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Early Treatment of Dento-Skeletal Class II Malocclusion: If, When, Why and How
May 5, 2018 1:15pm ‐ May 5, 2018 2:00pm
Dento-skeletal Class II malocclusions in growing children remain one of the most challenging problems in orthodontics. The most frequent are due to by mandibular retrognathism. Thus, a treatment for stimulating mandibular growth by functional appliances is often indicated. However, this early treatment is a widely discussed in the literature mainly due to the uncertainly of stable long term results. This clinical presentation will focus on the Function Regulator (FR-2), proposed in the 1960s by Fränkel to correct the function of the circumoral musculature. The efficacy and benefits of FR-2 treatment in developing Class II malocclusion will be analyzed and the importance of the ideal timing will be discussed. Moreover the long-term stability of the FR-2 treatment and the importance of the differential diagnosis in the treatment for dento-skeletal class II patients will also be discussed.
Learning Objectives:
- Recognize the benefits of early treatment in correcting dento-skeletal Class II malocclusions.
- Determine optimal timing for orthodontic treatment of dento-skeletal Class II malocclusions.
- Evaluate the major short- and long- term outcomes related to the Frankel II appliance treatment.
Speaker(s):
- Letizia Perillo, MD, MS, PhD
How Can the Orthodontist Help the TMD Patient
May 5, 2018 1:15pm ‐ May 5, 2018 2:00pm
Patients are often referred to the orthodontist for the management of TMD. Is this a reasonable referral or a naïve approach? As an orthodontist, do you encourage these referrals or dread them? This presentation will discuss when should orthodontic therapy be considered for the TMD patient and when should it be avoided. Nothing is more discouraging to the patient, and the orthodontist, than to finish the case and have the patient report, “but it still hurt”. This presentation will discuss issues that will help reduce these unfavorable results.
Learning Objectives:
- List three important questions that should be asked before orthodontic therapy is considered.
- Describe the most critical examination finding that would influence your selection of orthodontic therapy for a TMD patient.
- Describe the orthodontic treatment goals that would be appropriate for the TMD patient.
Speaker(s):
- Jeffrey P. Okeson, DMD
Acquired Open Bite Closed by using TADs: Treatment Outcome and Stability
May 5, 2018 2:05pm ‐ May 5, 2018 2:50pm
One of the unprecedented effects of using temporary anchorage devices (TADs) is to intrude posterior teeth and then to close the open bite. Posterior intrusion often decreases mandibular plane angle which leads to better chin projections in Class II malocclusion. For patients with degenerative temporomandibular joints, orthodontic treatment can benefit them for better chewing function after their joints have been stabilized . Treatment mechanics and outcome of conservative orthodontic treatment using TADs will be presented. Stability of using TADs or surgical orthodontics for closing these acquired open bites will be discussed.
Learning Objectives:
- Evaluate appropriate timing for treating these acquired open bites.
- Adopt this treatment modality using TADs and apply appropriate mechanics to treat acquired open bite.
- Address the stability issue to patients before treatment starts.
Speaker(s):
- Chung-Chen J. Yao, DDS, Cert.Orth., PhD
Treatment of Class II Malocclusion with Contemporary Fixed Functional Appliances
May 5, 2018 2:05pm ‐ May 5, 2018 2:50pm
This presentation will address the indications and timing for orthopedic treatment of Class II malocclusions. The age factor, growth pattern, and the severity of the malocclusion affect the treatment outcome when using a fixed functional appliance. Long-term treatment records will be presented to illustrate the stability after early orthopedic treatment.
Learning Objectives:
- Recognize the importance of indications and timing for Class II orthopedic treatment.
- Determine how the age factor, growth pattern and the severity of the malocclusion can affect the treatment outcome when using a fixed functional appliance.
- Identify the factors that affect the stability of early Class II orthopedic treatment.
Speaker(s):
- Dr. Peter Ngan, DMD
New Horizons in Orthodontics
May 5, 2018 2:05pm ‐ May 5, 2018 2:50pm
Preformed Clark Twin Blocks: A new design and protocol for fixed or removable Twin Blocks improves patient comfort and compliance and can be integrated with fixed appliances. Preformed lingual wires link the occlusal blocks with minimal interference to speech and comfort and this simplifies construction and management of Twin Blocks. TransForce Lingual Appliances represent a revolution in interceptive orthodontics in all classes of malocclusion from mixed dentition to adult therapy and may be combined with fixed appliances or clear aligners. Transverse and sagittal appliances are pre-activated with enclosed nickel titanium springs to achieve amazing changes in arch form using ‘patient friendly’ invisible lingual appliances.
Learning Objectives:
- Simplify treatment of Class II malocclusion using preformed removable or fixed Twin Blocks.
- Transform your interceptive treatment using aesthetic, comfortable and efficient appliances to deliver light physiological forces.
- Integrate fixed and functional therapy and enhance treatment objectives with invisible appliances.
Speaker(s):
- Dr. William J. Clark, BDS, DDO, DDSc, FDSRCS (Eng)
Emerging Applications of CBCT in Orthodontic Diagnosis and Treatment Planning
May 5, 2018 2:05pm ‐ May 5, 2018 2:50pm
The continued evolution of CBCT imaging technology including its reduced radiation dose combined with scientific evidence for its broader applications is readily expanding its utility in orthodontics. Besides the enhanced information from CBCT for the traditionally well-understood sagittal and vertical dimensions, and for impacted teeth, it is proving to be a useful tool in the differential diagnosis of skeletal and dental transverse discrepancies, asymmetries, and dentoalveolar boundary conditions. Additionally, recent studies are enhancing our understanding on the limits of adaptability of bone to orthodontic tooth movement. Finally, CBCT imaging is proving to be a valuable tool in the integration of precision and virtual treatment planning in the orthodontic practice. Dr. Kapila will provide an evidence-based update on these emerging applications of CBCT imaging to everyday orthodontic diagnosis and treatment planning.
Learning Objectives:
- Evaluate the evidence for emerging uses of CBCT in orthodontic therapy.
- Recognize how to extract information from CBCT imaging in evolving areas of its uses for personalized orthodontic treatment.
- Comprehend the use of CBCT imaging for virtual treatment and biomechanical planning in orthodontics.
Speaker(s):
- Dr. Sunil Kapila, DDS, MS, PhD
Disc Displacement in TMJ and Mandibular Growth
May 5, 2018 2:05pm ‐ May 5, 2018 2:50pm
Advanced disc displacement (DD) is often observed on the shorter side of the mandible in skeletal asymmetry cases. Over time, more information on the influence of DD on mandibular growth has been accumulated. Advancement in imaging techniques, such as MRI and CBCT allows us to evaluate the TMJ status objectively. Since DD is prevalent in adolescent pre-orthodontic patients, we, as orthodontists, need to equip ourselves with the knowledge to treat these patients successfully. In this presentation, I will discuss how to handle DD patients orthodontically using three sisters’ cases, where two of them are suffering from advanced DD and the youngest sister does not have DD.
Learning Objectives:
- Evaluate the joint problems from MRI and CBCT images.
- Recognize the progression of DD and the difference in mandibular growth between normal TMJ and joints with advanced DD.
- Evaluate treatment mechanics that are catered toward specific joint status.
Speaker(s):
- Dr. Kazumi Ikeda, DDS
Mandibular Positional Control with Mini-screw Implant Usage
May 5, 2018 2:55pm ‐ May 5, 2018 3:40pm
Average mandibular growth in normal subjects who did not require any orthodontic treatment during the phases of growth and development follows a forward and upward rotational pattern. Class II malocclusions on the other hand often portrays vertical characteristics with retrognathic chin positions. Treatment objectives for such malocclusions include correction of the jaw relationships, establishment of a harmonious soft tissue profile and mimicking of the normal forward and upward mandibular rotation. This type of change requires meticulous management of posterior tooth eruption/extrusion, especially the maxillary molars. It is essential to provide adequate anchorage to these teeth in pursuit of the noted treatment goals. Contemporary mini-screw implants fulfill this role superbly. The objective of this presentation is to illustrate how through translation research these clinical objectives can be attained.
Learning Objectives:
- Define the malocclusion which will benefit from this contemporary anchorage approach.
- Demonstrate the use of mini-screw implant anchorage to attain a harmonious chin position.
- Evaluate the correction of a retrognathic chin position.
Speaker(s):
- P. Emile Rossouw, BSc, BChD(Dent), BChD-Hons (Child Dent), MChD(Ortho), PhD, FRCD(C)
Treating Dentofacial Asymmetries with Orthodontics Only: Where are the Limits?
May 5, 2018 2:55pm ‐ May 5, 2018 3:40pm
Asymmetries can be dental, functional or skeletal in nature, hence requiring different treatment approaches. While dental asymmetries can be corrected by pure orthodontic means, skeletal asymmetries may require an additional surgical approach, especially in patients aiming at an optimum treatment result. As functional asymmetries are often caused by either posterior crossbites (with or without Class III features) or by deficient unilateral mandibular growth (Class II subdivision), which can lead to subsequent skeletal manifestations, an early correction is highly recommended. The author will show clinical patients to illustrate the different treatment approaches with emphasis on treatment approaches in the deciduous or early mixed dentition.
Learning Objectives:
- Recognize the three different asymmetry classes.
- Propose the correct treatment approach for the different asymmetry types.
- Comprehend the importance of early corrections of functional asymmetries with simple mechanics.
Speaker(s):
- Dr. Ute Schneider-Moser, DDS, MS
Definitive Orthodontic Treatment for Patients with TMD
May 5, 2018 2:55pm ‐ May 5, 2018 3:40pm
The Temporomandibular Joint problems is a severe physiological disease which affects and deteriorates the quality of life of many people and has been increasing among our patients due to the stressing social and work changes. During more than half a century there has been many controversy among general dentists, prosthodontists, orthognathic surgeons and orthodontists on how to diagnose and treat TMD.
Learning Objectives:
- Identify evidence based “definite and non invasive therapy” with orthodontic treatment has been performed for the last 18 years.
- Recognize a definitive solution to the patients that suffer this severe disease.
- Identify regenerative tissue therapy, as well as an Orthodontic Treatment along with Biomechanics therapy by opening the vertical dimension using a functional splint as reference to extrude the dentition and recapture the disc, which normally is anteriorly displaced.
Speaker(s):
- Dr. Mauricio González Balut, DDS, MS