Skeletal pattern

Patients are three-dimensional and therefore the skeletal pattern must be assessed in anterior-posterior (A-P), vertical and transverse relationships. Although the soft tissues can tip the crowns of the teeth the skeletal pattern fundamentally determines their apical root position. The relative size of the mandible and maxilla to each other will determine the skeletal pattern. The smaller the mandible or the larger the maxilla the more the patient will be Class II. Conversely with a bigger mandible or smaller maxilla the patient will be more Class III. The bigger the size discrepancy between the maxilla and mandible, the more difficult treatment becomes and the less likely it is that orthodontics alone will be able to correct the malocclusion. Although some orthodontic appliances have a small orthopaedic effect, treatment is generally most easily accomplished on patients with a normal skeletal pattern and a normal relationship of the maxilla to the mandible.

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