1. We use gentle, precise movement of teeth using 0.018" sized slots in our brackets. 67% of US orthodontists use "18" slots. The movement of teeth through bone is accomplished due to the close tolerance of the fixed slot size in the bracket, matched by the size of the final archwire--the horseshoe shaped tiny rectangular wire that fills every slot of every tooth from the rear-most tooth on the right to the rear-most tooth on the left. The size of the slot is set and unchangeable, filling the slot completely is at the discretion of the doctor, and complete filling of the slot is a critical necessity for proper completion of treatment.
The alternative slot size is a 0.022" slot in the bracket (also called the "22" slot), but the common final archwire is usually only 0.019", which allows a "slop" between the slot and the archwire, hence the system is inherently less precise. Precision is critical to the proper completion of a patient's care. The difference between the "18" slot and "22" slot dates back to the 1930s. Dr. Cinatl is happy to discuss the significant differences at your first appointment.
2. Our diagnosis focuses on the difference between bone-based problems and tooth-position problems. The distinction is fundamental to proper diagnosis and treatment! If the bone that bears the teeth is out of position, that bone must be guided during growth into the proper proportions. If the teeth are the culprit, then the proper decision must be made to correct the teeth.
3. The hand-wrist radiograph has been used since the 1940s to assess the growth stage of an orthodontic patient. Some girls finish growing at 11.5 years of age--that is early! If that significant fact is not known at the planning stage, a plan may be adopted that cannot be accomplished. Some boys grow much later, so their treatment may not start until age 15--quite a range of ages. We have always secured a hand-wrist radiograph on every growing patient since each patient deserves that thoroughness.
The findings of the hand-wrist radiograph are plotted against
the growth curve, which differs between female and male patients.
Knowing this critical information at the planning stage will deem some
treatment options possible; late stage growth or cessation of growth
limits treatment--and that must be known first.
4. The four photos below are plaster models mounted on an articulator (a device taught to all dentists to properly relate upper and lower models of teeth). The first photo is a patient with properly treated second molars--all posterior teeth are level.
The second photo is the typical result of ignored second molars--the lower molar erupted sooner, thus over-erupted, and will cause an interference during function, called a Balancing Interference.
The third photo shows an effect when the second molars are not corrected--an interference is caused during chewing movements by second molars contacting improperly.
The fourth photo is a close-up from the rear (only possible to show with mounted models): the second molars were not corrected, thus producing an interference by contacting improperly. Dr. Cinatl can explain this concept at your first appointment. Second molars must be treated by orthodontists.
5. Appliance Anatomy--use this handy reference to identify the precision appliances used to produce a quality result.
6. Some people can maintain the entire volume of all their teeth. Some people cannot. Each person is different, and each person requires a personalized treatment plan. A movement in American orthodontics since 1980 is for not removing any teeth--but that one-decision-fits-all cannot apply to all patients since people vary too much!
7. Maintenance of the result is only possible with common sense. Teeth move all throughout life--like it or not, that is reality. Hence, we are honest with our patients before treatment even begins: wearing retainers is a lifetime journey. A patient who wears their retainers at bedtime can have the same result 75 years later. Wearing retainers is no more involved than putting on eyeglasses, putting in contacts for sight, or placing a wristwatch for time, or wearing shoes! We believe in the honest truth--wearing retainers is easy, so just do it.