Question re: Closing of gap...

[catgyrl]

I'd like to know exactly how an ortho closes up a gap caused by an extraction. I'm getting my left premolar taken out on May 1st, which will leave an approximate 1/2" gap between my teeth.

When they go to close it, do they just move the front teeth to the left? (That will most definitely look strange, as my front teeth will be too far left). Or, is it a combination of moving the front teeth to the left, and the back molars to the right, so they meet up halfway? I know my midline is off a bit, but not by 1/2", so I just can't picture how that works.

(I apologize if this sounds like a dumb question, but sometimes the simpler things are, the harder they are for my brain to process. LOL!)

Thanks-
Cathy

[Denise]

Cathy I had a tooth pulled on the side as well. They won't change the position of your front teeth. They'll pull your back teeth forward. This is usually done because each top tooth has a bottom tooth that it should 'match up' with. So my ortho pulled mine to make my teeth match up properly. So my back teeth on that side have been moving forward slowly and the gap is almost completely closed up now. When I look at the symmetry of my teeth, I can't even tell that tooth is missing. Plus once they all get shaved to be a nice, even size and shape, I surely won't be able to tell. So no worries, it will look great in the end

[Sunny]

Cathy it depends on what needs moving.

With overbites, they usually move the front teeth back and sometimes if the overbite isn't that big, they move the front back some distance, then the back teeth forward to complete the closure of the gap.

Your ortho will have done the measurements and have a plan that dictates what is best for your bite. Talk to him about this, as he's the person who can explain it for you.

Over my impacted right canine, the teeth were moved forward ... the slower approach, but finally after three years it's done! Yah! With a lower gap on my lower left side, the front teeth were moved back. This means my midline is way off and will always be way off, but that's not a problem ... as who sees unless they're looking at your teeth while you do a full on 'it's all about my teeth' smile ... and if you've not obsessing about teeth ... who knows what a midline is, or where on the body to find one?

Good luck!

[MCOMarkhamOrthodontist]

This is a great question and will depend on the skill of your orthodontist. There are 4 categories of space closure, using the back teeth as the anchorage reference point.

1. maximum anchorage- back teeth don't move foward much, front teeth move back only
2. moderate anchorage- some combination of front teeth moving back, back teeth moving forward
3. minimum anchorage- back teeth move forward, front teeth don't move back much
4. absolute anchorage- back teeth don't move at all, front teeth move back (using TADs).

These are theoretical in nature, and the ability to manage these different scenarios is going to impact the result of your treatment. Hope this helps!

[catgyrl]

Thank you Denise, Sunny and Dr. Tam!!

Okay, the picture is now a bit clearer. I seriously cannot wait to see how they're going to do this. I'm finding this orthodontia stuff rather fascinating... It's amazing what orthos can do with our teeth, with the varying degrees and types of problems we all have.

Sunny - I didn't even know what a midline was until my first consult last month. And honestly, I've never, ever noticed that on anyone else, either. I've walked around for my whole life with this "off" midline, so if it's still a bit off at the end, I'll be fine, as long as they've made every effort to fix the main problem (the overjet).

Oddly, I still feel funny asking my doc a lot of questions. I don't want him to feel like I don't trust what he's doing (because I wholeheartedly do). Maybe I'll just explain to him my fascination and curiosity with all of this, and that's the main reason I want to ask so many questions. (I've since found out - in the last couple of days - that he's a really great guy with a great sense of humor, but the ambience of the office changed when they got a new office manager (his wife). Well, I'm not going to change who I am (talkative, inquisitive, and like to kid around) because of that, so they better expect a lot of noise while I'm in there.

[Silvana7rojas]

This is a great question and will depend on the skill of your orthodontist. There are 4 categories of space closure, using the back teeth as the anchorage reference point.

1. maximum anchorage- back teeth don't move foward much, front teeth move back only
2. moderate anchorage- some combination of front teeth moving back, back teeth moving forward
3. minimum anchorage- back teeth move forward, front teeth don't move back much
4. absolute anchorage- back teeth don't move at all, front teeth move back (using TADs).

These are theoretical in nature, and the ability to manage these different scenarios is going to impact the result of your treatment. Hope this helps!

I had 4 teeth removed two at top and two at bottom. I do not want my teeth to be pulled back! How are the back teeth moved forward? I want my iryho to do this so I don't get that recessed jaw look that I've been getting. I'm only 18 and my teeth move fairly quickly.

[Sunny]

My back teeth were moved forward with the use of elastics. Springs and closing loops can also be use in conjunction with elastics.

Teeth moving quickly can be an issue, as it's important for the bone to do it's work as the teeth move, so it's important that teeth don't move too quickly. I think teeth moving too slowly (like mine) causes more frustration though!

you shouldn't get a 'recessed jaw' look, as your jaw won't change at 18 ... well not without surgery that is.

Talk to your ortho about how he's planning to do this work for your mouth. Good luck!