Case of the Month

  • January 2019
    January 2019 by Dr. John Bunkers Please Note:This website is best viewed with the latest versions of all browsers. If you are having issues viewing this, or…
  1. Bruce Thomas
  2. Uncategorized
  3. Friday, 06 April 2018
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Dr Perry E. Jones Accepted Answer Pending Moderation
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Uprighting molars? Lots to talk about. Depends on many factors.Type of bone cortical or medullary and density type. Root movement/ bodily movement vs crown tipping. Tooth surfaces available to create sufficient force and properly directed force. One tooth or several teeth?
Probably not a strength of clear aligner movements, but possible with time, space and sufficient force properly directed.

Perry
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  1. more than a month ago
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Bruce Thomas Accepted Answer Pending Moderation
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I'm wondering if 1) I could successfully do this with a developing teenage jaw allowing growth in the factor. 2) If I chose to do this, what kind of treatment?
I am thinking a couple of months in leveling wires and full brackets followed by invisalign for the rest of treatment. (The patient is very motivated toward Invisalign rather than traditional ortho, but I can convince her for a short time).
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  1. more than a month ago
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Dr Perry E. Jones Accepted Answer Pending Moderation
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Really need more information. Do you have a CBCT, panorex, periapicals. Hand-wrist evaluation of sesmoid bone growth would help you define "Teenage jaw" development.That would help! I can send you comparison data location if interested.
Fixed mechanics to upright the second molar is a good idea. Then follow with Invisalign finish! Who wants bands and brackets when a removable/invisible/comfortable series of clear aligners (Invisalign) will work!
I don't know what the development of the root of the "impacted" second molar looks like as far as development. I have had success with several different "trapped" molar uprighting. Brass wire looped under the proximal contact and tightened can encourage uprighting. Simple rubber "separators" sometimes work. There is a purpose made "interproximal spring" that i have used many years ago prior to fixed mechanics that may work. That give you a few options to think about!

Hope this helps! Its a large mountain to climb to properly upright and align a second molar with Invisalign as the stand alone force system! If you have fixed mechanics in your armentarium of tooth movement, fixed with an Invisalign finish is great choice!
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  1. more than a month ago
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