Metal Mouth Message Board

Hi guys,

My first post here!

I've read many posts about patients having Bone loss / black triangle during or after their ortho treatment, and I'm one of them. I'm wearing invisalign myself (for 7 months now) but I'd believe this could also happen to patients who wear fixed braces.

From what I've read and what I was told my my dentist / ortho / periodontist, bone loss / black triangle cannot be reversed. I'm aware that IPR might improve the situation a little. But if the black triangle is so big then I guess IPR probably won't help much. I have 6,7 of those and the biggest one is about 2mm wide on the base. They were pre existing prior to the ortho treatment. Gum graft was performed but it made the black triangles even bigger!

Obviously I can't have a 2mm IPR because the teeth will look so long and thin. Thus, not having a natural proportion.

The worse thing is that not only the pre existing black triangles got even bigger during the ortho treatment, there are at least 4, 5 new ones formed. I'm very certain that these new ones were not there before.

The confusing part is, from the braces booklet I got from my ortho, it states that the bone will dissolve during the shifting of the teeth, and the body will deposit new bone after the teeth are shifted to the new position. This sounds to me the bone loss / black triangle caused by the ortho treatment should actually disappear / be reversed sometime after the treatment??

If the black triangle will stay there forever, then it totally defeats the purpose of us getting braces
! I honestly think I look worse than before!

Any thoughts experts?

Thanks

There is natural bone breakdown/buildup that happens as a result of braces moving teeth. As the teeth are pulled from the force of the wire thru the jaw bone, the bone on one side of the tooth breaks down, the tooth takes its position into that new spot, and the bone on the other side where the tooth came from is reformed--so on and so forth, over and over until braces are removed. In this case, if everything in your body is functioning properly, you will grow new jaw bone around all the teeth once they are straight.

Then there is permanent bone loss. Permanent bone loss is as the name suggests--permanent. I really don't know much about it except that it's very serious and can be exacerbated/caused by ortho treatment. Permanent bone loss can happen if braces are on too long, or if you have a genetic predisposition to bone loss.

Black triangles are usually due to tooth shape and are formed when the teeth are wider at the bottom than at the top. If your teeth are crooked and overlap each other, the triangles are not noticeable. When braces straighten the teeth and the teeth touch properly, the triangles show up. Unfortunately triangles can be made worse in some cases with braces however I would disagree that getting triangles defeats the purpose of braces. Healthy straight teeth and a proper occlusion trump black triangles.

As you already know, triangles can be minimized by IPR. You can also have the gaps bonded by your dentist or ortho with tooth colored material. And one final thought--when braces are removed and the gums settle down, sometimes they fill in a bit of the gap. This happened with me. I had a pretty large black triangle between my front teeth. It was very noticeable. I had some IPR done, but that didn't solve the whole problem. My gum came down and filled in a bit more of the gap. I still have a tiny triangle, but I don't really find it annoying or terribly noticeable.

Speak to your ortho or dentist about the triangles and discuss your options.

Sorry for such the long post but I hope it helps.

Jumping in here, can you tell me what IPR stands for? Thanks!

purplepetunia wrote:Jumping in here, can you tell me what IPR stands for? Thanks!

Interproximal Reduction.
Good overview here: http://www.bracesquestions.com/static/b ... ction-ipr/

Thank you TumbleDryLow. Good article!

TumbleDryLow, thanks for your comments!

I had discussed with my ortho about the black triangles and was assured that they can be closed with IPR. Now it doesn't look like they can be completely closed...

Regarding to the bonding you had, was it something like the below? They are Youtube links but I had to remove part of the URL to post this.

/watch?v=yFO69rZmmZo

/watch?v=qrYxXZI8pKM

Thanks

33333 wrote: Regarding to the bonding you had

I didn't have bonding. Sorry if I gave you the impression that I did. I only needed IPR and my gum tissue filled in enough of the triangle for me to be happy. And I couldn't watch the videos. I have a pretty serious dental phobia. I got about 10 seconds in before I got queasy. From what I know (from reading this site) bonding for triangles similar to getting a filling. I think that sometimes the teeth involved need to be ground down a bit to get the composite to stick and look natural. Going this route is a life-long commitment as the bonding will need re-doing when it breaks down.

I stumbled across this good Q&A which you may find interesting http://www.realself.com/question/what-c ... -treatment

Many of the orthos/dentist in the Q&A above seem to believe that the gum tissue will fill in over time (as mine did). They say that younger patients have a greater chance of the tissue filling in, but I'm 38--so it can happen if you are "older" too!

[quote="TumbleDryLow"][quote="33333"] Regarding to the bonding you had [/quote]

I didn't have bonding...[/quote]

If you add www dot youtube dot com before then you should be able to see them. My case is quite similar to the first link.

Yea bonding is a life long commitment but it's better than having the life long triangles. =/

Thanks for the link, I actually had read it. Useful information there.