CATEGORY AUSTRALASIAN DENTIST61 CLINICAL the permanent incisors, u malpositioned teeth which interfere with normal occlusal function or induce faulty patterns of mandibular closure, u lower lip trapped behind upper incisors, u pronounced constriction of arches, u open bites due to tongue-thrusting or digital sucking habits. Conditions that may be treated: u Distocclusions that are partly positional. Occlusal equilibration or tooth movements may restore normal function. e rest of the problem may be treated at this time or later. u Certain distocclusions of a skeletal nature are best treated at this age, but the patient must be socially mature, and the cases must be carefully chosen. Examples: – Extreme Class-II Div-1 or Class-I showing maxillary protrusion – Class-III malocclusions [true or pseudo]. Bilateral and unilateral posterior crossbite Anterior crossbite Early loss of deciduous teeth or delayed eruption of permanent teeth lead to intra-arch tooth-size/archsize discrepancy Early loss of deciduous molar leads to mesial migration of first permannent molars and loss of arch length. Sucking habits lead to anterior open bite Thumb-sucking habit leads to severe maxillary arch constriction and anterior open bite. Severe posterior functional crossbite in primary or early mixed dentition if left untreated could lead to asymmetric development of the jaw. Retained primary incisors/or delayed shedding, which interfere with the normal eruption of the permanent incisors. Maxillary hypoplasia or maxillary retursion in primary dentition (Class III) Prominent upper front teeth in children can cause trauma Lip Trap Conditions that should be treated u Early treatment for prominent upper front teeth in children reduces trauma as well as poor self-esteem and social adjustment. Contraindications to treatment in the primary dentition: Most pre-adolescent irregularities are rarely self-corrective. With the passage of time, these tend to become more severe and continue to follow the same unfavourable course if not intercepted by proper orthodontic treatment during mixed dentition developmental stages. Certainly, there are contraindications to treatment in the primary dentition when: u there is no assurance that the results will be sustained, u a better result can be achieved with less e ort at another time, u the social immaturity of the child makes treatment impractical. Improper early treatment can be harmful, and two-phase treatment may lengthen treatment time. Early treatment may not only do some damage or prolong therapy, it may also exhaust the child’s spirit of cooperation and compliance. Benefits of early orthodontic treatment a) Facial growth and development: Facial development involves the growth of the facial skeleton (jaws and associated structures) and the eruption of dentition. Both these processes are synchronized with a range of variability. If orthodontic treatment is started early, there is an opportunity to direct and correlate the treatment with growth, and allow the natural developmental forces to
RkJQdWJsaXNoZXIy MTc3NDk3Mw==