Orthodontic retreatment
Completing treatment with a stable result
Treatment time — from 8 monthsUnfortunately, repeat orthodontic treatment is not uncommon. This is primarily due to the fact that the complex dento-mandibular system is subjected to daily chewing loads, muscle pressure and adapts to constantly changing conditions.
What can cause orthodontic treatment to be repeated?
No retention period
Tooths are not rigidly anchored in the bone of the jaw, but are held in place by the periodontal complex – these are collagen fibers, blood vessels, nerves and tissue fluid. The periodontium provides an even distribution of chewing pressure as well as micro-movement of the teeth.
It does not matter if there has been previous orthodontic treatment – all physiologic properties of the periodontium are preserved, and thus the micro-movement of the teeth is also preserved. Therefore, after removing the braces, the doctor prescribes a retainer — a non-removable thin metal retainer on the back surface of the teeth and a removable night mouth guard. The retainer fixes the teeth in the correct position. Lack of a retainer or failure to wear a mouth guard can lead to orthodontic relapse.
Of course, after orthodontic treatment, the teeth will not return to their exact original position, but they can change their position to some extent: there will be tremors or crowding, incorrect rotation and tilting of the teeth, as well as changes in the shape of the dentition.
That is why we recommend wearing a retainer permanently after the removal of braces and regular check-ups with an orthodontist. At the annual appointment, the orthodontist evaluates the stability of the achieved result and, if necessary, prescribes additional retention mouthguards.
Tooth extraction without subsequent implants and dentures
Complicated forms of tooth decay, cracked and traumatized teeth can cause tooth extraction. A missing tooth is bound to change the position of the teeth over time. They will tilt toward the missing tooth, and the opposite tooth on the other jaw will move out of the tooth row.
The entire dentoalveolar system will be affected by these changes in tooth position without the orthodontist's supervision: the bite will change, chewing pressure will be redistributed in a different way, and there will be hypercontacts on some teeth
If you miss the moment and don't get an implant in the area of the missing tooth (or other prosthetics, such as a bridge) in time, you can't avoid repeat orthodontic treatment.
If a tooth is extracted during or before orthodontic treatment and there is no immediate implant or crown option after braces are removed, braces are left on 2 teeth on either side of the gap when braces are removed and a spring is placed between them to save space.
Bone and Periodontal Diseases
Bone and periodontal structure also changes with age – blood supply to the gum deteriorates, bone tissue becomes more porous and less elastic. This can lead to recessions, bone loss and increased tooth mobility. Teeth that used to handle chewing loads will now change their position.
To stop these changes, the teeth must be brought back into proper contact and carefully monitored during the retention period. The fixed retainer will then act as a splint to redistribute the pressure and keep the teeth in the correct position.
TMJ disorders
The temporomandibular joint – one of the most complex joints in the human body. Many factors influence its proper function: bite, posture, diet, healthy lifestyle, masticatory muscle function, general health conditions, and more.
In most cases, treatment will require repositioning the joint, which will also change the position of the lower jaw relative to the upper jaw and alter the bite. Repeat orthodontic treatment will then focus on creating proper alignment in the new, therapeutic position of the joint.
Incomplete orthodontic treatment
It is not uncommon for orthodontic treatment to be completed early before optimal functional and aesthetic results are achieved. This is due to the patient's reluctance to continue treatment due to fatigue or lack of understanding of the process. The biggest visible changes occur in the first year of treatment during the leveling stage, when previously misaligned teeth become properly aligned. The next stage of orthodontics — bite correction and detailing is not as obvious to the patient because the changes occur at the level of the teeth coming together. Some patients at this stage get tired of braces and insist on removing them because they are satisfied with the result of leveling.
The desire to get the braces off sooner is completely understandable. But if the correct result is not achieved, the treatment will be ineffective and will lead to the need for retreatment. It is the orthodontist's job to clearly explain to the patient what is happening now, what tasks still need to be accomplished, and what the risks of premature removal may be.
Why can repeat orthodontic treatment be longer or more complicated than the first time?"
Recurring orthodontic treatment presents the orthodontist with new complicating conditions that were not present before – extracted teeth or already placed implants, veneers or crowns, periodontal or temporomandibular joint disease. Such orthodontic treatment requires a more careful and thoughtful treatment plan, as well as cooperation with related specialists (gnathologists, osteopaths, dental surgeons, periodontists, prosthodontists, orthopedists, etc.).How to avoid repeated orthodontic treatment?
The most important thing is to choose your orthodontist. It's best to consult with several orthodontists and find one who you trust, whose treatment plan makes more sense to you, and with whom you are willing to work with throughout your treatment.
The next step – is to follow the doctor's recommendations, that is, attend regular professional hygiene, don't miss appointments, wear elastics and so on.
The success of orthodontic treatment depends not only on the professionalism of the doctor and his capabilities, but also on your cooperation with him.
What should I do if repeat orthodontic treatment is required?
- The first step — is to carefully select a doctor for retreatment. Since retreatment is usually more difficult to plan and implement, you need to make sure that the doctor you choose has the competence to meet your needs.
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Before the consultation on re-treatment, try to clearly formulate a request for a doctor:
- What is wrong with your current clinical situation?
- What result would you like to achieve?
The doctor will of course describe your clinical situation based on the results of the diagnosis, but it is not always possible to reconcile expectations with clinical options. And if the doctor has a clear understanding of your request, he or she will be able to give you more complete and detailed information about treatment options and risks.
1 hour 40 minutes Individually 1 hour 1-1,5 hours once every 2 monthsа 2 hours 2 yearsWhy can you trust us in matters of re-treatment?
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Our doctors have successfully completed many cases of repeated treatment.
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We are well aware of how difficult it can be to decide on a repeat treatment, so we will provide you with psychological comfort throughout the treatment.
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We honestly talk about all the possibilities and risks of treatment before it begins.
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The doctors of the clinic work with any clinical situation from the point of view of an integrated approach. Therefore, we will involve related specialists if additional clinical tasks need to be solved: recession closure, implantation and prosthetics.
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We work with modern and high-tech orthodontic equipment that will solve complex clinical problems.
Our clinic has a team of orthodontists specializing in repeated orthodontic treatment. To increase the level of expertise and achieve better results in the treatment of patients, doctors regularly upgrade their skills and analyze each case of overtreatment within the framework of clinical consultations.
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