Step 1
Braces are placed on
the top and bottom.
Teeth are leveled and aligned using light and flexible arch wires. This also allows for space to be opened for the missing tooth/teeth.
Step 2
Once the correct amount of space has been created, a heavy arch wire is placed, and a fake tooth (pontic) is added. This occurs approximately 8-12 months into treatment.
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BEFORE
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AFTER
Step 3
Correction of the occlusion (bite) begins.
Step 4
Once the orthodontist feels that the teeth and bite are in a good position, the patient visits their general dentist to have the sizing of the space evaluated. The dentist checks the space to ensure that there is adequate space for placement of a fixed temporary tooth (Maryland Bridge).
Step 5
At this time, the patient also visits the oral surgeon/periodontist to evaluate the root position of the adjacent teeth. This is to ensure that there is adequate spacing for implant placement in the future.
Step 6
Patient returns to the orthodontist to make any adjustments requested by the oral surgeon/periodontist to further move the roots.
Step 7
Once the oral surgeon/periodontist approves the root position, the orthodontist takes an impression for a retainer with a fake tooth (pontic) on it.
Step 8
3 weeks later, the orthodontist removes the braces. The patient is given the retainer with the fake tooth to wear full time.
At this visit, the orthodontist will also take impressions for upper and lower clear retainers for nighttime wear, as well as photos of the patient’s teeth and face, and panoramic and cephalometric x-rays of the teeth and jaw.
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BEFORE
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AFTER
Step 9
One week after removal of braces, the clear retainers are delivered to the patient and are worn every night. The retainer with fake tooth is still worn during the day. Consistent retainer wear is imperative to maintaining the correct spacing of the teeth.
Step 10
Patient sees their general dentist within 4 weeks of braces being removed to have a fixed temporary tooth placed (Maryland Bridge). This ensures that the position of the crowns and roots of the adjacent teeth remain in the optimal position for future implant placement. There is a separate charge for the bridge which is determined by the dentist.
Step 11
Once the fixed Maryland Bridge is placed, the patient will need to return to the orthodontist for a new impression to be taken in order to fabricate a new retainer that fits over the temporary bridge. The patient returns to the orthodontist within a week for the new retainer to be delivered. The new retainer is worn every night.
Step 12
The patient’s growth is monitored with periodic x-rays. Once it is determined that they have finished growing, the oral surgeon/periodontist places the implant(s). There is a separate charge for the implant(s) that is determined by the oral surgeon/periodontist.
Step 13
Once the implant has been placed, a new retainer will be needed. The patient returns to the orthodontist and a new impression is taken so a new retainer that fits over the implant can be fabricated. (There is a charge for the new retainer.) The patient returns to the orthodontist within a week for the new retainer to be delivered. The retainer is worn every night to ensure that the teeth remain in the ideal position.
