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Orthodontic Care - Copy - Copy


Many times during the course of orthodontic treatment, surgical procedures are needed to allow your orthodontist to complete your care. These procedures may include exposure of impacted teeth, frenectomy and surgical movement of teeth into their correct position. Sometimes movement of teeth into their correct position requires placement of a bracket. This allows the orthodontist to move the tooth into the correct position.

Our doctors are also specially trained in Orthognathic or Jaw Surgery. Patients who experience improper bite, or jaws that are incorrectly aligned can benefit from orthognathic surgery. Injury to the jaw or birth defects can also affect jaw alignment. Your dentist or orthodontist will determine whether or not you are a good candidate for orthognathic surgery, and then refer you to our office. A comprehensive consultation and evaluation will be performed, and additional x-rays, oral examination and studies may be done prior to rendering a treatment plan.

Classification of Teeth Overview

Orthodontics is the specialty of dentistry focused on the diagnosis and treatment of dental and associated facial irregularities. The results of orthodontic treatment can be dramatic — beautiful smiles, improved dental health and an enhanced quality of life for many people of all ages. Orthodontic problems, which can result from genetic and environmental factors, must be diagnosed before treatment begins. Proper diagnosis involves taking photographs, x-rays, and dental impressions, which enable our practice to make informative decisions about the form of treatment necessary.

Treatment typically lasts from 6 to 30 months, depending on age and the severity of the orthodontic problem. Outstanding results are also dependent on maximizing the coordination of care between you and our practice. We are committed to delivering the best possible service in order for you to achieve your orthodontic objectives.

Orthodontic Treatment Timing

Our surgeons provide orthodontic treatment for adults, adolescents and children. We follow the guidelines established by the American Association of Orthodontists by recommending that an orthodontic evaluation take place at age 7 for all children. This early evaluation can help to determine the best time to begin any necessary treatment.

Many progressive treatments are now available for patients 7 to 11 years of age that provide significant benefits, especially when jaw irregularities are present. These treatments may also prevent certain conditions from worsening. Treating children with these types of problems during their growth stages allows our practice to achieve results that may not be possible when face and jaw bones have fully developed. This early treatment can simplify or eliminate additional treatment for the child.

Expose
Bond
Luxate
Frenectomy

Exposure of Impacted Teeth

An impacted tooth simply means that the tooth cannot erupt into function. Patients frequently develop problems with impacted third molar (wisdom) teeth. These teeth get “stuck” in the back of the jaw and can develop painful infections among a host of other problems. Since there is rarely a functional need for wisdom teeth, they are usually extracted if they develop problems. The maxillary cuspid (upper eye tooth) is the second most common tooth to become impacted. The cuspid tooth is a critical tooth in the dental arch and plays an important role in your “bite”. The cuspid teeth are very strong biting teeth, which have the longest roots of any human teeth. They are designed to be the first teeth that touch when your jaws close together so they guide the rest of the teeth into the proper bite.

Normally, the maxillary cuspid teeth are the last of the “front” teeth to erupt into place. They usually come into place around age 13 and cause any space left between the upper front teeth to close tight together. If a cuspid tooth gets impacted, every effort is made to get it to erupt into its proper position in the dental arch. The techniques involved to aid eruption can be applied to any impacted tooth in the upper or lower jaw, but most commonly they are applied to the maxillary cuspid teeth. 60% of these impacted cuspid are located on the palatal (roof of the mouth) side of the dental arch. The remaining impacted eye teeth are found in the middle of the supporting bone but stuck in an elevated position above the roots of the adjacent teeth or out to the facial side of the dental arch.


Orthodontic Anchorage Devices

Temporary anchorage devices (TADs), provide a new way to move teeth into the proper position without having to use uncomfortable headgear. TADs provide further anchorage for orthodontic movement of teeth. Without TADs only anchorage available is the other teeth. TADs are small implants or plates that are temporarily fixed to bone within the jaw or roof of the mouth in order to provide orthodontic anchorage so that misaligned teeth may be moved into better position.

TADs can achieve a more precise tooth movement with far less inconvenience and discomfort.  

Placement of TADs is minimally invasive and can usually be done under local anesthesia or with sedation.

Luxation

This is a procedure where we have an unerupted tooth stuck in the jawbone well after is should have erupted and usually pertains to a posterior molar. This often occurs in 2nd molars and more often on the lower jaw. The problem is usually noticed by the dentist or orthodontist. On radiograph or x-ray, we see the second molar covered by bone and or tissue and is angled forward next to the tooth in front if it. This stuck tooth has minimal chance of erupting or straightening up on its own to erupt. If the dentist and orthodontist are worried this tooth wont erupt, a procedure called exposure with luxation is often done. During the exposure and luxation, the stuck normal molar is uncovered and once the wisdom tooth is removed, the stuck tooth is luxated or minimally moved to help it straighten vertically and put it on a path to help it erupt normally. There is a fine line between luxation and extraction of a tooth. Often the wisdom tooth behind this tooth is right up against this stuck tooth and is removed at the same time as the exposure and luxation. Prognosis for this procedure varies with how impacted the tooth we are trying to help erupt has developed and the angle of its eruption path. The more vertical the tooth, the better the prognosis for the exposure and luxation procedure. The exposure and luxation procedure has the least risk for devitalization of the tooth if we have less than two-thirds of the root formed on the tooth being luxated. The more formed the root is of this stuck tooth, the more risk we have of devitalization (the tooth dying by losing its blood supply and needing endodontic or root canal therapy).  Your surgeon will review your radiographs with you and help assess if this is the treatment indicated for your child.


Frenectomy