Orthodontics

introduction

A regular position of the teeth is both aesthetically and functionally desirable in every case. Position anomalies should therefore be eliminated. The Orthodontics can correct misalignments and thus restore the ideal state. Orthodontic treatments are mainly performed on children, but can still be successful in adulthood. Here, however, the duration of the treatment is in the Orthodontics much longer. Are you interested in Paediatrics?

Misalignments which orthodontics treat

Examination of the teeth

The misalignments in the jaw area can be varied. They range from the abnormal position of a single tooth to the malformation of an entire jaw. As Prognathy denotes too much protrusion of the upper jaw in contrast to Progenytoo much protrusion of the lower jaw. The premature loss of one or more milk teeth without a gap holder leads to misalignment of the permanent teeth because there is not enough space.

Even if a milk tooth persists i.e. If it does not fail properly, the following permanent tooth has no space and breaks out of its normal position and must be treated in orthodontics. It must then be brought into the correct position after the milk tooth has been removed.

Preparatory measures of orthodontics

Before each orthodontic treatment of a child, the orthodontist records the initial state of the jaw relationships with impressions. With the help of plaster models, which are repeated in the course of the treatment, the success of the regulation can be checked at any time. This is followed by a detailed discussion with the child's parents, in which the treatment steps and the approximate time frame are discussed. Any necessary renovations of the dentition are carried out by the family dentist.
The orthodontist decides whether a fixed or a removable appliance is used. If the temporomandibular joint is too tight overall, it may be necessary to remove a permanent healthy tooth to make room. If at all possible, however, healthy teeth should be preserved. If it is necessary, however, the first small molar tooth is generally used, as experience shows that this tooth is the most prone to caries. The cost of orthodontic regulation naturally also plays a role.

The orthodontist uses the orthodontic indication groups to classify the malalignment according to its severity.

Age-related beginning

Generally, regulation is not started until the permanent lateral teeth have erupted. This is the case between the ages of 9 and 11. In exceptional cases, however, it may be necessary to start treatment earlier. At this age it is still possible not only to regulate the teeth but also the jaw that is growing. There are no age limits to regulation later. It is also still possible in adults, but here only a movement of the teeth, no jaw regulation.

Removable apparatus

In the early days of orthodontics, removable appliances were used almost exclusively to regulate misalignments of the teeth. These usually had to be worn during the night, as speaking and eating were difficult due to the voluminous equipment. Unfortunately, things weren't always good with the help of the children. They often left the equipment in the nightstand drawer. This of course reduced the success of the treatment.

The activator was one such removable orthodontic appliance. It was a plastic plate with a gap in the middle. The two halves were connected by an expansion screw. The activator was held in place with a labial clip and clamps. By turning the screw at intervals of approx. 2 to 4 weeks, the two halves were pressed apart, thus expanding the jaw so that space was gained for the teeth to be moved. A modification of the activator was the so-called Y-plate, in which the plate was cut into 3 parts, mainly to make room for the canine. Since the removable appliances were often not worn long enough, their use has now declined sharply.

Read more too: The loose braces

Invisible rails

Lately there are also almost invisible orthodontic appliances. These are transparent plastic splints that have to be replaced with new ones every two weeks. The regulation takes place in very small steps, so it can only be used for minor malpositions in adults.

Fixed appliances

The fixed appliances are so-called Brackets. These are made of metal or, more recently, ceramic. They are usually bonded to the outer tooth surface with composite. A wire that regulates the teeth is pulled through so-called locks. With the help of Brackets additional wires or springs can also be attached, depending on individual requirements. The great advantage of the fixed appliances is that they can be worn all the time and the duration of regulation can be shortened. A disadvantage is that they are visible, but experience shows that the children are for the most part even proud to wear a regulation.

Learn more at: The fixed braces

Since the Brackets To create good starting points for plaque, careful oral hygiene is essential to prevent tooth decay. After successful treatment, the brackets are removed again. The enamel under the brackets may be decalcified, so fluoridation will restore remineralization.

Headgear

Of the Headgear is an orthodontic appliance anchored outside the mouth. It consists of two arches, one of which is hooked into a neck band behind the head. Inside the mouth, the second arch is attached in tubes to the molars or to a detachable appliance. The molars are also moved by the headgear. The success of such a treatment depends to a large extent on the cooperation of the patient, since it has to be worn for many hours every day. The headgear is a detachable orthodontic appliance and must be removed when eating.

The headgear is not without controversy. On the one hand, the aesthetics are disturbed by the noticeable outer arch and the neck band, on the other hand, the pull can also cause pain. This is why some orthodontists completely reject the headgear, as the same results can be achieved with other orthodontic appliances.

Side effects

Movement of the teeth naturally also has an effect on the Jawbone. The pressure moves the tooth, which means that bone is broken down on one side of the tooth and the bone has to be added on the opposite side. This can lead to pain in the periodontium, but this is reversible. In the case of insufficient oral hygiene Gingivitis or also for Caries occur, both can be avoided through oral hygiene.

Figure skull from the front and from the left (upper jaw blue)
  1. Upper jaw -
    Maxilla
  2. Zygomatic bone -
    Os zygomaticum
  3. Nasal bone -
    Nasal bone
  4. Tearbone -
    Lacrimal bone
  5. Frontal bone -
    Frontal bone
  6. Lower jaw -
    Mandible
  7. Eye socket -
    Orbit
  8. Nasal cavity -
    Cavitas nasi
  9. Upper jaw, alveolar process -
    Alveolar process
  10. Maxillary artery -
    Maxillary artery
  11. Under eye cavity hole -
    Infraorbital foramen
  12. Ploughshare - Vomer

You can find an overview of all Dr-Gumpert images at: medical illustrations

Summary of the tasks of orthodontics

The orthodontic measures regulate malformations of the jaw and teeth. Fixed and removable appliances are available for this. The treating orthodontist determines which appliance is the most suitable. In any case, however, the cooperation of the patient is necessary to ensure success. The aim of any orthodontic treatment should be to restore normal tooth position. The duration of treatment varies depending on the severity of the initial findings. Orthodontic treatment can still be carried out successfully in adults.