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We’re gonna talk about malocussions, rubber bands, braces, extractions, and more. Misconceptions have risen from all angles, so I want to address the million dollar question, “Will my braces/elastics/extractions etc. recess me?”
A malocclusion is just a general term for when your bite is misaligned. This can look different for many people, it includes cross bite, open bite, over bite, over jet, and underbite. You’ve probably heard terminology like “class 3 malocclusion”, well in orthodontics there are different classes of malocclusion, which correlate to different kinds of bites. Edward Angle created this system in the 1930s.
Class 1 malocclusion: This one is the most normal of them all, it is when you have a slight overbite while still having an aligned upper and lower jaw.
Class 2 malocclusion: this is when your upper teeth stick out more than your lower teeth. Signaling an underdeveloped lower jaw, an over-projected upper jaw, or even a mix of both. This class describes overbites and overjets.
Within class 2 AND ONLY CLASS 2, there are two “divisions”. These are subcategories within class 2 that describe your upper incision pattern.
Division 1: the incisors stick out/ protrude. Creating an overjet/buck teeth.
Division 2: this division on the other hand describes when the incisions are not flared outwards, so it’s just a typical overbite type deal.
Class 3 malocclusion: this is the “moon face” sort of look where your lower jaw sticks out significantly more than the rest of your face. Associated with underbites.
Moving on to elastics.
There are many different kinds. These kinds correspond with different malocclusion classes.
Class 1: Class 1 elastics are used within a single arch. They are meant to close tooth gaps and such.
Class 2: These are used for a class 2 malocussion, aka the overbite. These rubber bands are usually placed from the upper canines, to the lower molars to try and shift that overjet backwards.
Class 3: These are for the class 3 malocclusion, and begin around the upper molar area to the lower canine area. To reverse the underbite.
Vertical: These are placed up and down, to close open bites.
Midline/cross: These are to cure cross bites.
All of these elastics have varying degrees of thickness/strength since they are meant to cure different bites.
Now for the million dollar question, do these recess you? Well to a certain degree, yes they can. But not in the way you think. There are many studies about the effect of elastics on the maxillary profile. Let’s look at some.
https://pubmed.ncbi.nlm.nih.gov/27894547/
This study on the comparison between class 2 elastics and the AdvanSync appliance (a fixed orthodontic appliance. Basically class 2 elastics but on steroids) compares the skeletal, dentoalveolar, and soft tissue changes between the two.
“All patients had significant growth potential during treatment, as assessed by cervical vertebral maturation.” So this study involved young patients who were still growing.
The conclusions:
What it’s saying is this appliance RESTRICTED maxillary growth. Meaning no, it did not recess anyone (restriction =/= retraction). Its overall aim is to restrict any potential new forward growth. So yeah, you could say this will put a pause on ones forward growth, but that’s because it’s created for people who have significant overbites/overjets. This solution to the problem is by no means “negative”, as orthodontics are different for everyone.
On the other hand, the effects of class 2 elastics were less significant than the AdvanSync appliance. It relied more on dentoalveolar changes than maxillary restriction. It caused more retrusion, and retroclination of the upper incisors. That is not the same thing as maxillary retrusion. Though it can sort of give that “flatter, recessed-like” appearance, it’s not actual maxillary recession.
Class 2 elastics, as said previously, correspond with a class 2 malocclusion. So they are meant to cure an overbite. So the question “do they recess me?” Is kind of silly, as in order to fix an overbite, maxillary growth is supposed to be restricted in some measures. That “flatter” like appearance gained from them, can in reality be positive in certain cases.
Here’s more findings about class 2 elastics, this one’s a meta analysis. For those of you curious about the Herbst appliance, this has some good info on it as well.
https://pubmed.ncbi.nlm.nih.gov/36498570/
What we can conclude from this is that class 2 elastics are practically harmless in regards to maxillary recession, and that the Herbst appliance is pretty nice since its associated with a modest increase in mandibular length and ramus height, without causing any recession to the maxilla.
Moving on to class 3 elastics, it’s hard to find studies on plain tooth borne class 3 elastics.
https://link.springer.com/article/10.1186/s40510-019-0290-0?utm_
This one addresses the effects of class 3 elastics and the MARME appliance with Alt-RAMEC protocol. MARME is in the same family as MARPE, it’s an expansion device for the palate. Alt-RAMEC protocol on the other hand is a method of using the appliance where they go one week with it on expanded, and then one week restricted. Then expanded, then restricted. This cycle is done to loosen the maxillary sutures, so then when you decide to put on class 3 elastics/other appliances later, they will have greater impacts on your maxilla.
And in the end, this seemed to work.
In the study, the maxilla grew protracted and there were even changes in the midface. The maxilla was protracted by SNA 1.87° while SNB decreased by ~2°. This protocol was positive for class 3 patients. But we have to keep in mind that the MARME appliance is probably what’s responsible for this significant change, not entirely the class 3 elastics.
Skeletal underbites are harder to fix than overbites. So that’s probably why there’s few skeletal change centered studies on the effects of solely tooth borne class 3 elastics, as in most cases they need to be paired with something stronger to cause actual changes in the maxilla.
In general, class 3 elastics are supposed to protract the maxilla.
So the general claim that “elastics recess you” is retarded since aside from the fact that most studies display no impact on the maxilla, different classes of elastics do different things. In this case, class 3 is SUPPOSED to do the opposite of “recess you”.
Intraoral elastics within themselves have little to no effect on maxillary projection, but CAN when used alongside orthopedic systems. E.g. the palate expander+Alt-RAMEC protocol listed earlier.
So in conclusion, no. Your class 2 elastics your orthodontist prescribed you last Wednesday aren’t going to recess your maxilla, what they can do is cause retrusion and retroclination of your upper incisors which can produce that flatter look. But then again, that look may not be negative in your case, since you are dealing with an overbite/overjet.
“Do class 2 elastics recess me?” You know, I HOPE they do.
Now let’s talk about extractions, as these get discussed quite a bit in this community and are very widely debated.
Why are orthodontic extractions done? Well it could be for a variety of reasons.
It’s mainly done for fixing overcrowding of teeth or fixing malocclusions. Premolar extractions are the most common kind.
It is proven that extraction treatment will cause retraction of the lips and an increase in the nasolabial angle. So yes, it can look ugly and cause a flattened profile. It even reduces the width and height of your alveolar ridge. It’s also reported to have induced TMJ.
https://pubmed.ncbi.nlm.nih.gov/19929956/
But it’s important to remember, the alveolar ridge does not represent the entirety of your maxilla. So like it says in the study above, an alveolar width reduction of 3.87 mm does not mean a maxillary width reduction of 3.87 mm.
https://www.sciencedirect.com/science/article/abs/pii/S1532338217302439?utm_
It’s fair to say that many orthodontists use extractions as a way to camouflage malocclusions, which end up looking like shit. But sometimes extractions can be necessary, and aren’t just to camouflage the underlying problem. Sometimes they really do need to take something out for more space.
It is undeniable that there have been many cases of extraction that were completely unnecessary and resulted in disgusting results.
But I can’t deny that I’ve also seen beneficiary results in people with severe prognathism.
So to conclude, unless your side profile looks like a chimpanzee, I would avoid extractions.
https://pubmed.ncbi.nlm.nih.gov/27771001/
Now let’s discuss braces.
Traditional braces alone are the same story, they affect mainly the alveolar region, tooth position, and lip support.
To say “braces recess the maxilla” is a very bold claim to make. Braces in themselves have practically no reported effect on skeletal maxillary changes. They come in many different protocols, systems, and more, it’s different for everyone.
This topic also loops into the Damon braces concept everyone talks about.
Damon braces are fixed braces but without ties attached. Traditional braces use elastic ties to bind to the brackets, creating a tighter feel. So Damon braces allow for a more relaxed feel, and include self litigating brackets instead.
Now are Damon braces really what everyone is making them out to be?
Studies conclude some pretty interesting things..
https://www.ncbi.nlm.nih.gov/books/NBK80653/?utm_
This study finds that there are barely any differences between Damon and regular.
https://www.mdpi.com/2077-0383/14/10/3370?utm_
It results in protrusion of the upper and lower incisors.
https://pmc.ncbi.nlm.nih.gov/articles/PMC6279218/?utm_
This one explores the relationship between the self litigating system and its effects on the upper and lower dental arch. Findings conclude that there were significant increases in maxillary and mandibular arch perimeters.
But what does this really mean?
The dental arch is not the same as someone’s palate. Your dental arch is just the horseshoe shaped band of teeth in your mouth, the palate on the other hand represents the entire roof of your mouth. This is most likely where all the misconceptions have sprouted from. There are no clinical studies on Damon braces increasing actual palate width. Increasing the DENTAL ARCH on the other hand can be from the teeth being able to unpack in a freer manner than trad braces, leading to teeth rotating outwards.
So are these braces worth the hype? I mean, sure. They’ll procline your teeth and cause the appearance of a broader dental arch. But if you have traditional braces, the fact that you didn’t get Damon braces is not worth bitching over. Marketing claims online have over exaggerated and dramatized the differences between the two.
Hopefully this thread cleared the air on some things, and I encourage you to check out another teeth related thread of mine
https://forum.looksmaxxing.com/threads/diy-composite-resin-bonding
.175860/
@Chainsandwhips2 @Randomized @ecoli @Nbernical
A malocclusion is just a general term for when your bite is misaligned. This can look different for many people, it includes cross bite, open bite, over bite, over jet, and underbite. You’ve probably heard terminology like “class 3 malocclusion”, well in orthodontics there are different classes of malocclusion, which correlate to different kinds of bites. Edward Angle created this system in the 1930s.
Class 1 malocclusion: This one is the most normal of them all, it is when you have a slight overbite while still having an aligned upper and lower jaw.
Class 2 malocclusion: this is when your upper teeth stick out more than your lower teeth. Signaling an underdeveloped lower jaw, an over-projected upper jaw, or even a mix of both. This class describes overbites and overjets.
Within class 2 AND ONLY CLASS 2, there are two “divisions”. These are subcategories within class 2 that describe your upper incision pattern.
Division 1: the incisors stick out/ protrude. Creating an overjet/buck teeth.
Division 2: this division on the other hand describes when the incisions are not flared outwards, so it’s just a typical overbite type deal.
Class 3 malocclusion: this is the “moon face” sort of look where your lower jaw sticks out significantly more than the rest of your face. Associated with underbites.
Moving on to elastics.
There are many different kinds. These kinds correspond with different malocclusion classes.
Class 1: Class 1 elastics are used within a single arch. They are meant to close tooth gaps and such.
Class 2: These are used for a class 2 malocussion, aka the overbite. These rubber bands are usually placed from the upper canines, to the lower molars to try and shift that overjet backwards.
Class 3: These are for the class 3 malocclusion, and begin around the upper molar area to the lower canine area. To reverse the underbite.
Vertical: These are placed up and down, to close open bites.
Midline/cross: These are to cure cross bites.
All of these elastics have varying degrees of thickness/strength since they are meant to cure different bites.
Now for the million dollar question, do these recess you? Well to a certain degree, yes they can. But not in the way you think. There are many studies about the effect of elastics on the maxillary profile. Let’s look at some.
https://pubmed.ncbi.nlm.nih.gov/27894547/
This study on the comparison between class 2 elastics and the AdvanSync appliance (a fixed orthodontic appliance. Basically class 2 elastics but on steroids) compares the skeletal, dentoalveolar, and soft tissue changes between the two.
“All patients had significant growth potential during treatment, as assessed by cervical vertebral maturation.” So this study involved young patients who were still growing.
The conclusions:
The average person is gonna look at these buzzwords and go “muh this causes recession, never do this!”
What it’s saying is this appliance RESTRICTED maxillary growth. Meaning no, it did not recess anyone (restriction =/= retraction). Its overall aim is to restrict any potential new forward growth. So yeah, you could say this will put a pause on ones forward growth, but that’s because it’s created for people who have significant overbites/overjets. This solution to the problem is by no means “negative”, as orthodontics are different for everyone.
On the other hand, the effects of class 2 elastics were less significant than the AdvanSync appliance. It relied more on dentoalveolar changes than maxillary restriction. It caused more retrusion, and retroclination of the upper incisors. That is not the same thing as maxillary retrusion. Though it can sort of give that “flatter, recessed-like” appearance, it’s not actual maxillary recession.
Class 2 elastics, as said previously, correspond with a class 2 malocclusion. So they are meant to cure an overbite. So the question “do they recess me?” Is kind of silly, as in order to fix an overbite, maxillary growth is supposed to be restricted in some measures. That “flatter” like appearance gained from them, can in reality be positive in certain cases.
Here’s more findings about class 2 elastics, this one’s a meta analysis. For those of you curious about the Herbst appliance, this has some good info on it as well.
https://pubmed.ncbi.nlm.nih.gov/36498570/
What we can conclude from this is that class 2 elastics are practically harmless in regards to maxillary recession, and that the Herbst appliance is pretty nice since its associated with a modest increase in mandibular length and ramus height, without causing any recession to the maxilla.
Moving on to class 3 elastics, it’s hard to find studies on plain tooth borne class 3 elastics.
https://link.springer.com/article/10.1186/s40510-019-0290-0?utm_
This one addresses the effects of class 3 elastics and the MARME appliance with Alt-RAMEC protocol. MARME is in the same family as MARPE, it’s an expansion device for the palate. Alt-RAMEC protocol on the other hand is a method of using the appliance where they go one week with it on expanded, and then one week restricted. Then expanded, then restricted. This cycle is done to loosen the maxillary sutures, so then when you decide to put on class 3 elastics/other appliances later, they will have greater impacts on your maxilla.
And in the end, this seemed to work.
In the study, the maxilla grew protracted and there were even changes in the midface. The maxilla was protracted by SNA 1.87° while SNB decreased by ~2°. This protocol was positive for class 3 patients. But we have to keep in mind that the MARME appliance is probably what’s responsible for this significant change, not entirely the class 3 elastics.
Skeletal underbites are harder to fix than overbites. So that’s probably why there’s few skeletal change centered studies on the effects of solely tooth borne class 3 elastics, as in most cases they need to be paired with something stronger to cause actual changes in the maxilla.
In general, class 3 elastics are supposed to protract the maxilla.
So the general claim that “elastics recess you” is retarded since aside from the fact that most studies display no impact on the maxilla, different classes of elastics do different things. In this case, class 3 is SUPPOSED to do the opposite of “recess you”.
Intraoral elastics within themselves have little to no effect on maxillary projection, but CAN when used alongside orthopedic systems. E.g. the palate expander+Alt-RAMEC protocol listed earlier.
So in conclusion, no. Your class 2 elastics your orthodontist prescribed you last Wednesday aren’t going to recess your maxilla, what they can do is cause retrusion and retroclination of your upper incisors which can produce that flatter look. But then again, that look may not be negative in your case, since you are dealing with an overbite/overjet.
“Do class 2 elastics recess me?” You know, I HOPE they do.
Now let’s talk about extractions, as these get discussed quite a bit in this community and are very widely debated.
Why are orthodontic extractions done? Well it could be for a variety of reasons.
It’s mainly done for fixing overcrowding of teeth or fixing malocclusions. Premolar extractions are the most common kind.
It is proven that extraction treatment will cause retraction of the lips and an increase in the nasolabial angle. So yes, it can look ugly and cause a flattened profile. It even reduces the width and height of your alveolar ridge. It’s also reported to have induced TMJ.
https://pubmed.ncbi.nlm.nih.gov/19929956/
But it’s important to remember, the alveolar ridge does not represent the entirety of your maxilla. So like it says in the study above, an alveolar width reduction of 3.87 mm does not mean a maxillary width reduction of 3.87 mm.
https://www.sciencedirect.com/science/article/abs/pii/S1532338217302439?utm_
It’s fair to say that many orthodontists use extractions as a way to camouflage malocclusions, which end up looking like shit. But sometimes extractions can be necessary, and aren’t just to camouflage the underlying problem. Sometimes they really do need to take something out for more space.
It is undeniable that there have been many cases of extraction that were completely unnecessary and resulted in disgusting results.
But I can’t deny that I’ve also seen beneficiary results in people with severe prognathism.
So to conclude, unless your side profile looks like a chimpanzee, I would avoid extractions.
https://pubmed.ncbi.nlm.nih.gov/27771001/
This quote basically sums up everything.
Now let’s discuss braces.
Traditional braces alone are the same story, they affect mainly the alveolar region, tooth position, and lip support.
To say “braces recess the maxilla” is a very bold claim to make. Braces in themselves have practically no reported effect on skeletal maxillary changes. They come in many different protocols, systems, and more, it’s different for everyone.
This topic also loops into the Damon braces concept everyone talks about.
Damon braces are fixed braces but without ties attached. Traditional braces use elastic ties to bind to the brackets, creating a tighter feel. So Damon braces allow for a more relaxed feel, and include self litigating brackets instead.
Now are Damon braces really what everyone is making them out to be?
Studies conclude some pretty interesting things..https://www.ncbi.nlm.nih.gov/books/NBK80653/?utm_
This study finds that there are barely any differences between Damon and regular.
https://www.mdpi.com/2077-0383/14/10/3370?utm_
It results in protrusion of the upper and lower incisors.
https://pmc.ncbi.nlm.nih.gov/articles/PMC6279218/?utm_
This one explores the relationship between the self litigating system and its effects on the upper and lower dental arch. Findings conclude that there were significant increases in maxillary and mandibular arch perimeters.
But what does this really mean?
The dental arch is not the same as someone’s palate. Your dental arch is just the horseshoe shaped band of teeth in your mouth, the palate on the other hand represents the entire roof of your mouth. This is most likely where all the misconceptions have sprouted from. There are no clinical studies on Damon braces increasing actual palate width. Increasing the DENTAL ARCH on the other hand can be from the teeth being able to unpack in a freer manner than trad braces, leading to teeth rotating outwards.
So are these braces worth the hype? I mean, sure. They’ll procline your teeth and cause the appearance of a broader dental arch. But if you have traditional braces, the fact that you didn’t get Damon braces is not worth bitching over. Marketing claims online have over exaggerated and dramatized the differences between the two.
Hopefully this thread cleared the air on some things, and I encourage you to check out another teeth related thread of mine
https://forum.looksmaxxing.com/threads/diy-composite-resin-bonding
.175860/@Chainsandwhips2 @Randomized @ecoli @Nbernical
I now approve of your contributor status
