When can be removed the fixed appliance after doing the finishing bending? Should we leave the fixed appliance passively!! How long? Is there any evidence please?
The final step of finishing therefore is appropriately called
"settling," since its purpose is to bring all teeth into a solid
occlusal relationship before the patient is placed in retention.
There are three ways to settle the occlusion:
1. By replacing the rectangular archwires at the very end of
treatment with light round arches that provide some
freedom for movement of the teeth (16mil in the l8-slot
appliance, 16 or l8mil in the 22-slot appliance) and
allowing the teeth to find their own occlusal level;
2. With laced posterior vertical elastics after removing the
posterior segmentso f the archwires;o r
3. After the bands and brackets have been removed, with the
use of a tooth positioner
In the final phase of orthodontic treatment, after making compensation and finishing bendings, it is recommended a minimum passive stabilization time of three months to consolidate the new position. While some authors advocate for times ranging from 4 to 7 months. It will depend on the severity and the type of movement required.
I recommend this article about the finishing stage in orthodontics:
Kind Regards.
Article A method of finishing the occlusion
In preadjusted orthodontics appliances all teeth should be in ideal positions at the end of first stage so no need long time for finishing, you need only to make rebonding for selected brackets or pending for determined tooth. and last size of wires you leaf in the place not more than 2 visits (2-3) months
Thank you very much Dr. Mahmoud Al-Suleiman and Dr. Gonzalo Feijóo for the nice answers. I have read the article "A method of finishing the occlusion". It ist really a nice paper but I didn't finde any information about the passive stabilization! she said: "When the patient returns in 4 to 6 weeks for a Deband Check appointment, the assistant will untie the wire completely, mark interproximals of each wire and remove the wires. The orthodontist again will check the occlusion, and the assistant will note desired changes on the Detailing Form using another ink color and noting the date with that same ink color (Fig 13). The orthodontist makes the desired bends and the wire is inserted and completely tied in. When no more changes are needed, appliance removal is scheduled". Would you expect relapse if we do not do a passive Stabilization! Do you have please another papers/studies that we should leave the fixed appliances passively 2 or 4 to 7 months.
Thank you again for your comments
usually after one appointment basically 30 days , you can deb racket your appliance
Dear Dr. Ahmed Aloveid
We should do the following according to Contemporary Orthodontics (Proffit 2007):
1. Replacing full-dimension rectangular wires with light
round wires at the very end of treatment was the original
method for settling. These
light arches will quickly settle the teeth into final occlusion
and should remain in place for only a few weeks at most.
2. Or removing only the posterior
part of the rectangular finishing wire, leaving the
anterior segment (typically canine-to-canine) in place, and using laced elastics to bring the posterior teeth into tight
occlusion. This method sacrifices a large
degree of control of the posterior teeth, and therefore should
not be used in patients who had major rotations or posterior
crossbite.These elastics should
not remain in place for more than 2 weeks, and 1 week
usually is enough to accomplish the desired settling.
Thank you
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