Orthodontic Treatment

ORTHODONTIC TREATMENT

by Dr. H. Kopel
Phase one orthodontic treatment is sometimes referred to as interceptive orthodontics.
Some orthodontic conditions are simply easier to correct if they’re corrected early. Leaving orthodontic conditions untreated until all the baby teeth fall out can cause damage to the surrounding permanent teeth, trap permanent teeth in the jaw and other problems.
Interceptive orthodontic treatment is all about preventing more severe problems later on. It provides the opportunity for an orthodontist to have control over where the permanent teeth come in by addressing the structure of the jaw and teeth while the primary teeth are still in the mouth.
By age seven, your child’s mouth has grown enough and has enough sound structure to know how it will develop as the permanent teeth start to emerge.
In addition, common problems such as thumb sucking and tongue thrusting can be addressed.
If your Zak Dental diagnostic dentist detects any abnormalities your child will be referred to our in house orthodontist for a consultation.

Space Maintainers in Children

by Dr. J. Slaven
When a young child loses a baby tooth prematurely due to decay, infection or accident it creates a situation that requires immediate attention. One of the purposes of the lost baby tooth was to keep space available for the permanent tooth developing in the jaw underneath the baby tooth to have enough room to properly erupt into the child’s developing jaw. When teeth are lost the teeth on either side of the now empty space will quickly begin to drift into the space and effectively block the permanent tooth from properly erupting. If this is allowed to progress without intervention the permanent tooth can become impacted which will then require a surgery to uncover it to allow orthodontic movement of the tooth into proper position.

The simple solution to this is to fabricate and place a space maintainer. A space maintainer is either a passive space holding appliance or an active space opening appliance that is cemented to the tooth or teeth next to the space to assure that the permanent tooth can erupt into its’ proper position. The space maintainer consists of one or more bands that encircle the tooth next to the space with a stiff wire loop that touches the tooth on the other side of the space and keeps it open. If front teeth are lost early the space maintainer can have artificial teeth attached to the wire to create a cosmetic result allowing the child to have their self esteem intact and avoid being teased by other children.

Once the space maintainer has been placed it is important that the child be checked regularly, so that the appliance can be removed at the appropriate time. The space maintainer itself could prevent the final eruption of the permanent tooth, so monitoring is essential.

The role of orthodontics in Implant dentistry.

by Dr. Nadia Abazarnia, DDS

Orthodontics can be used to develop the peri-implant site prior to implant placement. Orthodontic treatment for children and adults can involve management of teeth missing due to agenesis, trauma, or extraction following dental disease or malformation.

An interdisciplinary approach between the dentist and orthodontist, and often the implant surgeon and prosthodontist, is usually  required to formulate the most appropriate treatment plan for the patient. A decision usually needs to be made as to whether the space or spaces should be closed orthodontically, or maintained for eventual prosthetic replacement.

Over the last decade the reliability, predictability and long term success rate of implants has made them the prosthetic replacement  of choice, especially when the teeth adjacent to the space are well formed and unrestored. When it is planned to incorporate  implants into the orthodontic and restorative treatment plan, growth considerations, implant space requirements and implant site development are three of a number of treatment planning factors that need to be considered.

Growth Considerations: It is not usually appropriate to place an implant until completion of dento-alveolar development and skeletal growth. Throughout active growth the implant responds like an ankylosed tooth while the adjacent teeth continue to erupt, creating a discrepancy between the gingival margin of the implant and the natural teeth. Particularly in a patient with a high lip line, this will produce a poor aesthetic result unless implant treatment is delayed until growth has been completed. Chronological age alone is not accurate in determining whether growth has been completed for an individual. We expect that most girls will have completed the majority of their active facial growth by 16 years of age and boys by 19 years of age. However, boys in particular can show significant late facial growth. Radiographic examination can help to determine whether active facial growth has been completed.

Although active facial growth may be considered to have been completed in the late teens or early twenties, continued facial maturation and changes, including in the vertical dimension, continue throughout the individual’s life. The space required for implant and crown replacement will be determined by a number of factors including the size and shape of the contralateral tooth, the size of adjacent and opposing teeth, aesthetics, the occlusion and by the size of the implant to be used.

In some situations the orthodontist may be forced to create more or less than the ideal space required for the implant due not only to the size of the teeth but also in order to establish normal overjet and overbite. Options to be considered, in consultation with the restorative dentist or prosthodontist, are whether adjacent teeth need to be increased in width using adhesive restorations, veneers or crowns, or whether the width of the teeth needs to be reduced by interproximal stripping and crown recontouring.

The incorporation of orthodontic therapy into comprehensive treatment planning is a valuable adjunct which can enhance aesthetic and functional outcomes in restorative dentistry.

Reference ; Australian society of orthodontists

Invisalign

by Dr. O. Karnakova

Invisalign is a clear orthodontic aligner tray made to replace traditional braces. Unlike braces, they do not contain any metal, are constructed out of a smooth comfortable plastic, and are removable. They are used to correct moderate under bites, open bites, crowding, cross bites, and gaps between teeth (diastema).

Invisalign should be worn a minimum of twenty-two hours per day and should only be taken off when eating or brushing. A new set of custom aligners are to be worn approximately every two weeks.

Invisalign offers many advantages over traditional braces. They are virtually invisible and are more esthetically pleasing. The aligners are much more comfortable to wear as compared to the metal brackets and wires. Braces also make it more difficult to maintain optimum oral hygiene. The brackets can trap food debris and plaque, resulting in gum infection.

Invisalign trays can be removed to perform oral hygiene and do not have any food restrictions. Studies have shown that Invisalign can align teeth faster than braces when used correctly.

A disadvantage of Invisalign is that they are not designed to correct severe malocclusions. Teeth that are overly rotated, severely misaligned, or have large gaps over 6mm are not candidates. Invisalign treatment also has the potential for higher costs than traditional braces. Another potential disadvantage with Invisalign treatment is noncompliance. Patients who do not wear their trays for at least twenty-two hours per day may slow the progress of treatment. Not wearing the aligners for long extended periods of time may relapse the progress and require additional costs with mid-course correction.

Orthodontics for Children

WHEN SHOULD CHILDREN HAVE THEIR FIRST VISIT TO AN ORTHODONTIST?

It can be a common misconception that oral care is simply a luxury, and as adults with completely developed teeth this may be true. However, at a young age tooth care is extremely important for insuring healthy, functioning teeth. So, the important question is when should children begin to visit an Orthodontist? This question can be answered by observing the development of teeth. Between the ages of 6 and 12, when the facial structure and teeth further grow and develop, an Orthodontist is able to best correct any incorrect growth that might be occurring in the child’s permanent set of teeth.

Tooth development occurs in two stages; the first set of teeth, called primary teeth, and the final, permanent adult tooth set. The early stages of oral development are a crucial time for the teeth of children. Primary teeth begin to break through the gums around six months of age, typically emerging in a pattern of front teeth to back teeth (1). A disruption of this order is one of the main causes of child dental problems; leading to the growth of teeth in the spaces of other teeth, infections, and crowding in the mouth.

Even though the primary teeth may appear to be straight and orderly, the underlying adult teeth are experiencing a number of changes that could potentially lead to malformed permanent teeth. By the age of 3 the primary set will be completed and the growth of the jaw and facial bones will begin to increase. It is important to remember that during this period of growth a child’s teeth will go through a lot of normal changes, such as the seemingly crooked appearance of the front permanent teeth. This is a problem that will simply correct itself as the rest of the permanent teeth come in, filling in spaces and providing the pressure needed to move each tooth into its proper position (1). However, not all mouth oddities are normal and therefore it is important to consider early Orthodontic visits.

Recognizing the signs of primary tooth trouble is essential to good health in a child’s teeth. Children who are experiencing even slight discomfort caused by tooth abnormalities will engage in actions intended to relieve the
irritation, such as sucking on the thumb, grinding their teeth, or biting of the cheeks and roof of the mouth (2). Such actions tend to appear more frequently around the age of 7, when the progression from primary to permanent teeth is in motion. Your Dentist will examine and will discuss early orthodontic intervention to correct and guide musculoskeletal
discrepancies. Give us a call and bring your son or daughter for your early orthodontic intervention exam.

Reference:

1. “Your Child’s Teeth: Development Chart and Eruption Schedule.” WebMD. WebMD, 26 June 2015. Web. 26 June 2015.http://www.webmd.com/oral-health/guide/dental-health-your-childs- teeth>.

2. “A Child’s First Orthodontist Visit.” A Child’s First Orthodontist Visit. N.p., 26 June 2015. Web. 26 June 2015. http://www.dentalassociates.com/braces-orthodontics/childs-first- orthodontist-visit/>.

Braces vs. Invisalign

The Healthy Smile

by ADA (American Dental Association)

It’s never too late to perfect your smile.
Ask dental professionals about the health reasons for having a correct bite.

When you have your teeth that are in cross bite, your teeth that are misaligned, and there is a great chance to have food buildup in between your teeth, then plaque buildup which has a trickle-down effect because the more food buildup, the more plaque you get. Therefore, the more concern for periodontal disease.
Improper bite also means you can’t chew food properly, which can lead to gastrointestinal problems.

Orthodontic treatments that use either braces or Invisalign are just few of the many techniques used by dental professionals in straightening the teeth. They straighten teeth to give them an ideal position, improve their look, and promote proper function.  Traditional braces utilze metal wires to get the most ideal movement or position for the teeth.  Invisalign on the other hand, utilizes a set of clear plastic trays to achieve the position.

What is the great thing about orthodontic dental treatments that use braces or Invisalign is that they do more than just straighten the teeth. They also correct bite issues that often require special diagnosis and treatment.

Benefits of dental braces

Dental braces feature brackets that tend to run along a wire. An orthodontist or other trained dental professional is responsible for affixing the dental braces onto the teeth. The wire and brackets that form part of the braces are pressed against the patient’s teeth. This supports slight movements that can help in properly aligning and straightening the teeth.

Dental braces can correct even the most complicated issues in aligning the teeth. The braces are not only esthetically pleasing, but functional as well. These are beneficial in closing gaps and correcting crooked teeth.

Benefits of Invisalign

The use of Invisalign is an efficient method for tooth movements that are not too complicated. A set of clear, computer-generated trays is ideally worn 24 hours a day with change-outs every two weeks. There are certain trays that can last for six months to one year. However, these require some form of retention to prevent the teeth from shifting back. One of its best advantages is that the trays are relatively invisible. Hence the name Invisalign. Some people simply don’t want anyone to know they are wearing braces. They also provide help for people who wish to obtain straight teeth while still feeling comfortable in social situations. Wearing Invisalign offers comfort because it does not affect your speech.

Invisalign treatment can be expected to work more efficiently for esthetic purposes rather than for the purpose of improving the functionality of the teeth. This is why many people, especially those who have complex dental problems, still prefer dental braces.

Dental braces are better for complex cases

There are plenty of reasons why you might choose dental braces over Invisalign. Mainly composed either of colored metal or resin brackets, braces are attached onto the face of the teeth. Braces also come with a wire that runs through them and affixes them in place. One benefit of dental braces over Invisalign is that these are not removable.

Unlike an Invisalign treatment which is extremely useful for esthetic purposes and simple dental issues, braces are functional and work efficiently for fixing complex tooth issues. Braces can also be expected to work faster at closing gaps and aligning the teeth than Invisalign.

According to patients, braces work in moving misaligned teeth within a relatively short period. The use of these dental materials in aligning the teeth is also a huge help in fixing bites and creating an attractive and healthy smile. This plays a significant role in boosting the patient’s self-confidence. Dental braces are also useful in correcting malocclusion (crooked or crowded teeth) and bad bites.

If the patient’s bite is abnormal, then the application of braces can bring out his or her best smile. The immediate correction of this problem can improve the patient’s smile while also boosting his or her oral health. This is beneficial because being unable to correct an abnormal bite, or other dental issues that are treatable using braces, can lead to oral health problems. This proves the usefulness of dental braces in curing various dental problems.

Are braces better than Invisalign? Ultimately it’s going to come down to determining the specific need in each case and deciding which one will meet that need in the best way for your patient.