TREATMENT OBJECTIVES IN DENTO FACIAL ORTHOPEDICS AND DECISION CRITERIA
I – TREATMENT OBJECTIVES
For orthodontic treatment to be successful, it must meet specific criteria once completed, otherwise the treatment would be incomplete and doomed to relapse.
Orthodontic treatment is considered successful and complete if it achieves the following goals:
- OCCLUSAL LENSES
- Static occlusion
– Concordance between RC and ICM
– The dental axes must present a certain degree of parallelism (panoramic radiography)
– Inter-arcade relationship:
CL I ideal relationship
CL II acceptable
CL III to be avoided
Angle Classification:
This is a classification that describes the arch relationships in the anteroposterior direction. It is based on the occlusion relationships of the vestibular faces of 6-year-old teeth in the sagittal direction in maximum intercuspation. It must be completed by the description of the occlusion relationships at the level of the permanent canines and the upper and lower central incisors.
Ballard classification:
The relationships of the bony bases in the anteroposterior direction do not necessarily coincide with the occlusal relationships, which is why Ballard proposed a classification of the relationships of the bony bases which complements Angle’s classification.
It takes into account the relative relationships of the mandible to the maxilla.
This is a classification which is based on the clinical examination on the one hand and on the TLR using the ANB angle on the other hand.
– Dynamic relationship:
– Restoration of the propulsion movement: Immediate disocclusion of the molars must be ensured. This disocclusion is a function of the incisal slope and the condylar slope.
– Restoration of lateral movement:
Non-working side disocclusion of lateral sectors
Working side Dental contacts allow the mandible to be guided during movement. These contacts are ensured either by the canine “canine protection”; or by the vestibular cusps of the upper teeth, we will thus speak of “group function”.
- AESTHETIC OBJECTIVES
– Search for facial harmony (The aesthetic line E)
– Search for harmony in labial relations with the presence of stomion at rest
– Concerning the smile line: At the moment of smiling;
- The edge of the upper lip should be at the level of the necks of the upper incisors.
- If the upper incisors are too low, too descended or too vestibular, the result will be a smile that shows the gums excessively (gummy smile).
3 FUNCTIONAL OBJECTIVES
- Restore all disturbed functions (swallowing, chewing, breathing, phonation)
- Delete parafunctions
- Swallowing:
The tongue participates in many functions (alimentary, respiratory, sensory, affective, relational). It plays an important role in the morphogenesis of the bony and dento-alveolar bases.
Its mode of operation will condition the modeling of the maxilla and the mandible.
- Breathing:
Optimal ventilation should be achieved exclusively and permanently through the nose, standing or lying down, except during exercise.
Ventilation that occurs exclusively or partially through the mouth should be considered pathological. In this situation, the tongue takes a low and forward position, to allow the passage of air through the mouth with risks on maxillofacial development.
4 – SPECIFIC OBJECTIVES
- Allow balanced prosthetic rehabilitation, by correcting mesio or disto-tipped bridge support teeth.
- Create favorable conditions for the treatment of periodontal diseases.
- Achieve stable and balanced results.
TREATMENT OBJECTIVES IN DENTO FACIAL ORTHOPEDICS AND DECISION CRITERIA
II- CRITERIA FOR DECIDING ON ORTHODONTIC TREATMENT:
The treatment plan in orthodontics depends on a number of general factors: the etiology of the dysmorphoses, growth, the location of the dysmorphoses, associated dysmorphoses, and the aesthetic and psychological context.
Establishing a prognosis makes it possible to predict the duration of treatment, to discern the limits of therapy, to inform and motivate the patient, and to implement means likely to improve it.
Decision-making cannot be separated from the expected outcome.
1 – Influence of the etiology of dysmorphoses on the treatment plan:
Hereditary and functional factors: Dysmorphoses of hereditary origin have a more reserved prognosis than those of functional origin.
In the presence of an etiology with a functional character, the prognosis is much more favorable if treatment of the etiology is put in place early.
2 – Influence of growth on the treatment plan:
The potential and type of growth are of great importance in establishing the treatment plan and prognosis.
Growth potential:
Björk demonstrated that the growth rates of the maxilla and mandible follow roughly the same variations as that of height growth.
The growth stage is an important factor that must be taken into account before, during and after the growth peak, either to take advantage of the maximum growth rate or, on the contrary, to avoid this very active period.
Growth direction:
Anterior rotation is more favorable than posterior rotation.
3 – Influence of dysmorphosis on prognosis and treatment plan :
The more severe the malocclusion, the more difficult it will be to correct everything in adult teeth.
Conclusion : After setting goals to achieve at the end of treatment, the practitioner can then establish an individualized treatment plan.
TREATMENT OBJECTIVES IN DENTO FACIAL ORTHOPEDICS AND DECISION CRITERIA
Wisdom teeth can be painful if they are misplaced.
Composite fillings are aesthetic and durable.
Bleeding gums can be a sign of gingivitis.
Orthodontic treatments correct misaligned teeth.
Dental implants provide a permanent solution for missing teeth.
Scaling removes tartar and prevents gum disease.
Good dental hygiene starts with brushing twice a day.