Recognizing and Correcting Developing Malocclusions

The editors Eustáquio A. Araújo, DDS, MDS, is an Emeritus Professor of Orthodontics at Saint Louis University in Saint Louis, Missouri, USA. Peter H. Buschang, MA, PhD, is a Regents Professor Emeritus, the Peter H. Buschang Endowed Chair of Orthodontics, and former director of research in the Department of Orthodontics at the Texas A&M University College of Dentistry in Dallas, Texas, USA.

• List of Contributors xiiiForeword xvPreface xvii1 A guide for timing orthodontic treatment 1Eustáquio A. Araújo, DDS, MDS and Bernardo Q. Souki, DDS, MSD, PhD1.1 Occlusal deviations with indications for interceptive orthodontic treatment 31.2 Ideal timing for early treatment 51.2.1 Psychological aspects 51.2.2 Severity of the malocclusion 51.2.3 Effectiveness and efficiency concepts 61.2.4 Maturational stage of development 7References 72 Development of the occlusion: what to do and when to do it 9Bernardo Q. Souki, DDS, MSD, PhD2.1 Stage 1—eruption of deciduous teeth 92.1.1 Biogenesis of the deciduous dentition 92.1.2 Dimensional changes of the dental arches at stage 1 112.1.3 Management of occlusal development at stage 1 112.2 Stage 2—completion of the deciduous dentition 112.2.1 Dimensional changes in the dental arches at stage 2 132.2.2 Management of occlusion development at stage 2 142.3 Stage 3—eruption of first permanent molars 162.3.1 Management of occlusion development at this stage 172.4 Stage 4—eruption of permanent incisors 182.4.1 Dimensional changes in the dental arches at this stage 182.4.2 Management of occlusal development at this stage 192.5 Stage 5—eruption of mandibular canines and first premolars 202.5.1 Management of occlusal development at this stage 212.6 Stage 6—eruption of second premolars 212.6.1 Management of occlusal development at this stage 232.7 Stage 7—eruption of maxillary canines and second molars 232.7.1 Management of occlusal development at this stage 232.8 Conclusions 24References 243 Mixed dentition diagnosis: assessing the degree of severity of a developing malocclusion 27Eustáquio A. Araújo, DDS, MDS3.1 Assessing treatment need, complexity, and outcome 273.1.1 Summers’ Occlusal Index 283.1.2 Dental Aesthetic Index (DAI) 283.1.3 Peer Assessment Rating (PAR) 283.1.4 Index of Orthodontic Treatment Need (IOTN) 283.1.5 Index of Complexity, Outcome, and Need (ICON) 293.1.6 The American Board of Orthodontics complexity index and outcome assessment 293.2 Assessing interceptive treatment outcome 313.2.1 Class I 313.2.2 Class II 313.2.3 Class III 32References 334 The genetics of the dental occlusion and malocclusion 35Robyn Silberstein, DDS, PhD and Mary MacDougall, PhD4.1 Introduction 354.1.1 Personalized medicine 354.1.2 Clinical examination 354.1.3 Principles of dysmorphology: variable expressivity and etiologic heterogeneity 364.2 Chromosomal abnormalities 374.3 Single gene defects 384.4 Multifactorial inheritance 384.5 Genetics of nonsyndromic malocclusion 404.6 Altered tooth number 424.7 Altered tooth structure 434.8 Altered eruption 434.9 Radiographic deviations associated with genetic conditions 454.10 Conclusion 47References 475 Class I: Recognizing and correcting intraarch deviations 515.1 Section I: The development and etiology of a Class I malocclusion 51Peter H. Buschang, MA, PhD5.1 Introduction 515.2 Prevalence of Class I malocclusion and changes in arch form 525.3 Class I malocclusion and the dental compensatory mechanism 585.4 What is anterior mandibular malalignment is related to? 605.4.1 Predisposing factors 605.4.2 Eruption problems associated with space loss 615.4.3 Contact displacements associated with relapse and tooth movements 62References 635.2 Section II: Intercepting developing Class I problems 67Eustáquio A. Araújo, DDS, MDS5.5 Tooth size arch length discrepancy (TSALD) 675.6 The assessment of crowding in the mixed dentition 685.6.1 Zero to minor TSALD 685.6.2 Small to moderate TSALD 695.6.2.1 Taking advantage of the transitional dentition 695.6.3 Gaining spaces in the dental arches 715.6.3.1 The importance of the leeway space/E space 715.6.3.2 Etiology of maxillary transverse deficiency 725.6.3.3 Maxillary expansion and headgear 735.6.3.4 Gaining space in the mandibular arch 835.6.3.5 Arch dimensions changes 845.6.3.6 Arch length and mandibular molar/MP 845.6.3.7 Arch length and mandibular incisors/MP 845.6.3.8 Transverse changes 845.6.3.9 Incisor irregularity changes 845.6.3.10 The Schwarz appliance 865.6.3.11 Two-by-four fixed therapy 865.6.4 Severe TSALD: fundamentals of serial extraction 925.6.5 Indications and contraindications for serial extraction (SE) 935.6.5.1 Additional important fundamentals in serial extraction 945.6.5.2 Sequence and timing of extractions 955.6.5.3 Alternative extraction sequences 95References 1026 Recognizing and correcting Class II malocclusions 1076.1 Section I: The development, phenotypic characteristics, and etiology of Class II malocclusion 107Peter H. Buschang, MA, PhD6.1 Introduction 1076.1.1 Prevalence 1096.2 Characterization of the Class II, division 2 phenotype 1106.3 Characterization of the Class II division 1 phenotype 1116.3.1 Hyperdivergent vs. hypodivergent Class II division 1 malocclusion 1146.4 Developmental changes of Class IIs 1156.5 Class II developmental changes 1186.6 Etiology 119References 1236.2 Section II: Class II treatment: problems and solutions 131Eustáquio A. Araújo, DDS, MDS6.7 Early Class II adjustment 1326.8 Treatment 136References 1587 Recognizing and correcting Class III malocclusions 1617.1 Section I: The development, phenotypic characteristics, and etiology of Class III malocclusion 161Peter H. Buschang, MA, PhD7.1 Introduction 1617.2 Characterization of the Class III phenotype 1637.3 Class III development 1687.4 Etiology 170References 1757.2 Section II: Class III treatment: problems and solutions 179Eustáquio A. Araújo, DDS, MDS7.5 Diagnosis 1837.5.1 Facial diagnosis 1837.5.2 Cephalometric diagnosis 1837.5.3 Dental diagnosis 1837.5.4 Functional diagnosis 1847.5.5 Hereditary diagnosis 1857.6 Communication 1877.7 Early intervention 1887.8 Orthopedic maxillary expansion 1887.9 Face mask and/or chincup orthopedics 1917.9.1 The face mask 1917.9.2 The chincup 1937.10 Leeway space control 1947.11 Orthodontic mechanics 1947.12 Finishing 1947.13 Retention 1947.14 Growth reevaluation 195References 2218 Special topics 2258.1 Section I: Habit control: the role of function in open-bite treatment 225Ildeu Andrade, Jr., DDS, MS, PhD and Eustáquio A. Araújo, DDS, MDS8.1 Nutritive vs. nonnutritive sucking habits 2258.2 Tongue physiology 2268.3 Tongue thrusting and forward resting posture of the tongue 2278.4 Breaking the habit 2278.4.1 How and when should a clinician intervene? 2278.4.2 The Araújo approach 2278.5 Treatment 229References 2358.2 Section II: Eruption deviations 239Bernardo Q. Souki, DDS, MSD, PhD and Eustáquio A. Araújo, DDS, MDS8.6 Eruption deviations 2398.7 Eruption deviation and PIOM: what are the most frequent eruption disturbances in each stage of dental development? 2418.7.1 Stage 2 – Completion of deciduous dentition 2418.7.2 Stage 3 – Eruption of the first permanent molars 2418.7.3 Stage 4 – Eruption of the permanent incisors 2418.7.4 Stage 5 – Eruption of the mandibular canines and the first premolars 2428.7.5 Stage 6 – Eruption of the second premolars 2478.7.6 Stage 7 – Eruption of maxillary canines and second molars 247References 2538.3 Section III: Strategies for managing missing second premolar teeth in the young patient 255David B. Kennedy, BDS, LDS (RCSEng), MSD, FRCD(C)8.8 General concepts 2558.9 Longevity of the second deciduous molar, resorption, and infraocclusion 2568.9.1 Resorption 2568.9.2 Infraocclusion 2578.10 The alveolar ridge in extracted deciduous molars 2578.11 Overall dental health and cost 2588.12 Case histories 2588.13 Summary 270References 2708.4 Section IV: Principles and techniques of premolar autotransplantation 273Ewa M. Czochrowska, DDS, PhD and Paweł Plakwicz, DDS, PhD8.14 Class II malocclusion with congenitally missing lower second premolars 2748.15 Traumatic loss of upper incisor/s 2748.16 Uneven tooth distribution with multiple agenesis 2748.17 Surgery 2778.18 Selection of anesthesia (local vs. general) 2778.19 Premolar to premolar transplantation 2778.20 Premolar to anterior maxilla transplantation 2798.21 Postoperative instructions 2798.22 Follow-up 2798.23 Pulp healing 2808.24 Periodontal healing 2818.25 Root growth 2818.26 Reshaping to incisor morphology 2818.27 Alveolar bone after autotransplantation 281References 2828.5 Section V: Dental trauma: revisiting posttrauma protocols and long-term follow-ups 285Eustaquio A. Araújo, DDS, MDS and Gabriel Miranda, DDS, MS8.28 An overview of dental trauma 2858.29 Orthodontic treatment and dental trauma 2868.30 Managing traumatized teeth and preserving bone width – The decoronation approach 2888.31 Final considerations 295References 2978.6 Section VI: Sleep-disordered breathing (SDB) in the growing child 299Juan Martin Palomo, DDS, MDS and Luciane M. de Menezes, PhD8.32 The need for sleep 2998.33 Diagnosis and management of sleep-disordered breathing (SDB) and obstructive sleep apnea (OSA) in children 3008.34 Risk factors for OSA in children 3028.34.1 Enlarged tonsils and adenoids 3028.34.2 Obesity 3048.34.3 Allergies and respiratory infections 3048.34.4 Structural abnormalities and craniofacial anomalies 3058.35 Consequences of SDB in children 3058.36 Treatment options for the dental and skeletal consequences of SDB in children 3098.37 New technologies: the use of apps and devices for SDB and OSA in children 3108.38 Conclusion 310References 3118.7 Section VII: Mixed dentition orthodontic mechanics 313Gerald S. Samson, DDS8.39 Definitions and terminology 3148.39.1 Center of mass and center of resistance 3158.39.2 Orders of tooth movements and orthodontic terminology 3168.39.3 Force systems 3168.39.4 Single-point force and moment of force 3168.39.5 Additive and subtractive couples 3168.39.6 Equilibrium and tooth movement – Newton’s third law 3178.39.7 Force systems and tooth movements 3188.39.8 Mixed dentition example of one tube (bracket) and one couple system 3198.39.9 Mixed dentition: maxillary anterior root convergence 3208.39.10 Orthodontic treatment of teeth with open apices 3208.39.11 Two brackets – two equal and oppositely directed couples 3208.39.12 Two brackets – two unequal oppositely directed couples 3218.39.13 Two brackets – two “same direction, additive” couples including increased anterior incisor root torque 3228.39.14 Clinical application – mixed dentition openbite, two “same direction, additive” couples including increased anterior incisor root torque 324References 326Index 327