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ORTHODONTICS

TOWARD A PERFECT SMILE

Malocclusion treatment - cooperation and trust

[               ]

DENTIST

MONIKA WALERZAK

Malocclusion (poor bite) affects not only your smile, but your health as well.

 

It may lead to periodontal diseases, caries (tooth decay) and chewing problems. Other potential conditions include temporomandibular joint dysfunction, injuries to the mucous membrane of lips and cheeks, or even tooth breakage and fracture. Speech impairment is also possible. That is why malocclusion should not be neglected, and treatment should be started as soon as possible.

 

In most cases of malocclusion, orthodontic treatment is sufficient. Some skeletal disorders, such as overgrowth or undergrowth of the upper or lower jaw, require a combined orthodontic and surgical treatment.

 

When starting your orthodontic treatment, you should be aware that over the next few years you will have to work closely with the orthodontist and faithfully follow their instructions. Otherwise the treatment may take longer or your condition may even deteriorate.

ORTHODONTIC TREATMENT

We all dream about a beautiful smile.

 

Sometimes, however, malocclusion stands in the way. It may lead to low self-esteem related to appearance. Discomfort caused by gum problems or improper tooth wear is also common. All these issues can be handled by orthodontic treatment. Although this is a long way to go, in the end you will be rewarded with a beautiful smile of your dreams.

 

Dental jewelry, as some call orthodontic braces, seems to be in fashion, but you should bear in mind that the treatment is a painstaking and complex process, in which wearing the braces is just one phase.

 

Orthodontic treatment can be divided into two phases.

 

In the active phase, the teeth are realigned with the help of a carefully adjusted appliance. However, teeth tend to move and return to their former incorrect position. To prevent this, you need a retention phase. Its results may be less spectacular, but if correctly applied and completed, this phase maintains the results of orthodontic treatment indefinitely. As a result, you will forever enjoy your beautiful and healthy smile.

CONDITIONS MOST OFTEN TREATED BY ORTHODONTISTS

Edge-to-edge bite

Incisal edges of the upper and lower incisors meet. The remaining teeth are aligned correctly.

Open bite

The upper and lower teeth do not meet, so a gap between them is visible, and the lower portion of the face is elongated.

Open bite, class I

Open bite, lip position

Crossbite

In this disorder, the upper teeth fit on the wrong side of the lower teeth. Early treatment encourages proper eruption of permanent teeth and symmetric development of alveolar processes and temporomandibular joints.

Anterior crossbite

Crossbite, lip position

Lateral crossbite

Deep overbite

The upper front teeth reach too far down over the lower front teeth. This results in excessive wear of upper and lower incisors.

Deep overbite

Distocclusion

In this malocclusion, the lower dental arch is positioned too far behind the upper arch. In facial features it is most often manifested by an everted or recessed lower lip. It constitutes about 80 percent of all recognized malocclusions.

Distoclusion

with proclined incisors

Distoclusion

with retroclined incisors

Underbite

In this malocclusion, lower front teeth are farther forward than the upper front teeth. It is frequently caused by genetic factors. In facial features, it is most often manifested by a protruding lower lip. It constitutes 3% of all recognized malocclusions.

Underbite, class III

Underbite, lip position

ORTHODONTIC
-SURGICAL TREATMENT

Not every type of malocclusion

can be corrected with an orthodontic appliance.

 

If the problem results from incorrect jaw position or size, an oral surgery is necessary. Such malocclusions pose not only health, but also esthetic problems, since they lead to facial deformities, for example, a protruding or retruded chin, lateral chin shift, no contact between the upper and lower front teeth, or excessive overbite. They may also cause biting, chewing, swallowing and speech disorders.

 

In short, this type of malocclusion is very troublesome for patients, so it should be corrected as soon as possible. Treatment involves surgical correction of the position or size of jaws. However, it begins with fixing an orthodontic appliance, in order to prepare the dental arches to fit perfectly when the surgery is performed. Full treatment takes from a year and a half to three years.

CONDITIONS WHICH MOST OFTEN REQUIRE

ORTHODONTIC-SURGICAL TREATMENT

Progenism

Progenism (manidibular prognathism) - a genetically caused skeletal disorder in which the lower jaw outgrows the upper jaw. It results in an extended chin and a protruding lip. Face profile is deformed and the lower portion of the face is elongated.

 

Progenism results in functional disorders such as biting, chewing and speech problems, and impaired temporomandibular joint dysfunction. In children and underage patients with diagnosed progenism, an early treatment and a regular orthodontic treatment may be administered, in order to stimulate the growth of the upper jaw and to stop the growth of the lower jaw.

Lower jaw osteotomy

with retraction

Genioplasty with chin reduction

Upper jaw advancement,

lower jaw retraction

Upper jaw osteotomy

with advancement

Laterognathia

Laterognathia (lateral deviation of the mandible)

 

There are two types of this disorder:

- functional - marked by facial asymmetry; the lower jaw is shifted to the side of the facial midline, as a result of lower jaw functional disorder (altered position of the jaw) related to tooth guidance. Inside the mouth, it is usually marked by a full crossbite or partial front crossbite.

- morphological - facial asymmetry is caused by the incorrect anatomic structure of the lower jaw.

 

Lower jaw asymmetry

Upper and lower jaw asymmetry

Mandibular retrognathism

(often with a deep overbite)

In this condition, the lower jaw fails to grow forward and alterations in structure occur, such as increased mandibular angle and a retruded chin.

 

The face has a bird-like profile, with a flattened and retruded chin and a shortened lower portion of the face. Intraoral examination reveals a retruded lower dental arch, usually combined with upper and lower incisor proclination. The condition may be accompanied by an open bite, in which upper and lower teeth do not come in contact in vertical plane.

 

In some cases of mandibular retrognathism, severe or moderate deep overbite occurs.

 

Occlusion may be improved by extraction of the first or upper premolars and retraction of six teeth in the upper jaw. A notable improvement in facial proportions is achieved with osteotomy and advancement of the lower jaw in order to correct the alignment of teeth.

Lower jaw osteotomy

with advancement

Upper jaw impaction in posterior section, lower jaw advancement

Gingival smile (gummy smile)

In this condition, a full smile reveals shortened tooth crowns, along with more than 2 mm of maxillary gingiva and a very pronounced frenulum. This can be remedied by shortening the gums, and correcting their and line and shape. The procedure also helps in case of teeth which are optically too short.

Gingival smile

ORTHODONTIC APPLIANCES

Orthodontic appliances may be fixed or removable,

 

depending on the medical indications and available treatment options. The type of appliance most suitable for treating your malocclusion will be chosen by the physician, after the first appointment, when they will make a diagnosis and draft a treatment plan with you.

Removable appliances

They are predominantly used
for children whose jaws are

in the active growth phase. Such an

appliance positively affects jawbone growth,

prevents defects, and may correct certain minor

existing irregularities. Treatment using a removable

appliance requires great discipline because

the results and effectiveness depend on the

number of hours the patient is wearing the

appliance. However, removable appliances have

a limited therapeutic effect and will not correct every type of defect.

Fixed appliances

Fixed braces remain fitted on your teeth until your orthodontist removes them. Although this type of treatment may seem troublesome, and involves a range of responsibilities (monthly checkups, improved oral hygiene), the therapeutic effect is spectacular. A fixed brace ensures precise correction of malocclusion even in case of severe disorders. Depending on the condition, you may have to wear it from one year to two and a half years.