Early Closure of Gap
The gap between permanent (adult) central incisors (Fig.1: 1) is usually temporary for 7-8 year old kids. When the lateral incisors erupt (2), the gap should be closed. But it does not happen to Hilary. Mommy wants to fix it as quickly as possible.
In three months, the big gap is closed with braces (Fig.2), but the mommy finds out that the upper and lower midlines are not in the same line (arrows). It appears that the upper midline is deviated to the right (our left handed side). The four front teeth should be moved to the left. Luckily there is a space between the lateral incisor (Fig.3: 2) and baby canine (3). A wire (vertical arrow) is used to tie this canine with two back teeth as one strong unit (anchorage). A rubber band (blue) is used to drag the lateral incisor backward (i.e. to the left, horizontal arrow). When the lateral incisor contacts the canine, they are tied together with the back teeth as one unit. This time, the central incisor (1) will be dragged the left with a new rubber band. So on and so on until all of the four front teeth are pushed to the left.
In another two months, the upper and lower midlines almost meet each other (Fig.4). In young kids, everything changes so rapidly. Everyone is happy, kid, parents, doctor and assistants. For an adult, these changes will take more time. So braces should be started as soon as possible, if necessary.
After fine tuning, these four front teeth are entering a stage of retention. We need to keep them in the new position. Before the braces (* in Fig.5) are removed, a small piece of wire is glued to the back of the four teeth (>) to keep them in place. Fig.6 shows final results, as compared to Fig.1 before braces.
One year and a half later, the girl's adult canines have erupted (Fig.7: #3). These two strong teeth keep the four incisors in between (#1,2) and prevent the gap from coming back (compare Fig.1). It is safe now to remove the wire behind the front teeth (retainer, Fig.8).
Xin Wei, DDS, PhD, MS 1st edition 05/28/2011, last revision 09/02/2013