hey this is dr amanda with straight smile solutions straight smile solutions.com and
today we're going to be talking about phase one braces a little bit more phase one alignment
and i love to look at other people's work and just comment on it it's one of the fun things
that you can do um so i don't have records on these patients beyond what i see but i like the
stock image that i purchased because it shows me befores and afters of patients as they get bonded
or what happens from one appointment to the next so you can see here this is one boy right here
this is before this is after initially it looks like he's presenting with generalized crowding
um he's gonna enter a crossbite here on the upper right one or number eight um a lot of crowding
personally i would definitely take a pattern on this patient and see the position of the canines
looks like both arches are likely underdeveloped you probably also want to take a saph here and if
you've seen all my i know seth like scares a lot of people but it shouldn't be scary because things
i want to know is his maxilla underdeveloped these are things i would want to know
if it's underdeveloped i might want to grow it or bring it forward and there's a couple different
ways you can do that yeah it's easy to fix that cross bite and what they're doing we'll fix that
crossbar but are we treating the root source of the problem which is a skeletal malocclusion just
by jumping that cross bit we're not fixing the root source so we need to see if there's actually
a skeletal problem the benefit of fixing the anterior crossbite by jumping the bones instead
of just the tooth or a combination of both is that you're also going to set him up for more success
later and you're going to improve his airway and speaking of airways i would also recommend a sdb
um evaluation on this patient there's lots of sdb forms out there i have one in my own store if you
go to my website straightsmilesolutions.com click on store you can see the sdb form it's 20 and if
you're one of our clients we give it to you for free so in any case i would definitely take a pano
might evaluate um doing some arch expansion upper and lower might evaluate doing a protraction face
mask um evaluate those canines seeing if they're impacted if they had risk of impaction besides the
expansion i would definitely consider taking out impacted uh the baby teeth the baby canines only
um which would help facilitate um the auto correction of the permanent teeth so that's
where we are you can see also one thing that's interesting here is they did bond the baby teeth
they bonded the baby canines which i probably maybe wouldn't have done but then again it
provides some initial stabilization um but the problem with that is you really gotta check
because i've seen all kind of crazy things happen when you do that and you forget that they're baby
teeth because it's really easy to forget right um and they get loose and then you cause trouble and
you can cause damage to the permanent teeth so proceed carefully with that um i tend to only
do that on much younger kids i might bond teeth further back that are going to be hanging out
a little bit longer but i don't normally bond baby canines at this stage but just a thought
okay this one looks a little bit better they also i think did bond baby teeth here again i might
not do that although i'm not really sure what teeth these are here but it looks like they're
just doing some initial alignment it looks like she has enough space so they're just maybe the
reason why they're doing this is for aesthetics maybe psychosocial maybe she's getting teased
um maybe they're trying to reduce overjet um looks like she's got a deep bite i don't think they're
really addressing that so they need to have a plan for addressing the deep bite and there's
lots of great ways to do that this is not gonna do it at all probably it's actually gonna make
the deep bite worse um what else overjet they're not addressing that besides maybe just closing the
spaces which will help it out which is good for trauma but they're not really addressing the root
cause of course you'd also want to have a ceph on a kid this age you also want to get stuff numbers
again it's not scary i have a lot of how-to's you should definitely check out my book which is only
9.99 at amazon there's a link on my website or you can email us at info straightsmilesolutions.com
and we'll be glad to share that link with you it has so much amazing tricks and tips
it took me four years to write it so i hope you will support my book all right in any case
hopefully this is helpful for you and you've learned a lot about phase one braces take care