Timing For Correction Of Malocclusions Flashcards
When should treatment be initiated in the primary or mixed dentition?
If the child has a malocclusion that interferes with facial growth, dentitional development, and/or has a negative impact on psychosocial status. Otherwise, treatment of the malocclusion can be delayed until the child is in the permanent dentition.
About what percentage of children are treated with two phases of orthodontic care?
About 1/3rd of children are related with two phases of orthodontic care. Whereas 2/3rds are treated with phase 2 only.
What is a pseudo class 3?
The incisors are usually in edge-to-edge bite in CR; however to function, the pt must shift the mandible forward into incisal crossbite so that the posterior teeth may occlude.
What is the appropriate timing for the treatment of an anterior crossbite with a functional shift?
The treatment can be started as early as 5-6
This correction helps to establish normal function and allows normal growth/development of the maxilla and mandible to occur.
What is the appropriate treatment of a skeletal class 3 malocclusion and when should it be done?
Early mixed dentition (6-8).
A common treatment protocol would utilize a protraction face mask with a rapid palatal expander to advance the maxilla forward. The mandible typically moves downward and backward accompanied by a slight increase in lower face height.
Occasionally, class 3 orthopedic treatment is required more than once for the skeletal class 3 cases because of the significant mandibular forward growth tendency throughout adolescence.
What is the timing of treatment for a class 2 malocclusion, and what kind of treatment is involved?
Early treatment w/ headgear or functional appliances at age 9 are positively impacted; however, this improvement cannot be sustained over time. By the end of phase 2 treatment, the differences between those who had received phase 1 treatment and those had not are indistinguishable.
Thus, moderate to severe class 2 malocclusions do NOT benefit from two-phase treatment more than from a single phase started in the late-mixed dentin.
Children requiring class 2 skeletal correction require treatment with growth modification, which is most successful if started when?
At the beginning of the adolescent growth spurt and ended about the time rapid growth subsides.
For girls, the growth spurt starts at about age 10.5-11. For boys, it starts at about age 12.5-13.
If treatment for skeletal modification for a girl starts at age 10 for class 2,when her growth spurt initiates, a first phase would be needed for about 1 year, and then continue with a second phase of treatment
What is the timing of treatment for a posterior crossbite with a lateral functional shift, and what kind of treatment is involved?
A posterior crossbite with a functional shift should be treated as soon as it is diagnosed to prevent the possible asymmetrical positioning and growth of the condyles.
Treatment can be initiated as early as the primary dentition (5-6) years old. The primary cause for the functional shift is a narrow maxillary arch.
Correction of the crossbite can be accomplished with maxillary expansion
What may happen if a posterior crossbite with a lateral functional shift is not corrected?
If left untreated, this condition may lead to asymmetrical growth of the mandible. Correction of the crossbite with the functional shift can be accomplished with maxillary expansion
What is the timing for treatment for bilateral posterior crossbite without a functional shift, and what kind of treatment is involved?
There is no evidence to support that treatment in the early mixed dentition results in greater stability than in late mixed dentition.
Expansion is done to correct this
Is early treatment indicated for a skeletal open bite, and what kind of treatment is involved?
Skeletal openbite malocclusions should be treated early to be successful and if indicated can be initiated in the mixed dentition (7-9 years)
If a skeletal open-bite is left untreated until the permanent dentition, the opportunity for growth modification could be lost. Control of the vertical dimension is the key to successful treatment of patients with a skeletal open bite.
A ___% spontaneous correction of the anterior open bite caused by digit sucking has been reported in patients from age 7-12 after they discontinued the habit.
80%
What is the appropriate timing for correction of anterior crowding?
Moderate crowding of 2-5mm should begin treatment by the late mixed dentition to utilize the leeway space.
Studies have shown that approximately __% of crowding cases in the mixed dentition can be treated successfully by…
Maintaining the leeway space Thus, procedures performed in the mixed dentition to expand or to develop arches to gain space for alignment may be unnecessary and not stable long term.
When should serial extraction be considered?
For severe crowding cases (>10mm) without skeletal problems. It is usually initiated in the early mixed dentition and involves a sequence of extraction of primary and permanent teeth. This allows the remaining permanent teeth to erupt within the alveolus and through keratinized tissue, and it simplifies later orthodontic treatment.
