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This presentation will discuss the findings of a series of prospective and retrospective clinical studies of orthodontic and orthopedics intervention in the early mixed dentition. Guidelines will be presented as to which patients will benefit from treatment with a bonded rapid maxillary expander, preceded in some instances by a removable lower Schwarz expansion appliance. Other patients, especially those with large tooth size, will benefit from a serial extraction protocol. In managing tooth-size/arch-size discrepancies in the mixed dentition, common sense must prevail.
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This lecture will discuss a bit of the history of the extraction/nonextraction controversy, which will focus on extraction of deciduous and then permanent teeth in the mixed dentition. The case reports used to illustrate this lecture have significant tooth arch length discrepancies that required the removal of dental units in order for the patient to have an esthetic, healthy, functional and stable dentition.
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The decision to treat with or without extractions is a treatment decision that should be based on specific, evidence-based facial, skeletal and dental treatment objectives. This lecture will explore two critical components of specific treatment objectives, facial esthetics and stability, and how the decision to extract or not impacts both.
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Class III malocclusion is characterized by a malrelationship of the maxilla and mandible, with maxillary hypoplasia being the most common characteristic. Facemask/ palatal expansion therapy has become the most common and predictable approach to early correction, which occurs by a combination of skeletal and dental movements. The amount of skeletal vs dental movement is due to many factors such as the expansion protocol, protraction force levels, hours of wear per day, overall treatment time, appliance design, retention protocol, and individual variation. Because of the skeletal etiology of Class III malocclusion, treatment focused on improving skeletal relations would seem to be most prudent with camouflage therapies limited/held for those cases with limited to no growth remaining, needing dental movements to obtain a final acceptable result.
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Class III problems with intermediate severity can be effectively managed with a camouflage treatment approach that improves the occlusion but does not change the underlying skeletal imbalance. This presentation will describe the case characteristics of Class III patients that will most likely benefit from a camouflage approach. In addition, this presentation will illustrate patient management strategies that are useful when treating growing patients with a “camouflage treatment plan” so that risks are minimized and parent and patient expectations are achieved.
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The observation recall system is often unrated as a future source of new practice. Charlene has helped many practices increase their practice productivity by evaluating the recall system in the practice.
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A practice’s core marketing plan is most often rooted in accomplishing three primary objectives: increasing new patient calls, improving case acceptance rates, and differentiating the practice to yield “top of mind awareness.” The strategic creation and deployment of multimedia can not only meet these three goals, but also accomplish such with minimal management overhead and oversight. And what’s more, multimedia can propagate its own return on investment, yielding better returns month after month.
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One of the most heated controversies in orthodontics concerns the role of early treatment for the correction of Class II malocclusion. These concerns have been based primarily on the interpretation of the outcomes of the randomized clinical trials (RCT) conducted at three leading universities. Although these studies must be considered milestones in orthodontic research, the results might not be relevant to the “real” world of orthodontic practice. This presentation will describe the clinical outcomes of orthodontic intervention of retrospectively collected random samples from the three private practices where the comprehensive early treatment modality is routinely delivered by the advocates of mixed dentition treatment. The discussion will focus on the effectiveness of early comprehensive treatment of patients with moderately severe Class II malocclusions when compared to the changes observed in untreated Class II and late single-phase Class II treatment samples. Other benefits and limitation will be discussed.
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Is functional jaw orthopedics (FJO) able to increase mandibular length in Class II patients? What is the best timing to start FJO? What are the factors that influence the outcomes of FJO, and who are the best candidates for this type of therapy? These and other key questions pertaining to FJO will be addressed. In particular, the issue of early vs late treatment of Class II malocclusion associated with mandibular retrusion will be illustrated by means of a systematic review and meta-analysis of the literature.
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This presentation will review the relevant prospective trials and retrospective studies that have provided information on the efficiency and effectiveness of treatment for class II malocclusion. Emphasis will be on the strength of the evidence available for early intervention versus intervention in the late-mixed/early permanent dentition.