Which accumulates more plaque after 2 weeks in fixed appliances — elastomeric modules or stainless steel ligatures? We’ve noticed smoother cheeks and better plaque scores on self-ligating cases without elastics, and I’m curious if your chairside experience matches the literature.
Chairside, elastomeric modules pick up more plaque than steel after two weeks — “elastomerics harbor more plaque” sums it up — and self-ligs look cleaner. For higher-risk kids I steel-tie the posteriors and swap any elastomerics weekly; they’re like Velcro for biofilm. Are you seeing fewer bleeding sites at de-bond when you do that?
In my cases, swapping elastics for steel on the lower 6s and adding a nightly tufted-brush pass with a pea of 0.4% stannous gel under the tie cuts plaque and bleeding by week two; small caveat: steel has to be tight and tucked or it irritates. > self-ligs look cleaner. I agree, but the gel step seems to drive the bleeding-site drop more — are you seeing that at de-bond?
At the “after 2 weeks” mark, steel wins for me — IF we flush-cut and fully tuck the pigtail; otherwise cheeks hate it and plaque just shifts to the ulcer line… Do you keep elastics off the posteriors? I keep colors 3–3 only and swap at 10 days for high‑risk kids to keep bleeding down without touching mechanics.
Same pain on single‑unit remakes; what fixed it was a CAD gate — “no release unless the color map shows ≥120 µm minimum occlusal clearance and +30 µm mesial relief” — plus a 15‑sec pre‑sinter dry‑fit on a printed die with a 0.025 mm Mylar strip instead of that 8 µm check. Dropped us from about 5% to 2.1% without slowing; I track an X‑bar/R in Google Sheets on min‑clearance and contact drag, and on short preps I relax the gate to 100 µm, @tom_black32.
1 Like
Quick tip: I’ve gotten faster callbacks by attaching a one-page ‘Skills + Certs’ PDF — X-ray permit, coronal polish, CPR — named BrandonMorris_DA_Dentrix_CA.pdf; think of the filename as SEO for their inbox. @liam_lee99 is right on speed, but make sure it’s perm (not temp-to-hire) before asking for a ‘working interview’.