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Retainers for Life, Straight Teeth Forever

April 15th, 2021

The Journey to your Forever Smile

You’ve worked hard for your beautiful Forever Smile and the day has finally come. You are getting your braces off! But instead of looking at this as the long-awaited end to the expedition through braces… what’s that? A retainer! There’s more?

As a Forever Smiles patient you have likely heard us talk about retainers throughout our treatment and why they are so important after treatment. Think of it like settling in after a long trip. Your teeth aren’t the only things we move when you’re wearing braces. Your teeth are held in place by elastic ligaments that hold the root in the socket. During orthodontic treatment, the force of moving your teeth over time means new ligaments and sometimes bone are formed. These new connective tissues and bone need time to stabilize. Enter the retainer.

There are two types of retainers – fixed and removable. Fixed retainers are made of a very thin, but durable piece of wire that fits along the lingual (backside) surface of the teeth. Spanning across several teeth, the wire is affixed on each side with bond and in that way is most like braces. Also like braces, fixed retainers require greater care to keep clean.

Removable retainers are easy to wear, make it easier to clean your teeth, and are typically most preferred by patients and orthodontists alike. Similar in look to Invisalign, removable retainers are awesome because you can remove them to eat and brush your teeth. However, just like clear aligners they only work if you wear them. In the way that every patient has different requirements in orthodontic treatment, Dr. Razdolsky will prescribe the course of retainer therapy that best suits you. Just be sure to stick to it to ensure the long-term effects of your orthodontic treatment.

Most patients begin by wearing removable retainers more often, then gradually wean off them over time up to the age of 26 – the age where the typical biological response to force and movement decreases, and the long-awaited trip is over. Your teeth have settled in.

Because these types of retainers are removable, and the duration you will need them long, you will need to be careful with them. Removable retainers are easier to lose or become damaged, in which case there is a charge for replacement.

Remember, braces are only the first step in your journey towards a beautiful Forever Smile. Maintaining your new smile is every bit as important as creating it, so understanding the importance of retainers to the long-term success of treatment is a critical final step in what has been a “wander-fully” long trip.

Play it Safe this Spring

April 7th, 2021

It's springtime and it's again time to remind our patients at Forever Smiles to protect their faces and pearly whites while out on the field playing sports. According to the National Youth Sports Safety Foundation, children, high-school athletes and adults have more than 5,000,000 teeth knocked out in sporting events annually.

If you are planning on participating in spring sports, it’s imperative to have a proper-fitting mouthguard. Mouthguards can prevent chipped or broken teeth, lip and cheek injuries, jaw fractures, mouth lacerations and even concussions.

Having a mouthguard can make the difference between losing your teeth or not, and because many of our patients who play high school sports have jaws that are still growing, last year’s mouthguard may no longer fit as it should. Dr. Yan Razdolsky and our team at Forever Smiles can fit you for a new guard.

To learn more about mouthguards or for general questions about your treatment at our Buffalo Grove office, please give us a call!

A Case Study In The Importance Of Interdisciplinary Treatment

April 6th, 2021

Recently, Dr. Yan Razdolsky, along with colleagues Drs. Sergio Rubenstein, Barry P. Levin, Elizabeth Razdolsky Michalczyk and Toshiyuki Fujiki, RDT were published as part of their case study in two industry publications helping further stress the importance of interdisciplinary treatment.

The articles, first circulated in the January 2021 online issue of Compendium as a case study titled, “The Importance of Interdisciplinary Treatment in an Esthetically Challenging Case.” The second, published in Inside Dental Technology titled “Interdisciplinary Treatment in an esthetically challenging case” which additionally details fabricating a screw-retained PFM for an anterior implant following the complex orthodontic treatment and interdisciplinary course of treatment.

In both articles, our multidisciplinary dream team shares with readers their clinical case involving a 7-year-old patient with a congenitally missing maxillary left central incisor. Despite having undergone orthodontic treatment, the patient’s smile was unacceptable and in a compromised state for a long-term restorative/prosthetic outcome. Further, the poor course of treatment previously administered resulted in not only considerable expense, but loss of valuable treatment time during a key development period. These issues further led to psychological-social concerns as the patient became shy, introverted and was uncomfortable smiling.

Fortunately, through a referral to our interdisciplinary dream team, and a thorough anatomical evaluation of the adjacent teeth, hard and soft tissue it was finally discovered the missing tooth was associated with a deficient alveolar ridge. Bone grafting would be required and implant position for the replacement tooth taken into consideration in addition to orthodontic space closure. Additionally, flaring of the anterior teeth became a concern as the buccal bone was extremely thin after the previous eight years of failed orthodontic treatment. Using a cephalometric radiograph, the dream team developed and implemented retraction of the upper and lower incisors, occlusal considerations for long-term function of an implant and crown, and a second round of orthodontic treatment.

Upon completion, occlusion and esthetic tooth alignment were evaluated to assess the space allocation on the missing tooth. A radiograph was taken to ensure that the future implant would have adequate mesial-distal space and not be in close proximity to adjacent roots, and a final cephalometric radiograph was taken to evaluate the patient’s profile and proclination of the anterior teeth.

As we learn from these collaborative writings, framing an implant-supported restoration with healthy hard and soft tissue for long-term stability is critical. With a thick, resilient periodontal biotype, a restorative/prosthetic solution is often achievable. When the tissue has experienced recession and/or the surrounding biotype of the tooth/teeth is friable, a more collaborative, and in many instances a surgical, approach may be indicated.

In this case however, the tissue matured and in the final stages of the restoration process, so the laboratory technician could accurately fabricate a final crown unique to the clinical situation using a castable screw-retained prosthetic with 65% gold ceramic alloy and porcelain crown for better long-term management and hygiene.

As this case demonstrates, complex diagnoses require an interdisciplinary team. While treatment may stretch over a long period of time, and not necessarily require every dental specialist be involved throughout every step of the process, it is essential that the treatment team follow the patient’s progress together. As in this case, failure to achieve an ideal outcome with the first phase of orthodontic treatment demanded mid-treatment revision. By following this framework clinicians can help ensure that a successful outcome is achieved, and the patient is happy with the results.

 

To read these articles in their entirety, please visit Compendium’s website at https://www.aegisdentalnetwork.com/cced/2021/01/the-importance-of-interdisciplinary-treatment-in-an-esthetically-challenging-case and Inside Dental Technology at https://www.aegisdentalnetwork.com/idt/2021/02/

When Does an Underbite Need Surgery?

March 24th, 2021

When does an underbite need surgery? The short answer is: when Dr. Yan Razdolsky and our team recommend surgery as the best way to give you a healthy, functional bite. But let’s take a longer look, and see just why your doctors might come to that conclusion.

  • First, what exactly is an underbite?

In a perfect bite, the upper and lower jaws align, well, perfectly. Upper teeth overlap lower teeth very slightly, upper and lower teeth meet comfortably, and jawbones and joints function smoothly. When the alignment is off, it causes a malocclusion, or “bad bite.”

When we talk about an underbite, or Class 3 malocclusion, it means that the lower jaw protrudes further than the upper jaw. This protrusion causes the bottom teeth and jaw to overlap the upper teeth and jaw.

  • What causes an underbite?

Sometimes an underbite is caused by childhood behaviors while the teeth and jaw are developing, including tongue thrusting or prolonged thumb-sucking and pacifier use. (Working to stop these behaviors before they affect tooth and jaw formation is one of the many good reasons children should have regular visits with their dentists and pediatricians.)

Most underbites are genetic, however, and tend to run in families. It’s estimated that from five to ten percent of the population has some form of underbite. The lower jawbone (mandible) might be overdeveloped, the upper jawbone (maxilla) might be underdeveloped, both bones could be affected, or, sometimes, tooth size and placement might cause an underbite. These irregularities in jaw shape and size and/or tooth crowding are not something that can be prevented, and require professional treatment.

  • Why? What’s the problem with an underbite?

Even a minor underbite can cause difficulties with biting and chewing. A more severe underbite can lead to speech problems, decay and loss of enamel where the teeth overlap, mouth breathing and sleep apnea, persistent jaw and temporomandibular joint pain, and self-confidence issues.

  • Can’t my dentist treat my underbite?

Most probably not. A very mild underbite can be camouflaged cosmetically with veneers, but this does not address the cause of the underbite, and will not work for moderate or severe underbites.

  • Can my orthodontist treat my underbite?

Dr. Yan Razdolsky will create an underbite treatment plan after a detailed study of each patient’s individual dental and skeletal structure. Treatment options will vary depending on the cause of the underbite, its severity, and even the patient’s age.

Early intervention is especially important for children who show signs of an underbite. That’s why we recommend that children visit our Buffalo Grove office by the age of seven.

If an underbite is caused by tooth misalignment or crowding, braces can reposition the lower teeth. Sometimes extractions are necessary to make room for proper alignment.

If the cause is due to jaw structure, children’s bones are still forming, so treatment can actually help correct bone development. Palatal expanders, headgear, and other appliances are various methods of encouraging and guiding bone development.

But braces and appliances aren’t effective for every patient with an underbite, and especially in patients (usually those in their late teens and older) when the jawbones are already fully formed. In this case, we might suggest coordinating treatment with an oral and maxillofacial surgeon.

  • What does an oral and maxillofacial surgeon do?

An oral surgeon has the training, experience, and skill to help correct an underbite by surgically reshaping and repositioning the jawbone. This corrective jaw surgery is called orthognathic surgery.

  • What will happen during orthognathic surgery?

Your treatment will be tailored to your specific needs. Two of the common surgical procedures for treating an underbite involve repositioning the upper jaw to lengthen it and/or reshaping the lower jaw to shorten it.

Bone is sometimes removed or added, small bone plates or screws are sometimes used to stabilize the bone after surgery—your surgeon will let you know exactly which procedures will give you a healthy, functional bite. The surgery itself is most often performed under general anesthesia and requires a brief stay in the hospital.

  • How will my orthodontist and oral surgeon coordinate my treatment?

Correcting a Class 3 malocclusion can take time. Your oral surgeon will work together with Dr. Yan Razdolsky to analyze the interrelationship of teeth, bones, and joints to determine dental and skeletal problems, and will develop the best treatment plan possible to create a healthy alignment.

  • So, when does an underbite need surgery?

Sometimes, a minor underbite can be corrected with braces and appliances alone. A serious underbite, however, will often require the specialized skills of both Dr. Yan Razdolsky and an oral surgeon.

And, while it’s not the primary purpose of surgery, corrective jaw surgery and orthodontics can also make you happier with your appearance and boost your self-confidence. Achieving a lifetime of beautiful, comfortable, and healthy smiles—that’s the answer to your question.