I. Introduction

Welcome to StraightSmile Solutions, your go-to destination for cutting-edge orthodontic insights and solutions. I’m thrilled to share that we’ve just posted a video on StraightSmile Solutions that delves into the nuances of using appliances like twin blocks and MA cases. These appliances play a crucial role in growing jaws and addressing overjet concerns. Our expert, Dr. Amanda, with over 20 years of experience, provides valuable insights into when to employ these appliances and when to stop, ensuring optimal results. Before diving into the details, check out the video for a comprehensive understanding. At StraightSmile Solutions, we’re committed to offering unbiased orthodontic education, empowering you to make informed decisions in your practice. Explore our content, stay informed, and elevate your orthodontic expertise.

II. Overview of Elastics

1. Purpose: Used to grow jaws and address overjet in orthodontic cases
2. Severity of cases:
3. Severe overjet – elastics for Class II or Class III cases
4. Mild overjet – elastics for minor situations (1-3 mm)

III. Elastics Mechanism

1. Misconception: Elastics do not grow jaws
2. Actions: Canting and tipping the inclusive plane
3. Caution: Side effects and unpredictability in treatment
4. Importance of understanding straight wire before using elastics in Invisalign

IV. Case Considerations

1. Class II cases
2. Usage: In aligners or braces
3. Bite situation: Consideration of bite opening or unwanted forces
4. Class III cases
5. Aligner preference: Better for intrusive forces
6. Case selection: Consider severity and desire for growth

V. When to Stop Elastics

1. Completion of treatment: Stop when the desired result is achieved
2. Muscle memory and deprogramming: Less of an issue with gradual changes
3. Relapse: Expect some relapse; plan treatment accordingly

VI. Class II Elastic Case

1. Endpoint: Achieve a solid Class I with minimal overjet
2. Relapse consideration: Plan for potential relapse, stop treatment conservatively

VII. Class III Elastic Case

1. Endpoint: Positive overjet, no anterior contacts
2. Relapse consideration: Expect relapse, especially if not worn full-time

VIII. Importance of Case Selection

1. Evaluate the severity of overjet or negative overjet
2. Consider patient growth and cephalometric analysis
3. Emphasize the need for understanding case dynamics and forces

IX. Caution against Blindly Trusting ClinCheck

1. Warning: Do not solely rely on ClinCheck predictions
2. Consultation: Seek advice from orthodontists for complex cases or uncertainty

X. Promotional Content

1. Mention of Straight Wear course
2. Benefits: Logical sequence, comprehensive content
3. Reminder: Price increase after January 31, 2024

XI. Acknowledgment of Support

1. Acknowledges support from viewers and course purchasers
2. Emphasizes the goal of providing unbiased and quality orthodontic education
3. Acknowledges the financial challenges of producing content but expresses dedication to continue

XII. Conclusion

Understanding the nuanced application of elastics in orthodontics is crucial for successful outcomes. Driven by a commitment to providing unbiased education, StraightSmile Solutions offers valuable insights. The recently shared video delves into the intricacies of when to cease interventions with various appliances. Dr. Amanda emphasizes prudent case selection, cautioning against overreliance on clinchecks. With a wealth of experience, the emphasis on comprehensive learning remains evident, urging practitioners to prioritize patient health and efficient treatment paths.

Finishing Invisalign with MA vs. Finishing Twin Block
I. Introduction
Dr. Amanda from StraightSmile Solutions and I’m excited to dive into a comparison today. We’ll explore the intricacies of finishing a case with Invisalign Ma versus the traditional Twin Block Invisalign. Invisalign Ma, an Align Technology innovation, not only straightens teeth but also aids in developing little jaws, particularly in growing kids. On the other hand, the Twin Block, around for almost a century, focuses on jaw growth but lacks some features of Ma. Join me as we delve into the nuances of these treatments, discussing their effectiveness, compliance, and the art of finishing cases with finesse.
II. Purpose of the Video
A. Comparison between finishing a case with Invisalign with MA and a standard twin block Invisalign
B. Explanation of Invisalign with MA and twin block
1. Invisalign with MA by Align Technology
2. Twin block – a predecessor of Invisalign with MA, used for growing jaws for nearly 100 years
III. Features of Invisalign with MA (Mandibular Advancement)
A. Aligns teeth and grows jaws
B. Specific focus on growing little jaws in growing kids
C. Attachments for teeth straightening
D. Higher cost, usually offered in Invisalign first or comprehensive options
IV. Features of Twin Block
A. Used for growing jaws and possibly expanding arches
B. Limited teeth alignment capabilities compared to Invisalign with MA
C. Compliance and case selection are critical due to the need for growth potential
D. Difficulty in creating an accountability loop for wear
V. Compliance Importance
A. Accountability is crucial for both Invisalign with MA and Twin Block
B. Invisalign with MA advantages in tracking wear due to regular appointments and visible wear on aligners
VI. Cost and Accessibility
A. Invisalign with MA
1. Offered by Align Technology
2. Cost: Around $1,300 to $2,000 in the US
B. Twin Block Invisalign
1. Can be made at any global lab
2. Estimated cost: $250 to $300
VII. Differentiating Between Invisalign with MA and Twin Block
A. Accountability loop challenges in Twin Block
B. Muscle memory and relapse concerns in Twin Block due to instant bite jumps
C. Difficulty in assessing effectiveness without months of wear
VIII. Completing Invisalign with MA Treatment
A. Assessing progress
1. Regular appointments
2. Monitoring aligner fit and wear
B. Potential need for deprogramming aligners to address shifts and muscle memory
C. Posterior open bite expected due to aligner design
D. Options for finishing: aligners, sloppy bonded retainers, or deprogramming aligners
IX. Completing Twin Block Treatment
A. Similar challenges in assessing progress
B. Posterior open bite expected
C. Options for finishing: braces, sloppy bonded retainers, or force eruption in aligners
D. Importance of monitoring bite settlement and relapse
X. Conclusion
The comparison between finishing a case with Invisalign MA and a standard twin block reveals distinct considerations. While Invisalign MA offers a more predictable path with regular check-ins, twin blocks rely on muscle memory, making compliance crucial. Case selection, accountability, and the potential need for deprogramming aligners or sloppy bonded retainers underscore the nuanced nature of each approach. Whether opting for MA or twin block, the journey to completion involves ongoing assessment, flexibility, and a tailored approach to achieve successful orthodontic outcomes. Refer to Dr. Amanda’s comprehensive videos on each technique for more in-depth insights.

How Elastics Work Differently in Invisalign and ClearCorrect vs Braces
I. Introduction
In this insightful discussion led by Dr. Amanda of StraightSmile Solutions, we delve into the intricacies of biomechanics in orthodontics, specifically comparing the use of elastics in traditional braces versus clear aligners like Invisalign. Dr. Amanda emphasizes the importance of foundational knowledge in Phase One orthodontics, highlighting the pitfalls of disregarding this essential step. With over 15 years of training experience, she sheds light on the nuances of elastic application, cautioning against common mistakes and providing valuable insights for achieving optimal outcomes in braces and aligners.
II. The Fundamental Role of Phase One Appliances
A. Personal experience and training background
1. 15+ years of training doctors
2. Distinction between doctors trained in braces and those starting with clear aligners
B. Importance of mastering braces and Phase One appliances
1. Essential for effective Invisalign, clearcorrect, or clear aligner treatment
III. Biomechanics of Elastics in Braces
A. Overview of the Straight wire approach
1. Align and level first with light nighttime wires
2. No space closure in light nighttime wires
B. Introduction of elastics in braces
1. Timing: Class two and class three elastics in the second half of treatment
2. Addressing deep bites and high canines with posterior box elastics
3. Impact on occlusal planes and space closure
4. Caution with impacted molars
IV. Application of Biomechanics to Aligners
A. Aligners vs. Braces biomechanics
1. Highlighting the differences
2. Emphasis on the need for a solid foundation in braces
B. Common Mistakes with Aligners
1. Incorrect use of elastics
a. Overuse and its negative impact on outcomes
b. Case-specific considerations for elastics in aligners
2. Importance of control in aligners
a. The advantage of control over anchorage in aligners
b. Utilizing buttons instead of hooking elastics onto plastic
V. Aligners in Complex Cases
A. Addressing complex cases with aligners
1. Demonstrating sequential distillation for major tooth movement
2. Leveraging control in aligners for effective anchorage
B. Understanding case specifics
1. Analyzing sagittal slices for class two and class three cases
2. Strategic use of elastics based on tooth inclinations
VI. Importance of Comprehensive Knowledge
A. High-level understanding of aligner success
1. Emphasizing the need for in-depth knowledge
2. Aligner success linked to fundamental orthodontic concepts
B. The role of technology
1. The necessity of a cephalometric machine or CBCT for sagittal slices
2. Integrating technology into treatment planning for aligner cases
VII. Conclusion
Dr. Amanda emphasizes the critical importance of understanding the biomechanics of braces and clear aligners, debunking the notion that mastering clear aligners can be achieved without a solid foundation in traditional orthodontics. Drawing on over 15 years of experience, she underscores the necessity of Phase One Braces training before delving into aligners. Dr. Amanda provides insights into the judicious use of elastics in braces, cautioning against their premature application in aligner cases. Her high-level discourse stresses the need for a comprehensive understanding of orthodontic principles and the essential role of diagnostic tools like CBCT for successful

How to Handle Mobility or Recession during Orthodontic Treatment
I. Introduction
Dr. Amanda from StraightSmile Solutions, let’s delve into the nuances of orthodontic challenges, specifically addressing concerns related to tooth mobility during Invisalign or clear aligner treatments, applicable to bar treatments. If you find yourself grappling with such issues, worry not! When doctors contact me about these cases, I often play detective, offering guidance based on crucial information. Before our consultation, I typically request a panoramic X-ray (PA), probing depths, and previous records. Tracking, progress intraoral photos, and a CBCT sagittal slice also top the checklist. Until we assess these, I recommend refraining from progressing with aligners. My goal is to decipher whether the issue stems from rapid movement or excessive forward shifts.
II. Initial Steps Before Diagnosis
● Discussion on mobility or recession during treatment
● Applies to Invisalign, clear aligners, and braces
● Addressing doctors rather than patients
III. Detective Work
● Dr. Amanda’s approach to diagnosing issues
● Emphasizing the need for information before meeting
● Detective analogy and potential need to consult or collaborate with colleagues
IV. Information Required Before Diagnosis
● List of information needed before meeting
● Number 1: Get a PA (Periapical) X-ray of the affected area
● Optional: CBCT (Cone Beam Computed Tomography)
● Include probing depths around the area
● Request both new and old PA X-rays
● Gather start X-rays and start charting for comparison
● Tracking photos explanation and importance
● Progress into oral photos with articulation or occlusion marks
● Include a Seom metric X-ray or CBCT sagittal slice
V. Holding Off on Treatment Progress
● Strong recommendation to hold off on aligner progression until diagnosis is complete
● Suggestion to remove the tooth from occlusion if necessary
● Potential use of bite bumps or retainers during the investigation
VI. Most Common Causes of Issues
● Discussion on common causes of mobility or recession
● Emphasis on moving teeth too fast
● Encouragement to learn treatment planning and understand appropriate speeds
● Importance of using adequate plastic to reduce forces and benefit oral health
● Orthodontists’ approach to smaller, frequent movements versus larger, infrequent ones
VII. Orthodontic Approach
A. Multiple iterations to optimize treatment plans
B. Emphasis on Slow and Low forces for better outcomes
C. Contrast with the potential mistakes of blindly following technician instructions
VIII. Conclusion
Addressing issues of mobility or recession during Invisalign or clear aligner treatment, and similarly for Bar’s treatment, requires a thorough diagnostic approach. When doctors encounter such challenges, gathering essential information is crucial before proceeding. This step involves obtaining a periapical X-ray or CBCT, probing depths, and historical records. Comprehensive tracking photos and progress intraoral photos with articulation marks are indispensable. Additionally, a sagittal slice X-ray or CBCT can provide valuable insights. Prioritize understanding the rate of tooth movement; favoring slow, incremental adjustments over rapid shifts is vital for long-term success. If complications arise, consider temporarily removing the tooth from occlusion. Remember, collaborating with experts and avoiding blind reliance on technicians is key to optimizing treatment plans and ensuring optimal patient outcomes. Remember, a cautious, informed approach is paramount in achieving the desired results.

When can you STOP wearing retainers? How many Retainer visits should an office offer for free?
I. Introduction
Dr. Amanda from StraightSmile Solutions your go-to resource for orthodontic expertise. If you’re eagerly awaiting the day you can bid farewell to your retainers, brace yourself—it’s not a swift journey. In this exploration, we’re addressing the persistent query that lingers in the minds of many. Whether you’re navigating this as a curious patient or a fellow practitioner seeking clarity, a fresh perspective is in store. Join us as we unravel when to part ways with your retainers. Spoiler alert: it’s a lifelong commitment. But fear not; I’ll guide you through managing this commitment tailored to each unique case. Stay tuned as we delve into the vital realm of retainer checks and discover the magic number for your office’s complimentary checks.
II. When to Stop Wearing Retainers
A. Importance of emphasizing lifelong wear
1. Reinforcement in debonding material and handouts
2. Discussion during office visits, braces tightening, or aligner check-ins
B. Handling patient inquiries
1. Responding with a focus on long-term results
2. Customized approach based on patient needs
C. Factors influencing retainer duration
1. Unique considerations for each patient
2. Exploring options to wear retainers less over time
3. Reference to available content and courses
III. Retainer Checks: How Many and Why
A. Setting the stage for retainer checks
1. Establishing the importance of post-treatment monitoring
2. Addressing the question of free retainer checks
B. Recommended retainer check frequency
1. Initial checks at one-month, three months, and subsequent three-month intervals
2. Emphasizing the flexibility in the number of visits
C. Documenting retainer fit
1. Capturing photos with retainers in and out
2. Importance of documenting perfect outcomes
D. Handling missed retainer checks
1. Initiate communication with patients
2. Documenting attempts to reach patients to avoid future complications
E. Addressing potential relapse
1. Emphasizing the role of retainer checks in preventing relapse
2. Risks of neglecting regular retainer visits
IV. Handling Requests for New Retainers
A. Post-one-year retainer checks
1. Offering free consults for retainer assessment
2. No charge for retainer checks within the first year
B. Dealing with lost or damaged retainers
1. Recommending more than one set-up front
2. Providing options for upgrading to premium retainers
C. Storing digital files
1. Emphasizing the importance of STL final scans
2. Cloud storage options and limitations with aligner companies
D. Encouraging digital file backup
1. Suggesting periodic storage of STL files
2. Preparing for potential long-term retainer replacements
Available resources
1. Mention of Straight wear course and retainer menu
2. Access to forms and documents through memberships, webinars, and document store
V. Conclusion
Dr. Amanda emphasizes the lifelong commitment to wearing retainers for optimal orthodontic results, dispelling any notion of a set timeframe. Regular retainer checks are important, with suggested frequencies and reminders to document patient follow-ups. Dr. Amanda advocates for meticulous record-keeping, including photographic evidence, and offers practical advice on managing retainer replacements. The importance of clear protocols and policies, supported by available forms and resources, is highlighted for orthodontic practitioners to ensure the success and longevity of their patients’ treatments.

The Orthodontic Implications of Premolar Root Agenesis in Panoramic X-rays

Taking a panoramic X-ray before starting work on new treatment plans is integral; just one reason is that this can give you a clear insight into the symmetry of your the roots. This can help you determine the most appropriate treatment plan – and understand the implications on orthodontics associated with the asymmetry.
What is Premolar Root Agenesis?
Premolar root agenesis occurs when one of the permanent premolars has not fully formed, either due to slow or arrested tooth growth, meaning that there is very little in the way of root growth (or none at all). In very young patients, there is the possibility that a slowly developing permanent tooth may catch up eventually. However, in older patients with fully erupted 4s, 5s, 7s, and one undeveloped premolar tooth, this will typically be a premolar root agenesis.
Orthodontics Treatment Plan Options for Premolar Root Agenesis
If you have a premolar root agenesis patient to create a treatment plan for, there are a few options. You could have a skilled oral surgeon pull the undeveloped tooth out, or you could leave it stacked with both the baby and the underdeveloped tooth.
However, if you leave it stacked, you likely won’t be able to move the teeth in that area through orthodontics, and if you attempt to move teeth on the other side, you’ll likely want to avoid braces and use clear aligners with a locked area instead. In line with this, delicately extracting the tooth will often be the preferred treatment plan.
Before you extract, it is often worthwhile to delay the treatment plan for a while to ensure that the tooth is no longer developing. However, this will delay the start of orthodontics work.
We strongly recommend consulting with a radiologist and an oral surgeon before starting on premolar root agenesis treatment plans, to find the most appropriate approach for a patient.

IN HOUSE alternatives to My Two Front and SDC Partner Network
I. Introduction
Dr. Amanda from StraightSmile Solutions discusses the challenges of launching orthodontics in a general or pediatric practice, including nervousness, lack of confidence, and needing support. She suggests White Label Aligners as an affordable option, charging only a one-time $90 setup fee and $18 per aligner, with batch printing reducing fees further. Dr. Amanda also advocates for third-party financing options and clinical training programs to facilitate ortho adoption. Additionally, she cites the potential for $300k-400k in revenue through comprehensive ortho offerings. Ultimately, Dr. Amanda stresses that practices can successfully integrate orthodontics through the right aligner partnerships, payment programs, and continuing education.
II. Options for Ortho in GP or Pediatric Dental Practices
A. Two Front, My Two Front, and Invisalign
1. Invisalign requirements
a. 150 new patients or recall patient visits per month per office
2. Use of alternative aligner systems like ITARO
a. Messy and difficult to manage
III. Alternative Aligner Companies
A. White Label Aligners
1. $90 setup fee (one-time)
2. $18 per aligner
3. Batch printing to reduce lab fees
a. First three or five aligners can be used for batch printing
b. Lab fees are reduced to $200 or less every few months
IV. Handling Lab Fees
A. Importance of a white label company that can handle lab fees
1. White label option
a. One-time fee that includes revisions and refinements
b. Lab fees reduced to $200 or less every few months
V. Third-Party Aligner Company
A. Lower cost than Invisalign
1. One-time fee for setup, revisions, and refinements
2. $18 per aligner
B. Benefits
1. Cost savings on lab fees
2. Allows dentists to focus on other aspects of their practice
VI. Potential Benefits of Using White Label Aligner Company
A. One-time fee for setup, revisions, and refinements
B. $18 per aligner
C. Significant savings for dentists with limited financial resources
VIII. Additional Information from Dr. Amanda
A. Benefits of batch printing for aligners
1. Lower cost than traditional methods
2. The company offering service at $18 per aligner, even less for higher volume
B. Third-party payment plan option for collecting money from patients
C. Clinical check service that is easy to learn, taught by Dr. Amanda
D. Advice on communication and education for patients about available options
IX. Two Front Services
A. Ability to collect money, put patients on a payment plan, or build insurance
B. Percentage of production offered, lower than what dentists would receive
C. Caution against building insurance due to potential negative impact on practice reputation
X. Ortho Revenue Potential with Two-Front
A. Offices potentially bringing in $300 to $400,000 in Ortho Revenue
B. Services offered, including aligners, braces, phase one, removables, and fixed braces
C. Introduction to teams for computerizing and placing brackets
XI. Educational Courses and Webinar
A. Phase One educational course
B. StraightWire course covering all necessary knowledge
C. Free Clear Aligner webinar on January 18th, with CE credits
XII. Conclusion
A. Availability and willingness to help with any questions
B. Encouragement to attend the free Clear Aligner webinar on January 18th
C. Emphasis on the benefits of batch printing, increased production, and potential revenue gains.

Class 3 Treatment Planning Considerations in Males Vs Females with Elevated SNB
I. Introduction
Amanda from StraightSmile Solutions delves into a crucial aspect of orthodontic treatment: addressing the unique considerations for patients based on their biological sex. Focusing on distinguishing between biological males and females, Amanda explores the challenges posed by mandibular prognathism, especially in those with a class 3 tendency. Stressing the importance of meticulous diagnosis and treatment planning, she outlines potential interventions for children exhibiting signs of mandibular prognathism. From lingual arches in mixed dentition to strategic timing of interventions, Amanda emphasizes the need for a proactive approach to prevent potential complications, including jaw surgeries or retreatment.
II. Class 3 Tendency and Treatment Planning Considerations
A. Emphasis on biological factors, hormones, and birth attributes
B. Significance in patients with class 3 tendency, mandibular prognathic, elevated SNB
C. Importance of distinguishing class 3 tendency early on
D. Reference to relevant educational resources on the Straightsmile Solutions website
III. Phase One Course and Free Content
A. Recommendation to take Amanda’s phase one course
B. Availability of free content on the website
C. Phase one playlist for comprehensive information
D. Specific topics covered, such as class 3 treatment planning and metric x-rays
IV. Identifying Class 3 Tendency in Children
A. Age-agnostic approach to identifying class 3 tendency
B. Emphasis on ruling out CRCO shift, capturing SEF, and analyzing SEF numbers
C. Impact of maxillary retrognathism in different populations
D. Consideration of family history in diagnosing class 3 tendency
V. Challenges and Considerations in Girls
A. Likelihood of worsening in girls
B. Age-related considerations in puberty
C. Role of handr x-rays in assessing pubertal growth
D. Caution against overreliance on family history
VI. Challenges and Considerations in Boys
A. Extended mandibular growth in boys with class 3 tendency
B. Possible growth spurts up to age 21-22
C. Need for careful treatment planning to prevent worsening
D. Avoiding premature interventions like excessive IPR
VII. Orthodontic Strategies for Overcorrection
A. Lingual Arch in mixed dentition for leeway space preservation
B. Delaying treatment until after lower third molars eruption
C. Invisalign and sequential distillation for controlled correction
D. Informed consent emphasizing potential need for retreatment
VIII. Informed Consent and Overcorrection
A. Additional informed consent for potential growth-related issues
B. Responsibility disclaimer regarding outgrowing treatment
C. Suggested age for IPR to maintain flexibility in treatment
D. Strategic planning to leave a margin of overjet for potential future growth
IX. Conclusion
Addressing class 3 tendencies in orthodontic treatment requires a nuanced approach, especially when dealing with biological males and females. Understanding the patient’s growth patterns, familial traits, and potential for further mandibular growth is crucial. Treatment planning should be tailored to overcorrect and accommodate potential changes, especially in cases where mandibular prognathism is predominant. Emphasizing the need for proactive measures, such as delaying certain interventions until growth is complete, utilizing appliances strategically, and maintaining flexibility for potential retreatment, is essential. Clear communication with parents about the long-term considerations and the possibility of additional orthodontic interventions can help set realistic expectations and contribute to successful outcomes.

Bracket Repositioning: How Straight Smile Solutions Can Help

In some cases, you might find that your patients need their brackets repositioned, and knowing how to go about this isn’t always easy. After all, there are several ways you can look at bracket repositioning, and knowing the difference is vital. Luckily, as your professional orthodontics consultancy team, we here at Straight Smile Solutions can help.
Tackling Bracket Repositioning in Orthodontics
There are three main ways you can approach bracket repositioning cases: tip, vertical, and occlusal views. You’ll need to first take a progress x-ray, which allows you to look at the root positioning; ideally, you want to make sure these are all parallel. Always consider that distortions are possible, so check any potential problems clinically.
When checking vertical cases, you need to consider factors such as gum line and the bite, as well as symmetry (especially in the upper 2s or 7 and 10).
Meanwhile, for occlusal cases, you’ll need to consider the upper and lower arches (taking a photo at 90 degrees to the occlusal plane helps significantly) and the current positioning of the teeth to see whether repositioning or rotation are needed.
Of course, if you are trying to reposition on a very minor case, this may not make a significant amount of difference in the final results (and could have aesthetic implications for the patient). As such, you may want to leave and monitor these cases, depending on the patient’s preference. However, more significant cases with root positioning issues will need to be addressed as soon as possible.
All of these factors are important to keep in mind when considering bracket repositioning; however, since this can be a lot to think about and consider (and getting the bracket repositioning wrong can have significant consequences for the progress of a treatment plan), our experts here at Straight Smile Solutions can help. Indeed, as orthodontics experts, we can help you determine the most accurate approach for your own cases.

When tackling orthodontics cases, there’s a good chance you’ll occasionally come across a trickier situation, and knowing how to create the right treatment plan for these can sometimes be tough. One such example is for patients who have impacted canines – but can you leave impacted canines, or should these be addressed first?
Can I Leave Impacted Canines in Orthodontic Cases?
In some cases, it can be obvious that an impacted canine will cause problems during an orthodontic treatment plan. As such, in situations where impacted canines are likely to cause damage to the surrounding teeth during ortho treatment, you will need to address the impacted canines first. This is most common when canines have erupted near to the roots of other teeth.
However, even if you think it might be possible, you should always get professional advice before you agree to do orthodontics for an impacted canines client. Indeed, if something should go wrong because the teeth haven’t been removed, you’ll be liable.
Even if the impacted canines seem high and low risk, always send the CBDT to a dental radiologist or OS first. In the referral form, ask the specialist whether it would be okay to do an orthodontic treatment plan while leaving the affected teeth impacted. The specialist should then let you know whether there is any risk with such cases; make sure you get this in writing to cover yourself, just in case. Also, make sure there is a section relating to this for the informed consent form to cover your business.