great smile Solutions straightsmilesolutions.com and it's yet another phase one video
these one braces again so just wanted to go over phase one wire sequence one more time
I have this in all my content in my videos but I just wanted to reiterate why we do sectional
wires and cinch initially on light wires an example of a sectional wire is this little
sucker right here now of course they're doing something wrong here I love to find stock images
where they're doing something wrong what are they doing wrong well obviously this is not gonna get
straight because there's no space if there's no space you can't make it straight now a cheating
way which some orthodontists do which makes me super mad as they pull out the C's or the lower
baby canines well what does that do well yeah you take up some of that space But now you just
block out those permanent teeth and you cause impactions so it's a short-term Band-Aid that
causes more problems down the road so what do you need to do first you gotta make the Arches
the right size if you don't make them the right size there's no space to put everything it's kind
of like if you have a closet and you got too much clothes in it it's not going to fit you
gotta have the right size closet or you got to get rid of some clothes so but we don't want to
be pulling teeth out not permanent teeth and we even really don't want to be pulling out
baby teeth unless we really really need to like there's impacted canines or something like that so
the point of doing cinch and sectional wires and if you don't know what section wires means
you need to watch my other phase one videos which means you need to go to my YouTube channel which
is Street smile Solutions find the phase one playlist watch all the content there
there's almost 200 videos there I even have a phase one course it's 13 hours long with CE is
launching q1 2023 it's going to be sponsored by CE Zoom price Point's gonna be less than
300 I believe and you're going to get 13 units CE but you're gonna have to take a 65 question
quiz and it's it's not super hard because I wrote it but you will have to pay attention
um but it won't be super hard it's kind of had some fun with it um there's also a non-ce version
that comes with help on two cases and you can get that off my website straightsmilesolutions.com
anyways so understand this first before I go into this whole why do we do sectional wires essential
and part of the reason is well these wires are really really flexible and kids in mixedcentition
have a lot of baby teeth and sure you can Bond some baby teeth as long as they're not falling
out anytime soon for support and stability and nothing wrong with that but we need to bond them
or something in the back be it a six a first molar an e to wield a round it out especially especially
especially if you've got gaps in between your teeth and you can see here well there's some bad
bracketing here I see what I'm looking at I like this one I don't like this one this one needs to
go clockwise and it's also too long so you got to work yourself up the wire sequence you got to
have something you know you can initially have it the wire be two to two assuming you have space but
what are they doing wrong here well first of all there's no space second of all they didn't fully
Engage The Wire in here right if it's not fully in the slot it's not going to get straight but
there's no space for it anyway so you'd have to do a figure eight or a steel tie there you also need
to create the space first so first thing you do is you build a foundation and you get the space be it
expansion Arch expansion you can there's there's lower Arch expanders that are out there there's
fleas there's Williams things like that and I know there's no suture but just expanding the arch to
the right size it was meant to be then you can go ahead and throw the brackets on and then you
can go ahead and tie them real tight and they'll get nice and straight kind of like they did here
and see they did a really really good job here because they made space for the permanent canines
you should have that size space if there's a dentless area there and a canine meaning
drop down so if the tooth will come down normally hopefully but you're going to go ahead and work
your way up the wire sequence be it 14 18 12 16 18 you know something like that the goal is to slowly
work your way up the wire sequence you might only need two you might need three eye wires I
don't go 12 14 16 18 that's a huge waste of wires if the teeth are super super wonky or the kid is
like really really jumpy I'll do a 12 because it's like a baby wire and they probably won't feel that
much and I might not even figure it the first time and then the next one we're going to figure eight
on the 12th then we might go to a 16. our wires should be cinched in here and here like they did
here this is the right thing to do they did do that right why do we cinch them well a wire is
especially a nighttime wire is like a smile and if you just trim it flush boom boom here first of all
it's going to be uncomfortable it's always going to be poking second of all it's going to slide
like this laterally it's going to slide and it's going to pull out of the slot and it's just going
to come out as they eat and chew if you put this little cinch Bend IN if you don't know how to do
cinch you need to watch my videos on cinch this is how you spell it c-y-n-c-h I have videos on
exactly how to do cinch you go ahead and get the wire a little bit longer than you need you Flame
the ends you go ahead and try it in make sure you got the right size leave about a million three
millimeters at the end of each side then you're going to go ahead and cinch it take it out of
the mouth cinch cinch don't cinch while it's in the mouth because you're gonna break the bracket
then you're going to go ahead and tie it in and you should have that cinch going inward so that
it's not cutting the patient and so the wire can't slip slide around and it stays nice and firmly in
place there should be enough slack so that you can go ahead and get it fully in the slot on all the
teeth assuming you had the right amount of space work your way up the wire sequence and repeat with
an X wire and repeat with an X wire you shouldn't be moving up wires until your wire is 110 passive
this not a passive wire this you wouldn't want to be moving up because you didn't get
your bracketing right so your bracket needs to be right before you move up the wire sequence I mean
this is clearly wrong I can see that right even this is wrong this one's longer than the other
so they shouldn't be moving up the wire sequence until they fix the bracketing on this one I can't
really tell this one this one's a little tricky this is definitely right they did a great job here
okay and then once you go ahead and you get to the 18 nighttime just like with regular phase uh phase
two or comprehensive brackets I recommend pausing once the wire is totally totally passive taking a
progress panel double checking that the roots are all parallel double checking the incisal edges
making sure they're all even making sure you have symmetry make sure eight and nine are the upper
ones are even make sure 7 and 10 or the upper twos are even make sure all your lower anteriors are
completely even there's no ins and outs there's no ups and downs or no major first order Bend issues
I always love to Loop the parents and the kids into this situation when you get to that point
because there's a lot of like art that goes into the science of Ortho some people want to have
their laterals laterals are meant to be stepped up a little before the centrals but you know there's
some give we could have a little longer a little shorter depending on what they're looking for and
I love to just have them doing the feedback at that stage because there's any miscommunications
or issues that are coming up I want to know at that stage why we can still fix them or adjust
them or at least clarify them um as opposed to the very end where I think we're done and all of
a sudden they're like oh this looks bad in their mind and we haven't clarified yet so that's the
time to fix things it's at the 18 nighttime stage we're going to go ahead and do the rebrackets then
and of course if you're doing indirect body you shouldn't have any rebrackets assuming that you
didn't screw up when you placed the brackets with the jig um and you like cured fully and no
one broke any brackets and then if you don't have any brackets to fix you can go ahead and take your
wires put in an 1825 night tie take it all the way to the back you can do some buccal tubes if you're
afraid it's going to flex you can do a cinch in the back as needed and if needed you can go
ahead and power chain at this point I don't have any examples of power chain but I have some other
videos on that you can see here they also use bumper tubing with the long spans if you are going
to go ahead and have long spans you need to have bumper tubing in a cinch because it will Flex when
the patient eats sleeps anything that rests on it lays their hand on it and the flexing will break
the adjacent brackets and that's pretty much it that's why we cinch that's the important part and
that's why we initially start with sectional wires because you're going to have a really flexible
wire and a long span and it's almost impossible to keep that span from breaking brackets and pulling
out the back too it's just going to be way less frustrating it's important to explain that to
your patients because they don't understand why they only have an itty bitty wire in the front
as opposed to a nice big wire like their friends do all right hopefully that was helpful thank you