To be brief and concise, coming from the AAO meeting in which I listened to a number of lectures and networked with my fellow orthodontists, the evidence and literature are pointing to the fact that there is no significant difference in treatment time, comfort, quality of treatment or any other parameter between self-ligated and ligated brackets. In the words of one lecturer, "...the answer is in the wire, not the bracket".
I will editorialize at this point. Some orthodontic manufacturers are now targeting the patient, rather than the clinician, in order to sell their products. This is similar to the drug companies and their heavy TV commercials targeting the consumer with a vast array of pharmaceuticals. My comment on this is "let the buyer beware and be aware".
Wednesday, May 20, 2009
Subscribe to:
Post Comments (Atom)
Posts
4 comments:
Hey Dr. Straight,
Always a pleasure to read your blog, I just wanted to clarify something with regard to self ligating vs ligating, when I was shopping around for an ortho, in many of the consults where they use conventional ligating braces deemed it was imperative for me to have 4 extractions, I was very extraction-averse finally the only ortho using damon braces in my city said it would not be necessary to extract and here I am 8 months into the treatment with no need for extraction. Is this a case of orthodontic expertise or philosophy ( extracting vs non-extracting) please shed some light on this.
There are some orthodontic companies that claim that if you use their self-ligating brackets you will do fewer or no extractions. Personally, I think this has nothing to do with the bracket and everything to do with the wider, expanded arch form that they use for their arch wires for these appliance systems.
There are those practitioners that have "drank the juice" of these claims and are expanding cases beyond what is safe or stable (my opinion).
Sometimes non-extraction treatment surprises us and we are glad that we did not take out teeth. Othertimes we end up taking teeth out or wishing that we did.
I am suspicious of any orthodontist that says that he/she never takes out teeth.
I would like to leave the question in here since I faced similar problem. I went for a coupne of orthodonts to get a consultation on my case. 1 of them suggested regular metal braces or damon (but possibly without extractions with both systems) and I was fine with this - I was thinking of chosing regular ones. BUT,I visited anothe one who is working only with regular ones, she requested for me to take out 4 teeth and probably all wisdom-teeth also (she claimed another specialist for saying that extractions are nor necessary) because if I wouldn't extract it my teeth at the end would change the angle and move forward. She says she doesn't believe in self-ligating systems as it wasn't proved scientifically. So I'm kind of mixed up right now, I booked a visit for the 3rd specialist but would like to hear your oppinion whether it is possible not to extract teeth (does it really make that bad consequences)? Somehow I do not really want to get rid of 8 of mine and therefore I am considerind Damons only because of that reason.
Thank you for an answer
Rita,
The brackets have little if anything to do with extraction vs non-extraction. It all comes down to the diagnosis made by the orthodontist,their idea of facial esthetics, stability and their educational background. There are many times in the case of "borderline extraction" cases when one practitioner will suggest extractions, one won't and another will do it as a trial non-extraction and see how things develop through treatment.
I would be cautious with anyone that says they never extract teeth just as much as I would be cautious with someone who extracts teeth in the majority of cases. I find that I have to extract in about 20% of my cases. This may vary with different orthodontists.
Post a Comment