A high percentage of cases can be well treated without the need for tooth positioners. However, they can be useful in the following situations:
• Tor patients who have shown excellent cooperation and who want ideal settling, with the best possible result. Many patients become tired towards the end of treatment, and are not able to cooperate fully in normal finishing and detailing procedures.
• For patients with persistent anterior or posterior tongue habits. A properly constructed positioner can have a bite-closing effect.
• In some treatments, it is necessary to remove the appliances early, for a variety of reasons. Further improvement can be obtained for these patients if they will wear a positioner, but sufficient cooperation is seldom forthcoming!
Positioners can be used at the completion of orthodontic treatment to allow for ideal settling of the occlusion. Major tooth movements such as torque control, significant rotation, and tip control are not possible. Minor settling movements, including tipping and rotation, can be carried out if cooperation is reasonable.
The major obstacle to the success of positioners is patient cooperation. Patients are often tired at the end of orthodontic treatment and are not willing to put in the additional time and effort to wear a positioner. If it is planned to use a positioner, it is best to explain this to the patient at the beginning of treatment. Therefore, offices that use positioners frequently, generally inform their patients before treatment, and achieve a better overall response than those that suggest a positioner at the very end of treatment.
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