I thought this was a great question that I got in my inbox today. Since I havent really covered this question to much detail in my videos I thought Id share my answer here and other people can join the discusson fi they have any more questions.
Here is the question:
First, Why cut the gingiva when you make the adam’s clasp?– When you make the adam’s clasp, every time cut the gingiva? Is it same as adult or child?Second, When you make the labial bow, every tooth contact to wire ?– If lateral incisor has lingual version, Is it also contacted by wire?
Here is my answer:
I cut the gingiva for the adams clasps to gain extra retention. In the Patients mouth, there is 2-3 mm of what they call “free gingiva” it is not attached to anything. It is hard to see on the model because the stone is hard and doesn’t move. So, I cut some of it away so that I can expose to more of the tooth to achieve more retention. When you place the retainer in the mouth the adams clasps slightly move the free gingiva out of the way. If done right the patient will not feel it. But of course, if you cut too much away you could hurt the patients mouth!Usually this is only done on children’s mouth’s only, because the molars are not fully erupted yet and retention is very difficult with other clasps. Adults, however, usually do not need the gums cut away because their molars are fully erupted and they have plenty of undercuts exposed. Usually with adults you can get plenty of retention with something simple like ball clasps.Other factors to consider:Gums may be “Puffy” because they just took the braces/bands off right before the impressions for the retainers, therefore the gums haven’t had a chance to recede or “tighten” back up. Also poor hygiene may cause puffy gums. In both these cases you might have to cut away more of the gingiva on the model than usual. You will have to imagine what the gums will look like once the patient heals up and make your cuts accordingly.As far as your labial bow, yes, you do have to contact every tooth you dont want to move. That is the purpose of retainers is to make sure the teeth don’t move after the braces come off. This is accomplished in the anterior by having acrylic on the lingual of the tooth and wire on the facial of the tooth. So the tooth is “Sandwiched” between the two.Exceptions:If you have a tooth that is more lingual than the others and you want to move it more facial with a spring on the lingual then you will have to make sure your labial bow does not touch the tooth. You have to bend the wire to were the tooth will be after it has been pushed forward.
If anyone has anymore questions leave them below n the comment field.
You can still design your retainer online but you will not be able to put the design in your current retainer. But remember us if you ever need replacements! But dont lose your retainers on purpose 😉 replacements can be VERY expensive!
No degree needed, just training. But there are schools you can go to, just search for: Dental Laboratory Technology Schools. I went to one in San Antonio, Texas. The school was very fun!
Yes you will! But practice, practice, practice! By practice I mean talk... a lot! Read books and magazines out loud to yourself, sing in the shower! Really anything that gets your brain and tongue used to an extra layer of plastic on the roof of your mouth. It will take anywhere from a few days to a few weeks depending on how much you can practice. I remember when I was an orthodontic assistant, there were some kids that I could tell never wore their retainer. Kids that could not talk at all was a clue to the doctor and assistants that they are not wearing their retainer, along with their teeth getting crooked again.
So, good luck and practice, practice, practice!
As far as your splints, yes we do make those. I think I know what you are talking about it looking dirty:
I used to use these sheets from Great Lakes isofolan
http://www.greatlakesortho.com/commerce/detail/?nPID=158
They did a great job keeping the stone out of the soft side of the suck down material. and it is very thin so it doesn't bother the retention much. What you do is do a suck down of the isofolan first, then remove the excess material (cut it against the model below the line where the splint will go) poke a few holes in the material against the teeth with a sharp knife to let air escape during the suck down of the half/half material. when your ready to separate the splint from the teeth that stuff just peels out
If you don't have that you can use a couple of layers of separator, my favorite is:
http://jbcandcompany.com/shopexd.asp?id=721
Second thing to watch out for is to make sure no monomer touches the soft side of the soft/hard thermoforming material. If you cut the material before you add cold cure make sure you wax out the exposed edge to the soft side of the material. If monomer touches that we figured out it makes it milky and white. When I cut out my material I leave a ledge that was created from sinking my model down into the beads of the biostar, that way it creates a support ledge for pouring the cold cure acrylic against and it keeps the soft side far away from the monomer.
I have question for you please about this acrylic design I saw in a website of another lab. You tell me if I am wrong but there is no way this design could be fabricated by layering acrylic of different colors right? It looks too complicated and small for it to be acrylic. could it be drawn by a sharpie or something and then clear acrylic over it? How would you fabricate this? I would really appreciate your help and input please.
