Early Orthodontic Management of Class 2 malocclusions- Part 2
September 5th, 2021
In this part 2 dentist podcast on the Early Orthodontic Management of Class 2 malocclusions , Orthodontist Dr Andrew Chang discusses:
- No treatment
- Interceptive Treatment now: Functional Appliances with U maxilla expansion + referral to speech therapist.
- Wait till permanent dentition, then camouflage with upper arch extractions, U expansion is less effective.
- Is it too early? Primary dentition?
- If have habits eg: thumb sucking or dummy, best to cease habit first
- Mixed dentition: best time for maximum orthopedic effect (CVMS 2: Baccetti 2002): Shape of vertebral bodies of C2-4 and inferior borders of C3-4
- Adult. Is it too late? What happens with functional appliances? Compliance and success rate (due to temporary speech disruptions), greater lower incisor proclination. Jaw surgery and risks of morbidity.
- Adv & Disadv of Early Treatment- Gingival trauma, Upper incisor trauma, psychosocial.
- Adv & disadv of Late mixed dentition or Permanent dentition Treatment: Orthopedic effects best retained.
What Should Dentists Be Looking Out For?
- Age and Dental Status. Mobile D’s and E’s at 10-11 yrs may be difficult to retain functional appliances.
- Habits - ask about thumbsucking, dummy, mouth breathing etc.
- Signs of Risk Factors manifesting as gingival trauma, narrow jaw, Upper Incisor trauma.
- Assessing risk factors through their lifestyles and habits ie: sports, mouthbreathing
- >7mm Overjets and referral to orthodontist
- My experience has been parents would prefer to do a combined functional appliance + teeth alignment that address root causes, rather than orthodontic camouflage and adults are not keen on jaw surgery procedures due to significant risks.