Therapy of Orthodontic Anomalies

By Dr. Vishaal Bhat on Thursday 6 December 2007 with 0 comments



The orthodontic therapy is based on the assumption that bone tissues adjust themselves to gradual changes of their functional load. The field can be divided into two basic branches:

1. Conservative orthodontics, that uses effects of forces (orthodontic instruments, functions) and often also the oro-facial system’s growth. Changes in shape of dental arches are initiated by reconstruction of the jaw bone tissue.

2. Surgical orthodontics changes the oro-facial system appearance by surgical operations.

The best time at which the orthodontic therapy should start is the period of mixed teeth, when cutting teeth can be lead to a correct position at the dental arch and when the growth of jaws may affect the teeth development in a positive manner. At the period of temporary dentition, a preventive and prophylactic treatment prevails. Its goal is to enable a natural development of the teeth. A treatment that begins after the dentition change, can be regarded as late therapy, since the main growth of the oro-facial system is over and the dentition development is finished. The period after the growth is finished is suitable for surgical correction of anomalies that require changing the size, the shape, or eventually positions of jawbones (progeniae, prognathiae, open bite). Orthodontic therapy is carried out by several means. Orthodontic instruments, orthodontic extractions, auxiliary surgeries and myotherapy are among the most often used ones.


Orthodontic therapy with the aid of instruments


Fixed appliances are wire arches of various shapes that are connected to the teeth with cemented rings or glued locks. They consist of various springs, elastic tensions and devices that influence the teeth by an external force.


Removable appliances can be divided according to the acting forces into active appliances (acting mechanically), whose elementary example is a plate fitted with active elements (screws, springs etc.), passive and combined appliances. Passive appliances (functional) use muscular functions for correction of an anomaly, they direct the growth and reconstruction of bones. Combined appliances act both mechanically during the therapy - using active elements - and through a muscular function. Treatment with the aid of orthodontic instruments is an exacting one, requiring cooperation of a patient and his/her parents in maintaining the therapeutic regime and oral hygiene.


Surgical therapy

The basic element of surgical orthodontics are orthodontic extractions that have become a routine part of therapeutic processes today. They enable for faster and more stable incorporation of teeth into the dental arch in case of tightness and lack of space. In case of unequal numbers of teeth at the upper and lower jaws, this method can provide for the correct inter-cuspidation of the teeth. Another reason for extraction may be unfavorable positions of teeth or a tooth’s germ, dental arches asymmetry etc. Extractions also find its application at orthodontic prophylaxis, since well planned extractions of temporary and permanent teeth achieve the correct teeth evolvement.


Surgical therapy of orthodontic anomalies is used mainly for correcting of congenital anomalies of jaws where the orthodontic therapy alone is not sufficient. Surgeries of jawbones are performed after their growth is completed, i.e. around 18 years of age. Until this age, attempts to adjust the teeth positions, height of the bite and mutual positions of jaws should be carried out, so that the best possible conditions for a surgery are achieved. Surgical therapy is most frequently applied in cases of mandibular progenia, open bite, maxillar prognathia, microgenia and laterogenia. A number of surgical techniques have been developed for correction of particular types of anomalies. These are always serious surgical interventions, requiring a patient’s hospitalization.


Myotherapy

Myotherapy serves for exercising of particular groups of muscles. It is not very demanding method that should create a proper muscular tonus. Favorable conditions for normal development of the teeth are created by increasing the tonus of flaccid muscles or by releasing a hypertonia.

Category: Orthodontics Notes

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