Teledentistry and Its Impact on Patient Convenience

Teledentistry and Its Impact on Patient Convenience

* The interplay between orthodontic forces and periodontal tissues in young patients.

Okay, let's talk about why getting braces for your kid used to be such a hassle, and then how teledentistry is making it easier.


For years, getting orthodontic treatment for children felt like a logistical puzzle. Think about it: you're already juggling school, extracurriculars, and just generally keeping your sanity. A child's bite can be improved with timely orthodontic intervention Youth orthodontic correction disease. Then you add in regular orthodontist appointments, often during school hours. That meant missed classes, rushed lunches, and the whole family scrambling. Travel was another big hurdle. Depending on where you lived, the nearest orthodontist specializing in children might be a significant drive away. Time off work, gas money, and the sheer exhaustion of the commute all added up.


And let's not forget about the kids themselves. Many children experience anxiety about dental or orthodontic procedures. The unfamiliar environment, the sounds of the equipment, the feeling of someone working in their mouth – it can all be quite overwhelming. This anxiety could make appointments difficult, and even impact the overall effectiveness of the treatment. Traditional orthodontic care, while essential for many kids, often presented a significant burden on families. The demands of scheduling, travel, and managing a child's anxiety created a real challenge to accessing necessary treatment.

Okay, let's talk about teledentistry and how it's making life easier for people wanting straighter teeth, specifically when it comes to orthodontic consultations and keeping an eye on progress.


Think about the traditional route. You suspect you need braces or aligners. First, you've got to find an orthodontist, which might involve asking friends, scouring the internet, and reading reviews. Then comes scheduling that initial consultation. Juggling work, school, family commitments, and then finding a time that works for both you and the orthodontist's office can feel like a logistical nightmare. Finally, you actually have to get to the appointment, which might mean battling traffic or taking time off work. And if you decide to move forward with treatment, get ready for regular follow-up appointments, often during business hours.


Now, here's where teledentistry steps in to make things smoother. Instead of that initial in-person consultation, many orthodontists now offer virtual ones. You might send in some photos of your teeth, answer a questionnaire online, or even have a live video call with the orthodontist. This saves you time and travel. You can do it from the comfort of your own home, during your lunch break, or whenever it fits into your schedule. It's particularly helpful for people in rural areas with limited access to specialists, or for those with busy lives who struggle to find time for appointments.


But it doesn't stop there. Teledentistry also makes monitoring your treatment progress easier. Instead of trekking to the office every few weeks, you might submit photos or videos of your teeth using a smartphone app. The orthodontist can then review these remotely and provide feedback and adjustments to your treatment plan. This reduces the frequency of in-person visits, saving you even more time and hassle. It also allows for quicker identification of any potential issues, meaning they can be addressed promptly, potentially preventing more serious problems down the line.


Essentially, teledentistry helps democratize access to orthodontic care and makes the whole process much more manageable for the patient. It's about leveraging technology to fit orthodontic treatment into your life, rather than the other way around.

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* Preventive measures to maintain periodontal health during orthodontic treatment.

Teledentistry is changing the game when it comes to patient convenience, and a big part of that change is remote monitoring. Think about it: traditionally, you'd have to carve out time for regular office visits, even if it was just a quick check-up. But with teledentistry, that's not always necessary.


A major perk is the reduction in actual trips to the dentist's office. We're talking about saving time, gas money, and the hassle of rearranging your schedule. Instead of physically being there for every little adjustment or check-in, your dentist can monitor your progress remotely. This is especially beneficial for things like orthodontic treatment. Imagine getting your aligners adjusted virtually, based on photos and videos you send in, rather than having to rush to the office.


And it's not just about fewer appointments; it's about faster treatment adjustments too. If your dentist spots an issue during a remote check-up, they can often provide guidance or make necessary tweaks more quickly than if they had to wait for your next scheduled appointment. This can lead to more efficient treatment and potentially better outcomes in the long run. It all adds up to a more convenient and ultimately, a more patient-friendly experience.

* The role of oral hygiene instructions for children and parental involvement.

Okay, so teledentistry is making waves, right? Especially when we talk about how convenient it is for patients. And you know who could really benefit from that convenience? Kids needing braces! Pediatric orthodontics is seeing a huge surge in teledentistry applications, and it's pretty cool what they're doing.


Think about it: getting to the orthodontist can be tough. School schedules, after-school activities, parents' work – it all adds up. That's where virtual consultations come in. Instead of trekking to the office for that initial "should we even consider braces?" appointment, families can now often do it from their living room. They send in some photos, maybe even a short video, and the orthodontist can give them a preliminary assessment. It saves time, gas, and a whole lot of hassle.


But it's not just about the initial consultations. Remote monitoring is another big deal. Imagine a smartphone app that lets you track your kid's progress with their aligners or braces. Some apps even have features where you can take pictures of your kid's teeth, and the orthodontist can review them remotely, checking for things like proper aligner fit or any potential problems. This means fewer in-office visits for routine checks, which is a win for everyone. It's like having a virtual orthodontist in your pocket, keeping an eye on things and intervening only when necessary.


Ultimately, these teledentistry applications in pediatric orthodontics are making orthodontic care more accessible and convenient for families. It frees up time, reduces the stress of appointments, and can even lead to earlier intervention, potentially resulting in better outcomes. It's a really exciting development that's making a real difference in how kids get the orthodontic care they need.

* Early detection and management of periodontal problems during orthodontic care.

Teledentistry, while streamlining many aspects of orthodontic care, has a particularly interesting impact on parental involvement. On one hand, it can genuinely enhance it. Imagine a busy parent, juggling work and family, now able to participate in virtual consultations. Instead of missing work for every appointment, they can join a quick video call to discuss progress and address concerns with the orthodontist, right from their office or home. This accessibility fosters a sense of being more connected and informed about their child's treatment.


However, there's also a potential for a slight disconnect. Traditional in-person appointments often involve a deeper level of interaction – a casual chat with the orthodontist about the child's oral hygiene habits, a physical demonstration of how to use elastics, or a more immediate, tangible sense of the child's comfort level during treatment. While teledentistry uses technology to bridge geographical gaps, it might inadvertently create a subtle emotional distance. It requires a conscious effort from both the orthodontist and the parent to maintain that important personal connection and ensure the child feels fully supported throughout the process. In essence, teledentistry offers a powerful tool for parental engagement, but its true value lies in how thoughtfully it's integrated into the overall treatment plan, always prioritizing the child's wellbeing and the parent-child-orthodontist relationship.

* Collaboration between orthodontists and periodontists for optimal outcomes.

Teledentistry offers a tempting shortcut to convenience, particularly for busy families navigating pediatric orthodontics. But before we fully embrace virtual smiles, we need to acknowledge the potential potholes on this digital road. One significant limitation is the "touch and feel" aspect. Orthodontics often requires a skilled clinician to physically assess a child's bite, jaw alignment, and tooth movement. While intraoral scanners and remote monitoring can provide valuable data, they may not fully replicate the comprehensive examination possible in a traditional office setting. This is especially crucial for younger patients who may struggle to articulate subtle discomfort or changes.


Ethical considerations also come into play. Ensuring patient privacy and data security is paramount, particularly with sensitive health information belonging to minors. We need robust safeguards to prevent unauthorized access and misuse of images and records transmitted electronically. Furthermore, the potential for misdiagnosis or delayed treatment due to reliance on remote assessments is a real concern. What happens if a subtle but critical issue is missed during a virtual consultation? Clear protocols and training are needed to minimize these risks.


Finally, accessibility must be considered. While teledentistry can bridge geographical gaps, it also risks widening the digital divide. Not all families have reliable internet access or the necessary technology to participate effectively. We need to ensure that teledentistry solutions don't inadvertently exclude vulnerable populations and that traditional in-person care remains readily available. The convenience of teledentistry is undeniable, but it shouldn't come at the expense of quality care, ethical practice, or equitable access for all children.

Orthodontics
Connecting the arch-wire on brackets with wire
Occupation
Names Orthodontist
Occupation type
Specialty
Activity sectors
Dentistry
Description
Education required
Dental degree, specialty training
Fields of
employment
Private practices, hospitals

Orthodontics[a][b] is a dentistry specialty that addresses the diagnosis, prevention, management, and correction of mal-positioned teeth and jaws, as well as misaligned bite patterns.[2] It may also address the modification of facial growth, known as dentofacial orthopedics.

Abnormal alignment of the teeth and jaws is very common. The approximate worldwide prevalence of malocclusion was as high as 56%.[3] However, conclusive scientific evidence for the health benefits of orthodontic treatment is lacking, although patients with completed treatment have reported a higher quality of life than that of untreated patients undergoing orthodontic treatment.[4][5] The main reason for the prevalence of these malocclusions is diets with less fresh fruit and vegetables and overall softer foods in childhood, causing smaller jaws with less room for the teeth to erupt.[6] Treatment may require several months to a few years and entails using dental braces and other appliances to gradually adjust tooth position and jaw alignment. In cases where the malocclusion is severe, jaw surgery may be incorporated into the treatment plan. Treatment usually begins before a person reaches adulthood, insofar as pre-adult bones may be adjusted more easily before adulthood.

History

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Though it was rare until the Industrial Revolution,[7] there is evidence of the issue of overcrowded, irregular, and protruding teeth afflicting individuals. Evidence from Greek and Etruscan materials suggests that attempts to treat this disorder date back to 1000 BC, showcasing primitive yet impressively well-crafted orthodontic appliances. In the 18th and 19th centuries, a range of devices for the "regulation" of teeth were described by various dentistry authors who occasionally put them into practice.[8] As a modern science, orthodontics dates back to the mid-1800s.[9] The field's influential contributors include Norman William Kingsley[9] (1829–1913) and Edward Angle[10] (1855–1930). Angle created the first basic system for classifying malocclusions, a system that remains in use today.[9]

Beginning in the mid-1800s, Norman Kingsley published Oral Deformities, which is now credited as one of the first works to begin systematically documenting orthodontics. Being a major presence in American dentistry during the latter half of the 19th century, not only was Kingsley one of the early users of extraoral force to correct protruding teeth, but he was also one of the pioneers for treating cleft palates and associated issues. During the era of orthodontics under Kingsley and his colleagues, the treatment was focused on straightening teeth and creating facial harmony. Ignoring occlusal relationships, it was typical to remove teeth for a variety of dental issues, such as malalignment or overcrowding. The concept of an intact dentition was not widely appreciated in those days, making bite correlations seem irrelevant.[8]

In the late 1800s, the concept of occlusion was essential for creating reliable prosthetic replacement teeth. This idea was further refined and ultimately applied in various ways when dealing with healthy dental structures as well. As these concepts of prosthetic occlusion progressed, it became an invaluable tool for dentistry.[8]

It was in 1890 that the work and impact of Dr. Edwards H. Angle began to be felt, with his contribution to modern orthodontics particularly noteworthy. Initially focused on prosthodontics, he taught in Pennsylvania and Minnesota before directing his attention towards dental occlusion and the treatments needed to maintain it as a normal condition, thus becoming known as the "father of modern orthodontics".[8]

By the beginning of the 20th century, orthodontics had become more than just the straightening of crooked teeth. The concept of ideal occlusion, as postulated by Angle and incorporated into a classification system, enabled a shift towards treating malocclusion, which is any deviation from normal occlusion.[8] Having a full set of teeth on both arches was highly sought after in orthodontic treatment due to the need for exact relationships between them. Extraction as an orthodontic procedure was heavily opposed by Angle and those who followed him. As occlusion became the key priority, facial proportions and aesthetics were neglected. To achieve ideal occlusals without using external forces, Angle postulated that having perfect occlusion was the best way to gain optimum facial aesthetics.[8]

With the passing of time, it became quite evident that even an exceptional occlusion was not suitable when considered from an aesthetic point of view. Not only were there issues related to aesthetics, but it usually proved impossible to keep a precise occlusal relationship achieved by forcing teeth together over extended durations with the use of robust elastics, something Angle and his students had previously suggested. Charles Tweed[11] in America and Raymond Begg[12] in Australia (who both studied under Angle) re-introduced dentistry extraction into orthodontics during the 1940s and 1950s so they could improve facial esthetics while also ensuring better stability concerning occlusal relationships.[13]

In the postwar period, cephalometric radiography[14] started to be used by orthodontists for measuring changes in tooth and jaw position caused by growth and treatment.[15] The x-rays showed that many Class II and III malocclusions were due to improper jaw relations as opposed to misaligned teeth. It became evident that orthodontic therapy could adjust mandibular development, leading to the formation of functional jaw orthopedics in Europe and extraoral force measures in the US. These days, both functional appliances and extraoral devices are applied around the globe with the aim of amending growth patterns and forms. Consequently, pursuing true, or at least improved, jaw relationships had become the main objective of treatment by the mid-20th century.[8]

At the beginning of the twentieth century, orthodontics was in need of an upgrade. The American Journal of Orthodontics was created for this purpose in 1915; before it, there were no scientific objectives to follow, nor any precise classification system and brackets that lacked features.[16]

Until the mid-1970s, braces were made by wrapping metal around each tooth.[9] With advancements in adhesives, it became possible to instead bond metal brackets to the teeth.[9]

In 1972, Lawrence F. Andrews gave an insightful definition of the ideal occlusion in permanent teeth. This has had meaningful effects on orthodontic treatments that are administered regularly,[16] and these are: 1. Correct interarchal relationships 2. Correct crown angulation (tip) 3. Correct crown inclination (torque) 4. No rotations 5. Tight contact points 6. Flat Curve of Spee (0.0–2.5 mm),[17] and based on these principles, he discovered a treatment system called the straight-wire appliance system, or the pre-adjusted edgewise system. Introduced in 1976, Larry Andrews' pre-adjusted edgewise appliance, more commonly known as the straight wire appliance, has since revolutionized fixed orthodontic treatment. The advantage of the design lies in its bracket and archwire combination, which requires only minimal wire bending from the orthodontist or clinician. It's aptly named after this feature: the angle of the slot and thickness of the bracket base ultimately determine where each tooth is situated with little need for extra manipulation.[18][19][20]

Prior to the invention of a straight wire appliance, orthodontists were utilizing a non-programmed standard edgewise fixed appliance system, or Begg's pin and tube system. Both of these systems employed identical brackets for each tooth and necessitated the bending of an archwire in three planes for locating teeth in their desired positions, with these bends dictating ultimate placements.[18]

Evolution of the current orthodontic appliances

[edit]

When it comes to orthodontic appliances, they are divided into two types: removable and fixed. Removable appliances can be taken on and off by the patient as required. On the other hand, fixed appliances cannot be taken off as they remain bonded to the teeth during treatment.

Fixed appliances

[edit]

Fixed orthodontic appliances are predominantly derived from the edgewise appliance approach, which typically begins with round wires before transitioning to rectangular archwires for improving tooth alignment. These rectangluar wires promote precision in the positioning of teeth following initial treatment. In contrast to the Begg appliance, which was based solely on round wires and auxiliary springs, the Tip-Edge system emerged in the early 21st century. This innovative technology allowed for the utilization of rectangular archwires to precisely control tooth movement during the finishing stages after initial treatment with round wires. Thus, almost all modern fixed appliances can be considered variations on this edgewise appliance system.

Early 20th-century orthodontist Edward Angle made a major contribution to the world of dentistry. He created four distinct appliance systems that have been used as the basis for many orthodontic treatments today, barring a few exceptions. They are E-arch, pin and tube, ribbon arch, and edgewise systems.

E-arch

[edit]

Edward H. Angle made a significant contribution to the dental field when he released the 7th edition of his book in 1907, which outlined his theories and detailed his technique. This approach was founded upon the iconic "E-Arch" or 'the-arch' shape as well as inter-maxillary elastics.[21] This device was different from any other appliance of its period as it featured a rigid framework to which teeth could be tied effectively in order to recreate an arch form that followed pre-defined dimensions.[22] Molars were fitted with braces, and a powerful labial archwire was positioned around the arch. The wire ended in a thread, and to move it forward, an adjustable nut was used, which allowed for an increase in circumference. By ligation, each individual tooth was attached to this expansive archwire.[8]

Pin and tube appliance

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Due to its limited range of motion, Angle was unable to achieve precise tooth positioning with an E-arch. In order to bypass this issue, he started using bands on other teeth combined with a vertical tube for each individual tooth. These tubes held a soldered pin, which could be repositioned at each appointment in order to move them in place.[8] Dubbed the "bone-growing appliance", this contraption was theorized to encourage healthier bone growth due to its potential for transferring force directly to the roots.[23] However, implementing it proved troublesome in reality.

Ribbon arch

[edit]

Realizing that the pin and tube appliance was not easy to control, Angle developed a better option, the ribbon arch, which was much simpler to use. Most of its components were already prepared by the manufacturer, so it was significantly easier to manage than before. In order to attach the ribbon arch, the occlusal area of the bracket was opened. Brackets were only added to eight incisors and mandibular canines, as it would be impossible to insert the arch into both horizontal molar tubes and the vertical brackets of adjacent premolars. This lack of understanding posed a considerable challenge to dental professionals; they were unable to make corrections to an excessive Spee curve in bicuspid teeth.[24] Despite the complexity of the situation, it was necessary for practitioners to find a resolution. Unparalleled to its counterparts, what made the ribbon arch instantly popular was that its archwire had remarkable spring qualities and could be utilized to accurately align teeth that were misaligned. However, a major drawback of this device was its inability to effectively control root position since it did not have enough resilience to generate the torque movements required for setting roots in their new place.[8]

Edgewise appliance

[edit]

In an effort to rectify the issues with the ribbon arch, Angle shifted the orientation of its slot from vertical, instead making it horizontal. In addition, he swapped out the wire and replaced it with a precious metal wire that was rotated by 90 degrees in relation—henceforth known as Edgewise.[25] Following extensive trials, it was concluded that dimensions of 22 × 28 mils were optimal for obtaining excellent control over crown and root positioning across all three planes of space.[26] After debuting in 1928, this appliance quickly became one of the mainstays for multibanded fixed therapy, although ribbon arches continued to be utilized for another decade or so beyond this point too.[8]

Labiolingual

[edit]

Prior to Angle, the idea of fitting attachments on individual teeth had not been thought of, and in his lifetime, his concern for precisely positioning each tooth was not highly appraised. In addition to using fingersprings for repositioning teeth with a range of removable devices, two main appliance systems were very popular in the early part of the 20th century. Labiolingual appliances use bands on the first molars joined with heavy lingual and labial archwires affixed with soldered fingersprings to shift single teeth.

Twin wire

[edit]

Utilizing bands around both incisors and molars, a twin-wire appliance was designed to provide alignment between these teeth. Constructed with two 10-mil steel archwires, its delicate features were safeguarded by lengthy tubes stretching from molars towards canines. Despite its efforts, it had limited capacity for movement without further modifications, rendering it obsolete in modern orthodontic practice.

Begg's Appliance

[edit]

Returning to Australia in the 1920s, the renowned orthodontist, Raymond Begg, applied his knowledge of ribbon arch appliances, which he had learned from the Angle School. On top of this, Begg recognized that extracting teeth was sometimes vital for successful outcomes and sought to modify the ribbon arch appliance to provide more control when dealing with root positioning. In the late 1930s, Begg developed his adaptation of the appliance, which took three forms. Firstly, a high-strength 16-mil round stainless steel wire replaced the original precious metal ribbon arch. Secondly, he kept the same ribbon arch bracket but inverted it so that it pointed toward the gums instead of away from them. Lastly, auxiliary springs were added to control root movement. This resulted in what would come to be known as the Begg Appliance. With this design, friction was decreased since contact between wire and bracket was minimal, and binding was minimized due to tipping and uprighting being used for anchorage control, which lessened contact angles between wires and corners of the bracket.

Tip-Edge System

[edit]

Begg's influence is still seen in modern appliances, such as Tip-Edge brackets. This type of bracket incorporates a rectangular slot cutaway on one side to allow for crown tipping with no incisal deflection of an archwire, allowing teeth to be tipped during space closure and then uprighted through auxiliary springs or even a rectangular wire for torque purposes in finishing. At the initial stages of treatment, small-diameter steel archwires should be used when working with Tip-Edge brackets.

Contemporary edgewise systems

[edit]

Throughout time, there has been a shift in which appliances are favored by dentists. In particular, during the 1960s, when it was introduced, the Begg appliance gained wide popularity due to its efficiency compared to edgewise appliances of that era; it could produce the same results with less investment on the dentist's part. Nevertheless, since then, there have been advances in technology and sophistication in edgewise appliances, which led to the opposite conclusion: nowadays, edgewise appliances are more efficient than the Begg appliance, thus explaining why it is commonly used.

Automatic rotational control

[edit]

At the beginning, Angle attached eyelets to the edges of archwires so that they could be held with ligatures and help manage rotations. Now, however, no extra ligature is needed due to either twin brackets or single brackets that have added wings touching underneath the wire (Lewis or Lang brackets). Both types of brackets simplify the process of obtaining moments that control movements along a particular plane of space.

Alteration in bracket slot dimensions

[edit]

In modern dentistry, two types of edgewise appliances exist: the 18- and 22-slot varieties. While these appliances are used differently, the introduction of a 20-slot device with more precise features has been considered but not pursued yet.[27]

Straight-wire bracket prescriptions

[edit]

Rather than rely on the same bracket for all teeth, L.F. Andrews found a way to make different brackets for each tooth in the 1980s, thanks to the increased convenience of bonding.[28] This adjustment enabled him to avoid having multiple bends in archwires that would have been needed to make up for variations in tooth anatomy. Ultimately, this led to what was termed a "straight-wire appliance" system – an edgewise appliance that greatly enhanced its efficiency.[29] The modern edgewise appliance has slightly different construction than the original one. Instead of relying on faciolingual bends to accommodate variations among teeth, each bracket has a correspondingly varying base thickness depending on the tooth it is intended for. However, due to individual differences between teeth, this does not completely eliminate the need for compensating bends.[30] Accurately placing the roots of many teeth requires angling brackets in relation to the long axis of the tooth. Traditionally, this mesiodistal root positioning necessitated using second-order, or tip, bends along the archwire. However, angling the bracket or bracket slot eliminates this need for bends.

Given the discrepancies in inclination of facial surfaces across individual teeth, placing a twist, otherwise known as third-order or torque bends, into segments of each rectangular archwire was initially required with the edgewise appliance. These bends were necessary for all patients and wires, not just to avoid any unintentional movement of suitably placed teeth or when moving roots facially or lingually. Angulation of either brackets or slots can minimize the need for second-order or tip bends on archwires. Contemporary edgewise appliances come with brackets designed to adjust for any facial inclinations, thereby eliminating or reducing any third-order bends. These brackets already have angulation and torque values built in so that each rectangluar archwire can be contorted to form a custom fit without inadvertently shifting any correctly positioned teeth. Without bracket angulation and torque, second-order or tip bends would still be required on each patient's archwire.

Methods

[edit]
Upper and lower jaw functional expanders

A typical treatment for incorrectly positioned teeth (malocclusion) takes from one to two years, with braces being adjusted every four to 10 weeks by orthodontists,[31] while university-trained dental specialists are versed in the prevention, diagnosis, and treatment of dental and facial irregularities. Orthodontists offer a wide range of treatment options to straighten crooked teeth, fix irregular bites, and align the jaws correctly.[32] There are many ways to adjust malocclusion. In growing patients, there are more options to treat skeletal discrepancies, either by promoting or restricting growth using functional appliances, orthodontic headgear, or a reverse pull facemask. Most orthodontic work begins in the early permanent dentition stage before skeletal growth is completed. If skeletal growth has completed, jaw surgery is an option. Sometimes teeth are extracted to aid the orthodontic treatment (teeth are extracted in about half of all the cases, most commonly the premolars).[33]

Orthodontic therapy may include the use of fixed or removable appliances. Most orthodontic therapy is delivered using appliances that are fixed in place,[34] for example, braces that are adhesively bonded to the teeth. Fixed appliances may provide greater mechanical control of the teeth; optimal treatment outcomes are improved by using fixed appliances.

Fixed appliances may be used, for example, to rotate teeth if they do not fit the arch shape of the other teeth in the mouth, to adjust multiple teeth to different places, to change the tooth angle of teeth, or to change the position of a tooth's root. This treatment course is not preferred where a patient has poor oral hygiene, as decalcification, tooth decay, or other complications may result. If a patient is unmotivated (insofar as treatment takes several months and requires commitment to oral hygiene), or if malocclusions are mild.

The biology of tooth movement and how advances in gene therapy and molecular biology technology may shape the future of orthodontic treatment.[35]

Braces

[edit]
Dental braces

Braces are usually placed on the front side of the teeth, but they may also be placed on the side facing the tongue (called lingual braces). Brackets made out of stainless steel or porcelain are bonded to the center of the teeth using an adhesive. Wires are placed in a slot in the brackets, which allows for controlled movement in all three dimensions.

Apart from wires, forces can be applied using elastic bands,[36] and springs may be used to push teeth apart or to close a gap. Several teeth may be tied together with ligatures, and different kinds of hooks can be placed to allow for connecting an elastic band.[37][36]

Clear aligners are an alternative to braces, but insufficient evidence exists to determine their effectiveness.[38]

Treatment duration

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The time required for braces varies from person to person as it depends on the severity of the problem, the amount of room available, the distance the teeth must travel, the health of the teeth, gums, and supporting bone, and how closely the patient follows instructions. On average, however, once the braces are put on, they usually remain in place for one to three years. After braces are removed, most patients will need to wear a retainer all the time for the first six months, then only during sleep for many years.[39]

Headgear

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Orthodontic headgear, sometimes referred to as an "extra-oral appliance", is a treatment approach that requires the patient to have a device strapped onto their head to help correct malocclusion—typically used when the teeth do not align properly. Headgear is most often used along with braces or other orthodontic appliances. While braces correct the position of teeth, orthodontic headgear—which, as the name suggests, is worn on or strapped onto the patient's head—is most often added to orthodontic treatment to help alter the alignment of the jaw, although there are some situations in which such an appliance can help move teeth, particularly molars.

Full orthodontic headgear with headcap, fitting straps, facebow, and elastics

Whatever the purpose, orthodontic headgear works by exerting tension on the braces via hooks, a facebow, coils, elastic bands, metal orthodontic bands, and other attachable appliances directly into the patient's mouth. It is most effective for children and teenagers because their jaws are still developing and can be easily manipulated. (If an adult is fitted with headgear, it is usually to help correct the position of teeth that have shifted after other teeth have been extracted.) Thus, headgear is typically used to treat a number of jaw alignment or bite problems, such as overbite and underbite.[40]

Palatal expansion

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Palatal expansion can be best achieved using a fixed tissue-borne appliance. Removable appliances can push teeth outward but are less effective at maxillary sutural expansion. The effects of a removable expander may look the same as they push teeth outward, but they should not be confused with actually expanding the palate. Proper palate expansion can create more space for teeth as well as improve both oral and nasal airflow.[41]

Jaw surgery

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Jaw surgery may be required to fix severe malocclusions.[42] The bone is broken during surgery and stabilized with titanium (or bioresorbable) plates and screws to allow for healing to take place.[43] After surgery, regular orthodontic treatment is used to move the teeth into their final position.[44]

During treatment

[edit]

To reduce pain during the orthodontic treatment, low-level laser therapy (LLLT), vibratory devices, chewing adjuncts, brainwave music, or cognitive behavioral therapy can be used. However, the supporting evidence is of low quality, and the results are inconclusive.[45]

Post treatment

[edit]

After orthodontic treatment has been completed, there is a tendency for teeth to return, or relapse, back to their pre-treatment positions. Over 50% of patients have some reversion to pre-treatment positions within 10 years following treatment.[46] To prevent relapse, the majority of patients will be offered a retainer once treatment has been completed and will benefit from wearing their retainers. Retainers can be either fixed or removable.

Removable retainers

[edit]

Removable retainers are made from clear plastic, and they are custom-fitted for the patient's mouth. It has a tight fit and holds all of the teeth in position. There are many types of brands for clear retainers, including Zendura Retainer, Essix Retainer, and Vivera Retainer.[47] A Hawley retainer is also a removable orthodontic appliance made from a combination of plastic and metal that is custom-molded to fit the patient's mouth. Removable retainers will be worn for different periods of time, depending on the patient's need to stabilize the dentition.[48]

Fixed retainers

[edit]

Fixed retainers are a simple wire fixed to the tongue-facing part of the incisors using dental adhesive and can be specifically useful to prevent rotation in incisors. Other types of fixed retainers can include labial or lingual braces, with brackets fixed to the teeth.[48]

Clear aligners

[edit]

Clear aligners are another form of orthodontics commonly used today, involving removable plastic trays. There has been controversy about the effectiveness of aligners such as Invisalign or Byte; some consider them to be faster and more freeing than the alternatives.[49]

Training

[edit]

There are several specialty areas in dentistry, but the specialty of orthodontics was the first to be recognized within dentistry.[50] Specifically, the American Dental Association recognized orthodontics as a specialty in the 1950s.[50] Each country has its own system for training and registering orthodontic specialists.

Australia

[edit]

In Australia, to obtain an accredited three-year full-time university degree in orthodontics, one will need to be a qualified dentist (complete an AHPRA-registered general dental degree) with a minimum of two years of clinical experience. There are several universities in Australia that offer orthodontic programs: the University of Adelaide, the University of Melbourne, the University of Sydney, the University of Queensland, the University of Western Australia, and the University of Otago.[51] Orthodontic courses are accredited by the Australian Dental Council and reviewed by the Australian Society of Orthodontists (ASO). Prospective applicants should obtain information from the relevant institution before applying for admission.[52] After completing a degree in orthodontics, specialists are required to be registered with the Australian Health Practitioner Regulation Agency (AHPRA) in order to practice.[53][54]

Bangladesh

[edit]

Dhaka Dental College in Bangladesh is one of the many schools recognized by the Bangladesh Medical and Dental Council (BM&DC) that offer post-graduation orthodontic courses.[55][56] Before applying to any post-graduation training courses, an applicant must have completed the Bachelor of Dental Surgery (BDS) examination from any dental college.[55] After application, the applicant must take an admissions test held by the specific college.[55] If successful, selected candidates undergo training for six months.[57]

Canada

[edit]

In Canada, obtaining a dental degree, such as a Doctor of Dental Surgery (DDS) or Doctor of Medical Dentistry (DMD), would be required before being accepted by a school for orthodontic training.[58] Currently, there are 10 schools in the country offering the orthodontic specialty.[58] Candidates should contact the individual school directly to obtain the most recent pre-requisites before entry.[58] The Canadian Dental Association expects orthodontists to complete at least two years of post-doctoral, specialty training in orthodontics in an accredited program after graduating from their dental degree.

United States

[edit]

Similar to Canada, there are several colleges and universities in the United States that offer orthodontic programs. Every school has a different enrollment process, but every applicant is required to have graduated with a DDS or DMD from an accredited dental school.[59][60] Entrance into an accredited orthodontics program is extremely competitive and begins by passing a national or state licensing exam.[61]

The program generally lasts for two to three years, and by the final year, graduates are required to complete the written American Board of Orthodontics (ABO) exam.[61] This exam is also broken down into two components: a written exam and a clinical exam.[61] The written exam is a comprehensive exam that tests for the applicant's knowledge of basic sciences and clinical concepts.[61] The clinical exam, however, consists of a Board Case Oral Examination (BCOE), a Case Report Examination (CRE), and a Case Report Oral Examination (CROE).[61] Once certified, certification must then be renewed every ten years.[61] Orthodontic programs can award a Master of Science degree, a Doctor of Science degree, or a Doctor of Philosophy degree, depending on the school and individual research requirements.[62]

United Kingdom

[edit]

Throughout the United Kingdom, there are several Orthodontic Specialty Training Registrar posts available.[63] The program is full-time for three years, and upon completion, trainees graduate with a degree at the Masters or Doctorate level.[63] Training may take place within hospital departments that are linked to recognized dental schools.[63] Obtaining a Certificate of Completion of Specialty Training (CCST) allows an orthodontic specialist to be registered under the General Dental Council (GDC).[63] An orthodontic specialist can provide care within a primary care setting, but to work at a hospital as an orthodontic consultant, higher-level training is further required as a post-CCST trainee.[63] To work within a university setting as an academic consultant, completing research toward obtaining a Ph.D. is also required.[63]

See also

[edit]
  • Orthodontic technology
  • Orthodontic indices
  • List of orthodontic functional appliances
  • Molar distalization
  • Mouth breathing
  • Obligate nasal breathing

Notes

[edit]
  1. ^ Also referred to as orthodontia
  2. ^ "Orthodontics" comes from the Greek orthos ('correct, straight') and -odont- ('tooth').[1]

References

[edit]
  1. ^ "Definition of orthodontics | Dictionary.com". www.dictionary.com. Retrieved 2019-08-28.
  2. ^ "What is orthodontics?// Useful Resources: FAQ and Downloadable eBooks". Orthodontics Australia. Retrieved 2020-08-13.
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  6. ^ von Cramon-Taubadel N (December 2011). "Global human mandibular variation reflects differences in agricultural and hunter-gatherer subsistence strategies". Proceedings of the National Academy of Sciences of the United States of America. 108 (49): 19546–19551. Bibcode:2011PNAS..10819546V. doi:10.1073/pnas.1113050108. PMC 3241821. PMID 22106280.
  7. ^ Rose, Jerome C.; Roblee, Richard D. (June 2009). "Origins of dental crowding and malocclusions: an anthropological perspective". Compendium of Continuing Education in Dentistry (Jamesburg, N.J.: 1995). 30 (5): 292–300. ISSN 1548-8578. PMID 19514263.
  8. ^ a b c d e f g h i j k Proffit WR, Fields Jr HW, Larson BE, Sarver DM (2019). Contemporary orthodontics (Sixth ed.). Philadelphia, PA. ISBN 978-0-323-54387-3. OCLC 1089435881.cite book: CS1 maint: location missing publisher (link)
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  11. ^ "The Application of the Principles of the Edge- wise Arch in the Treatment of Malocclusions: II.*". meridian.allenpress.com. Retrieved 2023-02-07.
  12. ^ "British Orthodontic Society > Museum and Archive > Collection > Fixed Appliances > Begg". www.bos.org.uk. Retrieved 2023-02-07.
  13. ^ Safirstein D (August 2015). "P. Raymond Begg". American Journal of Orthodontics and Dentofacial Orthopedics. 148 (2): 206. doi:10.1016/j.ajodo.2015.06.005. PMID 26232825.
  14. ^ Higley LB (August 1940). "Lateral head roentgenograms and their relation to the orthodontic problem". American Journal of Orthodontics and Oral Surgery. 26 (8): 768–778. doi:10.1016/S0096-6347(40)90331-3. ISSN 0096-6347.
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  17. ^ Andrews LF (September 1972). "The six keys to normal occlusion". American Journal of Orthodontics. 62 (3): 296–309. doi:10.1016/s0002-9416(72)90268-0. PMID 4505873. S2CID 8039883.
  18. ^ a b Themes UF (2015-01-01). "31 The straight wire appliance". Pocket Dentistry. Retrieved 2023-02-07.
  19. ^ Andrews LF (July 1979). "The straight-wire appliance". British Journal of Orthodontics. 6 (3): 125–143. doi:10.1179/bjo.6.3.125. PMID 297458. S2CID 33259729.
  20. ^ Phulari B (2013), "Andrews' Straight Wire Appliance", History of Orthodontics, Jaypee Brothers Medical Publishers (P) Ltd., p. 98, doi:10.5005/jp/books/12065_11, ISBN 9789350904718, retrieved 2023-02-07
  21. ^ Angle EH. Treatment of malocclusion of the teeth. 7th éd. Philadelphia: S.S.White Dental Mfg Cy, 1907
  22. ^ Philippe J (March 2008). "How, why, and when was the edgewise appliance born?". Journal of Dentofacial Anomalies and Orthodontics. 11 (1): 68–74. doi:10.1051/odfen/20084210113. ISSN 2110-5715.
  23. ^ Angle EH (1912). "Evolution of orthodontia. Recent developments". Dental Cosmos. 54: 853–867.
  24. ^ Brodie AG (1931). "A discussion on the Newest Angle Mechanism". The Angle Orthodontist. 1: 32–38.
  25. ^ Angle EH (1928). "The latest and best in Orthodontic Mechanism". Dental Cosmos. 70: 1143–1156.
  26. ^ Brodie AG (1956). "Orthodontic Concepts Prior to the Death of Edward Angle". The Angle Orthodontist. 26: 144–155.
  27. ^ Matasa CG, Graber TM (April 2000). "Angle, the innovator, mechanical genius, and clinician". American Journal of Orthodontics and Dentofacial Orthopedics. 117 (4): 444–452. doi:10.1016/S0889-5406(00)70164-8. PMID 10756270.
  28. ^ Andrews LF. Straight Wire: The Concept and Appliance. San Diego: LA Wells; 1989.
  29. ^ Andrews LF (1989). Straight wire: the concept and appliance. Lisa Schirmer. San Diego, CA. ISBN 978-0-9616256-0-3. OCLC 22808470.cite book: CS1 maint: location missing publisher (link)
  30. ^ Roth RH (November 1976). "Five year clinical evaluation of the Andrews straight-wire appliance". Journal of Clinical Orthodontics. 10 (11): 836–50. PMID 1069735.
  31. ^ Fleming PS, Fedorowicz Z, Johal A, El-Angbawi A, Pandis N, et al. (The Cochrane Collaboration) (June 2015). "Surgical adjunctive procedures for accelerating orthodontic treatment". The Cochrane Database of Systematic Reviews. 2015 (6). John Wiley & Sons, Ltd.: CD010572. doi:10.1002/14651858.cd010572. PMC 6464946. PMID 26123284.
  32. ^ "What is an Orthodontist?". Orthodontics Australia. 5 December 2019.
  33. ^ Dardengo C, Fernandes LQ, Capelli Júnior J (February 2016). "Frequency of orthodontic extraction". Dental Press Journal of Orthodontics. 21 (1): 54–59. doi:10.1590/2177-6709.21.1.054-059.oar. PMC 4816586. PMID 27007762.
  34. ^ "Child Dental Health Survey 2013, England, Wales and Northern Ireland". digital.nhs.uk. Retrieved 2018-03-08.
  35. ^ Atsawasuwan P, Shirazi S (2019-04-10). "Advances in Orthodontic Tooth Movement: Gene Therapy and Molecular Biology Aspect". In Aslan BI, Uzuner FD (eds.). Current Approaches in Orthodontics. IntechOpen. doi:10.5772/intechopen.80287. ISBN 978-1-78985-181-6. Retrieved 2021-05-16.
  36. ^ a b "Elastics For Braces: Rubber Bands in Orthodontics". Orthodontics Australia. 2019-12-15. Retrieved 2020-12-13.
  37. ^ Mitchell L (2013). An Introduction to Orthodontics. Oxford Medical Publications. pp. 220–233.
  38. ^ Rossini G, Parrini S, Castroflorio T, Deregibus A, Debernardi CL (September 2015). "Efficacy of clear aligners in controlling orthodontic tooth movement: a systematic review". The Angle Orthodontist. 85 (5): 881–889. doi:10.2319/061614-436.1. PMC 8610387. PMID 25412265. S2CID 10787375. The quality level of the studies was not sufficient to draw any evidence-based conclusions.
  39. ^ "Dental Braces and Retainers".
  40. ^ Millett DT, Cunningham SJ, O'Brien KD, Benson PE, de Oliveira CM (February 2018). "Orthodontic treatment for deep bite and retroclined upper front teeth in children". The Cochrane Database of Systematic Reviews. 2 (2): CD005972. doi:10.1002/14651858.CD005972.pub4. PMC 6491166. PMID 29390172.
  41. ^ "Palate Expander". Cleveland Clinic. Retrieved October 29, 2024.
  42. ^ "Jaw Surgery". Modern Orthodontic Clinic in Sammamish & Bellevue. Retrieved 2024-10-03.
  43. ^ Agnihotry A, Fedorowicz Z, Nasser M, Gill KS, et al. (The Cochrane Collaboration) (October 2017). Zbigniew F (ed.). "Resorbable versus titanium plates for orthognathic surgery". The Cochrane Database of Systematic Reviews. 10 (10). John Wiley & Sons, Ltd: CD006204. doi:10.1002/14651858.cd006204. PMC 6485457. PMID 28977689.
  44. ^ "British Orthodontic Society > Public & Patients > Your Jaw Surgery". www.bos.org.uk. Retrieved 2019-08-28.
  45. ^ Fleming PS, Strydom H, Katsaros C, MacDonald L, Curatolo M, Fudalej P, Pandis N, et al. (Cochrane Oral Health Group) (December 2016). "Non-pharmacological interventions for alleviating pain during orthodontic treatment". The Cochrane Database of Systematic Reviews. 2016 (12): CD010263. doi:10.1002/14651858.CD010263.pub2. PMC 6463902. PMID 28009052.
  46. ^ Yu Y, Sun J, Lai W, Wu T, Koshy S, Shi Z (September 2013). "Interventions for managing relapse of the lower front teeth after orthodontic treatment". The Cochrane Database of Systematic Reviews. 2014 (9): CD008734. doi:10.1002/14651858.CD008734.pub2. PMC 10793711. PMID 24014170.
  47. ^ "Clear Retainers | Maintain Your Hard to Get Smile with Clear Retainers". Retrieved 2020-01-13.
  48. ^ a b Martin C, Littlewood SJ, Millett DT, Doubleday B, Bearn D, Worthington HV, Limones A (May 2023). "Retention procedures for stabilising tooth position after treatment with orthodontic braces". The Cochrane Database of Systematic Reviews. 2023 (5): CD002283. doi:10.1002/14651858.CD002283.pub5. PMC 10202160. PMID 37219527.
  49. ^ Putrino A, Barbato E, Galluccio G (March 2021). "Clear Aligners: Between Evolution and Efficiency-A Scoping Review". International Journal of Environmental Research and Public Health. 18 (6): 2870. doi:10.3390/ijerph18062870. PMC 7998651. PMID 33799682.
  50. ^ a b Christensen GJ (March 2002). "Orthodontics and the general practitioner". Journal of the American Dental Association. 133 (3): 369–371. doi:10.14219/jada.archive.2002.0178. PMID 11934193.
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  54. ^ "Medical Specialties and Specialty Fields". Medical Board of Australia.
  55. ^ a b c "Dhaka Dental College". Dhaka Dental College. Archived from the original on October 28, 2017. Retrieved October 28, 2017.
  56. ^ "List of recognized medical and dental colleges". Bangladesh Medical & Dental Council (BM&DC). Retrieved October 28, 2017.
  57. ^ "Orthodontic Facts - Canadian Association of Orthodontists". Canadian Association of Orthodontists. Retrieved 26 October 2017.
  58. ^ a b c "FAQ: I Want To Be An Orthodontist - Canadian Association of Orthodontists". Canadian Association of Orthodontists. Retrieved 26 October 2017.
  59. ^ "RCDC - Eligibility". The Royal College of Dentists of Canada. Archived from the original on 29 October 2019. Retrieved 26 October 2017.
  60. ^ "Accredited Orthodontic Programs - AAO Members". www.aaoinfo.org.
  61. ^ a b c d e f "About Board Certification". American Board of Orthodontists. Archived from the original on 16 February 2019. Retrieved 26 October 2017.
  62. ^ "Accredited Orthodontic Programs | AAO Members". American Association of Orthodontists. Retrieved 26 October 2017.
  63. ^ a b c d e f "Orthodontic Specialty Training in the UK" (PDF). British Orthodontic Society. Retrieved 28 October 2017.

 

Crossbite
Unilateral posterior crossbite
Specialty Orthodontics

In dentistry, crossbite is a form of malocclusion where a tooth (or teeth) has a more buccal or lingual position (that is, the tooth is either closer to the cheek or to the tongue) than its corresponding antagonist tooth in the upper or lower dental arch. In other words, crossbite is a lateral misalignment of the dental arches.[1][2]

Anterior crossbite

[edit]
Class 1 with anterior crossbite

An anterior crossbite can be referred as negative overjet, and is typical of class III skeletal relations (prognathism).

Primary/mixed dentitions

[edit]

An anterior crossbite in a child with baby teeth or mixed dentition may happen due to either dental misalignment or skeletal misalignment. Dental causes may be due to displacement of one or two teeth, where skeletal causes involve either mandibular hyperplasia, maxillary hypoplasia or combination of both.

Dental crossbite

[edit]

An anterior crossbite due to dental component involves displacement of either maxillary central or lateral incisors lingual to their original erupting positions. This may happen due to delayed eruption of the primary teeth leading to permanent teeth moving lingual to their primary predecessors. This will lead to anterior crossbite where upon biting, upper teeth are behind the lower front teeth and may involve few or all frontal incisors. In this type of crossbite, the maxillary and mandibular proportions are normal to each other and to the cranial base. Another reason that may lead to a dental crossbite is crowding in the maxillary arch. Permanent teeth will tend to erupt lingual to the primary teeth in presence of crowding. Side-effects caused by dental crossbite can be increased recession on the buccal of lower incisors and higher chance of inflammation in the same area. Another term for an anterior crossbite due to dental interferences is Pseudo Class III Crossbite or Malocclusion.

Single tooth crossbite

[edit]

Single tooth crossbites can occur due to uneruption of a primary teeth in a timely manner which causes permanent tooth to erupt in a different eruption pattern which is lingual to the primary tooth.[3] Single tooth crossbites are often fixed by using a finger-spring based appliances.[4][5] This type of spring can be attached to a removable appliance which is used by patient every day to correct the tooth position.

Skeletal crossbite

[edit]

An anterior crossbite due to skeletal reasons will involve a deficient maxilla and a more hyperplastic or overgrown mandible. People with this type of crossbite will have dental compensation which involves proclined maxillary incisors and retroclined mandibular incisors. A proper diagnosis can be made by having a person bite into their centric relation will show mandibular incisors ahead of the maxillary incisors, which will show the skeletal discrepancy between the two jaws.[6]

Posterior crossbite

[edit]

Bjork defined posterior crossbite as a malocclusion where the buccal cusps of canine, premolar and molar of upper teeth occlude lingually to the buccal cusps of canine, premolar and molar of lower teeth.[7] Posterior crossbite is often correlated to a narrow maxilla and upper dental arch. A posterior crossbite can be unilateral, bilateral, single-tooth or entire segment crossbite. Posterior crossbite has been reported to occur between 7–23% of the population.[8][9] The most common type of posterior crossbite to occur is the unilateral crossbite which occurs in 80% to 97% of the posterior crossbite cases.[10][3] Posterior crossbites also occur most commonly in primary and mixed dentition. This type of crossbite usually presents with a functional shift of the mandible towards the side of the crossbite. Posterior crossbite can occur due to either skeletal, dental or functional abnormalities. One of the common reasons for development of posterior crossbite is the size difference between maxilla and mandible, where maxilla is smaller than mandible.[11] Posterior crossbite can result due to

  • Upper Airway Obstruction where people with "adenoid faces" who have trouble breathing through their nose. They have an open bite malocclusion and present with development of posterior crossbite.[12]
  • Prolong digit or suckling habits which can lead to constriction of maxilla posteriorly[13]
  • Prolong pacifier use (beyond age 4)[13]

Connections with TMD

[edit]

Unilateral posterior crossbite

[edit]

Unilateral crossbite involves one side of the arch. The most common cause of unilateral crossbite is a narrow maxillary dental arch. This can happen due to habits such as digit sucking, prolonged use of pacifier or upper airway obstruction. Due to the discrepancy between the maxillary and mandibular arch, neuromuscular guidance of the mandible causes mandible to shift towards the side of the crossbite.[14] This is also known as Functional mandibular shift. This shift can become structural if left untreated for a long time during growth, leading to skeletal asymmetries. Unilateral crossbites can present with following features in a child

  • Lower midline deviation[15] to the crossbite side
  • Class 2 Subdivision relationships
  • Temporomandibular disorders [16]

Treatment

[edit]

A child with posterior crossbite should be treated immediately if the child shifts their mandible on closing, which is often seen in a unilateral crossbite as mentioned above. The best age to treat a child with crossbite is in their mixed dentition when their palatal sutures have not fused to each other. Palatal expansion allows more space in an arch to relieve crowding and correct posterior crossbite. The correction can include any type of palatal expanders that will expand the palate which resolves the narrow constriction of the maxilla.[9] There are several therapies that can be used to correct a posterior crossbite: braces, 'Z' spring or cantilever spring, quad helix, removable plates, clear aligner therapy, or a Delaire mask. The correct therapy should be decided by the orthodontist depending on the type and severity of the crossbite.

One of the keys in diagnosing the anterior crossbite due to skeletal vs dental causes is diagnosing a CR-CO shift in a patient. An adolescent presenting with anterior crossbite may be positioning their mandible forward into centric occlusion (CO) due to the dental interferences. Thus finding their occlusion in centric relation (CR) is key in diagnosis. For anterior crossbite, if their CO matches their CR then the patient truly has a skeletal component to their crossbite. If the CR shows a less severe class 3 malocclusion or teeth not in anterior crossbite, this may mean that their anterior crossbite results due to dental interferences.[17]

Goal to treat unilateral crossbites should definitely include removal of occlusal interferences and elimination of the functional shift. Treating posterior crossbites early may help prevent the occurrence of Temporomandibular joint pathology.[18]

Unilateral crossbites can also be diagnosed and treated properly by using a Deprogramming splint. This splint has flat occlusal surface which causes the muscles to deprogram themselves and establish new sensory engrams. When the splint is removed, a proper centric relation bite can be diagnosed from the bite.[19]

Self-correction

[edit]

Literature states that very few crossbites tend to self-correct which often justify the treatment approach of correcting these bites as early as possible.[9] Only 0–9% of crossbites self-correct. Lindner et al. reported that 50% of crossbites were corrected in 76 four-year-old children.[20]

See also

[edit]
  • List of palatal expanders
  • Palatal expansion
  • Malocclusion

References

[edit]
  1. ^ "Elsevier: Proffit: Contemporary Orthodontics · Welcome". www.contemporaryorthodontics.com. Retrieved 2016-12-11.
  2. ^ Borzabadi-Farahani A, Borzabadi-Farahani A, Eslamipour F (October 2009). "Malocclusion and occlusal traits in an urban Iranian population. An epidemiological study of 11- to 14-year-old children". European Journal of Orthodontics. 31 (5): 477–84. doi:10.1093/ejo/cjp031. PMID 19477970.
  3. ^ a b Kutin, George; Hawes, Roland R. (1969-11-01). "Posterior cross-bites in the deciduous and mixed dentitions". American Journal of Orthodontics. 56 (5): 491–504. doi:10.1016/0002-9416(69)90210-3. PMID 5261162.
  4. ^ Zietsman, S. T.; Visagé, W.; Coetzee, W. J. (2000-11-01). "Palatal finger springs in removable orthodontic appliances--an in vitro study". South African Dental Journal. 55 (11): 621–627. ISSN 1029-4864. PMID 12608226.
  5. ^ Ulusoy, Ayca Tuba; Bodrumlu, Ebru Hazar (2013-01-01). "Management of anterior dental crossbite with removable appliances". Contemporary Clinical Dentistry. 4 (2): 223–226. doi:10.4103/0976-237X.114855. ISSN 0976-237X. PMC 3757887. PMID 24015014.
  6. ^ Al-Hummayani, Fadia M. (2017-03-05). "Pseudo Class III malocclusion". Saudi Medical Journal. 37 (4): 450–456. doi:10.15537/smj.2016.4.13685. ISSN 0379-5284. PMC 4852025. PMID 27052290.
  7. ^ Bjoerk, A.; Krebs, A.; Solow, B. (1964-02-01). "A Method for Epidemiological Registration of Malocculusion". Acta Odontologica Scandinavica. 22: 27–41. doi:10.3109/00016356408993963. ISSN 0001-6357. PMID 14158468.
  8. ^ Moyers, Robert E. (1988-01-01). Handbook of orthodontics. Year Book Medical Publishers. ISBN 9780815160038.
  9. ^ a b c Thilander, Birgit; Lennartsson, Bertil (2002-09-01). "A study of children with unilateral posterior crossbite, treated and untreated, in the deciduous dentition--occlusal and skeletal characteristics of significance in predicting the long-term outcome". Journal of Orofacial Orthopedics. 63 (5): 371–383. doi:10.1007/s00056-002-0210-6. ISSN 1434-5293. PMID 12297966. S2CID 21857769.
  10. ^ Thilander, Birgit; Wahlund, Sonja; Lennartsson, Bertil (1984-01-01). "The effect of early interceptive treatment in children with posterior cross-bite". The European Journal of Orthodontics. 6 (1): 25–34. doi:10.1093/ejo/6.1.25. ISSN 0141-5387. PMID 6583062.
  11. ^ Allen, David; Rebellato, Joe; Sheats, Rose; Ceron, Ana M. (2003-10-01). "Skeletal and dental contributions to posterior crossbites". The Angle Orthodontist. 73 (5): 515–524. ISSN 0003-3219. PMID 14580018.
  12. ^ Bresolin, D.; Shapiro, P. A.; Shapiro, G. G.; Chapko, M. K.; Dassel, S. (1983-04-01). "Mouth breathing in allergic children: its relationship to dentofacial development". American Journal of Orthodontics. 83 (4): 334–340. doi:10.1016/0002-9416(83)90229-4. ISSN 0002-9416. PMID 6573147.
  13. ^ a b Ogaard, B.; Larsson, E.; Lindsten, R. (1994-08-01). "The effect of sucking habits, cohort, sex, intercanine arch widths, and breast or bottle feeding on posterior crossbite in Norwegian and Swedish 3-year-old children". American Journal of Orthodontics and Dentofacial Orthopedics. 106 (2): 161–166. doi:10.1016/S0889-5406(94)70034-6. ISSN 0889-5406. PMID 8059752.
  14. ^ Piancino, Maria Grazia; Kyrkanides, Stephanos (2016-04-18). Understanding Masticatory Function in Unilateral Crossbites. John Wiley & Sons. ISBN 9781118971871.
  15. ^ Brin, Ilana; Ben-Bassat, Yocheved; Blustein, Yoel; Ehrlich, Jacob; Hochman, Nira; Marmary, Yitzhak; Yaffe, Avinoam (1996-02-01). "Skeletal and functional effects of treatment for unilateral posterior crossbite". American Journal of Orthodontics and Dentofacial Orthopedics. 109 (2): 173–179. doi:10.1016/S0889-5406(96)70178-6. PMID 8638566.
  16. ^ Pullinger, A. G.; Seligman, D. A.; Gornbein, J. A. (1993-06-01). "A multiple logistic regression analysis of the risk and relative odds of temporomandibular disorders as a function of common occlusal features". Journal of Dental Research. 72 (6): 968–979. doi:10.1177/00220345930720061301. ISSN 0022-0345. PMID 8496480. S2CID 25351006.
  17. ^ COSTEA, CARMEN MARIA; BADEA, MÎNDRA EUGENIA; VASILACHE, SORIN; MESAROÅž, MICHAELA (2016-01-01). "Effects of CO-CR discrepancy in daily orthodontic treatment planning". Clujul Medical. 89 (2): 279–286. doi:10.15386/cjmed-538. ISSN 1222-2119. PMC 4849388. PMID 27152081.
  18. ^ Kennedy, David B.; Osepchook, Matthew (2005-09-01). "Unilateral posterior crossbite with mandibular shift: a review". Journal (Canadian Dental Association). 71 (8): 569–573. ISSN 1488-2159. PMID 16202196.
  19. ^ Nielsen, H. J.; Bakke, M.; Blixencrone-Møller, T. (1991-12-01). "[Functional and orthodontic treatment of a patient with an open bite craniomandibular disorder]". Tandlaegebladet. 95 (18): 877–881. ISSN 0039-9353. PMID 1817382.
  20. ^ Lindner, A. (1989-10-01). "Longitudinal study on the effect of early interceptive treatment in 4-year-old children with unilateral cross-bite". Scandinavian Journal of Dental Research. 97 (5): 432–438. doi:10.1111/j.1600-0722.1989.tb01457.x. ISSN 0029-845X. PMID 2617141.
[edit]