Week 4 Growth Modification Flashcards
The choice of treatment for skeletal malocclusions
- Growth modification
- Camouflage
- Surgical treatment
Growth modification is for ______
kids with mild to moderate skeletal problems.
Site of Facial Growth and its modifiability.
- Sutures: Good
- Nasal septum: ?
- Synchondrosis: poor
- Condyle: ?
- Alveolus: Good
Sutures can be found in…..
maxilla and cranium
True or False?
You need to have the function in the mandible for it to grow. If there is no function, it won’t grow
True
Requirements for growth modification
Growing patients
Ability to affect structures
functioning condyles
Alveolus require teeth or a functional unit
Period of Rapid Growth for Males and Females
Males: 12-14 (13-15) years old
Females: 10-12 years old
True or False?
Boys grow a bit later, but grow with more magnitude, usually have a larger plateau to begin from.
True
True or False?
Faces and bodies are related in growth timing
False
Faces and bodies are loosely related in growth timing (roughly at the same time)
True or False?
Lips tend to grow vertically more than the skeleton does.
True
More ______ growth in males
more _____ growth in females
nose, chin, mandible
maxilla
Methods for growth assessment (as general practitioners)
Height and Weight measurements
Secondary sex characteristics
Menarche: generally indicates that females have passed their peak growth
True or False?
Maxilla and mandible both grow down and forward
True
All class II’s are about ______ %
All class III’s are about _______ % in US
15-20
less than 3
Diagnosis of skeletal problems as a GP
Facial profile analysis
Dental relationships
Profile analysis is difficult for….
very young children (younger than 6)
Class 3
when vertical problems are present
(profile analysis can be done… but it just needs to be done carefully)
True or False?
Mandible is easier to grow than Maxilla
False
Maxilla is easier because mandible has condyles so modification can be difficult
Possibilities for growth modification
Maxilla/mandible: maxilla is easier
Anteroposterior
Vertical: hardest to modify (but longest acting growth)
Transverse: 1st dimension to stop growing (that is why we usually correct posterior crow bite & Maxillary constrictions early)
Types of growth modification
- Ultimate size changes (stimulation/retardation)
- Timing changes (acceleration/deceleration)
- Redirection (ap to vertical or vertical to ap_
What do you need to do to get a successful growth modification?
must control all planes of space
interaction between the vertical and AP
For class II maxillary protrusion, the best treatment options are:
Headgear (favored): force on maxilla, mandible grows
Functional appliances
For class II mandibular retrusion, the best treatment options are:
Functional appliance (favored): best choice to put mandible forward
Headgear
For Class III maxillary retrusion, the best treatment options are:
Face mask: best choice for max retrusion (pull forward)
functional appliances
For class III mandibular protrusion, the best treatment options are:
Functional appliances
Chin cup: very minimal success, changes do not last
What can you do to modify transverse growth?
opening of midpalatal suture: RPE for near and post-adolsecent
lingual arch type in primary and mixed dentitions: pre-adolescents
True or False?
Early mixed dentition is no benefit to ultimate growth over late mixed dentition
True
If you do it too early…. you might end up doing 2 separate treatments..
Is early transverse treatment beneficial?
Skeletal and dental changes can be made and maintained.
The changes can affect the unerupted teeth.
When is early treatment justified?
- Esthetics or trauma reduction (class 2)
- Class 3’s - True max deficiency (can be corrected with max protraction)
- Posterior crossbites: with functional shifts and arch length shortages
