hey it's dr amanda with straight smile solutions straightsmilesolutions.com and today we're going
to talk about reverse curve wires there's upper ones there's lower ones and if you flip them
over they're called accentuating curves for so for terms of abbreviation and brevity i use the
acronym rcs for reverse curve of speed wire and ecs for extenuated um curve of speed wire so
reverse curve is to open a deep bite a saturated curve is to close an open bite how do these work
well i've made plenty of other videos on how they work so if you want to access that please go to my
youtube channel put in the search bar straight smile solutions that'll take you to my youtube
channel which has a green banner once you're there there's a little magnifying glass towards
the right of the tabs not in the top right hand corner but near the right and you could put in
the acronym rcs or acs better rcs a reverse curve and all my videos should pop up explaining exactly
how they work and when to use them but here the specific question is should you just use lower
only or should you do upper versus lower how does that work so you have to remember what they do
obvious reverse curve helps to level the curve of speed this is something that can happen naturally
if you just let the wires work or you put in an anterior bite plate or anterior bite turbos
personally i don't use reverse curves until the very very very very very end of treatment because
i've seen what happens when you leave them in too long and if you put one in and then you take it
out and put a flat wire in you're pretty much negating what you already did so for me it's
like a last minute thing we everything's straight we're class one you know but the bite is still a
little bit deep i don't quite want to finish what do i do well of course the first thing i would do
is i would have tried the other ways to level at the beginning with the bite turbos and the bite
plate and box elastics and probably bonding the lower sevens second rollers to level the curve is
b can't really level it very well if you're only going to the sixes right that's not going to work
so we try all that first and if i still had a slightly deep bite at the very very end i would
put in an rcs wire to help me out also sometimes i put one in this is a bit of a one-off let's say
there's a situation where you have spaces on the top maybe some overjet maybe you took out upper
floors you're trying to close space but the front teeth are a little bit deep and the lower brackets
are blocking the space closure sure you could put some bite bumps in the back teeth but for me in a
deep bite case you know where maybe i should have done something but i didn't at the beginning and
i don't want to go back to the beginning to level in line in that first phase with an appliance and
elastics then i might put in a reverse curve just for a short period of time just to open that bite
so that i can close those spaces on top and then i'm going to take it out and do things another way
but anyways let's talk about upper versus lower for the most part i only use lower the problem is
whenever you're using ones and this is how it's going to go in right if you're doing reverse curve
it looks like a curve right and yeah i usually buy the nighttime ones i usually
ate use 18 or 1925 sure you can make your own out of stainless steel we did that in
residency it's a heck of a lot of work and it's really hard to make it even so
and it's even harder to put it in so pass on that i'll just buy the expensive pre-made once
when you put it in you got to see basically your teeth are going to move like the
like the nighttime shape right so the back is going to intrude the molars are going to enter
it a little bit the premolars are going to extrude and the incisors are going to intrude same thing
if you put in the top one top version same thing are going to happen so what's going to happen if
you do top and bottom together first of all if you have a gummy smile that kind of makes sense
because this is going to push up right it's going to be less gummy if you have extruded
lower incisors that's gonna make sense because this is gonna intrude it right so you're gonna
see where you actually need it where's the problem for the most part i don't even know if i've done
an upper one ever i've done an upper extenuated which is basically a flipped version of it on
open mic cases and usually on deep by cases i do a lower you don't really want to do upper and lower
together because you're just going to end with a posterior open by on the molars for the most part
so that's why i don't recommend that but anyways that is the story and i'll tell you the story what
happens when you leave a reverse curve wire in too long i saw one in one office i was filling in for
it was some type of dso and the patient had moved to mexico for a year and little did they know the
reverse wire was in and this is another comment i want to make about reverse curve wires you need to
have a tight hold on those patients i almost want you to put an alert run a put a code in
so you know exactly who has reverse carved wires in at all times if they miss an appointment they
have to come in it's not for someone who's going on an extended vacation might be disappearing a
patient that's kind of flaky you need to make it crystal clear that they must come in in four weeks
or you're gonna hunt them down you're gonna go to their door and knock on the door because i don't
remember if this patient had it in first nine months twelve months longer but when she came back
her arches and i think she had upper and lower end look like potato chips literally they looked like
a pringles chip it it was blown out buckley um super posterior open bite on the molars just like
a centimeter it was like her face was messed up her bite was messed up i don't even remember what
i did i think i took them out put no wires in for a little while and then i don't know if that i saw
her again and we escalated the situation i wasn't really my patient i was just babysitting him
um but it was horrifying whatever i saw and it was a kid or a teenager or something and i was like
so horrified i mean i'm so surprised that parents didn't notice that i mean the front
teeth were like like weird flare anyways i hope she didn't lose your teeth that's all i can say
but this is why you have to really i just i see so many general dentists just putting it in hey
reverse curve uh do you know what happens if you lose this patient remember if a patient disappears
that's patient abandonment on you if you haven't done everything i mean if you didn't know this
was in and what could happen so this is this is a big issue with me is patient abandonment
because it's on you the doctor and i feel like so many general dentists don't realize if their
patient doesn't show up and they have braces on it's on them any damage that can happen
you have to be you have to know who your ortho patients are you have to know who has what and
what things are dangerous if you let them go you know unbabysat so anyways a bit of a rant
but i want you guys to understand that these wires can be dangerous so be careful thanks