amanda with straight smile solutions straightsmilesolutions.com and today
we're going to talk about counter moments and braces how to de-rotate premolars with power
chain and you could also do this with canines or molars as needed so but most frequently most
commonly i use it to de-rotate premolars and i'm going to explain what you're looking at here so
um i kind of did this just with some photoshop but you can see this number 29 is rotated
this is where the cust the facial cusp tip is the buccal class tip right here here's the lingual
okay so it's about i don't know 45 50 60 degrees rotated so what's gonna happen if you just put
the bracket right here and you know where it's supposed to go is first of all you may not be able
to put the bracket on perfectly because it's too rotated if you can put it on perfectly you might
be okay you might not need to do this macgyver act but if you can't put it on perfectly that's
where i don't even put the bracket on at bonding if i can't put it on perfectly i have a philosophy
no don't do it because what's going to happen is you're going to forget that you didn't put it on
perfectly because it's going to kind of quasi improve but it's not going to fully improve
and then later you're going to forget and then you're going to be like oh no and you're going
to miss the bus to reposition it so it's much more efficient if you put all the brackets on
perfectly that you can put on perfectly and then use a series of buttons in your initial aligning
wires so you might have like a 14 night tie you've engaged everything you would probably want to
leave your 14 night tie short cinch this end in put a button as far measly as you can go because
buttons are smaller than brackets right so you put it as far measly as you can go so maybe more like
even here where you can still engage the button okay then you put another button as far distal
as you can go on the distal lingual okay again buttons are smaller than a bracket so you can get
in there more and you also put another button here or here you can do either way um wherever you can
usually buttons are pretty tiny so you should be able to get it here but if you can't you can put
it here and then obviously you have a band and a hook here but if you didn't you could just connect
it to the bracket there then this is a piece of power chain that goes from here to here and a
segment of power chain going from this button to this button or this button to this button if you
put it there okay um and you know pretty tight not crazy tight there's no wire on this tooth there's
no wire going back here okay and this power chain is pulling it this way and this power
chain is pulling it this way and we call this a counter moment so it's much more efficient than
just pulling one side you're pulling both sides it works very similar to what we do in invisalign
and i have a separate video on that where you put an attachment here an attachment there and
it helps to spin that tooth in invisalign but you could even like let's say you wanted to do like a
more express kind of a visual invisalign but you had like one crazy rotated tooth you could
theoretically you could pre-rotate that premolar just with a series of buttons not even any wires
you could pre-rotate it now remember for every action there's an equal and opposite reaction
so when you're in braces you know you're in kind of light wires i mean this one might rotate a
little bit this way as it's pulling this one this way and that's okay it's not going to be that much
and same thing this this molar which is less likely to it might rotate a little bit in this way
but it's going to be super minor because that's a much bigger tooth right because if you're putting
a big tooth against a little tooth it's probably not going to move much this one is most likely to
do the majority of the movement then once you've rotated enough that you can put the bracket
on properly and engage it you pull the buttons off and it's probably only going to be a month or two
and you put the bracket on properly and then you just treat it like any other tooth because you've
already rotated it you know possibly the whole way or at least 30 degrees or something like that so
that is how i rotate premolars counter moments in braces now you can do that if the tooth is up to
90 degrees rotated i would say you know if it's like totally at you know a full rotation if it is
180 rotated you just leave it make sure you don't try to spin it unless you have a crazy amount of
unless you have a crazy crazy amount of space where you could get in there and actually spin it
usually we just leave them if they're completely rotated around but if it's up to 90 that's how
we're going to rotate it now of course if it's 180 and it's completely flip-flopped
you're going to have the higher cusp on the lingual which is going to affect the occlusion
so you may have to flatten the occlusion a little bit in order to get a good bite
all right hopefully that was helpful really really easy way you can get buttons from anywhere you can
i would just get the cheap metal buttons if you're gonna do that you can get it from ebay um or any i
mean it's like 20 cents each so it's a no-brainer all right thanks so much and then if you want to
watch any of my other videos on rotating premolars you can just go into my channel which is straight
smile solutions not youtube in general but straight smile solutions youtube channel
search you can look at our straight wire playlist which has i think over 130 videos that are helpful
and i'm always making i make a new one almost every day so we have 3 000 videos already we add
at least four or five a week so it's crazy growing this is free orthodontic education
no reason to even take a class you can learn everything you need to know about
every kind of ortho pretty much just from our free educational videos that we put out there
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