Twenty Four Month Braces!

Twenty four month braces! 

A new revolution in orthodontics

Over the past few years there have been several new innovations in orthodontics that have simply been reinventions of existing techniques and are sold as something new for the adult market.  As a result, I thought that I would take a light hearted look at Twenty Four Month braces!

This new orthodontic system provides a revolutionary system for the treatment of malocclusion.  It utilizes new stainless steel brackets and metal coloured wires.  The novel brackets have precise tooth positioning technology built into the slots. The arch wires are held in the bracket using a specially designed polymeric “module”. Importantly, the brackets allow precise control of the root position, particularly when used with the space technology “rectangular archwires”.

24 month brace bracket

24 month brace bracket

This appliance can be used to correct overjets, overbites, crowding and buccal segment relationships.

 

 

 

 

 

 

 

Who can be treated by twenty four months braces?

Anyone can be treated with this appliance and there are no limits with what it will do. Note the wider arches in the finish picture below!

Before 24 Month Braces

Before 24 Month Braces

After 24 months Braces treatment

After 24 months Braces treatment

All about treatment

Screen Shot 2014-02-21 at 15.39.26Extractions may be prescribed as part of the treatment, when there are indications.  There is some discomfort when the appliances are adjusted and you have to be careful what you eat.

 

 

Training

Unlike other systems the treatment is not supervised by experts in other countries by sending them your records.   This treatment cannot be taught in one day courses based in airports, helped out by business coaches, interested advocates and flash advertising. There are no shortcuts, training is provided by attending a three year specialty training course or gaining considerable supervised experience. This takes time, effort and hard work!

How do I sell the treatment?

You do not need to sell this type of treatment.  It is the best way to comprehensively treat malocclusion.  You need to explain this to your patients and they can then decide whether they want to have treatment or try another method that is a short-term compromise provided by people with minimal training………

 

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  1. I think we should take a leaf out of the book of short term orthodontics (STO) and get business coaches like Ashley Latter and Chris Barrow to market the 24 month braces, give a a catchy tag line like “More profit in less time”, a punchy name like “Perfect smile in 2 years”. You never know, this may be the next big thing in “Aesthetic Orthodontics”. This may also trounce the STO with predictable results.

  2. What is your motivation for writing such an article? It smacks of arrogance and protectionism. P.S. your lower arch is bowing during space closure.

    • Thanks for the comment. My motivation was to draw attention to the power of marketing in driving non evidenced based claims for orthodontic treatment techniques. We all need to remember that “new” techniques such as short term orthodontics are not new and have been practiced for many,many years. However, in the past this was termed compromise treatment or tailored treatment. I frequently carry out this form of care for my medically compromised child patients and when I taught adult orthodontics on the specialty programme I would always seek the compromise treatment first. I did not dress it up as something new. Finally, It is very important to remember that if you are going to compromise you need to know the aetiology of the problem (the teeth are in a certain position for a reason) and this cannot be taught in a short course.

      As for arrogance and self protectionism. I am sorry to give that impression. If you read my publications etc, you will see that I have spent my whole career questioning the need for orthodontic treatment, clinical dogma and areas such as the effectiveness of early treatment. I am also going to follow up this article with one on the concept of the “social six” in terms of whether this is something that we should consider more.

      Yes, the lower arch is bowing, I took this from a lecture on space closure given by colleague, Jon Sandler, and the mechanics are set up to continue space closure and correct the bowing.

    • J Blogs, please leave constructive, evidence based and sensible comments only! If you have any sense you will take time to interpret KOB’s blogs and reflect upon them. He is only trying to protect the under trained and ignorant from themselves. He is without doubt the least arrogant man in orthodontics. I hope for your patients’ sake that you stay lucky! I wish you all the best Sir!

  3. May we ask why 4 teeth were taken out – no choice because poor prognosis, or the typical 20th century approach saying extractions of healthy teeth prescribed routinely for moderately crowded cases?

    Yours curiously,
    Tony.

    • I would rather have 4 teeth out to achieve a functional and aesthetic result avoiding gingival recession from excessive proclination than have all my enamel removed and replaced with porcelain and entering me into the cycle of dental maintenance.

  4. Loved it Prof!!! Will share it on my facebook and spread the words. Hope to be able to host you one day in Indonesia with Mr John Sandler as well. Take care and Cheers…..

  5. Interesting article, and very thought provoking. Two things I’d like to ask though:
    1. In extraction cases, which seems to be the fast track method to achieve rapid “two year” results, if the overall result is stable, then why do you need fixed retainers in the majority of cases and despite this why do so many cases relapse? (I am a restorative and implant dentist, who has dabbled briefly in ortho, but who was very uncomfortable with my lack of overall knowledge on this subject and now refers all out.)

    2. Can we avoid extractions and maximise stability? Avoiding relapse?

    • HI David, thanks for the comments. You have raised some very relevant points. We have a surprisingly knowledge of retention. What we do know is that with continuing facial growth and facial muscle maturation, it is almost certain that orthodontic treatment will relapse. In terms of retention we also know that it is not possible to retain treated occlusions for life. So we have a problem. We do know, to a degree, that if we expand the arches then there is likely to be more relapse, but the level of this evidence is not high. So we need to consider overall clinical wisdom which tells us that it is best not to expand the arches,but then there are always exceptions. My main concerns about short term orthodontics are based around the acceptance that this is likely to be a compromise treatment and before an operator can consent a patient into a compromise, they ethically need to have an in depth knowledge of all the options, including comprehensive treatment. This is currently lacking when an interested dentist attends a one or two day course. I hope that I have addressed your question?

  6. I enjoyed this article, and definitely would be interested in being an accredited “24 month braces provider” and being listed on the “find a 24/12 Braces Doc in your area” locator.

    Where do I register and who do I pay? Can I pay by paypal or bitcoin?

    • I think that all specialist providers have done their time being accredited. The list of providers is sometimes known as a “specialist list”!

  7. Hi Kevin,

    Just wondered if you had chance to to check the records as to why 4 teeth were taken out.
    Were non-extraction options fully considered in this case?
    Also how was the lower arch Bowing dealth with – did this extend treatment time beyond 24 months at all?

    Yours curiously,
    Tony.

    • Hi Tony, in order to answer your questions.
      1 the teeth were taken out for crowding
      2 Yes, of course they were
      3 The bowing was dealt with by checking the wires for binding and flattening them. Not a big deal and it would not have extended the treatment.

      Kevin

  8. great kevin…love it…I predicate this in all my courses….when I get asked …doc how long will treatment take…my answer is always…as long as it takes to get an excellebnt result functionally and esthtically…and long long will that be doc…between 24-30 months….no one leaves my practice !!!

    • Hi Domingo, thanks for the comments on this post. It is the most popular post on my blog. I had originally intended it to be a light hearted post, but it has been viewed over 2,000 times! I hope that all is well with you.

      Best wishes: Kevin

  9. Hi Prof,
    I chuckled when i read this post, i thought to myself ‘ooo..british humour at its best, the comments should be interesting’ and it was! why so serious (joker face)

  10. Dear Mr o Brien

    One can infer from your tongue in cheek piece called 24 month braces that you suggest all orthodontics should be only be comprehensive in nature ( equating in restorative terms to a reorganising full mouth rehab ) and any orthodontics should only ever be undertaken by a registered orthodontic specialist .

    It appears that you feel that a GDP is unable to comprehend simple mechanics to align anterior teeth only ( especially pre restoratively )with either fixed or removable appliances ( which equates to a comformative anterior restorative solution in a restorative analogy ) .

    I value your experience , you dedication to research but I am amazed by your lack of insight at grass roots level into why adult patient seek these ‘compromised ‘ though better termed ‘limited outcome ‘ orthodontic treatments over comprehensive orthodontics . A hint might be in the name 24 month braces .

    • Hi, thanks for the comments and yes 24 month braces was a tongue in cheek parody of the advertising for rapid treatments etc. I then followed this up with a blog post that discussed the issues of short term orthodontics, if you have a look at this, you may see that I think that there is a place for STO and not have such a lack of insight, I hope. The post is here http://kevinobrienorthoblog.com/bit-controversial-orthodontic-blog/

      Best wishes: Kevin

  11. Part of the problem is the patients who dont qualify for free treatment have to then seek private.
    Listening to your customer needs is key to growing your business, thus telling them their treatment will take in the region of 24months and will fully treat their malloclusion does not fill them with confidence especially when they can go to a dentist who tells them they can ‘straighten’ the crooked teeth, omitting treating the malloclusion, in 6months or less.
    I believe we have to offer STO also as we know how to treat it better due to our training, and park our ego at not treating the full malloclusion, with a waiver in the treatment planning of course!

  12. The best post ever!
    It is suggested the patients to sue those who promise faster treatment time since there is no treatment time to compare with. The question should be: “Faster than what?”

  13. Bravo! Well said. It says something about the level of ethics in our profession that Snake Oil Salesmen still exist, that the practitioner’s bottom line is more important than the patient’s welfare.

  14. Good points – not sure if anyone suggested checking the vitality of the upper left central incisor after treatment…maybe it was bumped along the way. The slight colour variation may suggest it needs some endodontic care.