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Is pushing Teeth always bad?

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undoortho1
(@undoortho1)
Posts: 2
Topic starter
 

Hello All,

 

I have read and heard a lot about bone borne appliances vs tooth borne, for example MSE vs DNA. Many people say that MSE is superior because it does not push teeth and the other devices may. My question is, if someone has had teeth pulled backwards via headgear and/or elastics, say 8 mm, is it fine to “push teeth” 8 mm forwards to closer to the original position? In the case of a jaw locked back due to pulled back bite, is adding new bone neccesary or it fine to just advance the teeth?

 

I am not very familiar with the anatomy or what exactly happens when teeth are pulled back. I have read pushing teeth pushes them through the alveolar bone, so when they are pulled back is the alveolar bone pulled back as well? Or would a there be space or extra alveolar bone in the patient that was pulled back?  

 

 
Posted : 28/09/2020 10:03 pm
Limebike
(@limebike)
Posts: 74
 
Posted by: @undoortho1

Hello All,

 

I have read and heard a lot about bone borne appliances vs tooth borne, for example MSE vs DNA. Many people say that MSE is superior because it does not push teeth and the other devices may. My question is, if someone has had teeth pulled backwards via headgear and/or elastics, say 8 mm, is it fine to “push teeth” 8 mm forwards to closer to the original position? In the case of a jaw locked back due to pulled back bite, is adding new bone neccesary or it fine to just advance the teeth?

 

I am not very familiar with the anatomy or what exactly happens when teeth are pulled back. I have read pushing teeth pushes them through the alveolar bone, so when they are pulled back is the alveolar bone pulled back as well? Or would a there be space or extra alveolar bone in the patient that was pulled back?  

 

It depends, but usually, advancing teeth forward works and I would advise it to release a trapped mandible. If you have retroclined upper incisors, proclining them will give you more room for the mandible to come forward already. If more advancement is needed, you can keep pushing the incisors out and see what happens: usually, it is a combination of further proclination + bodily movement of the upper incisors. The incisors moving forward will pull alveolar bone with it (the periodontal ligament fibers pull the bone).

Regarding your question with what happens when teeth are pulled back: I have seen cases where incisors are mostly pushed through the alveolar bone (there is always some minor remodelling of the alveolar bone) but the bone in the front is preserved. What can also happen is a phenomenon called “adaptive resorption” in which the anterior part of the alveolar bone resorbs as it no longer houses the incisor. Which option is going to take place depends on the patient’s biotype.

 
Posted : 28/09/2020 10:54 pm
undoortho1
(@undoortho1)
Posts: 2
Topic starter
 

Thank you for the response. Based on this input it sounds like the case I described would be best off using something like dna/vivos or would even invisalign or somethint else you can recommend work?

 

In regards to MSE, are the teeth moved forward when the gap is closed or would someone that has a locked back jaw still have a locked back jaw after MSE?

 
Posted : 28/09/2020 11:16 pm
Sergio-OMS
(@sergio-oms)
Posts: 146
 

@undoortho1

MSE is a transverse expander. It is used within a comprehensive treatment plan in combination with other appliances (Invisalign, braces, microimplants for anchorage…) or even surgical procedures to protract the maxilla. It creates bone within the alveolar bone, in the midline, that can be used afterwards by moving teeth towards the midline.

DNA claims to do many things, I won’t get into that, there are many messages about it.

I do not think it is the appliance that really makes the difference but the orthodontist. It looks to me that that DNA is a tool preferred by general dental practitioners who do orthodontics, maybe it is more versatile and easy to manage… I do not know… but if the only tool you have is a hammer, you treat everything as if it were a nail.

I won’t get into your case, I think you should consult with orthodontists who are opened to challenges and who are comfortable with surgical orthodontics. I am saying this because you need to keep you options opened to surgical procedures or you risk ending with serious problems.

 
Posted : 29/09/2020 12:38 am
TheBeastPanda
(@thebeastpanda)
Posts: 137
 

@sergio-oms For mewing should one be pushing on the alveolar ridge?

 
Posted : 03/11/2020 12:06 pm
TheBeastPanda
(@thebeastpanda)
Posts: 137
 

@sergio-oms For mewing should one be pushing on the alveolar ridge?

 
Posted : 03/11/2020 12:06 pm

THE GREAT WORK