Unexplained Movement

[Donal Inman]

Dear Dr. Qureshi:

I received a call from a very busy orthodontists here in the US.
He is a major user of Inman Aligners and loves them but recently he has had some unwanted movement of the cuspids. The scenario is that the cuspids are rolling in mesial lingual on cases with more moderate to severe crowding. We find it near impossible to move cuspids when we whish to and this disturbs me very much. Also maybe we could figure out what is going on and use it to help us when we want to realign cuspids.

My best guess is that the laterals as they are realigning are creating force on the mesial of the cuspids and rolling them even though we have a lingual acrylic stop. We are going to make sure the cuspids are supported lingual for the full width of the tooth; we are even considering adding a lingual wire to this doctors cases.

Have you or any other orthodontists or dentists seen this clinically?



Regards,

Don I.

Donal P. Inman CDT
Inman Orthodontic Laboratories Inc.
Space Maintainers Laboratory of the Southeast
800-289-0118
Inman Orthodontic Laboratory

[Dr. TifQureshi]

hi Don,


The chances are that this is unwanted domino effect coming from the bows.
This maybe because he isn't doing quite enough IPR from the mesial of the canine to canine and the canines are trying to distalize but coming up against the premolars.

it also might be because the models needed the canines distalizing, more taking space from the premolars both sides. If a case with 3.5mm or more crowding, without expansion, IPR needs to performed between the canines and premolars to gain the extra space.
It is important that the operator checks that the canines are not tightly locked in by the opposing arch canines or surrounding teeth.

This happened to me early on a couple of times., but only because I wasnt stripping enough and wasnt stripping distal to the canines.


Hope this helps


Tif