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Regular Treatment Plan

Indications for the
Pre-Orthodontic Trainer

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Pre-Orthodontic Trainer

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The Research


The Research

Dante Bresolin, DDS, MSD, Peter A. Shapiro, DDS, MSD, Gail G. Shapiro, MD et al.
Am J Orthod Dentofac Orthop 1983.

"While there are many claims that abnormal breathing patterns alter facial growth, there are limited controlled data to confirm this. We evaluated forty-five North American Caucasians of both sexes, ranging in age from 6-12 years. Thirty chronically allergic mouth-breathers were selected from pediatric allergy practice, and fifteen nonallergic nose breathers were selected from a general pediatric practice. Each subject underwent an intraoral clinical examination and a cephalometric radiograph analysis. Various skeletal and dental relationships were evaluated for statistic differences related to mode of breathing and age. The upper anterior facial height and the total anterior facial height were significantly larger in the mouth breathers. Angular relationships of the sella-nasion, palatal, and occlusal planes to the mandibular plane were greater in the mouth breathers and their gonial angles were larger. The mouth breathers' maxilla and mandibles were more retrognathic. Palatal height was higher and overjet was greater in the mouth breathers. Maxillary intermolar width was narrower in the mouth breathers and was associated with a higher prevalence of posterior cross-bite. Over all, mouth breathers had longer faces with narrower maxillae and retrognathic jaws. This supports previous claims that nasal airway obstruction is associated with aberrant facial growth. Longitudinal studies are needed to evaluate the effectiveness of early intervention in preventing these growth alterations."

Mouth Breathing in Allergic Children: Its relationship to Dentofacial Development
From the AJO-DO 1963 Jun (418-450):
The "Three M's": Muscle, Malformation and Malocclusion - Graber

"An analysis has been made of muscles and their relationship to structural configuration in Class I, Class II, and Class III malocclusions. The effect of muscle forces is three-dimensional, although most orthodontists have considered it only in one vector - that of expansion. Whenever there is a struggle between muscle and bone, bone yields. Muscle function can be adaptive to morphogenetic pattern. A change in muscle function can initiate morphologic variation in the normal configuration of the teeth and supporting bone, or it can enhance an already existing malocclusion. In the latter instance, the inherent structural malrelationship calls for compensatory or adaptive muscle activity to perform the daily functions. The structural abnormality is increased by compensatory muscle activity to the extent that a balance is reached between pattern, environment, and physiology. At times it is impossible to assign a specific cause-and-effect role to any one factor. It is imperative that the orthodontist appraise muscle activity and that he conduct his orthodontic therapy in such a manner that the finished result reflects a balance between the structural changes obtained and the functional forces acting on the teeth and investing tissues at that time."

Alan M. Gross, Phd, Gloria D. Kellum, PhD, et al.
Am J Orthod Dentofac Orthop 1994: 106:635-40.

"It was observed that children with open-mouth posture displayed a significantly slower pattern of maxillary growth compared with children who display anterior lip seal posture."

C.T. Nevant, P.H. Buschang, R.G. Alexander and J.M. Steffen
(AM J Orthod Dentofac Orthop 1991;100:330-6).

"Lip bumpers have been used to gain arch length for the alignment of mild to moderately crowded dental arches. The dental changes produced can be attributed to removal of lip pressure on the lower anterior dentition..."

Donald G. Woodside, Sten Linder-Aronson, Anders Londstrom and John McWilliam
Am J Orthod Dentofac Orthop 1991;100:1-18.

"The amount of maxillary and mandibular growth and the direction of maxillary growth were studies in 38 children during the first 5 years after adenoidectomy for correction of severe nasopharangeal obstruction. The amount of mandibular growth measured between successive gnathion points on superimposed radiographs was significantly greater in the group who had an adenoidectomy than the matched controls.

In the boys the difference was 3.8mm (p < 0.01), and in the girls the difference was 2.5mm (p < 0.01). The boys also showed a tendency towards greater growth in the maxilla as measured between subnasal points. (1.2mm, P < 0.05).

Linder - Aronson demonstrated varying degrees of recovery from steep mandibular plane angle, narrow maxillary arches and retroclined maxillary and mandibular incisors during the 5 years after adenoidectomy and change from mouth to nose breathing."

Ram S. Nanda, DDS, MS, Phd, and Surender K. Nanda, DDS, MS
American Journal of Orthodontics and Dentofacial Orthopedics April 1992.

"The question of long term retention and stability of occlusions after orthodontic treatment has always engaged the attention of the specialty. The improvements achieved from long and painstaking treatment may be lost to varying degrees after the appliances are removed. Sometimes relapse in tooth positions is noted even during the period when a patient is using the retention appliances. The question often asked by patients is how long should active retention with appliances be maintained?

Recent studies on assessment of long term observations of post-treatment results have indicated that relapse occurs in most cases. Orthodontic treatment rendered in conjunction with extraction or nonextraction procedures met the same fate. No variable was found to be predictive of either stability or relapse. Does contemporary orthodontics have no satisfactory solution to the problem of achieving long-term stability?

The debate on extraction versus nonextraction orthodontic treatment approaches has waxed and waned thought this century. The matter of long term stability of the corrected result has never been satisfactorily resolved. Perhaps several additional factors may have an important bearing on orthodontic stability."

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