Orthodontic traction and movement away from the barrier = continued root development Such as nasal floor, it is the cause of the arrested development If root abuts with an anatomical barrier. Yes but increased treatment difficulty and duration, example of 2 yearsĬan arrested root development be reversed? Prevalence and severity of dilaceration increase with age until apex closed Impacted incisor 2.3mm shorter root Sun 2016, Impacted canine 2.3mm shorter roo Cao 2021 Hooked apex 3-4 times more likely with impacted canines Orthodontic traction: Delay until bony infil, otherwise loss of gingivla and alveolar supoort If apex is open = root formation occurring What to do when premolar root formation has not occurred in adolescent patient Timing of impacted premolar interceptive treatment Impacted incisor due to obstruction – ideal time =7-8 yrsĭilacerated upper incisors – ideal time – at ½ root or less = 6-7 yrs, as removal of root proximity to the anatomical barrier can reduce the dilaceration of the forming root Removal of obstruction + space creation spontaneous eruption 82-89% Removal of obstruction, spontaneous eruption 36-75% Spontaneous eruption not predictable, likely require active (orthodontic traction) Likely spontaneous eruption, but risk of damage to permanent incisor in surgery Timing of impacted maxillary incisor interceptive treatment Prognosis of treatment of impacted canines is uncertain and reduces with age. Interceptive treatment includes: extraction C, D, distalisation molars, RME Timing of impacted maxillary canine interceptive treatment Root completed within 2.5 to 3 yrs post eruption Peak of eruptive potential is at 2/3 to ¾ of final root length Orthodontic traction: Ideal time for active (orthodontic traction) eruption is 2/3 to ¾ final root length. Interceptive treatment Ideal time for spontaneous eruption is ½ to 2/3 of final root length. Implications of timing on impacted teeth: Role of timing to the impacted tooth, the adjacent teeth and alveolar and skeletal growth. This podcast is a summary of the AAO lecture by Stella Chaushu and Adrian Becker. This podcast also explores the occurrence of asymmetries of both dental and facial due to impacted teeth, and what can be done about it.
Join me for a summary looking at impacted teeth and key components of timing which affect not only the success of alignment, but also root formation. Please like and subscribe if you find it useful! We get to hear of Audrey’s take on the AAO White paper on obstructive sleep apnoea.Ĭlick on the link below to view previous episodes, to refresh topics, pick up tricks and stay up to date. Audrey explains her thoughts on why the field of airways and orthodontics is controversial, and answers critical questions regarding orthodontics and sleep medicine. “Lots of patients are struggling with the symptoms (of obstructive sleep apnoea) when a little kid doesn't sleep it's not just the child's problem, their parents and other family member who also become sleep deprived”Īudrey describes her motivation in the young field of dental sleep medicine, the role of orthodontics in the management of paediatric obstructive sleep apnoea, the patient’s orthodontic treatment is appropriate in managing OSA, as well as those patients it is inappropriate for. Refer to physician if risk factors presentĬontents and video editing – Shanya Kapoor Mouth breathing does seem to have craniofacial influence, however OSA does not RME increases nasal airway volume initially of 1604 mm3, but reduce to 579mm3 after 3-5 months and non-significant SR Zhao 2021ĭoes not stop mouth breathing, even if OSA resolved Bae 2020īreathing involves complexity of 3D structures and fluid dynamics is not well understood MARPE increases cross sectional area, by 40% oropharynx, 7% nasopharynx Zhao 2020 Twinblock improves pOSA AHI 14.08 to 4.25 in the short term, severe to mild Zhang 2012 Investigating effects of treatment on these categories Recent study by Carlos Flores Mir, combine factorsĭemographics, lifestyle, craniofacial features and sleep features. No craniofacial difference in pOSA vs controls SR Fagundes 2022 OSA is defined disruption to breathing American Academy of Sleep Medicineĭefining mouth breathing at airflow over 25% through the mouth The lectures explore this controversial area in both medicine and orthodontics and review the current understanding of the topic, the relationship with facial features and current recommendations for orthodontists. Join me for a summary of two lectures from this year’s international orthodontic symposium (IOF), looking at mouth breathing and paediatric obstructive sleep apnoea, by Hong He and Carlos Flores Mir.
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