Orthodontics Care For Defects In The Teeth

Orthodontics is a branch of dentistry dealing with the treatment of malocclusion, maxillofacial defects and the correction of dental defects.

Orthodontic treatment consists in the prevention, diagnosis and treatment of all dental and occlusal defects. The braces can be worn from the age of 8, and there is no upper age limit. There are different types of orthodontic appliances, which can be broadly divided into removable and fixed appliances. Orthodontic appliances from the first group bring results a little slower, the second ones a bit faster, but both lead to straight teeth.

Patients are afraid of the pain associated with orthodontic treatment and find it long and monotonous to wait for the results. Modern treatment methods used with the use of innovative solutions allow you to quickly achieve the desired effect, reducing pain to a minimum.

 Before Treatment

The treatment we were to undertake together was to shift the teeth to the right again and restore the area after the four removed. Usually, this is done with the help of additional devices placed on the palate, which are designed to widen the arches and distalize the lateral teeth in this patient’s right. However, the patient was not willing to wear them. So we decided to try to correct the asymmetry with the self-ligating fixed apparatus in the Damon system with the support of carrying the lifts.

It is a modern type of fixed appliance, the brackets of which have a unique structure and allow to act on the patient’s teeth in a faster and more comfortable way than in the case of a traditional ligated appliance. With its help, I expanded my patient’s upper dental arch, and I also created a place for the missing tooth. As a result, the centerline of the upper arch was reconstructed, i.e. all the teeth moved to where they should be. The symmetry of the arch has also been restored, and an implant will be inserted into the resulting gap. It was also possible to widen the jaw and get out of a cross bite on the right side. The therapy is still ongoing because the patient’s teeth are still deflected.

During treatment

The second treatment course that could be considered is to remove the right top four. Then also the centerline would be recreated and the arch symmetry restored. Such treatment would even be simpler to perform. It would also be easier to fight tooth deflection. On the other hand, the patient would lose another healthy tooth, which is certainly not beneficial. There was also the question of whether the bottom two fours would not need to be removed then as well. Both arches would thus become significantly narrower. Together with the patient, we gave up on additional extractions – the patient did not consent to her.

Of course, the patient is aware that despite the treatment, the teeth may remain slightly raised. This was clearly stated to her at the very beginning, before we moved on to putting on the camera. In adulthood, orthodontic treatment with the use of braces alone has limited possibilities of obtaining effects, due to the insight into the completed stage of growth and the difficult possibility of modeling the bones of the maxilla and mandible. Therefore, such defects are best treated in childhood, possibly in adolescence – then rather without carrying out asymmetric extractions. If the patient came to me at the age of 15, we would most likely recreate the space for a crowded three by extending and distalizing, that is, shifting the lateral left teeth backwards, which would be the most optimal.

Of course, tooth extraction is sometimes unavoidable, for example, it should be considered in very crowded conditions, especially if we consider treatment in the period after the end of growth. The teeth set in such a way can also be set evenly in the full set, but it can be achieved at the cost of their large deflection and unfavorable changes in facial features. Then treatment with tooth extraction can be considered.

The non-sectional treatment that we have carried out is also somewhat of a compromise, but the effect we managed to achieve is still good and more natural and aesthetic than if we were to remove the next fours. It satisfies the patient and it coincides with the goal we have set in the treatment plan