Early timely treatment may benefit young patients with a maxillary transverse deficiency with or without a posterior crossbite that requires maxillary expansion. It may also be indicated in children with anteroposterior jaw discrepancy that requires chin cup or maxillary protraction.
Full Answer
Should the maxillary first premolars be removed for occlusion?
If thinking about occlusion is limited to the tooth level without considering the condition of the TMJ, it's easy to see why extracting the maxillary first premolars would make sense. Figure 1: Maxillary arch.
Is it safe to extract first premolars for orthodontic treatment?
The extractions were subtractive dentistry, which led to both esthetic and airway issues in both patients. My advice is to always take a closer look at the jaw joints when patients present with maxillary first premolars extracted for orthodontic treatment.
Is there an overjet issue with maxillary first premolars?
My advice is to always take a closer look at the jaw joints when patients present with maxillary first premolars extracted for orthodontic treatment. In most of these cases, there will be an undiagnosed joint issue that causes the overjet issue.
What is the best treatment for transposing teeth with occlusion?
The most suitable treatment depends on the occlusion, level of dental crowding, aesthetics, position of the radicular apices, and specific needs of the patient. In this case, we opted for definitive treatment with orthodontic alignment of the transposed teeth into their physiological position.
Why are extractions needed for braces?
By removing one tooth, the space makes room for other teeth to move in, and the orthodontist can carefully adjust the teeth into their correct positions. This is especially useful for cases where the patient has too many teeth, or overcrowding makes it impossible for all the teeth to align properly.
What is maxillary protrusion?
Maxillary protrusion is a dental malocclusion that causes the maxillary dental and/or jaw to protrude from the mandibular dental and/or jaw excessively, resulting in exposure of the upper teeth.
Is a palatal expander necessary?
When prescribed by your orthodontic professional, a palatal expander is really necessary to correct the bite. For a posterior crossbite in a child, a palatal expander is the Gold Standard for true skeletal correction. Palatal expanders are necessary to correct skeletal jaw discrepancies.
Do braces affect maxilla?
No. They do not. Even though braces can adjust the width of your upper jaw, they don't extend into the structures that affect the shape and size of your nose.
What causes maxillary protrusion?
The etiology of bimaxillary protrusion is multifactorial and consists of a genetic component as well as environmental factors, such as mouth breathing, tongue and lip habits, and tongue volume.
Why is curve of Spee important?
This normal occlusal curvature is required for an efficient masticatory system. Exaggerated curve of Spee is frequently observed in dental malocclusions with deep overbites. [1] Such excessive curve of Spee alters the muscle imbalance, ultimately leading to improper functional occlusion.
Why do orthodontists use expanders?
An orthodontic expander is an appliance that gradually widens your child's jaw and palate, allowing room for their adult teeth to grow in normally or to correct jaw misalignment.
Why are expanders necessary?
The expander is most commonly recommended when there is a crossbite between the two arches or if there's not enough space for permanent teeth to come in correctly. It works best for children and preteens because their bones are still in a growing phase.
What is the purpose of an expander?
An expander, also called a rapid palatal expander or RPE, is an appliance designed to correct a narrow upper arch that can result in crossbite, crowding, or impacted teeth. Two bands are cemented onto the last upper molars and connected by a metal screw that gets turned regularly to expand the appliance.
How do you raise maxilla?
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What is a maxilla?
The maxilla is the bone that forms your upper jaw. The right and left halves of the maxilla are irregularly shaped bones that fuse together in the middle of the skull, below the nose, in an area known as the intermaxillary suture. The maxilla is a major bone of the face.
How does face change after braces?
In this case, your face before and after braces can look noticeably different. By correcting the imbalance between the upper and lower jaw and fixing the way the teeth and jaws meet, the lower half of your face will appear more harmonious. Your features will look a lot softer and more proportionate.
Evaluation & Diagnosis
Extra-oral frontal photograph. The patient presented lip incompetence, or the inability to achieve a closed-lips resting posture without muscle tension. In addition, the patient complained about her left ear being everted.
Progress & Completion
Intraoral frontal photograph on the day that fixed orthodontic appliances were placed. Damon System 2 braces were used with 0.014 copper NiTi round arch for both upper and lower arches.
Follow-Up & Outcome
Close-up extra-oral frontal photograph post-treatment. Note the tooth exposure with resting lips had been greatly reduced.
Team members
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What is the gold standard for orthodontic treatment?
The “Gold Standard” of starting orthodontic treatment is in the late mixed dentition or early permanent dentition. This is because there will be some growth remaining to assist in the treatment and permanent dentition will be available for positioning of occlusion.
What is the width of a maxillary intermolar?
The maxillary intercanine width (ICW) was 26 mm and the mandibular ICW was 27 mm width. The maxillary intermolar width (IMW) was 37 mm and the mandibular IMW was 40 mm. There was moderate-to-severe crowding in the maxillary and mandibular arches with a 2 mm median diastema and blocked out maxillary laterals [ Figure 2 ]. Panoramic evaluation showed the presence of all permanent teeth and no pathology [ Figure 3 ]. Lateral cephalometric analysis revealed a Class I skeletal relationship (ANB = 2, Wits = 0 mm) with a normal divergent growth pattern [ Figure 4 ]. Soft-tissue analysis showed lip incompetency in repose with a slightly protrusive lower lip.
How early can malocclusions be intercepted?
An estimate of 25% of malocclusions can be intercepted at an early age . [ 1] However, there is still an ongoing discussion among dentists and orthodontists as to the optimal time to initiate orthodontic or orthopedic treatment under various clinical conditions. [ 2] The fact is that there is a delicate balance between the benefit of early orthodontic or orthopedic treatment and the biological and financial cost of having another phase of treatment. Hence, clinicians are still debating as to which type of treatments are most beneficial to initiate in the mixed dentition.
Is there a balance between orthodontic treatment and the biological cost of having another phase of treatment?
The fact is that there is a delicate balance between the benefit of early orthodontic or orthopedic treatment and the biological and financial cost of having another phase of treatment. Hence, clinicians are still debating as to which type of treatments are most beneficial to initiate in the mixed dentition.
Is there a universal agreement on orthodontic treatment?
There is no universal agreement as to which type of orthodontic or orthopedic treatment deserves early intervention. In addition, there is a need for more information as to which treatments are the most effective and less costly if they are initiated timely in the mixed dentition.
Can a dental compensation patient have a posterior crossbite?
However, patients with dental compensation of the posterior molars may not present with a posterior crossbite.
