More On "Instant Orthodontics" by Dr Chan Joon Yee There is actually no such thing as "instant orthodontics". In fact, we don't do orthodontics here. The illusion of instant orthodontics is created by a technique which involves elective root canal treatment and crowning for crooked teeth. Below is a case we completed recently. The patient is a young and attractive teacher on her way to a new career as an air stewardess (or cabin attendant if you want to be PC). Below is a plaster model of her teeth before treatment. From the inside, we can see that her two central incisors are protruding forward. The incisor on the right side was even rotated. Her lateral incisors were also sunken relative to the rest of her teeth. It's our duty to inform her that the ideal treatment for her case is orthodontics. She would have to extract a couple of teeth, put on braces for 2 to 3 years. She rejected the option because as an air stewardess, she would not be allowed to put on braces. She also needed to look good in time for her final interview. I took impressions of her mouth and studied her case closely. The twisted right central incisor was marked (x) for elective root canal treatment. I would have to break off the crown and then rebuild it from scratch. The two lateral incisors only needed to be "thickened up" with crowns to put their outer surfaces in alignment. The tilted canine on the right side could be set straight also by covering it with a crown. Below is what we call a diagnostic wax-up. It's similar to a mock up of the final result we can get. It's done by adding wax to recontour the original study model. Of course, the twisted crown was broken off on the model and reset in a new position. In this wax-up, I included the canine on the left. The patient decided to do just 5 Empress® crowns from her right canine to the left lateral incisor. I performed the root canal treatment as planned and then cut the crowns accordingly. The impressions were sent to the lab and in a week, they were ready for cementation. The plaster models below was taken from the patient after the crowns were cemented. Note that we managed to completely realign 5 of her teeth by crowning. Root canal was only required for one tooth. It should be noted that "instant orthodontics" is a compromised and less than ideal solution. Vital teeth which have been crowned in this case may require root canal and quite a bit of follow up treatment in future. Cost Estimation The above case would cost about S$4200 today

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