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orthodontic process and NCR
By Boyer Cole
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The way that I understand the orthodontic process is that wires are put onto the teeth to actively move the teeth. At the end of a month, the tooth movement has become "passive." So each month, when the patient comes in for an orthodontic adjustment, the dentist will "tighten" the wires to change the "passive" situation to an "active" one.
What I understand is that the dentist is not literally tightening the wires per se but is putting in heavier wires to change a passive situation to an active one for tooth movement. Once those heavier wires have had their affect in about a month, the patient comes in again for heavier wires; and so the process of putting in heavier wires continues month after month.
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RE: orthodontic process and NCR
By Dr Dean Howell
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What you say here is not entirely true. Most adults getting orthodontia see the doctor every six weeks. If they have brackets on their teeth, then many times wires will be use to connect the brackets together. The wire is forcefully inserted through all of the brackets on the upper or lower teeth using forceps to force the wire through the bracket openings on the outside of each bracket. The wire will be tightly attached to one of the back teeth by tying the bracket and the expansion wire together with another small wire. Then the wire is attached to the next tooth, and then another, and then another. When completed, the wire is sequentially hooking all of the brackets together. Gradually the action of the wire and its brackets is to move the teeth in the direction pulled or pushed by the wire. So each visit the wire is made longer or shorter and inserted through the small space on the front of each bracket. The length of the wire determines if the teeth will move apart or closer together. Additionally, if the teeth need to be pushed or pulled more powerfully because of resistance from the cranial sutures, then thicker wire might be substituted. As the position of the cranial bones and teeth change from the action of the tight wire, the tension in the wire diminishes. So after the wire loses its tension, the action, as you said, becomes passive. Time for another visit to the orthodontist!
What has been happening to the skull? The orthodontia has been pushing the teeth and bones in the direction desired by the dentist. If (by chance) the movements improve the pattern of stability in the interactive structure of the skull, then the movement will be easy and long-lasting. If, instead, the movement makes the skull structure unstable, then the body will resist this change, and, if the orthodontic device is removed, the body will return to its old pattern. This is why retainers are used. The retainers are used to retain the abnormal movement of the teeth and skull created by the orthodontia.
If no NCR is performed, then the timing of the treatments must be spread out, because rapid, powerful action by the brackets and wires lead to “blunting” of the nerves, indicating that the cranial bones resisted movement and only the nerves were compressed, leading to nerve resorption, an irreversible damage to the tooth. This is the general concept of the six week orthodontic intervals and the gradual lengthening and strengthening of the wires---the treatments are slow enough that no nerve resorption occurs and some tooth and skull movement does occur.
With the addition of NCR, the joints of the skull are mobilized, triggering the unwinding of the skull’s connective tissues. This permits treatments to be timed closer together, because the structures do not “resist” the changes of the improved orthodontia, so no nerve damage can occur. This also removes the need for a retainer, because the body no longer resists a treatment that restores its original design..
Poorly performed orthodontia can oppose NCR. But with continued NCR, the body will reject much of the bad orthodontia, and the dentist will have to adapt or he/she will have a permanent patient, never reaching the poorly visualized orthodontic goal of the doctor. (Orthodontists make one-price bids at the beginning of treatment and have to fulfill their contractual obligation before completing treatment. Sometimes this can go on for over six years.) The NCR, properly performed, will gradually force the ideal body to be displayed, despite the attempts by poor orthodontia to push the body into an undesirable structural pattern
So, at first, the NCR can be timed to give a patient more comfort by following soon after the orthodontist visit (because the tighter wires make the gums and teeth sore, and this diminishes as the wires loosen) or to the NCR can be used to move the skull faster by making the NCR treatments more frequent. But eventually the realities of time and budget will determine the visit frequency of the patient to both the orthodontist and the NCR doctor. As NCR treatments accumulate, the orthodontia is unable to lock up the head, and by that time the timing between the NCR and orthodontia is irrelevant. The patient will now be comfortable and always ready for the orthodontia. It is now up to the dentist to help the body realize its ideal design.
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