Fifth Week: Orthodontics

An appliance we were able to observe in our class
used to treat an open bite in children

Our fifth week began with our rotation in Ortho, Carolina and I were very excited because this is the area in which both of us would like to specialize in the future. The clinic was beautiful, there was music in the background and everything ran smoothly. We were able to attend to the clinic every morning from 9-12, as well as Monday and Wednesday afternoon from 1-5, and the rest of the week we attended Ortho classes with the first year residents in which we were able to discuss subjects such as Cephalometrics, Research Design and Methodology, Contemporary Orthodontic Appliances, Clinical Seminars and Human Cranio Development. Each class consists of 6 residents, which allow the leaders to offer them undivided attention. Classes are very dynamic, because they have computer screens that project the PowerPoint but also allow the teachers or students to draw on top of them allowing the students to understand thoroughly. 

The learning technique used

 

This appliance aids the treatment of a patient with Class III 

The clinic was very organized, every resident has their own chair which contains all of their materials and their computers which contain their patient's appointments and information.

Each student's individual cart where they have their material 

                                   

The way each unit looks like.

Each appointment starts as usual: taking the patients information, initial impressions, intra and extraoral photographs, evaluation of X Rays, evaluation of occlusion and a overall exam of the facial distribution. The patient is also given an initiation packet which includes: a T shirt, a brochure with instructions of how to deal with cleaning brackets, of what food to eat, a new toothbrush and a special rigid floss to make the flossing easier.

          
 

These are some of the instruments used for the first appointment. Here they use flexible trays which allow the resident to open it in order to take the impression in patients that have bigger arches, and they use wax on the borders in order to copy the vestibule area 

This is an alginate mixer which eliminates the possibility of bubbles and helps maintain
a clean bowl making the process of mixing alginate quicker and more effective

After developing a treatment plan the patient comes back to the appointment where his brackets are placed; we were able to see two techniques of bracket placement: Direct technique and Indirect technique. The Indirect technique is faster for the patient and delivers a more exact bracket placement  but requires lab work for the clinician, which in my opinion is the best way to go. The direct technique involves the traditional way of bonding brackets one at a time which makes the appointment a little bit longer. Prior to the placement of brackets a sealant is placed over the buccal surfaces of the teeth which helps protect the teeth from white lesions during the treatment. We were also able to witness a patient treated with Invisalign and the procedure this involves.  

This was the tray required for this appointment 

This was the Direct Technique where the brackets were placed
individually, these were covered because they were pre cemented

This technique was the Indirect Technique where the brackets were already
placed in a custom tray which were then bonded to the teeth all together 

This was another presentation of the brackets for the Direct Technique 

           

                                 This instrument came to be very handy when placing the brackets because it isolated the
cheeks and tongue in order to create a dry environment to provide excellent
bonding results

                            

                             At the end of the appointment the patient was able to choose the color of the
                                           band they wanted

This was the tray needed when a patient came back because
one of the brackets detached. 

 After the treatment is finished the patient comes back to get impressions so that the retainers are made in order to maintain the position their teeth are in.

This is a special alginate used to take impressions of a patient with
braces, due to its  rubbery consistence it enables the clinician
to take the impression without tearing the alginate

Here are some examples of retainers 

After retainers are delivered the patient is able to leave with a beautiful smile. Being able to see how the patient evolves from the first to the last appointment is priceless. That's when you know you have completed your job.