and it was straight smile Solutions straight smilesolutions.com and I'm going to make yet
another bonded retainer video I have an entire playlist I have a retainer menu all of which I'll
give to you for free if you want to access the playlist you can just go to my YouTube channel
straight smile Solutions scroll down on that home page which has a green banner and you'll
see one that says retention there's a lot of content around bonded retainers and retainers in
general if you want a copy of our retainer menu at this moment I am giving them away for free
um you can just email me info straightsmilesolutions.com or contact me
through my website straightsmilesolutions.com ask for a copy of the retainer menu um okay so so so
this is a new way to do bonded retainers well not new because I've done this many times and many of
you are already doing this but how to ask for it and a lot of you ask what kind of bonded retainer
should I make and a lot of that's going to depend on the reason why you needed a bonded retainer to
begin with so let's just say run the mill you know there's not a tongue thrust there's not
a frenectomy issue we're doing bonded retainer because patient either requested it or because
you want to settle a bite which are like the two main reasons that I do it now again if you've
read my my uh playlist on retainers and if you know my theory my theory is that every patient
should that doesn't mean you have to do this but should get one set of retainers as directed by
the dentist so if you think a bonded retainer is the best option maybe you needed to settle a bite
or maybe they started with crazy crowding and they've had relapse a couple times and they
just aren't great about wearing their removable and you're okay with that that's fine remember
you place a bonded retainer you marry the patient indefinitely so you need to have a plan you need
to have a warranty plan in place for the bonded retainer for breakage because breakage will happen
and certainly you shouldn't be fixing it for free especially after 30 days there should be a cost to
it certainly you shouldn't be retreating for free when relapse occurs because when Recaps relapse
occurs with the bonded retainer it actually occurs faster than with a removable retainer
and you can't get it back like you can with an Essex you can't get it straight again so it's it's
a big problem so you need to warn the patient of the wrist the patient needs to be checking
their bonded retainer on a regular basis and as soon as they realize something is loose they need
to give you a call certainly our policy in our offices 30 days any breakage that happens within
30 days is on us you know and any relapse occurs within 30 days is unless after that it's on you
um if there's no movement and it's just a repair you know fifty dollars hundred dollars not a big
deal if there's movement then we're not going to be able to repair it so then you could decide if
you want to have a new one made that you know captures the relapse um indefinitely and like
basically glues the relapse permanently um that's I don't love that idea a lot of it's
going to depend on the bite that might not be an option if they're going to want to retreat we can
maybe retreat with some white label aligners maybe we can retreat with an Invisalign five
um maybe we were smart and we saved a copy of the um fine hopefully you're taking scans of
all your patients at the end and saving them because that's really good due diligence and
it's good standard of care we did that even 25 years ago we were taking not scans but
Impressions and saving the models for seven years that really actually is standard of care
in pretty much every state and Country not just not saying you all are doing it but you need to
be doing it because if you did save that scan and you're storing in the cloud which is a great idea
um you have to kind of um purchase that that cloud space you know Invisalign might store
it for a little while on itero but they're not going to store it indefinitely so you got to
think about this but if you did do that you can always print out a model or have one printed and
a lot of labs would do that for you or have an Essex made off the final model before this bonded
retainer was put on and then they can go ahead and try to wear the S6 and it might move their
teeth back so just a little tip that's a really really cheap solution probably 50 to 75 dollars
Max and then you can always put that bonded retainer back on if you save it that would be
my suggestion but anyways back to fabrication so my new favorite definitely not my new favorite but
it's always kind of been my favorite just for a run-of-the-mill case is the braided
um wire but I don't want you doing this chair side because if you don't put it on unless you know how
to bend it and put it on perfectly and everything like that any type of pressure in terms of making
it or non-passiveness is going to move teeth it's a wire it's going to move teeth which is why you
want a lab to custom make it for you they're going to flatten it they're going to bend it
and they're going to put it in a jig the transfer tray and then all you got to do is just basically
etch Prime adhesive slap it on like here peel it off really easy but this is a cool thing that
um I'm gonna give olendorf lab which is one of my favorite labs they are based in
St Louis I think of course I love St Louis because I went to college there but
um they do this you can ask for and they totally know what this is basically they're going to
create a trough here here I don't know if you can see the trough that they create
um and then you're going to put your own composite you can even put flowable here
just fill it up just perfectly not overfill it or a nice hybrid composite Smash It Down
etch Prime slap this on you know assuming it's all dry and everything and just light here through the
tray peel it off it's on perfectly so this is a as opposed to coming with already composite
buttons already on you're basically making the composite buttons yourself so we call this the
trough and this is the stainless steel flat braided ribbon so you can if you order this
from from olendorf it comes pretty standard I've been told that specialty appliances will make this
for you but you have to be very specific so you might actually want to even reference this video
there are doctors that have it made but that isn't their default they will not have it on
their website you have to ask for flat stainless steel braided wire with a transfer tray jig with
troughs I will add my own composite to make my own composite buttons and there might be a better way
to say this but you could probably just send this video lab fee I'm being told is about 70 ish for
this and this okay plus a model fee because they always charge a model fee um and plus shipping
so it's about a hundred if you're ordering upper and lower it's going to be about 200
um with the shipping maybe 210. it's pretty pretty common and then once the bite settles
you're also going to need to make an Asics so this is a fair amount of retention so again
flat braided wire transfer tray with troughs I will make my own composite pads in your troughs
so that is my suggestion because the braided wire does have a little give to it doesn't mean
it's going to relapse but it allows the teeth to function naturally within their own periodontal
ligaments as opposed to just being like splinted so obviously um the other opposite would be let's
say there was a fracture or there was a major Peril issue trauma and you want to splint the
teeth well then this isn't what you'd use you'd use just the bar the stainless steel bar you know
or if you really needed something a little more rigid you know because there was an issue with a
tongue thrust that you're trying to hope there was no relapse and no promise there that I might use
the stainless steel bar okay but that's a lot more rigid and doesn't have that give so when something
breaks it's pretty big deal but this I think will last you longer some people have these for 10 20
15 years some people's you know it really depends on how they take care of it what foods they bite
into how they clean it how aggressively clean it if they clean it so there's a lot of variables
that's why you need to have that warranty program and that's why they need to know up front before
they even get it what their fees are going to be if it breaks if it breaks with relapse and what
the options are because there's nothing worse than doing one of these and having to come back
three six nine months later they're saying they didn't know it was broken or they're saying it
was always broken which we know isn't true which is why I always want to have that 30-day visit
after one of these is placed um and if they missed that visit they need to understand that you know
they're going to avoid the warranty they missed that visit and if they come in in
30 days and everything's cool and nothing has relapsed and nothing is broken well
then after that there will be a fee if anything breaks or relapses so all right thanks so much