Orthopedic treatment in ODF
Introduction
Orthopedic treatment represents all the therapies which aim to correct anomalies of skeletal origin (endomaxillary, retromaxillary, retromandibulia) or to avoid their worsening (class III, prognathism, vertical excess)
1. Treatment of endomaxillary
Its management from an orthopedic point of view is done using a circuit breaker activated 2 /day. This device will open the midpalatal suture and allow the expansion of the maxilla. The earlier the treatment, the more orthopedic the effect, a late treatment will generate a dentoalveolar expansion therefore orthodontic
2. Delaire’s orthopedic mask
Its effect is to pull the maxilla forward to bring it into harmony with the mandible.
This movement of the maxilla is done by activation of the maxillopalatine and pterygopalatine sutures. So we have an interest in taking care of the retromaxilla as early as possible (from 4, 5 years) in order to have an orthopedic response. Beyond the pubertal peak the response to traction will be rather dentoalveolar therefore orthodontic.
Early treatment, but at what age should it start? (text by Sylvain Chamberland)
To answer this question, the researchers had to group the subjects by age group. The undisputed leaders in face mask therapies are Dr. Jean Delaire and Dr. Pierre Verdon in France, Dr. Peter Ngan of West Virginia University and Dr. Patrick Turley of UCLA in California.
Three age groups were identified:
• 4 to 7 years old
• 7 to 10 years
• 10 to 14 years old
All three groups had significant skeletal changes.
The 4-7 year group demonstrates more than double the maxillary advancement compared to the other two older groups. Skeletal changes are achieved more rapidly and with fewer hours of face mask wear per day than the older groups.
The 7-10 year old group shows more changes than the 10-14 year old group.
The 10-14 year group demonstrates that it is possible to have skeletal changes at this age, but they are less than the groups treated at younger ages.
3. The activator
Indicated in the case of class II with mandibular responsibility, the activator has the main purpose of stimulating mandibular growth in the antero-posterior direction and allowing the mandible to regain a correct relationship with the maxilla. According to the authors it would therefore have an orthopedic effect in addition to other effects in the vertical direction and at the dentoalveolar level.
4. Extraoral forces FEB
FEBs have an orthopedic effect, in particular by slowing down maxillary growth. They are indicated in particular in the case of promaxilia in mixed dentition or young adult dentition.
Good oral hygiene Regular scaling at the dentist Dental implant placement Dental x-rays Teeth whitening A visit to the dentist The dentist uses local anesthesia to minimize pain