ORTHOPAEDODONTICS
Phase 1 - Module 1
Presented by Dr. Bert Botha
Field of Practice: Orthodontics & Early Dental-arch Development
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
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
dimension- time- enters into concern.
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)
That branch of dentistry concerned with the correction and prevention of irregularities and malocclusion of the teeth.
(https://medical dictionary)
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.
11 Y YEARS 7 YEAR YEARS
12 Y YEARS 7 YEAR YEARS
13 Y YEARS 7 YEAR YEARS
Western Reserve University, School of Dental Medicine, Cleveland, Ohio, USA.
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?
growth, harmonious TMJ- and overall growth in the mandible”
WHO QUALIFIES FOR ORTHOPAEDODONTICS?
CONCLUSIONS
1 2 3 4 5 6 7 8 9 10 10 11 11 12 12 13 13 14 14 15 15 16 16
1’st Growth Spurt
“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”
Growth (cm/y)
2’nd Growth Spurt Phase 1 (Orthopaedics)
Phase One is at Age 8
have a normal mouth at 9.
Age 11 and 14 (Boys: 12-16) – use phase 2 to finalize and finish what has been started at 8.
Phase 2 (Orthodontics)
Age - years
Eruption space for the remaining 12 permanent teeth should be present Dental- and skeletal relation corrected Vertical dimension corrected (deep / open bite) Habits must be broken
Get et th the pati tient t as normal as possible for his age as s soon n as p possible
applicable fixed appliances are present.
are reached when covering both growth spurts
corrections done after nine tend to relapse easier.
AGE - 8 YEARS – USUALLY STILL 12 PRIMARY TEETH PRESENT
applicable fixed appliances are present.
are reached when covering both growth spurts
corrections done after nine tend to relapse easier.
AGE - 8 YEARS
applicable fixed appliances are present.
are reached when covering both growth spurts
corrections done after nine tend to relapse easier.
AGE - 8 YEARS
applicable fixed appliances are present.
are reached when covering both growth spurts
corrections done after nine tend to relapse easier.
AGE - 8 YEARS
1
1 - TRANSVERSE
2
2 -LONGITUDINAL
3
3 - VERTICAL
4 - TIME
Eleven of the 22 Cranial Sutures are connected to the Maxilla
Basion Sella Tursica Midpalatal Suture Nasion Olfactory bulb
SERIOUS COMPLICATIONS OF INSUFFICENT GROWTH
The base of the skull expands with the Maxilla.
Basion Sella Tursica Midpalatal Suture Nasion Olfactory bulb
SERIOUS COMPLICATIONS OF INSUFFICENT GROWTH
age -8 years – USUALLY STILL 12 PRIMARY TEETH PRESENT
The amount of nasal mucosa is programmed for the surface of your normal Maxilla.
age -8 years – USUALLY STILL 12 PRIMARY TEETH PRESENT
If the maxilla is narrowed, the Olfactory nerve endings are buried under the greater amount of mucosa.
age -8 years – USUALLY STILL 12 PRIMARY TEETH PRESENT
The development of the Pituitary gland gets enhanced as the Sella 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.
BIRTH
BIRTH MOUTH BREATHING
Allergies/malnutrition
BIRTH MOUTH BREATHING
Allergies/malnutrition
NO BREAST FEEDING NARROWED MIDFACE (MX COMPLEX) MOUTH BREATHING LACK OF N2O TEMPORALIS CHEWING Intercept this tragic sequence 8Y
BIRTH MOUTH BREATHING
Allergies/malnutrition
NO BREAST FEEDING NARROWED MIDFACE (MX COMPLEX) MOUTH BREATHING LACK OF N2O TEMPORALIS CHEWING Intercept this tragic sequence 8Y VERTICAL GROWTH SOFT DIET
BIRTH MOUTH BREATHING
Allergies/malnutrition
NO BREAST FEEDING NARROWED MIDFACE (MX COMPLEX) MOUTH BREATHING LACK OF N2O TEMPORALIS CHEWING Intercept this tragic sequence 8Y VERTICAL GROWTH SOFT DIET TMJ MALFORMATION + DISFUNCTION Reduced OLFACTORY FUNCTION
BIRTH MOUTH BREATHING
Allergies/malnutrition
NO BREAST FEEDING NARROWED MIDFACE (MX COMPLEX) MOUTH BREATHING LACK OF N2O TEMPORALIS CHEWING Intercept this tragic sequence 8Y VERTICAL GROWTH SOFT DIET TMJ MALFORMATION + DISFUNCTION Reduced OLFACTORY FUNCTION Reduced PITUITARY FUNCTION POSTURAL DEVIATION
BIRTH MOUTH BREATHING
Allergies/malnutrition
NO BREAST FEEDING NARROWED MIDFACE (MX COMPLEX) MOUTH BREATHING LACK OF N2O TEMPORALIS CHEWING Intercept this tragic sequence 8Y VERTICAL GROWTH SOFT DIET TMJ MALFORMATION + DISFUNCTION Reduced OLFACTORY FUNCTION Reduced PITUITARY FUNCTION POSTURAL DEVIATION DISTURBED CSF FLOW COMPROMISED HEALTH AND EARLY DEATH ?
About dr. Weston A. Price
THE ROLE OF NUTRITION IN FACIAL GROWTH
For over ten years, he traveled to isolated parts of the globe to study the health of populations untouched by western civilization. His goal was to discover the factors responsible for good dental health. His studies revealed that dental caries and deformed dental arches resulting in crowded, crooked teeth are the result of nutritional deficiencies, not inherited genetic defects. The groups Price studied included remote villages in Switzerland, Gaelic communities in the Outer Hebrides, indigenous peoples of North and South America, Melanesian and Polynesian South Sea Islanders, African tribes, Australian Aborigines and New Zealand
disease and fine characters were typical of native groups on their traditional diets, rich in essential nutrients. When Dr. Price analyzed the foods used by isolated peoples he found that, in comparison to the American diet of his day, they provided at least four times the water- soluble vitamins, calcium and other minerals, and at least TEN times the fat-soluble vitamins, from animal foods such as butter, fish eggs, shellfish, organ meats, eggs and animal fats—the very cholesterol-rich foods now shunned by the American public as unhealthful. The isolated people Price photographed—with their fine bodies, ease of reproduction, emotional stability and freedom from degenerative ills—stand in sharp contrast to civilized moderns subsisting on the “displacing foods of modern commerce,” including sugar, white flour, pasteurized milk, lowfat foods, vegetable oils and convenience items filled with extenders and additives. The discoveries and conclusions of Dr. Price are presented in his classic volume, Nutrition and Physical
The photographs of Dr. Weston Price illustrate the difference in facial structure between those on native diets and those whose parents had adopted the “civilized” diets of devitalized processed foods. The “primitive” Seminole girl (left) has a wide, normal face with plenty of room for the dental arches. The “modernized” Seminole girl (right), born to parents who had abandoned their traditional diets, has a narrowed face, crowded teeth and a reduced immunity to disease.
He also studied the influence of the maxillary position and width on the total well being of the body and the structures around it. In his classic book “Nutrition and Physical Degeneration” in the chapter ‘’Mental and Moral Deterioration’’ he investigated the abnormalities
He concluded: “In the processes that are involved in the production of facial and dental arch deformities, it is helpful to think of the face as, constituting the floor of the anterior part of the brain”.
One of his most interesting cases was a 16 year
Binet test showed mentality of a four year old. Roëntgenograms of his hands showed that the epiphytical bones did not unite. He played on the floor with blocks and rattles like a small child. His interests were that of a child. Another outstanding facial characteristic was his maxillary arch which was so much smaller than the mandibular arch, that it fitted inside the lower arch. The genitals were those of a boy of 8 years old.
In order to give him a chewing surface and with the hope of helping him physically and mentally
the maxillary bones one-half inch apart with his FIXED EXPANDING APPLIANCE. An important fact of this case study was that the left nostril was entirely occluded all his life until this expansion took place. (A Rhinologist tried to shrink the tissue with no success.)
temporal bones that produced a force downwards on the floor of the anterior part of the brain, stimulating functions of the pituitary gland.
Th The result of
his maxillary expansion:
Lateral Cephalograph - (Longitudinal and Vertical)
GROWTH FROM THE CRANIaLCENTRE
On the Ba-Na line, where the posterior periphery of the Pterion meets the Ba-Na line, is the Cranial Centre.
GROWTH FROM THE CRANIaLCENTRE
On the Ba-Na line, where the posterior periphery of the Pterion meets the Ba-Na line, is the Cranial Centre. 2,5 mm growth per year takes place between age 5 and 18 directly away from CC in the direction of the Mentum and approximately 1,3 mm per year in the Maxilla in the direction
Lateral Cephalograph - (Longitudinal and Vertical)
MANDIBULAR GROWTH
Xi = The mandibular center situated at the Inferior Alveolar Foramen. The mandibula grows radiant from this point and in the same ratio as the cranium.
Lateral Cephalograph - (Longitudinal and Vertical)
(A) NAM = 175-180 degrees
(A) NAM = 175-180 degrees (B) MXI = 115 degrees
(A) NAM = 175-180 degrees (B) MXI = 115 degrees (C) NBM = 60
(A) NAM = 175-180 degrees (B) MXI = 115 degrees (C) NBM = 60 (1) BNA = 63
(A) NAM = 175-180 degrees (B) MXI = 115 degrees (C) NBM = 60 (1) BNA = 63
(A) NAM = 175-180 degrees (B) MXI = 115 degrees (C) NBM = 60 (1) BNA = 63 (2) BCCM = 90-100 (Age dependent)
A lateral Ceph tracing ONLY reveals 2 dimensions of growth . LONGITUDINAL- AND VERTICAL (In other words the Saggital Plane)
Always focus on correcting the Dental Occlusion especially during phase 1 treatment
z z
Z-Z Line
Z-Z Line T-T Line
z z t t
Z-Z Line T-T Line G-G Line
z z t t g g
T-T/Z-Z = 0,5 T-T/G-G= 0,75
z z t t g g
z z t t g g
ZZG = 33 deg IDEAL
z z t t g g
ZZG = <33 deg (30) BRACHIOFACIAL
z z t t g
ZZG = >33 deg (37) DOLIGOFACIAL
g
z z t t g
FACIAL GROWTH DYNAMICS
AP - ANALYSIS
N M
Z-Z Line T-T Line G-G Line T-T/Z-Z = 0.5 TT/G-G= 0,75 SYMMETRY (N-M) N-M LINE - CROSS
g
Patient Transformation Lies In Your Hands. End of Module 1