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Neal, I am extremely grateful for the time and effort you put into these pearls. They have been very helpful. I'm a better orthodontist due to your influence. Thank you.

Right on! BTW you mentioned the ext 5's, have you ever placed bonded retainer at the 4-6 spot?

Agreed! Usually it's rests on D's, mesial extension on c's, then cut off rests after expansion and ext if needed.

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Congratulations to your patients on this level of care and passion they are getting from you. And thanks as always for sharing your wisdom. I'd like to ask you about a clinical situation: gum recession on a lower incisor (or any other tooth). Is it preferable to perform the perio surgery before or after orthodontic treatment?

Is it useful if I already got slightly chemical burn after peeling?A bit red and bumps on both side of the cheeks.

Couldn't agree more. I have learned this lesson the hard way and now try to insist on the mom being there for deband.

hello Dr Kravitz! thank you for another informative video again. may i know the reason behind your wire choice (upper retanium, lower orthoflex tech)? do you do the fixed retainers from the canine - canine or the premolar-premolar? do you use the direct or indirect bonding technique for fixed retainers? thank you!

Amazing video Dr Kravitz! I’ve been pondering exactly this during residency today. I’m wondering if your conclusions (specifically the part about how it’s acceptable finishing the midlines on with each other, but slightly off from the face) would apply to all subdivision cases in general. I find with any major subdivision case even if we achieve class I canines and get the dental midlines on with each other, they may end up slightly off from the face… exo or not. It’s a challenge… but I presume as long as they’re not significantly deviated from facial it’s acceptable? Thank you!!

Hey Dr. Kravitz. thanks for the video, as usual. wherever you have the occlusal rests, how are you bonding them onto the tooth? are you just etching the tooth underneath and using assure and flowable composite? and does that come off easily during debond?

Do you promises them only 2 mo in braces ? Or is the 2 months just a trial to see how they like it

Nice one! How do you handle this when you're not sure if mom is not in the picture and feel hesitant asking dad (who brought kid in)? Or parents are divorced and only one comes in?

Great tip! Any pearls for posterior openbites due to clear aligners (ie finishing)

Hi Neal, thanks for all you do for our profession. Question - do you routinely always bond/band second molars. If so, do you pick them up from the beginning or during treatment? Thank you

Great video Dr Kravitz! One question: In these adult women where you’re extracting U5s (instead of U4s) for “less retraction”, are you therefore accepting some residual OJ? Perhaps finishing super class II molars? Or, do you still try and correct the rest of the OJ through lower mesialization with class II elastics and aim for socked in class II molars?

Regarding the Class II with the strong pogonion in adults, are you referring to the orthopaedic effect from the Class II elastics bringing the mandible forward, or retracting the upper incisors? If it's the orthopaedic effect, isn't some of it lost once treatment is completed, even if you get a socked in occlusion? Thank for you for the videos!

Would love to hear an extension on the example of the Class II case? didn't understand it correctly. Thanks!

Totally agree! Furthermore, we also look at the vertical characteristics of the profile and the incisor exposure at rest and/or the presence of a gummy smile to use long or short elastics and increase or decrease the occlusal plane rotation !

इस वीडियो को बनाने के लिए धन्यवाद, भारत की ओर से प्यार और सम्मान।

Great review!

Grateful for all the wonderful clinical and practice management pearls! I would love to know if you have come across Invisalign cases with an incisor changing in color/having delayed pulpal response. Thanks so much Dr. Kravtiz!

Great advice, as always!! You are a blessing to this profession. Thank you for all the wonderful pearls!

Maxilar Premolars Extraction and good anchorage for retraction. Anterior Miniscreews if Gummy Smile.

Hello Dr Kravitz want to enquire about what to do when the anterior four teeth have retroclined due to space closure with e chain

I have a second question. I see you have the curing light Flashmax P4 Ortho. What is your curing time per bracket ? 1 second ? Thanks

Notice that early distalization of 16/26 can cause impaction or ectopic eruption of 17/27. I wait till 7 at or passes the CEJ of 6.

Great Video Doc...do you use class II elastics with pendulums/pendex type appliance distalizers to control the overjet?..or to aid it with the kind of headgear effect of the class II elastics ? and also aren't you worried that the effects on buccal segment maybe due to lower incisors proclination rather than distalization of upper....one other thing Do you use Class II elastics with the tad based distalzation too? thank you

Well explained treatment options for hypo non surgical options include RCS in lower and ECS in upper arch. Sometimes due to increased over jet u might need to have anterior bite plane and need to over correct for future deepening of bite Or intrusion arches in lower arch Or sometime with lower anterior TADs to intrude lower arch or intrusion of upper arch if there’s associated gummy smile or intrusion arch one couple system in anterior segment etc

Nance better option as compared to TPA as Sagittal anchorage TPA doesn’t provide sagittal anchorage or if any very minimal but TPA is good for vertical anchorage

Dr. Kravitz, thank you for these pearls. What is your take on using a nance as an anchorage device vs. a TPA? Thank you!

Dr Kravitz, my mentor wanted me to look for papers recommending videos por diagnosis in Orthodontics. Can not find much... Any suggestions? Thank you!

Hi Dr Kravitz! Always love the daily pearl for residents like myself. Are you able to cover the biomechanics of a transpalatal arch (TPA)? Also touching on how it can be used to control the vertical dimension in high angle cases. Thank you!

Happy 4th of July! Thanks again for taking your time to make these videos. We really appreciate you for sharing all these clinical pearls. I know you appreciate ideas and topic suggestions for future videos , so here I got one for you…Expand on your preference for anchorage management in extraction case to correct several common types of malocclusions ( adults/ adolescents) in your daily clinical practice. Thanks again for your contribution to the orthodontic community.

Dear doc , can you provide me with literatures about surgical uprighting of 2nd molar, thx

Do you not use any of TMA wires? For final settling of occlusion with vertical elastics, what wire do you use?

What is your treatment choice is this cases? and in those subdivision class II hiperdivergent patients with the lower dental midline deviated from the midline of the face.

Great video Dr Kravitz! What about using fixed class II correctors like Forsus or Twinforce in hyperdivergent Class IIs for the AP correction? I assume these are also acceptable choices as they have molar intrusive effects (unlike class II elastics which you mentioned is contradicted)? Thanks again for these videos.

Beautiful beautiful beautiful! I wish every orthodontist could hear this!

Brilliant for use in the upper to add torque!

Thank you so much for these videos Dr. Kravitz, they are incredibly helpful. I’m not sure if you ever have people consult with you on cases they’re stuck on, but if you do I have one I’d love to send you. Thanks for all you do for the profession.

reason for choosing reverse curve nitis with distal toe in vs distal legs that are straight?

Thanks a lot! What do you do when patient is class 2 Dvi1 with upper 4s only, and you run into deep bite during retraction on 19x25SS and upper incisors don't clear the lower brackets?

I use 018 slot and I like to try to keep it simple. On most of my patients, I use a 3 wire sequence. I start with an 016 heat-activated Niti until all the rotations are gone. Then I switch to a 16x22 Niti and keep that in for about 3 months and then finish in a 16x22 SS. Certainly there are situations where I use reverse curve Nitis or 17x25 archwires to express more torque, but in general I try to keep it to 3 wires. Thanks for all the daily clinical pearls! I really enjoy them!

I saw a lecture at the AAO once about using reverse curve Nitis to close an open bite in patients with a steep mandibular plane angle that I thought was very fascinating. You need a patient that is VERY compliant! You place upper and lower reverse curve Nitis and have the patient wear heavy triangle rubber bands. This causes the posterior of both the upper and lower to intrude helping aid in open bite closer and reduce the mandibular plane angle. I have used this method on a number of my patients with great success. However, you HAVE to catch it early if the patient is NOT compliant because it can make things worse.

I usually use .016×.022 counter force Niti and leave it for 2-3 months.

Awesome tips! How long do you leave in your rectangular niti wires and your RC arch wires?

How and which bracket do you bond on double tooth for eg 32,33. Thank you

Practice management question: How do you manage consultations where it is obvious that the parent or the adult patient has unrealistically high expectations or when they just seem like they are the type of patient who will have an argumentative or combative personality? What is your scripting like in these scenarios? Thank you for these videos!

Thank you for these videos. What do you do to prevent the light wires from shifting and flexing out of posterior tubes especially in patients with missing posterior teeth?