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Int Poster J Dent Oral Med 3 (2001), No. 3     15. Sep. 2001

Int Poster J Dent Oral Med 2001, Vol 3 No 3, Poster 84

Is There Still A Need For Interceptive Orthodontics?

Language: English

Authors: Dr. Ulrike Grohmann, Prof. Dr. Dietmar Kubein-Meesenburg
Department of Orthodontics, Georg-August-University, Göttingen, Germany

Date/Event/Venue: 
23.- 26. June 1999
75 th Congress of the European Orthodontic Society
Straßbourg, France


Abstract

Interceptive treatment carried out with removable appliances at the correct time may save the patient from a more complicated treatment at later stage.
Early orthodontic treatment will not resolve all potential orthodontic problems or totally inhibit adverse skeletal growth patterns. However, by identifying problems at an early stage it is possible to redirect skeletal growth, improve the occlusal relationship, enhance the patient's esthetics and self-image and, perhaps of even greater importance, achieve results that are unattainable later with the eruption of the teeth and the cessation of growth.


Introduction

To reduce orthodontic treatment procedure in the late childhood it is sometimes necessary to treat dental malocclusions in early childhood. Therefore interceptive orthodontic treatment with removable appliances has proved its success in special indicated cases such as an unilateral buccal crossbite with displacement of the mandible, skeletal Class III relationship with anterior crossbite and the serial extraction therapy. We want to share our experiences and we present three representative cases of interceptive orthodontic treatment in early childhood.


CASE 1

Diagnosis

7 year old girl with an anterior crossbite of the teeth 11/41, Class I malocclusion and a mild skeletal Class III pattern.

Therapy

The patient was treated with a Fränkel III regulator. After 3 months the anterior crossbite was corrected. The appliance was used as a retainer for 18 months until all front teeth showed a correct overbite. The overjet and the overbite were successfully improved. No other retention was needed.

The lateral cephalometric film shows the anterior crossbite at the beginning of treatment


The anterior crossbite of the teeth 11/41
 
  The Fränkel III regulator


After treatment the cephalometric radiograph. The anterior crossbite is corrected The overjet and overbite are regular


CASE 2

Diagnosis

5 ½ year old boy suffered of a laterognathia due to an unknown collum dysplasia of the right condyle with a shift of the mandible to the left, a midline discrepancy and a tilt occlussal plane to the left. The mobility of the mandible was normally.

Therapy

An avtivator was inserted for 12 months. A constructive bite was taken, bringing the jaw to the midline. The appliance was used to guide the eruption of the first molars while different growth at the condyles corrects the asymmetry.
The occlusal plane was leveled and the mandibular displacement was improved. Additionly an appliance with posterior bite blocks for the vertikal dimension was inserted for further 6 months.

The Enface photo shows the laterognathia to the right The Enface photo shows the improved laterognathia


The X-Ray demonstrates the laterognathia to the right The X-Ray demonstrates the improved laterognathia




The orthopantomogramm shows the collum dysplasia at the right


The orthopantomogramm after 3 years
The activator The removable appliance with the posterior bite blocks


The lower central line is displaced to the right The midlines of the arches coincide


CASE 3

Diagnosis

5 ½ year old girl with an unilateral buccal crossbite with mandibular displacement to the left, a reduced width of the maxilla and a mild Class III pattern.

Therapy

We inserted a removable appliance with a midline screw and posterior bite blocks. The maxillary arch was expanded bilaterally for 2,5 mm. The mandible displacement was improved and the occlusion was stable after 5 months.
The bite blocks were removed. The appliance was used as a retainer for further 6 months.





The lateral displacement of the mandible The unilateral crossbite left and the midline discrepancy


The removable appliance with an expansion screw and a lateral bite plane


Inraoral view of the maxillary expansion appliance
After expansion the lateral displacement is improved After treatment the midlines of the arches coincide and the lateral crossbite is corrected


Conclusion

Early therapy by using removable appliances can reduce dental and skeletal malocclusions in the late childhood. Therefore we recommend the interceptive orthodontic therapy as a short and temporary limited intervention and we think that there is still a need for interceptive treatment.


Bibliography

  • Korbmacher H., Kahl-Nieke B., Schnabel S: Early orthodontic treatment of Class-III malocclusion in Germany. J Orofac Orthop 2000, 61, S. 168-174
  • Linder-Aronson S.: Early interceptive treatment of asymmetry. Proceedings of the Finnish Dental Society 1991, 87, S.159-166
  • Major PW., Glover K: Treatment of anterior cross-bites in the early mixed dentition. Journal / Canadian Dental Association. 1992, 58, S. 574-575, 578-579
  • Melson B: Removable orthodontic appliances. Dental Clinics of North America. 1981, 25, S. 157-176
    Richter M: Prophylaxe und Frühbehandlung. In: Diedrich P (eds.): Kieferorthopädie II (Bd. 11/II, "Praxis der Zahnheilkunde"). 4.Aufl., Urban & Fischer, 2000, S. 110-116
  • Thilander B., Wahlund S., Lennartsson B: The effect of early interceptive treatment in children with posterior crossbite. European Journal of Orthodontics, 1984, 6, S.25-34


This Poster was submitted by Dr. Ulrike Grohmann.

Correspondence address:
Dr. Ulrike Grohmann
Georg-August-Universität Göttingen
Zentrum Zahn-, Mund- und Kieferheilkunde
Abteilung Kieferorthopädie
Robert-Koch-Str. 40
37075 Göttingen
Germany