Last appointment quite a lot happened. Initially the ortho said that she wants to remove the wire from the brackets, letting the molars settle by themselves. She doesn't want to remove the brackets just yet in case they'll be needed again later on.
I said that I feel like my bite is still quite a bit off on the left site. She got marking foil and inspected my bite and contact points. While the second molar uprighted well, the opposite force tilted my first molar a bit. Usually such force is distributed among all other teeth when all teeth have brackets. Due to the tilting, instead of removing the wire, she took it out, added a bend and reinserted it.
She asked how I got along with my top plate. I explained to her that I tried different wear times and finally settled on wearing it through the night for the reasons laid out in my last update. She seemed to be fine with it as an interim solution.
Next came the expected discussion about retainers. After stating my point of view I got the feeling that she hopes that I won't need removable retainers with the fixed retainers considering all the complications I had with my removable braces. When I mentioned that I'll need a bruxism guard anyway, she mentioned a possible compromise of having a fixed retainer in the bottom where people have less problems with it and the bruxism guard in the top jaw. However, so far in my bottom jar during treatment spaces developed between my canines and first premolars, and the first premolars and second premolars. Even if the permanent retainer would include all four premolars (which would be pretty extreme), there's no guarantee that no space between my premolars and molars would open up. I don't think the retainer discussion is finished yet…
Then came the lower plate. As discussed during the previous appointment, we are sticking to the plan of finishing up the bite, then the lower teeth and finally the upper ones. While the bite isn't fully fixed yet, we're getting close enough to start with the lower incisors and canines again. The ortho inserted the lower plate and checked how it fit. Surprisingly the triangle holding clasps didn't interfere with the brackets and wire at all. They fit perfectly in between. But I felt pressure everywhere. She decided to cut away everything going back further than the first molars on both sides. The wisdom teeth derotation springs aren't needed anymore and she feared that the holding clasps between my molars might wreck more havoc than they're worth at this point. After spending quite some time bending the holding clasps, letting me check, and bending again, the lower plate fit well enough. We tried minimizing the pressure from the holding clasps.
To move the canines distally, she applied inwards pressure with the labial bow. She explained that usually it also moves them distally if there's space. If that doesn't work in my case, the plate will need to be modified to add springs similar to the ones in my top plate to move the canines backwards.
I asked how long I should wear the lower plate. Her response was to wear them as long as possible without my bite becoming worse again. Similar to what I did with my top plate I need to figure out how long I can wear it and when I should keep it out to let my bite go back to normal. But 12 hours are needed at minimum to properly move the other teeth. In addition I should continue wearing the top plate as long as needed to keep the lower canine and top lateral incisor from interfering with each other.
And with that, I now have top and bottom removable braces and bottom brackets (albeit "only" 3) all at the same time. Probably a dream treatment for many here.
Already on the day after my appointment the gap between my lower canines and premolars was closed. With the lower left canine back, it stopped interfering with my upper incisor. While having all the braces and plates at the same time is quite an experience, I quickly stopped wearing the upper plate. It isn't necessary for its current purpose anymore but still changes my bite quite a bit.
The lower plate isn't perfect and has similar problems, but not nearly as strongly as the upper brace. When I take out the lower brace, it takes about an hour for my top and bottom premolars to fit together again. I'm wearing it for about 16 hours each day. The 8 hours off seem to be enough to keep the bite stable.
Interestingly, the small gap that reopened behind my upper left canine has closed completely.
Not having an anterior bite plate or posterior bite plane, my joints are aching a bit in the morning as I'm primarily biting down on the holding clasp wires when clenching / grinding. Also every morning I have pretty deep imprints in my cheeks from the brackets.
It's interesting how the mouth adapts to talking with braces. Some months ago when I had the long bottom plate and the thick upper bite plate, after a few weeks I was able to talk with them without too much of a noticeable lisp (although I feel like there'll always be a rest-lisp with a bite-plate). Not having any plate in my mouth for a few weeks completely reset everything that I'd learned about talking with them in. After getting back the top plate two appointments ago I was struggling to pronounce everything correctly again, even though the bite plate was shaved down significantly which should have helped significantly. But again, after a week or so I was able to talk with them in okayly. Now with just the bottom brace I've adapted to speak pretty much perfectly, so much so that even some family doesn't notice. But putting it the top plate again, I can barely be understood. Apparently it only takes few weeks to learn and unlearn everything.
My next appointment will be on Tuesday.
Just so you know, I have top and bottom permanent retainers and they're really cool!!!
That's interesting. What do you like about them? Don't they just interfere with everything? For example doesn't flossing take ages?
