Orthodontic treatment in the transverse and sagittal planes

This course will take you from zero to hero of the following orthodontic topics: Transverse discrepancies and Treatment of sagittal discrepancies

Here are the main headlines that this course covers:

Transverse discrepancies

1. Development of crossbite

1.1 Classification

2. Posterior crossbite

2.1 Etiology of posterior crossbites

2.1.1Genetic factors

2.1.2 Habits

• Mouth breathing
• Finger sucking
• Infantile deglutition
• Lingual interposition

2.1.3 Interferences and occlusal factors

• Trauma
• Other causes

2.2 Types of posterior crossbites

• Functional crossbite
• Dentoalveolar crossbite
• Skeletal crossbite
• Scissors bite

2.3 Diagnosis for posterior crossbite

2.4 Variables that can have influence in the correction of posterior crossbites

• Teeth inclination
• Lateral functional displacement during mandible closure
• Estimation of the necessary expansion
• Age of the patient
• Vertical changes

2.5 Reasons and timing of treatment of posterior crossbites

3 Disjunction

3.1 Effects of disjunction

3.2 Effects on the maxillary complex

3.3 Effects on the alveolar process

3.4 Dental effects

3.5 Effects on the mandible

3.6 Effects on the adjacent facial structures

3.7 Disjunction indications and Counter indications

4. Treatment for posterior crossbite

• Quad Helix
• Transpalatal arch with an extension arm
• Inverted NiTi arch
• Overlay
• Crossed elastics or “Z” elastics
• Hass
• Hyrax
• Surgical disjunction

Treatment of sagittal discrepancies

1. Development of a sagittal problem

2. Diagnosis of sagittal discrepancies

3. Class II malocclusion

3.1 Clinical examination and functional assessment

3.2 Morphologic characteristics

3.3 Treatment planning

3.3.1 Dentoalveolar Class II malocclusions

• Maxillary distalization:

Fixed distalizers – open coil spring, elastic NiTi wires or Dr Richard Vlock’s technique, sliding hooks, Pendulum appliance, Distal jet

Removable distalizers – Cetlin plate, Veltri distalizer, Belussi Distalizer

• Non extraction headgear treatment

3.3.2 Functional Class II with distally forced bite

3.3.3 Skeletal Class II with maxillary prognathism

• Extraction treatment
• Management of the extraction space
• Indications and contraindications
• Extraction pattern in class II cases
• Extraction space closure biomechanics by:

1. Elastics,

2. Coils,

3. Loops:

• The open ”I” loop.

• The closed ”I” loop.

• The closed helicoid ”I” loop,

• Ricketts loop.

• Bull or Keyhole loop,

• The “T” loop,

• The segmented “T” loop,

• The utility retraction loop.

• The DKL (Double Key Loops).

4. Retroligature

3.3.4 Skeletal Class II with prognathism and anteinclination of maxilla

3.3.5 . Skeletal Class II with retrognathic mandible

4. Class III malocclusion

4.1Treatment Problems

4.2 Anterior crossbite

• Etiology
• Clinical evaluation
• Classification – Dental anterior crossbite, Functional anterior crossbite, skeletal anterior crossbite
• Differential diagnosis between true and Pseudo Class III malocclusion
• Treatments for anterior crossbites

1. Dentoalveolar Class III

• Extraction treatment
• Forward arch
• Bite block
• Lingually placed bracket

2. Functional Class III malocclusion (with pseudo-forced bite or anterior displacement)

3. Class III malocclusion with retruded maxilla

• Face mask treatment
• Orthognathic surgery

4. Class III malocclusion with mandibular prognathism

• Orthognathic surgery

5. Class III malocclusion with a combination of maxillary retrognathism and mandibular prognathism