Very rare case of real buccal non-occlusion or Brodie syndrome (the maxilla is too wide)
Result: lower face height collapsed
Result: retruded profile
Treatment : establishment of correct jaw width with fixed appliances and treatment of profile using intrabuccal elastics.
Correction of lower facial height
Young man's straight profile
Retained canines: two upper (red) and one lower (green)
Fixed appliances in both jaws
This solution is chosen when:
The needed corrections are too much to be done without surgery.
Too late. Growth is finished.
Examples (orthodontic preparation and finishing Dr Dahlquist)
Correction of both jaws
Correction of open bite(surgery Dr A. Jaquinet, Clinique de Genolier)
Surgery allows major improvement of the profil (Surgery Dr A. Jaquinet, clinique de Genolier)
Very seldom surgery case:
Patient with retruded(too posterior) mandible and 4 congenitally missing lower teeth. Surgery was needed from start
Complex orthodontic treatments
All gaps/spaces closed and surgical mandibular advancement done by Dr Jaquinet/Genolier
Change of profil, before-after surgery.Patient did not want more improvement.
Young patient with premolars which have decided to grow in a peculiar direction:
First step: remove the decideous tooth and put in a space retainer. Second step: wait!
Full success above. The tooth below needed some surgical help(Dr Jaquinet/Genolier).
Both teeth develop normally.
Lower picture: treatment finished. Both teeth are in place.
Multiple missing adult teeth in a teenager:
The existing adult teeth are marked with a green dot: 7 instead of 12 in the upper. 5 instead of 12 in the lower. There is missing a total of 12 adult teeth. Without including the wisdom teeth.
In such a case the only solution is to prepare for implants when adult.
Look at: "implants or close spaces" for more info.
Treatment plan: Obtain the best possible temporary esthetic result. Close as much as possible the spaces due to the numerous missing adult teeth.
Above:In this young person the decideous/baby teeth have been included in the treatment. This is not usual practice. Here nothing is usual.
Below: During treatment. A first goal has been reached. The lower temporary bridge has been inserted after orthodontics.
Above: treatment(temporary) finished. Adult teeth(green) are in place.
The double wire in top is behind the teeth. It is used as:
2/ Mean to maintain the temporary crowns(red dots and see below) which are not visible on the x-ray
Below: Result in mouth. This young person can have a normal social life. The lower temporary bridge did not last and has been replaced by a removable prothesis.
As an adult he will have implants.
Young patient with mandibular retrusion: The lower jaw is posterior:
Decay and filling in the upper jaw on both molars(in red).
Growth modification using a "monobloc" functional appliance(look at the page: "Growth Modification")
Removal of both upper first molars.
Let the second molars(in green) growth spontaneously into the space left.
Goal is reached: Good position of the jaws. The second molars have grown into the space left by the first molars(green). The wisdom teeth(blue) will develop normally and grow into the space left.
PATIENT HAS ONLY HAD THE REMOVABLE APPLIANCE.
No decay problem and no need to do upper wisdom teeth extraction.
Adolescent patient with big anterio-posterior difference between the jaws.
Such patients are best started at age 10-11.
Combined treatment "carrier" to correct antero-posterior then fullfixed appliances(braces)
Same kind of problem as previous patient but this is an adult!!!.
The profile of this patient allows for retraction of upper incisors.
Same treatment but after Carrier he had Invisalign.
After first stage of "Carrier" patient is now ready for Invisalign to align the teeth and obtain good occlusion:
Skeletal open bite:
These cases are usually treated by surgery(see above surgery case). Here was decided to try a less invasive technique: two temporary implants were installed and elastics attached to them to pull the upper molars upwards
The upward movement of the upper molars(light green) has allowed for a closing rotation of the mandible(orange) correcting the open bite: