June 26, 2013

Yet Another Adjustment

Hello all,

So today I had another visit with Dr. P. It's the first adjustment since my second meeting with the surgeon (which was highly uneventful, ended up just signing some paperwork and having some x-rays. Okay the x-rays were quite exciting). Though he was a bit more clear about what he wants done before surgery, in particular the movement of the lateral incisors.

I created a picture (in paint, woo!) of how I understand it:

So the red lines indicate where the surgeon wants to cut so he can move the front section down and close my open bite. However the lateral incisors seem to be a bit tilted side-ways and the roots are in the way of the cutting path. Dr. P's approach was to break off the brackets on the lateral incisors and re-position them on an angle. This means that when the arch wire is put back on, the teeth would want to move in the direction of the yellow arrows. The problem with this is basic physics - the tooth wants to rotate around it's centre of gravity (being approx where the purple dot is) the root rotating in the direction of the orange arrow. This is not ideal as it doesn't really solve the problem of creating a space for the surgeon to cut.

The solution is to whack a wire (shown in grey) around the front four teeth to keep them together, thereby moving the centre of rotation down to where the bracket is attached to the tooth. The parts of the teeth that show stay where they are, while the roots rotate in and out of the way:

Resulting in lot's of room for the surgeon to chop chop chop away:

Here is a photo of the funky wire configuration (that sits behind the arch wire):

And a photo to illustrate the rotated bracket and resulting curved wire (shown by the green arrow and red lines):

The blue arrow is showing the gap that has already appeared since this morning...

As you can imagine, they are pretty sore. But nothing I haven't dealt with before! :)