Dr. Maryam Hamid Al-Doori

“Inadvertent Tooth Movement After Fixed Lingual Retention: A Clinical Case and Prevention Strategies”
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🔺A Real Case presented to my clinic shows a side effect, inadvertent movement of the teeth, after successful orthodontic treatment with a twisted fixed lingual retainer. Over time, the retainer gradually caused the anterior teeth to tip and altered their torque.

🔺To avoid this: It is better to use dead-soft lingual wires and avoid twisted wires. The reason is that twisted wires are inherently susceptible to unwinding, which can cause tooth rotation, as illustrated in the teeth and composite interface diagrams.

🔺A study titled “Inadvertent Side Effects of Fixed Lingual Retainers” suggests that inadvertent tooth movements are most often observed in patients with retainers made from multistranded wires.

🔺Another study shows that small-diameter flexible spiral wires bonded to each tooth pose the greatest risk of causing significant inadvertent tooth movement and related complications.

🔺Why this activation occurs:
1. Wire deformation may occur post-treatment from biting hard foods or trauma, effectively activating the wire as if the orthodontist had bent it.
2. Patients may inadvertently distort the retainer wire while flossing, as enough force can be generated under the wire with dental floss.
4. Wire breakage can create separated segments that become active, leading to unintended tooth movement.

🔺Best steps to follow during the retention stage:
1. Ensure passive wire fabrication
2. Maintain regular monitoring of retainer integrity
3. Use a working model for flexible wire adaptation
4. Choose DEAD-SOFT WIRES

▫️P.S. The white illustrated diagram of the teeth and wire twisting, as well as the last image in this post are from the Contemporary Orthodontics textbook and the study cited above.

🔁 RePost

“Inadvertent Tooth Movement After Fixed Lingual Retention: A Clinical Case and Prevention Strategies”

🔁 RePost

___________
🔺A Real Case presented to my clinic shows a side effect, inadvertent movement of the teeth, after successful orthodontic treatment with a twisted fixed lingual retainer. Over time, the retainer gradually caused the anterior teeth to tip and altered their torque.

🔺To avoid this: It is better to use dead-soft lingual wires and avoid twisted wires. The reason is that twisted wires are inherently susceptible to unwinding, which can cause tooth rotation, as illustrated in the teeth and composite interface diagrams.

🔺A study titled “Inadvertent Side Effects of Fixed Lingual Retainers” suggests that inadvertent tooth movements are most often observed in patients with retainers made from multistranded wires.

🔺Another study shows that small-diameter flexible spiral wires bonded to each tooth pose the greatest risk of causing significant inadvertent tooth movement and related complications.

🔺Why this activation occurs:
1. Wire deformation may occur post-treatment from biting hard foods or trauma, effectively activating the wire as if the orthodontist had bent it.
2. Patients may inadvertently distort the retainer wire while flossing, as enough force can be generated under the wire with dental floss.
4. Wire breakage can create separated segments that become active, leading to unintended tooth movement.

🔺Best steps to follow during the retention stage:
1. Ensure passive wire fabrication
2. Maintain regular monitoring of retainer integrity
3. Use a working model for flexible wire adaptation
4. Choose DEAD-SOFT WIRES

▫️P.S. The white illustrated diagram of the teeth and wire twisting, as well as the last image in this post are from the Contemporary Orthodontics textbook and the study cited above.

The more I dive into the DAMON System, the more I appreciate and admire its philosophy. Even though I’ve attended many certification courses, it never gets boring, it remains just as exciting every time.

A big thank you dear Dr. Dr Haithem Dhan أخصائي تقويم أسنان for the outstanding way you present and teach this system. As always, it was an excellent lecture.

And thank you Ormco Iraq , Dr. Ali Methaq and Dr. عُمر, for the kind invitation. It was truly a pleasure to be part of it.

‎شكرًا د. هيثم على المحاضرة المميزة، كالعادة
شكراً اورمكو العراق (د. علي و د. عمر) على الدعوة الكريمة…سعدت جداً بالحضور..

You can start canine & molar distalization in the early stages of treatment using light mechanics and controlled movements.

🔺 I always disarticulate the arches with this technique. The positioning of the bite raisers depends on the case.

🔺 When you want to apply this technique, it’s always better to use SLB (Self-Ligating Brackets) with CuNiTi wires.



Have you ever used early IME with SLB?

🔺On the last NiTi wire, I routinely take an OPG for all of my cases and carefully evaluate each bracket position in relation to the long axis of its corresponding root. The goal is to ensure proper root alignment and distal root angulation where indicated. This stage is commonly referred to as the Panoramic Repositioning {Pano Repo} stage.

🔺In this case, I was able to identify the problem clinically even before taking the OPG, which was later confirmed radiographically. After repositioning the bracket to align it correctly with the long axis of the tooth, the tooth angulation improved significantly.

Evidence of this correction was {the space} that was gained and the disappearance of the black triangle.

🔺Following completion of the Pano Repo stage and achievement of the desired root positioning, space closure was initiated on a heavy S.S. archwire.

As I leave Al-Kamali to begin a new journey, I would like to share a few words from the heart…

Dear Professor Dr. , you are the one who showed me the way in dentistry after graduation and supported me in ways I cannot fully put into words. Every single day with you was an opportunity to learn from your experience, guidance, morals, and humility.

My courage to pursue Orthodontics came because of you, Prof., after the tawfiq of Allah. You are the reason I began this journey and found myself working in the field I am most passionate about, and today, I work in orthodontics with confidence because of the trust you placed in me from the very first bracket placement.

This is not the end of the journey. I will always remain your grateful student, continue learning from you, and always be like a daughter for the rest of my life.

Dr. .ryd , thank you for the successes we achieved together, and for the lovely dinner gathering yesterday. Wishing you, the center, and our lovely staff all the very best.

🔺Growth Modification | Early treatment of skeletal class III malocclusion {that was exacerbated due to the presence of supplemental lower right lateral},
using:
1. Lower anterior inclined bite raisers
2. Segmented S.S. arch wire “on lower anteriors” with two hooks created on both sides inside the arch wire for holding the inter-maxillary elastics
3. Class III IME


OTME = {Orthodontics Tips Made Easy} By Dr. Maryam Hamid Al-Doori

🔺“Skeletal” ClassIII case | 31 Y.O Male pt. | Problem list:
* Deep Anterior Cross Bite
* Deep Uni-lateral Cross Bite
* Class III (Dental/ right side & Skeletal)
* Canting
🔺Treatment managed:
* Without Surgery
* Without the use of Expanders
* Without extraction (Only Wisdom teeth)
🔺Treatment stages is still in progress..
Full detail of the treatment plan to be shared in an upcoming post..

OTME = {Orthodontics Tips Made Easy} By Dr. Maryam Hamid Al-Doori