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Posted by: ma6
« on: September 17, 2014, 07:44:58 pm »

PUMA,

I asked CrystalBraces if they use elastics, and they do not. So, I don't think I will use them. I'd have to rig my own elastics or headgear, and in that case I could use a DIY "invisible" retainer instead which would be cheaper.

I'm contemplating 3 options for my particular problem:
  • Invisalign with class III elastics (ie: elastics between the top and bottom teeth, not headgear)
  • Full braces with reverse-pull headgear (possibly in addition to class III elastics)
  • DIY clear retainer tray, and I cut hooks for elastics that I use with my own reverse-pull headgear
#1 isn't really face-pulling since it's pulling against my lower teeth, and I would rather not affect them.
#2 is going to be expensive.
#3 may be risky.

I plan to schedule some consultations with orthos and ask them how they would treat me, and ask them if #1 would fix my problem.

After I talk to a few orthos and learn what I can from them, I'm leaning toward #3. It will be SO much less expensive that I might as well give it a try. Even if it fails, I'm not out that much money. Worse case is I mess up my bite/teeth somehow. But, that wouldn't happen overnight. Teeth don't move that fast. So, I would watch things carefully and I may have to give it up and use a real orthodontist.

This PDF explains how Invisalign uses "precision cuts" to create elastic hooks and Button cutouts:
http://provider.invisalign.com/documents/PrecisionCuts.pdf
One thing that says is:

Quote
Class II - Elastic Hooks on the upper cuspids and Button Cutouts on the lower first molars
Class III - Elastic Hooks on the lower canines and Button Cutouts on the upper first molars

So, they use a button for the one that's pulling forward. I wonder why they can use a hook on the bottom tray for class III elastics, but not both the top and bottom. They must have a good reason. This concerns me. I wonder if there's not enough grip on the back molars. An advantage I might have is that I don't need to pull downward, I could pull straight forward, or possibly even an upward angle.

I was not planning to ask Invisalign if they would use reverse pull headgear. I'm assuming the answer would be no. There's a lot of information about Invisalign publicly available, and searching their whole site for headgear (and synonyms) returns nothing. If headgear was an option, I think their site would mention it. I still think it's possible. If you can pull against the bottom teeth, I don't see why you can't pull against reverse-pull headgear. Maybe they just haven't tested it yet. Maybe they would need to get FDA approval and maybe they don't think it would pay off. I'm just speculating.

I'll be curious to hear what you learn as well. Thanks.
Posted by: PUMA
« on: September 17, 2014, 05:56:16 am »

MA6, hey are you going to ask Invisalign company or a provider regarding anchor points on the aligner?

I'm going to ask Dr Howell or Plato, if invisalign could be used for face pulling if it had anchor points. I want treatment with invisalign because I have an open bite that incisor extrusion with invisalign would probably solve.

The thing is, I also need to bring the maxilla forward and that's what I want to pursue as priority (even with my open bite issue and all)

If you ask invisalign company, pls post here or PM me what they say and I'll let you know what Dr Howell says as well.
Posted by: ma6
« on: September 13, 2014, 09:07:03 am »

Well, I'm middle-aged, so I don't think my jaw is growing. I think it's some of all of these:

  • My top teeth have always been a little too far back, and the top has been very slowly progressing backward for a couple decades, and now it's simply, finally, reached the limit of my TM joint
  • I used to grind my teeth all night. That helped my bite because my top and bottom teeth were pushing each other where they need to be. A few years ago I started using a night guard because I have significant wear that needs to stop. But, with the night guard my jaw and upper teeth are now free to relax and drift wherever they want. There's nothing to push the top forward anymore, or the bottom back.
  • Lately, occasionally, I found myself sleeping face down (sort of at an angle but mostly face down at the edge of my pillow), and this is likely pushing my top teeth back further. I'm trying to not sleep that way, but I don't have that much control. If I ever catch myself face down, I turn over. I think the face-down sleeping is what has pushed my teeth past the limit these last few weeks.
Posted by: PUMA
« on: September 12, 2014, 11:09:53 pm »

How did that happen? Is your lower jaw growing forward or something?

That's a interesting website, thanks for sharing. In the before and afters, the results of the open bite guy looks pretty legit/good.

Posted by: ma6
« on: September 12, 2014, 05:50:54 pm »

All the sudden I'm getting TMJ pain now. Great. My bite has gotten a lot worse lately. Pretty soon I will have to change how I chew, and chew with an underbite. So far I still have a "normal" bite, but now it hurts to chew that way because it's just too hard to get my lower jaw back far enough. So, now I have to do something.

I'm thinking about Invisalign with class III elastics, or reverse pull headgear. Perhaps from crystalbraces . com

I think that might be the cheapest and easiest solution.
Posted by: PUMA
« on: August 20, 2014, 01:34:09 am »

Wow the doc was trying to discourage you. Interesting. I guess you should feel lucky about that. 

Personally, i think if the maxilla can come forward 2-3mm, NOT the incisors, it would be worth it. Orthodontics can achieve about 2mm forward movement by flaring the teeth outwards though, so i do hope that the reverse headgear, which seems to be the new thing, is doing a lot more than that...
Posted by: ma6
« on: August 18, 2014, 07:54:43 pm »

I consulted with 3 orthos now. We did not get in to specific types of headgear. Two docs mentioned it as likely being part of the treatment. I want to use The Crane, but I haven't asked yet.

Now, I'm questioning if I want to go though with this. At my latest consultation, the doc assured me that my current bite, even though it's 2-3mm off from where it should be, will never wear down or wear out my teeth from normal function (ie: eating). The doc assured me my teeth would only wear out by grinding at night if I did not wear a night guard. The doc said teeth can take that kind of use even though my teeth are rubbing more than they should as I eat.

The excessive wear was my biggest concern. So, now I have to decide if I want to do this (move my maxilla forward) for the other benefits. Is it worth it to me? The doc thought it would cost > $6000. Though, with that price he was trying to discourage me.
Posted by: PUMA
« on: August 17, 2014, 10:05:47 am »

Have you consulted with an orthodontist about this and also brought up about headgear? What type of headgear are you interested in? Personally i'm looking towards facemax or the crane or rampa but rampa is not avail in the US as far as i know. It'll be important to find an ortho willing to work with the type of headgear you want. A lot of orthodontists don't want to work with treatments they are not familiar with. 



Posted by: ma6
« on: August 16, 2014, 09:27:27 pm »

I had not started to think about where it would be pulling from. But, that's an interesting point to consider.

My concerns with braces are the added expense and discomfort and looks (actually, I think everyone looks good in braces, so it's a little irrational of me to worry about looks).

But, I'm pretty sure I will have to get braces, because I doubt an orthodontist would use reverse pull headgear without being fully braced for fear of teeth being pushed out of position. But, when I saw that youtube video, I thought wow, maybe I don't need braces after all!

And, I suspect I will need class III rubber bands all day in order to maintain the movement from the headgear at night. I bet that's what my orthodontist will say anyway. Even though, it sounds like some folks here are doing face pulling for only a short time per day, and without class III rubber bands.

I'm worried about the rubber bands because they will be pulling my lower jaw back, and I don't want that. If anything, I'd like my lower jaw more forward not back. My progress would be slower without rubber bands, but I wonder how much slower?
Posted by: PUMA
« on: August 16, 2014, 04:50:53 pm »

I'm a bit worried about facepulling while wearing braces too. I think usually they hooks are attached to the bicuspids area and pulls from there, but I had my bicuspids removed and i've had some bone loss and gum recession in the bicuspid areas. It's it's anchored at the back like that it would be better for me.
Posted by: ma6
« on: August 16, 2014, 10:37:16 am »

To correct my bite and stop my teeth from grinding, I need to move all my top teeth forward in unison about 2mm by my estimate. I'm also looking forward to other benefits of pulling my maxilla forward:
  • Look better
  • More room for my tongue
  • Possibly breathe better

So, I need reverse pull headgear of some kind. I'm looking at using The Crane. I don't have braces yet. I'm in the planning stages now.

I'm wondering if it's possible to use reverse pull headgear without also using class III rubberbands between the top and bottom braces?

The reason I'm asking is because then it might not be necessary to have braces at all, but something like the video below where the headgear pulls against a permanent retainer type thing. Is that picture actual possible like they show it, without braces (brackets+wires)?

Thanks.

https://www.youtube.com/watch?v=gGdbLOocydM