Early orthodontic treatment: current clinical perspectives.
Although controversy remains about the value of EOT as ascertained by the randomized clinical trials for the class 11 malocclusion, this study clearly indicates that a variety of conditions benefit from a staged approach to the orthodontic correction. This study did not try to assess clinical efficiency of phase I treatment nor did it compare phase I appliances. but rather it attempted to survey referred early treatment case types and to illustrate successful outcomes frequently achieved with phase I therapy. Treatment acceptance of doctor recommendations (for early orthodontic intervention) was high (98%), illustrating excellent screening by referring dentists and a high level of parental awareness of the value of early intervention. Appliances selected for use were designed to be "user" friendly. Orthopedic appliances were prescribed to improve the harmony within the developing functional matrix of both the growing jaws and the dentoalveolar structures. All force systems were incorporated to use the basic principles of directional force mechanics to optimize favorable jaw growth and to create dentoalveolar changes that enhance function and esthetics while minimizing unfavorable responses. As part of the initial orthodontic treatment plan, most cases require a second phase (comprehensive treatment with full braces) to optimize the occlusal correction and to further enhance function and stability. We are convinced that EOT provides the following desirable benefits to the patient: Application of orthopedic appliances achieves predictable tissue response of muscle. growing bones, and sutures in younger patients (Figures 5-8). Improvement of the oral environment at a young age enhances self-esteem (Figures 5-8). Orthodontic intervention before all adult teeth erupt improves long-term stability (Figures 6-8). Patients spend less time in full braces (phase 11 treatment) during their teenage years. After analyzing the records of 100 consecutively referred patients for EOT, the findings verify that multistage orthodontic treatment is an important step in creating the treatment goals of improved function. enhanced facial and dental esthetics, and better health and stability for a select group of patients with significant skeletal and dental imbalances. In EOT teamwork, communication, case selection. and the recommendation of an effective treatment approach are essential elements of success.
Musich
David
D
Department of Orthodontics, University of Pennsylvania, USA.
Busch
Matthew J
MJ
D002508:Cephalometry; D002648:Child; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000145:classification / Q000628:therapy; D008445:Maxillofacial Development / Q000502:physiology; D003765:Models, Dental; D009967:Orthodontic Appliances / Q000145:classification; D016910:Orthodontic Brackets; D009969:Orthodontic Wires; D009971:Orthodontics, Corrective / Q000379:methods*; D009972:Orthodontics, Interceptive / Q000379:methods*; D010155:Palatal Expansion Technique / Q000295:instrumentation; D010347:Patient Care Planning; D023861:Photography, Dental; D011862:Radiography, Panoramic; D013997:Time Factors; D016896:Treatment Outcome