Week 4 Flashcards
3 possible approaches to skeletal malocclusions
Growth Modification
Camouflage
Surgical Treatment
5 sites of facial growth
What happens when each is messed up
Sutures - small cranial vault Nasal septum - AP growth Synchondrosis - Maxillary deficient Condyle - grows off to one side Alveolus - deficient ridge
Which growth sites are most modifiable?
Sutures
Alveolus
What two things do you need to modify growth?
A growing patient
Ability to affect structures
Eg: alveoli need teeth or a functioning unit in order to adapt it
What are the ideal ages to start growth modification treatment in males and females?
At the start of the growth spurt.
Females: 10-12
Males: 12-14
What are the best ways to determine age/growth?
Height and weight measurements Secondary sex characteristics Menarche - indicates end of peak growth Serial cephalometric radiographs Cervical vertebrae
What percentage of people have class II and class III malocclusions?
Class 2: 20%
Class 3: less than 3%
When is growth modification indicated?
Minor to moderate skeletal problems
Won’t work for severe skeletal
Discuss the ease/difficulty of modifying growth in…
Maxillary vs mandible
Vertical vs Transverse
Maxilla easier than mandible (suture vs condyle)
Transverse easier than vertical. Transverse is the first to stop growing, which is why we start early. Vertical doesn’t stop for a long time so it’s hard to stop.
Tx of class 2 with max protrusion
Headgear
Tx of class 2 with mandibular retrusion
Functional appliances and headgears
Tx of Class 3 Maxillary retrusion
Reverse pull Face mask
Functional appliances
To of Class 3 mandibular protrusion
Functional Appliance
Chin cup- not found to be effective
Can skeletal changes be maintained?
Skeletal changes tend to go back during the maintenance period
Is early class II treatment beneficial
No. Early mixed dentition is of no benefit to ultimate growth over late mixed dentition
Is early class III Treatment beneficial?
Protracting a retruded maxilla is shown to be effective before the age of 10.
Restricting the mandible may have some short term benefit, but no long term.
Is early treatment if of posterior crossbite effective?
Yes.
What are three surgical solutions to A-P discrepancy.
Le Fort I - for maxilla
BSSO - for mandible
Genioplasy - decrease of the chin
Surgical solution to transverse problem
SA RPE
2 - piece LeFort
Mandibular midline osteotomy
Distraction osteogenesis
Why is pre-surgery orthodontics often indicated?
For the elimination of dental compensation
Dental alignment
Any other procedure to facilitate optimal surgery
Which surgical procedures are most and least stable?
Most stable:
Moving the maxilla up, mandible forward
Least stable:
Moving mandible back, maxilla down or wider
What type of patient is camouflage treatment indicated for?
Non-growing
Acceptable facial esthetics
Minor-moderate skeletal prob
Adjust dental relationships
When can you no longer use an RPE without surgery?
15 for females, 16 for males
Advantages of DO
No bone graft
More bone movement
Good for infants and young children
Less invasive
