Orthodontology is a correction of orthodontic anomalies in children and adults.
Correction of orthodontic anomalies in children and adults, is especially important for functional reasons. It allows better chewing function, creates conditions for the smooth maintenance of oral hygiene. Also, prevents excessive wear of dental tissue, tooth injuries, periodontal disease and tooth loss. Of course, esthetic reasons should not be forgotten.
In order to make a plan of therapy, a clinical examination and analysis of models, images, and photographs are required. Orthodontics deals with the aesthetics of the patient’s face, so all these parameters should be taken into account when planning the further treatment.
Even at an early age is possible to diagnose some orthodontic anomalies, so a visit to the orthodontist is advised as early as possible (no later than age 7). Although there is no age limit for orthodontic treatment, some irregularities can be easily corrected in younger patients, especially in the period of growth. Also, advises related to nutrition, correcting bad habits (tongue thrusting, mouth breathing issue, thumb sucking). Exercises to activate certain muscle groups, selective grinding of teeth in order to eliminate forced bites. As well as creating a space holder in case of premature tooth loss, fall into the methods of prevention and early treatment of orthodontic anomalies.
Mobile appliances, better known as mobile dentures, can be active (for spreading the jaw and correcting the position of one or a group of teeth) and functional (for correction of the relation between the upper and lower jaw during the period of intense growth). Patients wear mobile appliances at night and over the day (as much as possible), and for the success of the therapy, good cooperation with the patient is required. In order to motivate children to carry these appliances, they are made in various colors and cheerful applications, according to their wishes. Controls are performed for 4-6 weeks.
It should be noted that mobile appliances very often serve as preparation of a patient for therapy with fixed appliances.
Fixed appliances, also known as fixed prostheses, allow treatment of many irregularities in teeth position and bites. Some of them are therapy of dental crowding, diastema, correction of the position of buck (protruding) teeth. Also, therapy of bite irregularities with the use of intermaxillary traction (elastics) or camouflage. Use of traction to pull the impacted teeth (most often the canines), correction of deep bite, open bite and crossbite, closing the space created by the teeth removal, pre-prosthetic orthodontic preparation…
The setting of the fixed appliance is a painless procedure, “gluing” brackets to the teeth and their interconnection with archwire, which will do the tooth movement. Sometimes, apart from these elements, additional elements are set.
In addition to classic metal brackets, mini metal brackets can also be used (considerably smaller dimensions), self-locking brackets, lingual brackets (placed on the inside of the tooth), esthetic brackets (made of monocrystalline sapphire glass, ceramics or plastic materials). A large selection of esthetic brackets, arches, rubber ligatures and additional tooth-colored elements, today provide minimal visibility of fixed appliances, which is especially important to adolescents and patients of certain occupations. Fixed appliance controls are performed on every 2-6 weeks. After the end of the therapy, it is necessary to maintain the achieved results by applying foil or fixed retainers (fixed on the inside of the tooth).
It should be emphasized that regular oral hygiene is of great importance for patients with fixed appliances. The use of special brushes, floss, and antiseptic mouthwashes will prevent the appearance of caries and gum inflammation in places that are hardly accessible for cleaning.
When the analysis shows a great lack of room for permanent teeth, then it is approached to the removal of some permanent teeth. These are mostly the first premolars, but there are also exceptions when other premolars or first molars are extracted. The decision, on which teeth will be extracted, is made by an orthodontist based on an individual plan of therapy. As well as the assessments of teeth condition (big fillings, endodontically treated teeth, teeth with present chronic bone lesions).
Sometimes a great lack of space can be diagnosed very early (in the period of multiple dentitions). So with the serial extractions is provided space for the smooth emergence of permanent teeth. Tooth extraction is also an integral part of the treatment with camouflage in adult patients, in who growth has been completed, but it is necessary to correct irregularities of the bite. Of course, more significant irregularities in the bite require combined orthodontic-surgical therapy.
Thanks to the progress of 3D technology in dentistry, scanning of tooth and tooth models is possible. On these models, based on the previous therapy plan, are produced a series of foils. Each of which performs a gradual shift and correction of the teeth. Duration of therapy and number of necessary foils for achieving the desired results depends on the degree of expression of an anomaly. The advantage of this technique is that these foils almost are not seen on the teeth, and maintaining oral hygiene is greatly facilitated because the patient can remove them alone. About the possibilities of this method of treatment for each individual case, review, and consultation with the orthodontist is mandatory.