Growth modification with removable appliances

Important: These treatments are not possible in the adult

Goal is to obtain a good fit between upper and lower jaw.

Treatment example :

Growth modifcation of a young male between ages 11 and 13.

Beginning

End of treatment

Growth modification can make a big improvement of the profile. Same patient.

At what age is it recommended to start a growth modification treatment?

 

In order to obtain a stable result, it is mandators that end of treatment all the adult teeth(wisdom teeth not included) have erupted.

 

For a simple reason : 

Adulte teeth. Like LEGO, stable

Baby teeth, flat, unstable relationship

Adulte teeth fit together, like LEGOs, much better than baby teeth.

The decision at what age to start treatment is easy to calculate:

  • At what age have the adult teeth erupted ? Around 12-13.

  • How long time takes the treatment ? About 18-24 months.

  • Treatment should start at 10-11.

 

To start earlier will extend the duration of treatment.

 

 

Growth modifying applicances

Happy young patients, this is what your parents had to wear and you don't.

Appliances used today are inside the mouth. The goal is to slow growth of maxilla and enhance growth of mandible.

 

The most common appliance,the Activator or Monobloc, has been around for over half a century and it works perfectly, like the others, but only with cooperation.

  • Appliances are custom made for each patient.

  • Disconfort : it's like walking with ski boots, annoying at start then you get used to it. No pain.

  • Appliance is worn at night AND 2 hours at home.

  • We use 3 different types of appliances (Activator, Herbst, PUL). The decision as to which to use depends of treatment.

  • It only works with good cooperation from patient AND parents.

This has been established for 20 years. No university teaches otherwise.

 

But :

- This concerns only growth modifications.

- Due to social pressure, psychological aspects, some patients will     start earlier.

- In order not to miss anything, a first appointement is recommended   at age 6-7.

mandible

 

maxilla

10:00am - 6:00pm

10:00am - 6:00pm

10:00am - 6:00pm

10:00am - 6:00pm

Monday
Tuesday

Wednesday
Friday

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Growth modification using the monobloc appliance:

This patient has only had treatment with a monobloc:

 

Before:                                                                                                        After:

The monobloc is the most versatile growth modification appliance around but it is a bit bulky. It has been used in Europe for a very long time.

It is like walking with ski-boots. Difficult at first and then okay. Patients adapt to it.

 

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Other patient treated solely with a monobloc:

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1/Activator or Monobloc. 2/ PUL. 3/ Removable Herbst