ORTHOPAEDODONTICS Phase 1 - Module 1 Presented by Dr. Bert Botha - PowerPoint PPT Presentation

ORTHOPAEDODONTICS Phase 1 - Module 1 Presented by Dr. Bert Botha Field of Practice: Orthodontics & Early Dental-arch Development

There seem to be two kinds of clinicians ; One professional may be involved in the thinking process of just straightening permanent teeth alone. This leads to a concentration on the model. For that person, treatment planning may be conducted with static thinking or rearranging the teeth as if fixed on an articulator. That orthodontist may rely later on jaw surgery for maxillo-mandibular correction. Treatment to him or her is fraught with remarkable limitation. A second professional thinks biologically and dynamically . Growth, physiological change, induced skeletal change and biology now occupy the consciousness. A three dimensional view is present, and the fourth dimension- time- enters into concern. Dr. Robert Ricketts – 1996 .

ORTHO THOPAEDICS EDICS + O ORTHO THODO DONTICS TICS

ORTHO THOPAEDICS EDICS+ORTHO THODO DONTICS TICS

ORTHO THOPAEDICS EDICSRTHO THODO DONTICS TICS

ORTHO THOPAEDICTHO EDICTHODO DONTICS TICS

ORTHO THOPAEDIHO EDIHODO DONTICS TICS

ORTHO THOPAEDIO EDIODO DONTICS TICS

ORTHO THOPAEDO EDODO DONTICS TICS

ORTHOPAEDICS The medical specialty concerned with the preservation, restoration, and development of form and function of the musculoskeletal system, extremities, spine, and associated structures by medical, surgical, and physical methods. (https://medical dictionary)

ORTHODONTICS That branch of dentistry concerned with the correction and prevention of irregularities and malocclusion of the teeth. (https://medical dictionary)

ORTHOPAEDODONTICS The medico-dental specialty concerned with the development and function of the musculoskeletal system, followed by the correction of irregularities and malocclusion of the teeth.

7 YEAR YEARS 11 Y YEARS

7 YEAR YEARS 12 Y YEARS

7 YEAR YEARS 13 Y YEARS

Prof. M. Thomas Wilcko, Western Reserve University, School of Dental Medicine, Cleveland, Ohio, USA.

WHO QUALIFIES FOR ORTHOPAEDODONTICS? According to the Am America can O Orthodo dontic S c Societ ety a as well a as the Am American can De Dental al As Associ ciat ation, every child should visit the Orthodontist at around 7 years of age, regardless if any problems are noticed.

WHO QUALIFIES FOR ORTHOPAEDODONTICS? - According to Bench et al (J.Clin.Orthodontics 1996) 80% of all ortho patients needs some type of arch expansion. - “Early cross-bite corrections lead to a stable and normal occlusion pattern, and contribute to symmetrical condyle growth, harmonious TMJ- and overall growth in the mandible” -Kutin & Hawes, Harberson & Meyers, Vadiakas & Roberts, Barenie & Bell et al

THE BEST TIME TO START “Young patients should start visiting the orthodontist around 4 years of age…..Waiting until after 9 years can lead to TMJ problems and future relapse” - BELL R.A, LE COMPTE E.J. American Journal of Orthodontics 1981 CONCLUSIONS Phase 2 (Orthodontics) 1’st Growth Spurt My Recommended Age To Start o Growth Phase One is at Age 8 2’nd Growth (cm/y) Spurt 1’st Growth Spurt at Age 9 – aim to o Phase 1 have a normal mouth at 9. (Orthopaedics) 2’nd Growth Spurt between o 1 2 3 4 5 6 7 8 9 10 10 11 11 12 12 13 13 14 14 15 15 16 16 Age 11 and 14 (Boys: 12-16) – use phase 2 to finalize and finish what Age - years has been started at 8.

Habits must Dental- and be broken skeletal relation corrected Eruption space for the remaining 12 permanent teeth should be Vertical present dimension corrected (deep / open bite) Get et th the pati tient t as normal as possible for his age as s soon n as p possible

• All the teeth needed for the applicable fixed appliances are present. • Best growth management results are reached when covering both growth spurts 1’st Growth Spurt is at Age 9 – all • corrections done after nine tend to relapse easier. AGE - 8 YEARS – USUALLY STILL 12 • It is cool to have braces at 8 PRIMARY TEETH PRESENT

• All the teeth needed for the applicable fixed appliances are present. • Best growth management results are reached when covering both growth spurts 1’st Growth Spurt is at Age 9 – all • corrections done after nine tend to relapse easier. AGE - 8 YEARS • It is cool to have braces at 8

• All the teeth needed for the applicable fixed appliances are present. • Best growth management results are reached when covering both growth spurts 1’st Growth Spurt is at Age 9 – all • corrections done after nine tend to relapse easier. AGE - 8 YEARS • It is cool to have braces at 8

• All the teeth needed for the applicable fixed appliances are present. • Best growth management results are reached when covering both growth spurts 1’st Growth Spurt is at Age 9 – all • corrections done after nine tend to relapse easier. AGE - 8 YEARS • It is cool to have braces at 8

THE 4 DIMENSIONS 1 1 - TRANSVERSE

THE 4 DIMENSIONS 2 2 -LONGITUDINAL

THE 4 DIMENSIONS 3 3 - VERTICAL

THE 4 DIMENSIONS 4 - TIME

SERIOUS COMPLICATIONS OF INSUFFICENT GROWTH Sella Tursica Olfactory bulb Eleven of the 22 Cranial Nasion Sutures are connected to the Maxilla Midpalatal Basion Suture

SERIOUS COMPLICATIONS OF INSUFFICENT GROWTH Sella Tursica Olfactory bulb The base of the skull expands with the Nasion Maxilla. Midpalatal Basion Suture

The amount of nasal mucosa is programmed for the surface of your age -8 years – USUALLY STILL 12 PRIMARY TEETH PRESENT normal Maxilla.

If the maxilla is narrowed, the Olfactory nerve endings are buried under age -8 years – USUALLY STILL 12 PRIMARY TEETH PRESENT the greater amount of mucosa.

The development of the Pituitary gland gets enhanced as the Sella age -8 years – USUALLY STILL 12 PRIMARY TEETH PRESENT Tursica expands with the palate.

COMPROMISED BREATHING:

UNDERDEVELOPED UPPER ARCH :

8 WEEKS INTO TREATMENT:

IMPROVEMENT AFTER 8 WEEKS:

JUMPING THE BITE AS SOON AS POSSIBLE:

After only 3 months she could smell things she couldn’t smell before in her life

PERMANENT COMPLICATION: The mouth breather who develops a narrow upper arch and skeletal open bite can be cured from all abovementioned complications EXCEPT this one.

PERMANENT COMPLICATION: The mouth breather who develops a narrow upper arch and skeletal open bite can be cured from all abovementioned complications EXCEPT this one.

THE VICIOUS CYCLE OF NEGLECT BIRTH

THE VICIOUS CYCLE OF NEGLECT BIRTH Allergies/malnutrition MOUTH BREATHING

THE VICIOUS CYCLE OF NEGLECT BIRTH Intercept this tragic sequence Allergies/malnutrition MOUTH BREATHING NO BREAST FEEDING 8Y NARROWED MIDFACE (MX COMPLEX) MOUTH BREATHING LACK OF N 2 O TEMPORALIS CHEWING

THE VICIOUS CYCLE OF NEGLECT BIRTH Intercept this tragic sequence Allergies/malnutrition MOUTH BREATHING NO BREAST FEEDING 8Y NARROWED MIDFACE (MX COMPLEX) MOUTH BREATHING LACK OF N 2 O VERTICAL TEMPORALIS SOFT DIET GROWTH CHEWING

THE VICIOUS CYCLE OF NEGLECT BIRTH Intercept this tragic sequence Allergies/malnutrition MOUTH BREATHING NO BREAST FEEDING 8Y NARROWED MIDFACE (MX COMPLEX) MOUTH BREATHING LACK OF N 2 O TMJ Reduced VERTICAL TEMPORALIS SOFT DIET MALFORMATION OLFACTORY GROWTH CHEWING + DISFUNCTION FUNCTION

THE VICIOUS CYCLE OF NEGLECT BIRTH Intercept this tragic sequence Allergies/malnutrition MOUTH BREATHING POSTURAL NO BREAST FEEDING 8Y DEVIATION NARROWED MIDFACE (MX COMPLEX) Reduced PITUITARY FUNCTION MOUTH BREATHING LACK OF N 2 O TMJ Reduced VERTICAL TEMPORALIS SOFT DIET MALFORMATION OLFACTORY GROWTH CHEWING + DISFUNCTION FUNCTION

THE VICIOUS CYCLE OF NEGLECT BIRTH Intercept this tragic sequence Allergies/malnutrition MOUTH BREATHING POSTURAL DISTURBED NO BREAST FEEDING 8Y DEVIATION CSF FLOW NARROWED MIDFACE (MX COMPLEX) Reduced COMPROMISED PITUITARY HEALTH AND FUNCTION MOUTH BREATHING EARLY LACK OF N 2 O DEATH ? TMJ Reduced VERTICAL TEMPORALIS SOFT DIET MALFORMATION OLFACTORY GROWTH CHEWING + DISFUNCTION FUNCTION