Clinical Pearls

How to position cuspids in lingual cases and set up an orthodontic museum

Final Positioning of Cuspids in Lingual Cases

Alfredo Gilbert, DDS, Mexico City, Mexico

In some lingual orthodontics cases, the final positioning of the cuspids is difficult to obtain because of the bite plane of the upper anterior brackets. To resolve this problem, we have constructed a setup using an impression that is taken on the same day that the braces are removed. We move the malpositioned tooth to the correct position and take an impression of the correctly positioned cast. Over this model, we melt an Essix sheet of type A .040 plastic. The appliance is left in the patient’s mouth and is worn for the entire day, except while eating.

From left to right: the plastic appliance that the patient wears the first day after treatment, a correctly positioned cast, and before and after photos of this case.

The Orthodontic Museum/Newseum

John Gerling, DDS, McAllen, Tex

Introducing new treatment concepts to our patients should be a continuing effort by the orthodontist and the staff. As we focus on the work at hand, it can be difficult to remember to engage in these types of conversations with patients and parents, and this results in fewer referrals.

We have recently engaged in an activity that is fun and informative, and that opens the gate to have these types of conversations. We call it the Orthodontic Museum/Newseum. It can be set up in the reception room on a wall or in display cases. In the museum, we display some of the artifacts from “the good old days” of orthodontic care. A model with full bands and two types of headgears (I no longer use headgears) are displayed alongside some fossils and arrowheads. We even found a cartoon picture on the Internet of Fred Flintstone admiring his braces.

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On the other side of the display case we use The Jetsons theme and show several of the more recent developments in orthodontic care. Small bonded braces, clear braces, Invisalign, and TADS are displayed. We also show “before and after” pictures of smiles where we used the diode laser to recontour gingival tissue.

Patients seem to enjoy looking at the past technology, and parents often reminisce about when they had braces that wrapped all the way around the tooth.

Keeping patients and parents educated and entertained is vital to a healthy practice.