Roberts Harry1 and J Sandy2

There are various reasons for offering patients orthodontic treatment. Some of these include improved aesthetics, occlusal function and the long-term dental health.

ORTHODONTICS

1.

Who needs

orthodontics?

2.

Patient assessment and

examination I

3.

Patient assessment and

examination II

4.

Treatment planning

5.

Appliance choices

6.

Risks in orthodontic

treatment

7.

Fact and fantasy in

orthodontics

8.

Extractions in

orthodontics

9.

Anchorage control and

distal movement

10.

Impacted teeth

11.

Orthodontic tooth

movement

12. Combined orthodontic

treatment

^Consultant Orthodontist, Orthodontic Department, Leeds Dental Institute, Clarendon Way, Leeds LS2 9LU; 2Professor in Orthodontics, Division of Child Dental Health, University of Bristol Dental School, Lower Maudlin Street, Bristol BS1 2LY "Correspondence to: D. Roberts-Harry E-mail: [email protected]

^Consultant Orthodontist, Orthodontic Department, Leeds Dental Institute, Clarendon Way, Leeds LS2 9LU; 2Professor in Orthodontics, Division of Child Dental Health, University of Bristol Dental School, Lower Maudlin Street, Bristol BS1 2LY "Correspondence to: D. Roberts-Harry E-mail: [email protected]

Refereed Paper doi:10.1038/sj.bdj.4810592 © British Dental Journal 2003; 195: 433-437

Orthodontics comes from the Greek words 'orthos' meaning normal, correct, or straight and 'dontos' meaning teeth. Orthodontics is concerned with correcting or improving the position of teeth and correcting any malocclusion. What then do we mean by occlusion and malocclusion? Surprisingly the answer is not straightforward. There have been various attempts to describe occlusion using terms such as ideal, anatomic (based on tooth morphology), average, aesthetic, adequate, normally functioning and occlusion unlikely to impair dental health.

With these different definitions of what constitutes malocclusion, there is, not surprisingly a degree of confusion as to what should be treated and what should not. Although some tooth positions can produce tooth and soft tissue trauma, it is important to remember that malocclusion is not a disease but simply a variation in the normal position of teeth. Essentially, there are three principal reasons for carrying out orthodontic treatment:

1.To improve dento facial appearance

2. To correct the occlusal function of the teeth

Orthodontic TreatmentMaloclusion Clase Division

Fig. 1a A child with a Class II i Fig. 1b The same child as division 1 malocclusion and in Fig. 1a very poor aesthetic appearance

Fig. 1a A child with a Class II i Fig. 1b The same child as division 1 malocclusion and in Fig. 1a very poor aesthetic appearance

-tun Fig. 2a Same child as in Fig. 1 after orthodontic treatment

Fig. 2b Occlusion of the same patient as in Fig. 2a, there has been a significant improvement in the buccal segment relation and overjet compared with the initial presentation in Fig. 1b

-tun Fig. 2a Same child as in Fig. 1 after orthodontic treatment

Fig. 2b Occlusion of the same patient as in Fig. 2a, there has been a significant improvement in the buccal segment relation and overjet compared with the initial presentation in Fig. 1b

Table 1 Features children most dislike or are teased about (Shaw et al.1)

Feature

Disliked appearance

or teased (%)

Teeth

60.7

Clothes

53.8

Ears

51.7

Weight

41.5

Brace

33.3

Nose

29.3

Height

25.3

Fig. 3 This patient has a severe anterior open bite with contact only on the molars

Fig. 4 Class II Division 1 with an increased overjet. The anterior teeth are at risk of potential trauma with an overjet of 10 mm or greater

Fig. 3 This patient has a severe anterior open bite with contact only on the molars

Division1 Teeth

Fig. 4 Class II Division 1 with an increased overjet. The anterior teeth are at risk of potential trauma with an overjet of 10 mm or greater

3. To eliminate occlusion that could damage the long-term health of the teeth and periodontium

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