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Post retention changes in mandibular
crowding: a review of the literature
An evaluation of changes in mandibular
anterior alignment from 10 to 20 years
post retention
Many appliances are designed to treat
relapse, though none of them do it on a
part-time basis at night. Being able to
do so efficiently and much more
affordably is quite appealing to
patients.
Initial Treatment - For Class I
cases where the anterior teeth are the
major concern, NightShift® is an
excellent option. It is also capable of
limited posterior applications.
There are also patients who should have
braces or other functional treatment,
but choose not to. These patients,
properly informed, will often decide to
treat only the anterior teeth because
they can now do so relatively quickly
and affordably with a nighttime
removable appliance.
It’s suggested to get a signed waiver
from all patients, but especially those
where known deficiencies will be left
untreated.
Concurrent with Braces - Numerous
doctors are now using a version of
NightShift® without the labial bow,
concurrently with brackets and wires on
the same arch to enhance treatment
efficiency. Because esthetics are not an
issue in such cases, it should be worn
full-time.
Esthetic Treatment Adjunct -
Esthetic treatment is one of the most
widely taught and highly active segments
of dentistry today. NightShift® is a
perfect adjunct to quickly and
affordably position the teeth optimally,
before bonding and/or veneering,
providing the patient and the doctor
with the best end result possible and
keeping the case in-house from start to
finish!
Interceptive Treatment - can now
be done practically and affordably.
Numerous cases present with cross bite
in one or more teeth, or other problems
which can cause major trouble if left
untreated. NightShift® is highly
efficient in cross bite correction in a
majority of anterior and posterior cases
where buccal movement is required to
solve the problem.
It can also be very beneficial in
guiding
improperly erupting teeth into proper
position or to move erupted teeth out of
the way of erupting teeth requiring
space to properly erupt.
Pre-prosthetic Treatment -
Closing and opening of spaces and
uprighting of abutment teeth is often
necessary before a proper prosthetic
appliance can be fabricated. When teeth
are moved into proper alignment prior to
fixed prothesis, it is not necessary to
remove excessive amounts of tooth
structure. NightShift® can often
accomplish this quickly and practically.
Retention - NightShift® is not
only capable of highly efficient tooth
movement, it can also be used to keep
the teeth in place after NightShift® or
conventional orthodontic treatment.
A typical Hawley, or other retainer not
worn for a period of time, won't fit and
will need to be replaced. The springs in
NightShift® remain active after
treatment and will reactivate to move
relapsing teeth back into proper
position if non-compliance is allowed to
occur.
Retainer wear is typically a life-long
requirement, though minimizing nightly
wear can be attempted. Our rule of thumb
is to wear them nightly in retention for
a year. Then try every other night or
twice a week for a time. Depending on
the severity of the original
malpositions, it may need to be worn
occasionally for life or may be
permanently removed without incident.
It’s better to err on the side of
caution and recommend occasional wear
for life, which could mean as little as
once a week or so after the first year. | 