Bracket Positioning Errors and Their Effect on Tooth Movement

[@gvouronikos]

Amazing material as always!

[@قطراتالمطر-ه2ر]

Hi Dr. What's up? please, can you us how to prevent the wagon wheel effect, when a torque teeth especiallya the laterals, and if happend, how can we fix it? because I have a case of CL 1 moderate crowding, upper 6s are missed, every thing was alright till I reached 17 *25 NiTi wire, the upper 2s becamed with flared crowns and tipped distally, I did all I know to fix the problem but it didn't work, torque bend, torque spring, upside down bracket, change the right bracket to left and vise versa, Z bend, putting the power chain under the bracket, reposition of the bracket more gingivally, with no hope. the teeth are with normal phisiological movement, good occlusion, enough space mesially and distally, no sign of ankylosis, the x_ray showed no Pdl widening, radiolucensy or changes. the bracket used is mbt 22, amirecan type. Please Dr, if you have an account on Instagram to send you photos, I have no facebook, to give me your kind opinion. 🌹🙏

[@Powerprox]

It is difficult to fully assess without records (and I do not have Instagram) but I would say that MBT brackets have more built in buccal crown torque. A 17x25AW does not fill the slot enough on an 022 size bracket to give good torque control. Also, the tooth has distal crown tip which can cause issues in appearance as well. I would say start with a panorex to see the root angulations and confirm have mesial root tip. Sounds like you will. If so, rotate bracket to correct as explained in this video. While you are repositioning the bracket can turn upside down. Once tip is better corrected with something like an 018niti AW you can then place a 19x25AW or even a 21x25AW to better fill the slot and activate torque. This could work even better is you place an 018 bracket instead of an 022 and finish in a 17x25AW instead.

[@قطراتالمطر-ه2ر]

@@Powerprox Yes Dr. I indeed did so, I rotated the bracket, change mesial to distal, upside down, and reached even to 18*25 NiTi w., but the teeth seem as I rise to a larger guage, as the teeth tip and flare more and more. hoping when I reach 21*25, I can control the torque. thank you so much Dr. I really appreciate your kindness 🌹🙏

[@stephensonpawan1158]

Hello sir I am abit confused on correcring transpositioned teeth how to go about that?

[@Powerprox]

Transposed teeth can be very difficult to treat. These situations have to be figured out on a case by case basis. Have to keep in mind that sometimes the transposition cannot be corrected and have to switch gears and set up the case for an approach utilizing cosmetic dentistry options ie bonding, veneers, etc.

[@stephensonpawan1158]

@@Powerprox Ohh I have never delt with such a case but I never thought it could be that hard to deal with.

[@kazmeensayyed3068]

Nice vdo

[@kidzone2190]

Reprox means?

[@Powerprox]

Enamel Reproximation aka IPR

[@osamaelleithi5404]

Than you so much

[@jamshidkhan913]

Sir I want to in six months course please give your country code so that I can contact or please guide me how to enroll

[@Powerprox]

Here is a direct link to the Sign Up Page for the course and case support page: www.powerproxdocs.com/public/241.cfm

[@jamshidkhan913]

@@Powerprox thanks sir for your cooperation