Hargo Basuki






         

February 9, 2009

Orthodontics

Filed under: Uncategorized — hargo-b @ 10:22 pm
Definition

Orthodontics is formally defined by the American Association of Orthodontics as ‘The area of dentistry concerned with the supervision, guidance and correction of the growing and mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and mal relationships between and among teeth and facial bones by the application of forces and.or the stimulation and redirection or the functional forces within the craniofacial complex’

history

Irregular teeth have been a major problem for some individuals since antiquity and attempts to correct them go back to at least 1000 B.C. Orthodontic appliances have been found from Greek and Etruscan materials.

Dr. Edward H. Angle was the first orthodontist—the first dentist to limit his practice to orthodontics only. He is considered the “Father of Modern Orthodontics.”
Also removable appliances, or “plates”, headgear, expansion appliances, and many other devices can be used to move teeth. Functional and orthopaedics appliances are used in growing patients (age 5 to 14) with the aim to modify the jaw dimensions and relationship if these are altered. (See Prognathism.) This therapy is frequently followed by a fixed multibracket therapy to align the teeth and refine the occlusion.
After a course of active orthodontic treatment, patients will often wear retainers, which will maintain the teeth in their improved position while the surrounding bone reforms around them. The retainers are generally worn full-time for a short period, perhaps 6 months to a year, and then worn periodically (typically nightly during sleep) for as long as the orthodontist recommends. It is possible for the teeth to stay aligned without regular retainer wear. However, there are many reasons teeth will crowd as a person ages; thus there is no guarantee that teeth, orthodontically treated or otherwise, will stay aligned without retention. For this reason, many orthodontists recommend periodic retainer wear for many years (or indefinitely) after orthodontic treatment.

Appropriately trained doctors align the teeth with respect to the surrounding soft tissues, with or without movement of the underlying bones, which can be moved either through growth modification in children or jaw surgery (orthognathic surgery) in adults.
Headgear & J-hooks for connection into the patient’s mouth.

Several appliances are utilized for growth modification; including functional appliances, Headgear and Facemasks.

These “orthopedic appliances” may influence the development of an adolescent’s profile and give an improved aesthetic and functional result.

Methods

If the main goal of the treatment is the dental displacement, most commonly a fixed multibracket therapy is used. In this case orthodontic wires are inserted into dental braces, which can be made from stainless steel or a more aesthetic ceramic material.

Dental braces, with a powerchain, removed after completion of treatment.
Hawley retainers are the most common type of retainers. This picture shows retainers for the top and bottom of the mouth.

Conditions

The most common condition that the methods of orthodontics are used for is correcting anteroposterior discrepancies. Another common situation leading to orthodontic treatment is crowding of the teeth.

Anteroposterior discrepancies

Anteroposterior discrepancies are deviations between the teeth of the upper and lower jaw in the anteroposterior direction. For instance, the top teeth can be too far forward relative to the lower teeth (”increased overjet”.) The headgear is attached to the braces via metal hooks or a facebow and is anchored from the back of the head or neck with straps or a head-cap. Elastic bands are typically then used to apply pressure to the bow or hooks. Its purpose is to slow-down or stop the upper jaw from growing, hence preventing or correcting an overjet. For more details and photographs, see Orthodontic headgear.

Headgear & J-hooks for connection into the patient’s mouth.

Crowding of teeth

Another common situation leading to orthodontic treatment is crowding of the teeth. In this situation, there is insufficient room for the normal complement of adult teeth, which may require tooth removal in order to make enough room for the remaining teeth.

Orthodontic treatment of crowded teeth; the canine is being pulled down into proper position with highly flexible co-axial wire. This patient also presents with a cross bite, where the upper molar is more lingual (towards the tongue) than the opposing lower molar.

Diagnosis and treatment planning

In diagnosis and treatment planning, the orthodontist must (1) recognize the various characteristics of malocclusion and dentofacial deformity; (2) define the nature of the problem, including the etiology if possible; and (3) design a treatment strategy based on the specific needs and desires of the individual. (4) present the treatment strategy to the patient in such a way that the patient fully understands the ramifications of his/her decision. [1]

References

1. ^ T. M. Graber, R.L. Vanarsdall, Orthodontics, Current Principles and Techniques, “Diagnosis and Treatment Planning in Orthodontics”, D. M. Sarver, W.R. Proffit, J. L. Ackerman, Mosby, 2000



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