Nongrowing Patient Research Articles

A nonsurgical approach to treatment of a high angle class II, division 1 malocclusion in a nongrowing patient

This case report is presented according to the guidelines set by the American Board of Orthodontics. The patient presented with a Class II, Division 1 malocclusion, characterized by a high mandibular plane angle, severe overjet with excess gingival display, and high, labially positioned maxillary canines. Treatment of this malocclusion consisted of maxillary second molar extraction and maxillary buccal segment retraction with a combination headgear, followed by comprehensive fixed appliance therapy. [This case report was presented to the American Board of Orthodontics in partial fulfillment of the requirements for certification by the Board.]

Case report MM. Surgical-orthodontic correction of bilateral buccal crossbite (Brodie syndrome)

A surgical approach to treatment was required for this 35-year-old patient to correct a malocclusion characterized by a bilateral buccal crossbite. Surgical procedures included a LeFort 1 osteotomy to reduce maxillary width and correct the vertical asymmetry. The mandible was lengthened with a bilateral sagittal split osteotomy. Treatment options for the nongrowing patient are limited in the correction of severe skeletal disharmonies.

Differential diagnosis and treatment planning for the adult nonsurgical orthodontic patient

Increasing numbers of adult patients are seeking orthodontic care and some, despite significant skeletal malocclusions, elect not to have combined orthodontic-surgical treatment. The purpose of this article is to outline some of the diagnostic and therapeutic principles that can be used in the adult nonsurgical orthodontic patient. The importance of realistic goal setting in the face of compromised occlusions is emphasized. Diagnosis should include evaluation of all three dimensions and recognize the limitations of therapy in each dimension for the nongrowing patient. Periodontal considerations, extraction decisions, and retention regimens are of vital importance to the achievement and maintenance of an optimum result. Clinical records will demonstrate four commonly seen problems and their resolution.

Control of the transverse dimension with surgery and orthodontics

Control of the transverse dimension through surgical techniques now available for use by the orthodontist is a valuable treatment consideration for orthodontic therapy in the nongrowing patient. In this article, proper diagnosis of relative and absolute transverse maxillary deficiency or excess is stressed as being imperative prior to completion of definitive orthodontic and/or surgical treatment planning. Therapeutic alternatives designed to facilitate correction of transverse discrepancies concomitant with treatment objectives in the sagittal and vertical dimensions are discussed and illustrated with case reports.

The adult orthodontic patient

Adults now make up an increasing portion of the orthodontist's patient load. Though most seek esthetic correction, requests for multidiscipline treatment are expanding. The etiology of adult malocclusion, unlike that of malocclusion in the young, presents us with psychological and physiologic factors that specifically affect treatment and dictate special diagnostic, planning, and mechanical procedures. The adult patient offers the orthodontist a new challenge and the stimulus to develop successful treatment approaches peculiar to the nongrowing patient. Careful diagnosis and treatment planning on a multidiscipline basis will result in satisfactory resolution of most adult malocclusions, and there is no requirement for esoteric appliances or mechanics. An evaluation of treated cases indicates that all corrective dental movements are possible and that the health, function, and esthetics of the dental apparatus can be markedly improved. The cases presented demonstrate that adults are amenable to treatment over the full orthodontic spectrum. Treating the adult patient can be very satisfying. The patient is invariably pleased with his effort (and your help), once the “braces” are off. Since the original need was great in the patient's mind, success in its satisfaction is especially rewarding and it overflows on everyone involved.