hey this is dr amanda with straight smile solutions street smile solutions.com
and today i wanted to tell you a little bit about what round tripping is and i hear a
lot of dentists throwing this word out but i'm not sure if you really understand what it is
and if it's good if it's bad should you do it should you not do it so for example when you
have crooked teeth on the lower arch like here or like here okay whether you're doing braces
or you're doing aligners there's different ways that you can fix crowding right and if you go back
a few videos that i posted i posted one that was more consumer-facing about how correcting crowding
works right we go over the options you can expand the arches you can procline the front teeth
you can add ipr you can extract a tooth or teeth so those are some of our options
so let's say for example we wanted to do ipr well most doctors find it easier to do ipr when the
teeth are straight than when the teeth are crooked this would be really tricky to do ipr right here
or even right here but it might be okay to do it here right so that's one of the options you have
when you do invisalign or sometimes other aligner companies is you can give them feedback i want to
do it early in treatment i want to do it later in treatment that's a personal preference that
you'll need to let the treatment plan advisors know you can build that into
your personal preferences at least in invisalign not at all but i digress now it's not always
the best thing to round trip so round trip means we straighten the teeth first
we add ipr and then we retract the spaces why so for example let's say we tried to do that here
okay you can already see that this tooth is pretty much out of the bone okay there's nearly no labial
bone here you can see it's blanching here here here so if we tried to straighten these add ipr
and bring it back will likely cause some damage that's irreversible to those teeth sure we get the
bite nice but at what cost to the to the healthy teeth right so my suggestion is actually not to
round trip sometimes you can you're going to have to either take a cbct or even sometimes at a ceph
you can look at the labial bone to see if there's bone labial to the incisors to see if you could
round trip safely but often i just do it just by eyeballing the photos so i look for blanching
i look for root scalloping and things like that and that tells me that i don't want to round trip
because the teeth might be permanently mobile we might have perio issues we might have
devitalization sensitivity issues that might be irreversible it's just not something that i
would prefer to do now remember your treatment planners at invisalign six-month smiles um
you know all these companies they don't know nor do they care so well maybe they care but
they really don't so if you tell them to do the ipr later and straighten the teeth they're gonna
do that they don't know if there's bone they don't know if there's not bone they don't know
if there's gonna be complications that's your job as the dentist okay you tell them what you
want them to do and they do it they are not making the clinical decisions you are and this is where i
see a lot of dentists getting into trouble with their case selection and treatment planning you
can't just do what the treatment planner is saying you have to put your dentist cap on and be like
is this healthy for my patient they don't know you have to find out okay so that's what i'm trying to
explain to you so there are some good systems um and you should definitely go into some of my ipr
videos if you go to letter g letter p like gp webinar.com gpwebinar.com i have all my archive
webinars it's free you can just go in there um and i want an ipr so there are some ipr systems
that could be pre-curved where you can do ipr where it's crowded it's really not that hard
um so i recommend just getting it done even if it's trickier
if it's a lot you can stage it over multiple appointments so let's say you're on the
five-week appointment frequency okay do some ipr to line r1 do some ipr at a liner five so you can
make the ipr match your frequency now not all aligner systems you can do that with so you need
to find out if you can some of them you have to do it all at the beginning okay remember ipr can be
done anytime before it's due it's like a library book so if you got ipr stage at 8 and 15 doesn't
mean you have to do it at appointment 8 and 15. you need to do those before appointment 8 the
ones that are due on 8 and the ones that are doing 15 before 15. you just have to keep organized keep
notes and make sure that you see your patient on the right frequency so hopefully this was helpful
and hopefully you learned something about round tripping and why i'm not a fan of round tripping
all right in any ways it makes your treatment take longer too because you're moving it all
the way one way and then you're moving it back besides all the other symptoms all right thank you