Anterior open bite, retreating 20 yrs later, intro and ?

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jfriend33
Posts: 255
Joined: Wed Aug 27, 2014 6:07 pm

Re: Anterior open bite, retreating 20 yrs later, intro and ?

#76 Post by jfriend33 » Thu Apr 14, 2016 6:39 pm

ajs604 wrote:Oh wow I didn't realise they needed pilot holes, sounds pretty crazy!

I did read somewhere that Essix can induce an open bite as you can't close your teeth when wearing them as opposed to the Hawley. However, saying that I read it on a forum so you could say it was no an accurate source. I would say the pros for the Essix are that they are practically invisible but a con would be they crack easily. I already have a crack on my last molars, that's probably to do with clenching. Still it fits well and will get checked when I next go to the orthodontist. I wear mine every night and use chewy bite aligners to get a better seal, my orthodontist told me it also helps maintain intrusion during the renetention phase as well.

From talking to you on here I have also decided to go and see an oral myologist as well, even though I am sure I don't have a tongue thrust but feel it makes sense to get it checked out.
Yes to the chewies! A guy that created orthotropics recommends those just for general chewing! I need to get some of those!

jfriend33
Posts: 255
Joined: Wed Aug 27, 2014 6:07 pm

Re: Anterior open bite, retreating 20 yrs later, intro and ?

#77 Post by jfriend33 » Tue Apr 26, 2016 1:24 pm

Well yesterday's visit went ok. Now have strange figure 8 steel ties on upper 6 teeth. No power chain. Trying to close the gaps between a few teeth... Ummm ok. Did more interproximal reduction, this time on the bottom (yet last time when they did it to the top they said it's bad for bottom teeth).

Reconfigured my elastic pattern and indicated it with different color ties, brilliant idea.

Dr was encouraging one of those tooth positioners and I respectfully declined. She claimed they are custom made so they took some impressions. I just remember even with chincup headgear I could not keep that in at night.

I said I am highly leaning towards permanent upper and lower with essix then transition to hawleys.

Back four molars don't touch which is acceptable. But on one side a molar and pre molar do not make contact and need to tip outward. They allegedly modified my upper archwire to widen the arch so we will see.

As long as I have moderately level planes, my midline is good enough for me, and they fix these black triangles and gaps, and do more tooth shaping I'll be content. I just don't like that they are trying to rush me because my Dr is graduating.

So 2 weeks for one more adjustment and June 6th is the tentative debonding date but I doubt I will be ready!
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rebecca121760
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Re: Anterior open bite, retreating 20 yrs later, intro and ?

#78 Post by rebecca121760 » Fri Apr 29, 2016 12:17 pm

I just wanted to say, AMAZING!!
I wanted to send a picture of Noah's mouth and sorry it took me forever. We are in treatment in Denver but things are not moving. Going back out there tomorrow. The travel is killing us financially. Where did you have your treatment done? What appliances did they use? Did they use an ALF by chance?
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jfriend33
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Re: Anterior open bite, retreating 20 yrs later, intro and ?

#79 Post by jfriend33 » Fri Apr 29, 2016 12:40 pm

rebecca121760 wrote:I just wanted to say, AMAZING!!
I wanted to send a picture of Noah's mouth and sorry it took me forever. We are in treatment in Denver but things are not moving. Going back out there tomorrow. The travel is killing us financially. Where did you have your treatment done? What appliances did they use? Did they use an ALF by chance?
I will message you location privately. It's at a university.

How far do you travel? I do about 1hr45 each way every 4-6 weeks.

My appliances that didn't break were lower lingual holding arch (with spikes that were later removed then all removed when tads removed) to prevent tipping when intruding my lower molars. My Nance appliance with acrylic button broke then one without the button broke too so they just used palatal tads with niti Springs.

I'm no ortho and don't know everything but if it were me I'd have tongue checked, possible tongue tamers, and full upper and lower braces, use a palatal expander attached to one palatal tad later for intrusion. Check for mouth breathing, swallowing, and resting tongue posture.

What's their plan? Msg me here or privately.

rebecca121760
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Joined: Mon Feb 16, 2015 5:28 pm

Re: Anterior open bite, retreating 20 yrs later, intro and ?

#80 Post by rebecca121760 » Fri Apr 29, 2016 1:57 pm

Yes, Noah is the one with the "cheerleaders syndrome." We found a dentist in colorado who is trying to treat him starting with a palate expander. it was removable, but it broke this week and nobody local can fix it so we have to travel out there this weekend and stay 5 days. It is about 9 hours or a 2 hour flight. Their plan is to put in an expander that hooks to his molars while we are out there. The plan after that is a myobrace, myofunctional therapy to address the tongue thrust, braces and tads to try to fix it. Everyone else wanted braces, then surgery then more braces. They also wanted to replace his tmj's which i am dead set against because I feel we are setting him up for more surgery as the years go by and the tmj replacements have not been out long enough to suit me. He was making good progress with the expander, then the screw started turning itself back and he didn't realize it, so then he wasn't making progress. We send pictures every couple of months. Anyway, they told us to start turning it twice a day instead of once every 3 days which seemed like a huge jump. It promptly broke after about a week and a half of that. I have recently been reading about something called an ALF appliance. they are using it in functional orthodontics which is basically Dr. Lauson"s idea with a better appliance. If you google Park Avenue dentist open bite on utube, she has an amazing video and it only took 13 months. The problem is.... She is in New York and we are in Missouri. Sigh...

HummerMan3
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Re: Anterior open bite, retreating 20 yrs later, intro and ?

#81 Post by HummerMan3 » Wed May 11, 2016 5:33 am

Jfriend,
Just wanted thank you immensely for this thread. Although I've been lurking on Archwired for the last couple months in anticipation of getting braces, my orthodontic consultation yesterday confirmed that I have many of the same issues that you have faced (open bite, over jet, tongue thrust). I've known for the longest time that I'm a tongue thruster, and I'm pretty sure it is the cause for my relapsed open bite after having braces some dozen or so years ago. After the diagnoses and referral to oral surgeon yesterday, I found your thread and read it end-to-end. You do your homework ...you must drive your orthodontist nuts! hehe At least you're keeping the ortho students on their toes.
Looking forward to seeing your final results!

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Mimo1985
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Re: Anterior open bite, retreating 20 yrs later, intro and ?

#82 Post by Mimo1985 » Sat May 14, 2016 11:30 pm

I think this is a really interesting post :)

I too have Anterior open bite. Had braces from 15-17, everything fell in line nicely (for a while) and then a year later - open bite came back. It was theorized that it was jaw growth on one side that led again to the open bite- but my current and new ortho has concluded that it is all the tongue. As she says, "the tongue is a wild animal". She is right.

Anyway - I find this interesting because I have never had to deal with the issue that pushing my tongue to the front of my mouth was a problem. I seem to have an issue with pressure pushing at night and when I wake up its against the front full force. I think it might be a stress thing for me, Im not sure.

I dont know how "well" I can self treat it besides focusing constantly on keeping my tongue back. My braces (again at age 31, and only a week on) make my teeth so tender that even if I do push my tongue even close to the front, my arches ache and I immediently pull it back. Maybe thats the upside to braces and sore teeth.

They have discussed with me putting on the Habit Breaker things on there (the ones that look like shark teeth, or white spikes). I am not looking forward to it, but I do want to be a compliant and good client to my ortho so if she strongly suggests them I will get them. Anyway - good luck to you and congrats on all your progress!

jfriend33
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Re: Anterior open bite, retreating 20 yrs later, intro and ?

#83 Post by jfriend33 » Mon May 16, 2016 1:12 pm

Well no debonding next month. Cest la vie.

Did a ton more IPR to reduce black triangles on top and bottom. Also refused to do any bracket repositioning. Whatever.

Did a few other archwire tweaks to flare out my upper back 6's.

Reconfigured elastics to my preference and also did power chain.

Said things should close up in a few days.... We'll see!

I'm at the end. I hate to not pick but why rush?
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FixMyOpenBitePlz
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Re: Anterior open bite, retreating 20 yrs later, intro and ?

#84 Post by FixMyOpenBitePlz » Tue May 24, 2016 9:16 pm

Thank you for sharing this!

jfriend33
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Re: Anterior open bite, retreating 20 yrs later, intro and ?

#85 Post by jfriend33 » Tue May 24, 2016 9:32 pm

FixMyOpenBitePlz wrote:Thank you for sharing this!
Whoops I replied to the wrong post!
FixMyOpenBitePlz wrote:I got them on when I was 10, but they relapsed because the orthondontist basically didn't "catch" my open bite. I think he just didn't care about his patients and cared more about the money
Ditto. It still an interesting thing. To this day I have overheard surgeons insist that after orthognatic surgery and braces, with a proper bite, the tongue will rest on the bony ridge of the palate. This does happen sometime but it's no guarantee.

Are you planning on being retreated? What are your symptoms?

I always forget to mention how much better I breathe. I'm not sure if it's because I'm older ( and as you age your tonsils shrink) but it's twenty times better than it was 2 years ago while I was still in myofunctional therapy.

I do suggest getting allergy tests done. For me simple generic Flonase or nasocort really sealed the deal. Although one time when I was sick I accidentally got hooked on a vicks vapo inhaler... I had used one previously that only contained menthol so naturally I assumed all were the some. Nope! Just as bad as afrin!


In other news after my MAJOR IPR 8 days ago for black triangles... things are slowly creeping.... Just weird to see all these gaps!!! I feel like this should have happened earlier and not at the end stages. And I still can't convince anyone to do too much bracket repositioning. I'm like, shouldn't you take a pano and see what my root positions are like since I'm almost done, they said nope, maybe next time. If I were an ortho I would be shaping teeth and doing tons of bracket repositioning all through TX instead of mostly archwire bends but that's just me!
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jfriend33
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Re: Anterior open bite, retreating 20 yrs later, intro and ?

#86 Post by jfriend33 » Thu May 26, 2016 1:24 pm

http://www.scielo.br/scielo.php?pid=S21 ... xt&tlng=en

#27 seems quite interesting. Custom made tooth positioner prior to essix. I didn't know they actually used molds with braces, shaved them off the molds, and can even reposition one tooth per quadrant. Neat!

I am very interested in these for upper and lower paired with essix: http://www.tripleodentallabs.com/labora ... p-retainer

They seem to be longer lasting and easier to floss with!

jfriend33
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Re: Anterior open bite, retreating 20 yrs later, intro and ?

#87 Post by jfriend33 » Mon Jun 13, 2016 9:06 am

Last appt with the student thats treated me for about 2 years. Now next month I start seeing a different 2nd year student but with the same supervising doctor.

To accelerate closing of the gaps from IPR on top, they used powerchain but installed it BELOW the archwire since both my archwires are TMA (beta titanium and produce the most friction). I guess placing the powerchain below the wire will lessen the friction. I did notice things closed up pretty nicely up top, but not so much on the bottom.

Wearing triangle elastics this last month and then changing to class 2 to close up my overjet.

I am still not happy with the position of my upper k9s and think they need to be rotated.
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jfriend33
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Re: Anterior open bite, retreating 20 yrs later, intro and ?

#88 Post by jfriend33 » Fri Jul 08, 2016 4:38 pm

Hope everyone is having a great week out there in ortho land. Just bored and posting an update before I have my adjustment on Monday. I had to stop the triangle elastics on both sides because I was biting my lower archwire, so I switched to upper k9 lower 2nd premolar early. Usually in the past biting on it has caused the powerchain to break, and its just uncomfortable in general to bite wire! But hey this is great that my bite has closed this much, right?!

So most of my gaps are closed from IPR except for one small one between my lower two front teeth. All my black triangles are gone, except for the ones between my lateral incisors and my upper k9s. I feel if my k9s were tipped differently my smile would look better and the triangles would disappear (and also make a little room to close up the overjet). I think my two front teeth need to come down some which should be an easy fix. But this overjet has got to go! (they did mention stepping up my lower front teeth as a last resort).

I am really disliking how fast these ligatures fade. What is it? I do not drink coffee more than once a week, I don't drink tea, I don't brush my teeth 20 times a day with whitening paste, and I don't smoke! You can even tell a difference in the pics from today how faded they look. Heck on the bottom even the silver powerchain has a slight yellow tinge to it. Is it because its at a teaching school and they are using some cheap brand? lol I know one thing, I was being bad and ate some popcorn, and sprinkled some kraft macaroni cheese powder on it to make cheesecorn, wowee that stuff took 5 days to wash out of the grey powerchain! Ah well not a big deal!

I did take antibiotics quite frequently as a child which has caused some mild discoloration that I'd like to address post debonding. It looks a little like white flecks but its not that noticeable.

Also at my last visit when I was expressing my concern for my lower 2nd molars that are only making contact with my lower 1st molars on the corner, they didnt seem to care. It creates this huge space where food gets stuck. They claim that everything will move forward and settle after debonding. I will ask them to put lingual buttons and connect with powerchain so they can move along, It will probably be heck for my tongue but c'est la vie.

I have also asked like 3 times now about bracket repositioning and everytime I get shut down. They are all hell bent on making archwire bends and using this TMA wire which I feel has made my treatment take longer.

Also I am never EVER allowing them to do that powerchain under the archwire thing again. What a NIGHTMARE. Yes it sure did work, but even yesterday my dentist was like wow that is basically touching all of your teeth be very careful. I just thought it was weird in general that since my supervising doc was gone, another one came over to check on my student doc, and they said why are you even using a TMA archwire with powerchain. Dont you know how much friction TMA causes? You should be using something completely different. Then the student said no, this is all we are allowed to use for finishing. The super said to do the powerchain under the wire technique. I also just discovered from google that they make a low friction TMA wire, that would have been helpful!

Don't my upper and lower k9s look way too pointy still? I think they'd look better if they were contoured. Thoughts??? I really hate to turn into a perfectionist, but I really had NO idea that my bite would ever get this good. Some days I am really ready to be done though...........
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jfriend33
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Re: Anterior open bite, retreating 20 yrs later, intro and ?

#89 Post by jfriend33 » Fri Jul 08, 2016 4:43 pm

ok apparently you can only upload 3 photos, sorry for the double post, but here is the photo of the overjet
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jfriend33
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Re: Anterior open bite, retreating 20 yrs later, intro and ?

#90 Post by jfriend33 » Tue Jul 12, 2016 2:38 pm

Well my visit with a new student went well. He is in his 2nd year. That felt good to know it wasn't someone brand new, or had no experience with tads, or open bites, etc!

So, basically they just added more steps to my upper archwire, to bring down my front two teeth. And also to flare out slightly my upper 2nd molars. They also did more IPR (just with the manual lightning strips not the powered burr), apparently there was some bump way down low keeping my lower two teeth apart.

Still not happy about the black triangles by my k9s. They seem pretty clueless on how to fix this without making more problems. I still think the torque is not right on my upper k9s and even though I am NOT a dentist and may try to sound like one, I think if they were turned and did minimal IPR between the k9s and bicuspids it would be fine.

No more 24 hr elastics! Wahoo. Only at night, wearing from upper k9's to first premolar. Very loose, dont really see the point.

ANYWAY I am very please with the overall space closure, and in just 24 hours how far my front two teeth have dropped. They said braces for sure off by christmas. But the annoying this is I am only able to get in every 6 weeks for a while with this new person....pretty sure every 4 weeks would speed things up.... I think I am going to make an album somewhere so things can be higher resolution and less grainy!

They are also not that thrilled about my insisting of the use of permanent retainers that differ than what they use. I am getting the v loop style even if I have to pay for it. They are so awesome looking (sorry if I have rambled about this before or posted a link but look how cool they are! no floss interference! http://www.tripleodentallabs.com/labora ... p-retainer of course paired with essix in day, and hawley at night or something!
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