the
bottom okay now you want to explain that to the patient don't just send them home because they're
going to think you screwed up and missed a tie now sometimes when they eat something it's gonna pop
it's gonna pop out of the under and it's gonna go back in the slot we don't want that because that's
going to negate what you just did so you need to show the patient what you did and say hey keep an
eye on this if it pops over and goes back in the slot I'm going to need you and you can give them
the easiest way to do this is probably with an elastic Placer you know those
little like elastic hooks that you can use to put rubber bands on they cost like five cents
um you could buy them probably overpriced from Amazon but if you're doing braces I'm assuming
you have an entire pack of them in your office that is a good way to do it I would say use a
use like a toothpick but I'm afraid they're gonna poke themselves so let's not do that
um usually it doesn't happen they can also use their nail or if it happens tell them to come
back in and you guys can do this with an Explorer in like 10 seconds just hook it back over again
this should only take a few weeks I don't want them waiting eight weeks in between appointments
like two to three weeks Max it's gonna force her up very very fast and it's frustrating for the
patient because it is going to pop over pop over pop over so there's no sense in cooking
this longer than needed so once it does its job once you can check with articulating paper and
it is an occlusion or once you get to the point where it looks good once it's forced erupted then
what you're gonna have to do the next visit is you're gonna have to pop the bracket off pop the
bracket off and now that you have more enamel because you've forced erupted it and hopefully
it's clean then you can go ahead and scooch that bracket like we discussed a little bit
gingival a little bit gingival tie it in normal back into the 18 night tie for a few weeks then
you can move up your wire sequence to the next wire and then you're pretty much done unless
you have spaces to close or elastics to wear and that's it if you do your braces appointments in
a logical sequence and stay on the right train stay on the right track don't skip steps don't
get all like hyper and be like oh I have a space and you're still in 1490 or 16 or 18 nighttime
remember the wire sequence videos and use this trick you will be done with your
braces case is 50 faster than what y'all are doing them I hope this helped thanks