Treatment of transverse basal anomalies

                          Treatment of transverse basal anomalies

Introduction​

The treatment of transverse direction anomalies remains a priority in the chronological framework of an ODF treatment plan according to the opinion of all authors. If not detected early, they risk generating a cascade of anomalies as they evolve. Since the anomalies of this transverse direction are in most cases of acquired origin, the stable treatment of these anomalies will aim to eliminate the etiology responsible for the deformation and the elimination of these;

The most frequent abnormality is relatively endomaxillary.

1. Diagnosis of endomaxillia

^{(see 3rd} year course )

2. Treatment of endomaxillary

figure1

   2. 1. Etiological treatment

As endomaxillary is often caused by mouth breathing , the patient must be referred to an ENT specialist in order to re-establish nasal breathing and allow the tongue to return to its physiological position on the palate. After releasing the upper respiratory tract, functional rehabilitation sessions are often necessary so that the patient can relearn how to breathe through the nose.

2. 2. Symptomatic treatment

The objective of this treatment is to obtain vestibulo-lingual harmony of the lateral sector by opening the mid-palatal suture. Expansion can be done using a rapid or slow method.

Before the age of 6 years, some authors recommend the use of the jack or the quadelix to widen the arch (slow expansion) and restore the harmony of the 2 bony bases in the transverse direction.

                  figure 3: quad’helix on 

 figure 2: plate with cylinder rings

 transverse action                                                                                                                  

. But the circuit breaker remains the element of choice in the reactivation of the suture (rapid expansion). This circuit breaker can be integrated into 

a gutter, or glued to the rings sealed at the level of the upper 1st ^molars and at the level of the 1st ^premolars .

figure 4

figure 5 intermaxillary disjunction using the Haas appliance

 Effects of intermaxillary disjunction

figure 7 correction of occlusion               
figure 6 creation of a crossed diastema    

interincisive

figure 9 opening of the intermaxillary suture

     Widening of internasal width figure 10

The duration of treatment with this device is generally 1 month of activation and 6 months of retention.

Activation is ¼ turn each time

After one month the suture is opened, an intermaxillary space is created, the internasal width is increased and the crossbite is corrected at the level of the lateral sector.

a retention with maintenance of the disjunction in place not activated is recommended for a period of 6 months during which ossification will be observed in this space created thus allowing the enlargement of the maxillary width,

Other methods of expansion called physiological can also be used; these are the Planas technique and the Fränkel apparatus. 

figure 11

Planas slopes

figure 12

3. Treatment of laterognathia

It frequently involves orthognathic surgery except in certain minor cases where the treatment will be orthodontic.

figure 13

figure14

Conclusion

The most common transverse bone anomaly is endognathia or endomaxillary, which should be screened early. 

• of possible mouth breathing as the main cause of this anomaly
• By looking for signs of this deformation (posterior crossbite).
• Thus allowing: 
• The cascading appearance of other anomalies
• Allows you to avoid having to extract permanent teeth in the event of dental crowding. 

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  

Treatment of transverse basal anomalies