The comments
Yang says:
Hi Doctor,Thank you for your valuable response, I sent the X-ray, pictures and the picture of that bite corrector by email. Because my son also has a little bit cross bite, the corrector will fix it also for making space for canine come down. Actually I don’t want the way to extract the teeth. I’m just wondering is there the way to fix the problem without extracting the teeth. Thank you for your time!
Best regards
Yang
Dr Sylvain Chamberland, Orthodontiste says:
I don't think Invisaling would be effective to treat impacted canines.If the front teeth are shift to one side, this mean that there is space loss on that side and the canine will be ectopic. Extraction of 4 teeth is not a bad treatment plan.
I don't know what you mean by a "bite corrector appliace" There is so many appliance. This name is to vague.
You may upload xray to a dropbox and send me the link in the comments box of my website.
Dr Sylvain Chamberland, Orthodontiste says:
If the canine are place buccally and between the roots of the lateral and the premolars, you could wait and reassess in 6 months. If the canine are place buccally over the root of the latera incisors, you should not wait.Don't expect that the canines will align nicely if there is a lack of space.
Yang says:
Hi, my 11 years old son has his upper permanent canine tooth come out from his gum, and his upper front two teeth kind of shift to one side. We went to the two orthodontist and they give different ways to let let the canine tooth come to the right place, one is extract 4teeth and put braces. Another is to put:1. Bite corrector appliance (for about 6-8 months)
2. Invisalign (for about 12-14 months)
3. Retainers after treatment
I don’t know which is the perfect and suitable plan for my son’ s case, for us we don’t want to extract teeth, so if possible would you please give us some advice and the way to fix my Son’s canine tooth, thank you very much!
Can I send you the X-ray by email, because I don’t have Facebook
Angela says:
Hello, my daugher is 12 years old. I was told that "13-23 are buccaly placed without space to form maxillary arch". This was just after a visually exam,there is some space but I am wondering if should we wait a little and see if they nicely completely erupt or start to contact and orthodontist.Dr Sylvain Chamberland, Orthodontiste says:
It is not to late to fix you crooked smile. You may require orthognatic surgery to correct your occlusion (and face) in the 3 planes of space.Melanie says:
I am a 53 year old woman who has TMJ. Found out back in 1990, when working for an orthodontist at the time, wanted to test out a new panoramic X-ray machine. To my surprise he told me that my mandible was broke off at the condyle! I can’t remember when this happened. He suggest going to Dr Pamela Stead in Indianapolis. She had taken more xrays, photos showing my misaligned jaw and dental molds of my teeth ( which my back molars on the side of my jaw problem are lower than the other side). Dr Stead started treating me with an appliance to help with the TMJ and neck pain. Over the years I notice that my smile is crooked and my face also. I absolutely hate it! Wished that I knew when this happened as a child and that someone could of helped with the alignment of my bite and off center of my smile!Dr Sylvain Chamberland, Orthodontiste says:
CHances are that you have a retrognatic mandible and you may need a surgery to advance the mandible of the chin.Dr Sylvain Chamberland, Orthodontiste says:
Bimax protrusion can be solve by 4 premolars extraction.SUrgey may be possible if there is a skeletal discrepancy too.
Dr Sylvain Chamberland, Orthodontiste says:
No, I do not use a chin cup. It would be very impopular in my area. It will not stop mandibular growth anyway.Orthognathic surgery is easy, accessible and predictable. Moreover, our health care system cover the cost.
Hong Li says:
In the case of mandibular excessive growth:Do you ever make use of chin cup?
or just wait till 18 yrs old and surgery?
Thank you
Dr Sylvain Chamberland, Orthodontiste says:
I would be hesitant to use a facemask in a vertical grower if there is an open bite. However, if one use an hybrid hyrax with miniscrew, forward movement of the maxilla will be easier. See the picture above.I don't use bonded expander with occlusal rest. I only use banded expansion device.
Dr Sylvain Chamberland, Orthodontiste says:
At this age we can use hybrid hyrax with 2 miniscrew. This would help protracting the maxilla. It is true that the Facemask does not limit mandibular growth. The goal os to bring the maxilla forward enough to achieve positive overjet + some extra.This case show the change in only 2 weeks. The expansion device was bonded, activation 1 swing per day. Wear of facemask 12 hours per days.
At baseline, centric relation show edge to edge incisor relationship. At 14 days, a positive overjet is obtained. The patient is 9 years old.
Dr Sylvain Chamberland, Orthodontiste says:
You can send it via my professional facebook page. If you dod so, it means that you accept that I can use some of the xray and intraoral photo to answer on this web page. I WILL NOT publish your face or identity.qing guo says:
Thank you for the great article! I really enjoyed reading it.I have these questions:
1. Would you consider NOT using the facemask in a vertical grower or high angle case - in case the mandible rotates too much after facemask and patient looks too long in the face? What can be done instead if you are concerned with vertical growth? Or at that age (7-8) it is still early therefore not to worry?
2. Would you prefer bonded expander with occlusal coverage over a banded hyrex so the expansion is more orthopedic and less buccal tipping?
Regards
Hong Li says:
Hi Dr Chamberland,How/would you use the chin cup and face mask to treat combination case (11 yrs old boy with 2mm deficient max with 1mm negative overjet) to protract max and limit mandibular growth ?
Since you mention earlier on that face mask doesn't control mand growth.
Thanks
Jeff says:
Hi Dr. Chamberland,Would I be able to forward you my cephalometric xray, panoramic xray, and several pictures of myself to determine whether I am to be considered bimaxillary protrusive, and whether I would benefit from some variety of treatment?
Thanks
Dr Sylvain Chamberland, Orthodontiste says:
It is not unsual to have the 4 wisdom teeth removed and 4 premolars. The removal of 4 teeht in the back has no effect on the bimax protrusion.Dr Sylvain Chamberland, Orthodontiste says:
I do not beleive that Invisalign will be effective to correct class II malocclusion with effectiveness although it may achieve some change.I would prefer braces and fixed functional device like Forsus or mara.