Short Term Orthodontics (STO) is typically thought of as a cosmetic procedure. Similar to treatment with aligners, most patients pursue STO primarily for cosmetic reasons, but changes to tooth position can greatly benefit function and help to preserve tooth structure and TMJ integrity. For these reasons, restorative dentists have found STO to be an essential part of their offerings.
In our practices, we oftentimes see patients who have constricted chewing patterns. Also described as a constricted envelope of function, these people have premature contacts on their anterior teeth and various forms of adaptation occur to allow for posterior teeth to contact. In other words, the brain and body adapt to allow for a maximum intercuspal position that includes posterior occlusal contacts. Adaptive changes that occur to help establish these posterior occlusal contacts generally include: muscular retrusion of the mandible with distalization of the condyles, anterior tooth wear, anterior fremitus and/or anterior spacing. In essence, the maxillary anterior teeth are simply “in the way” of the lower anterior teeth and are an obstacle that makes normal and healthy function of the stomatognathic system more difficult.
When a constricted envelope exists, it is challenging for restorative dentists to address because the etiology stems from non-ideal tooth positions.Many dentists will suggest a referral to an orthodontist, but the acceptance rate for conventional orthodontics among adults is extremely low. Typically, many dentists would then plan a restorative process aimed at altering the dentition and alleviating the constricted envelope. Unfortunately, because of the significant additive changes that need to be made, a restorative treatment plan that can effectively eliminate the constriction is usually a costly endeavor and can involve the preparation of multiple teeth. Similar to conventional orthodontics, many patients are unable or unwilling to pursue an extensive and costly restorative option.
Short Term Orthodontics has proven to be a highly desirable cosmetic procedure and the most practical and effective method for treating some occlusal discrepancies such as a constricted chewing pattern. It is a cost effective, minimally invasive and time-sensitive solution. Also, it is a procedure that general dentists can easily learn and implement. General dentists who have a treatment modality that can alter tooth position in a timeframe that is feasible for adults are able to greatly expand the scope and effectiveness of their clinical offerings. The treatment planning process completely changes when alterations to tooth position, gingival margin location and interocclusal relationships can be made predictably and in a manner that adults will actually say yes to.
The Six Month Smiles System is a GP friendly cosmetic braces system that provides for impressive orthodontic changes to be achieved in an average of six months. The attractive treatment times are achieved by a combination of unique orthodontic brackets and a shift in treatment goals compared to conventional orthodontic treatment. When adult patients refuse traditional orthodontic treatment, the Six Month Smiles System provides general dentists with the ability to offer an orthodontic option that is more practical for most adults. The system includes easy one step seating of pre-positioned brackets and shape memory wires work in conjunction with the unique brackets to safely achieve the desired results.
The goals of treatment are very similar to those associated with aligner cases. In most cases, angle class is not altered and bucco-lingual root movement is minimal. However, with very light forces, significant changes can be made in 4-9 months. The arches are rounded out and leveled, crowding is eliminated, spaces are closed and visual symmetry is achieved. Cosmetically, the changes are life-changing and the control over the occlusal scheme that is afforded is significant. As the arches are leveled and aligned, constricted chewing patterns are very easily alleviated. Also, occlusal improvements can be achieved that allow for cessation of occlusal dysfunction that can occur when the existing occlusion prevents the central pattern generator (in the central nervous system) and the muscles from establishing a healthy and regular maximum intercuspal position.
The inability to orthodontically move teeth in a way that adult patients will accept greatly limits the treatment opportunities that dentists can provide to their patients. When non-ideal tooth position is the source of a problem like a constricted chewing pattern, the most appropriate and conservative solution is one that favorably changes the position of the teeth. Short Term Orthodontics gives restorative dentists a powerful tool that greatly expands their treatment options and broadens their capacity to help their patients. Whether used to achieve cosmetic goals, occlusal changes, or a combination of both, STO is firmly being ensconced in the dental profession as a minimally invasive and necessary tool in the tool belt of the well-rounded restorative dentist.
This case was treated in six months and demonstrates the ability to alleviate a constricted envelope of function with a short-term orthodontic approach. Carious lesions on the laterals were also exposed during treatment to facilitate easy restoration.
Click to view a free on-demand informational webinar all about the Six Month Smiles system! You'll learn:
The Goals of Six Month Smiles & Short Term Orthodontics