hey it's doctor amanda with straight smile solutions street smile solutions.com and today
we're going to be talking about wire sequence we're going to be talking about figure eights
we're going to be talking about steel ties we're going to be talking about what to use as your
first wire how to tell if you can progress to the next wire and i actually have videos
on all of this already each of these components that i mentioned has its own specific video so
if you go to my straight smile solutions youtube site and you put in like wire sequence or put in
figure eight or steel tie or sst um or just wires in general um you will see an individual video
that will kind of dig more into depth into each of these topics so this video is just going to
be a very high level overview another great resource that you can jump on would be our
digital education course you can access that at straightsmilesolutions.com go to digital education
our straight wireless course we have a lot of resources there there is a fee for that course
another resource that you can use which is cheaper and the youtube videos is free another pro free
resource would be to go to letter g letter p webinar.com that's gpwebinar.com and we have a
lot of archive webinars there with a lot of free resources and lastly another resource which is
very affordable it's between nine dollars and fifty dollars depending on if you have a kindle
or if you like paperback is our textbook or a book um again if you go to straightsmilesolutions.com
there's a banner at the top which takes you to our book and there's a i mean for that price there's
so much nuggets in that book that you could definitely use so so many nuggets so anyways
let's get back to our high level overview on wire sequencing steel ties figure eights etc
so let's look at this case here and this is not even my case this is just a stock photo
sometimes i love using stock photos because i can just purchase them i have a subscription
and i see all kind of things that i can talk about and have to get releases or anything like that so
it's just easier but all in all the bracket placement is pretty decent here there's definitely
some things i think they did wrong here that i would do differently i'm not saying they're wrong
it's just different than i would do but um let's see if you can point out some of the mistakes so
bracket placement is decent all in all clearly either they knew how to put on their brackets or
they use indirect bonding and again if you are a newbie dentist who is not an orthodontist or
you're not going to orthodontic residency just use indirect bonding don't be cheap okay you can
get this for so cheap now really high quality 0-2 slot mbt brackets a variety of different
companies do it of course i have my favorites the one i like to use is about 300 to 350 dollars for
3m unitec victory series mbt brackets top of the line metal brackets not cheap ones there's a lot
of really really cheap brackets that are out there on the market they will not express the
way they're supposed to will not express torque you will not get the right outcomes they'll get
bent they'll get ugh no don't go cheap so if you want that referral this is a word of mouth
situation only originally they were in beta but now they're not but they just don't spend money on
marketing because they try to leave their prices low for you so if you want and they only take
certain types of doctors so i kind of vet the doctors and i send them because i just love
working with them so they've asked me to vet the doctor so contact me and if i think you're a good
fit i will send you to my resource for a really great indirect bonding but lots of different
good companies out there too a lot of other ones are a lot more expensive but they'll still work
so anyways mistakes that are made here so obviously i always say first wire should be
the biggest possible wire that you can fully put in and engage into the patient so if you look here
i'd look at this it really depends on the patient i might use 14 i might use 12 i don't use 12 very
often usually 14 is my or 16 is my go-to wire it really depends on the patient if the patient
is super high maintenance a whiner a complainer then i probably go with 12. you know i can just
kind of tell by their personality how high strong they are how much they complain how much they're
like moaning and groaning over little things that shouldn't hurt at all then i'm going to
use the lightest possible wire which would be a 12. um if i think they're a little more tough
and they're really excited to get going then i'd use a 14 here but again it's the you can always
go lighter right it's not a problem what's the worst thing that's gonna happen maybe
it's gonna take a few more weeks but you know patient will be a little more comfortable so
um personal choice but yeah i mean first thing i see here is they didn't fully engage this tooth
or this tooth well actually they figurated them i think it's hard to tell they only have this
one thing so maybe they did fully engage it but definitely you want to make sure that the wire is
fully in the slot so the figure eight and you can watch my video and figure it will really help it
get in slot it just holds it in tighter you can do figure eight on everything if you want and
there's nothing wrong with that um but just takes more time right to put on and take off
but a figure eight stays tighter and it'll fully slap it or you can do a stainless steel tie or
ligature tie again this is technique sensitive if you don't do it right you can break a bracket
with those so i kind of like figure eights better but you can break a bracket with figure eight too
so um yeah it would really depend on whether or not this was fully rotated
fully engaged fully in the slot from even at this kind of right angle i'm guessing it's probably not
if it wasn't then what i might do is i might put a button on a lingual aspect
and do a counter rotation but i'd have to see the picture to show you how to do that but otherwise
the bracket placement is excellent they fully engage this one this was a tricky one i think i
don't know if this is fully engaged you'd have to see if it wasn't then maybe i'd use a lighter wire
or a ligature fork would help but they did a good job the other thing that i probably would
have done different is i probably would have put some temporary posterior bite bumps on here just
because i think this is going to get locked in um it might not depends on how much of a clencher the
patient is um but certainly if you didn't see it jump after one visit i would definitely put some
bite bumps on just to help open the occlusion so that this jumps forward and once it jumps forward
and this comes back then you can just zig those off you don't want to leave posterior bite bumps
on for too long because you'll get intrusion of those teeth over time and then you're going to
have to deal with bringing those teeth back up and one of the biggest mistakes i see is that people
slap those things on all the time even in deep bite faces you're actually making your deep bite
worse by putting those on and of course you're getting uneven step in the occlusion so they're
not my preference anytime i do a posterior bite bump it is a temporary thing only i'm gonna put
a big alert on the chart to say check it every visit and then reduce it every visit to as much
as i can and they need to be off within two to three months if they're not then you need to
change directions and do something else to address that issue and there's all the types of different
types of other techniques you can use but i mean 90 day max on posterior bite bumps and too often
doctors forget they put them on which is why you should definitely watch my posterior bite bump
video again you can search for these if you can't find them in my youtube just email me at info
streetsmilesolutions.com or message me through my website and i will personally send that video to
you i know where all my videos are it's very easy you can find it in one second and i will send it
to you because you want to make your poster by bums colored you don't want to have them tooth
colored because you'll forget they're on there and they can trap decay and other issues and you
want it to be like glaringly obvious that there's posterior bite bumps on at every visit so you make
sure to remind yourself to take it off fully all right hopefully this was helpful thanks so much