MINI-IMPLANTS IN ORTHODONTICS (Mini implants or TADs, temporary anchorage device). Malocclusion is when the teeth aren’t aligned properly. A Skeletal Class III malocclusion is one of the most difficult things to correct. Skeletal Class III anomalies are associated with maxillary retrusion (the upper jaw is placed behind the lower jaw) or mandibular protrusion (the lower jaw is placed a little ahead of the upper jaw) or both. When there is a maxillary deficiency where the lower jaw is not markedly affected, treatment may involve stimulation and guidance of upper jaw growth by orthopedic forces. “There are treatments involving various types of extraoral appliances, such as facemasks and reverse pull headgears have been used to this. However, many patients fail to comply with this because of the appearance of the headgears and facemasks are not appealing. Implants as a useful tool in orthodontic therapy are quickly gaining acceptance. They provide the qualities of an ideal orthodontic anchor. Meaning, they help to guide the bones back into their correct place. In fact, recently mini-screws (mini-implants) have become popular because they are easier to both insert and remove. These implants make patient compliance unnecessary, provide absolute anchorage as there is no periodontal ligament, are easily used under a variety of treatment modalities, and are easily placed and removable, if necessary.Once the Implant is gently positioned into place, it can be loaded immediately; there is no reason to wait for the soft tissues or bone to heal. Neither is traumatized by this non-surgical procedure, which rarely even requires ibuprofen administration. Mini-implants can be safely used on adults as well as on children after the age of 13 years.

INCOGNITO BRACES

Incognito is a high-tech appliance for patients with all kinds of different malocclusions. It is completely invisible, easy to keep clean and the only one who knows you are having orthodontic treatment is you. It is designed only for your teeth so not only does this mean it is a perfect fit but that you will get perfect results. Both the brackets and the wires of the Incognito appliance are manufactured individually with the latest state of the art CAD/CAM technology. The remarkable flat design of the gold alloy brackets (anti-allergic) provides maximum patient comfort and rapid adaptation to speech.

Invisible
New generation of orthodontic braces for teens and adults. Because they are placed behind your teeth, no one will ever know you are wearing braces unless you tell them. Incognito Appliances can give you a beautiful smile, even while you’re wearing them.
Individualized
The only 100% customized fixed appliance system for invisible orthodontic treatment. They are created using state-of-the-art technology and are completely customized to the shape of your teeth and to your dental situation. And they have the unique prescription that your orthodontist creates for you built-in, to ensure you get the results that you want.
Intelligent
With Incognito you get efficient, effective tooth movement and great aesthetics. From the outset, the brackets and wires are engineered to deliver targeted results

CLEARPATH ALIGNERS

From clearpath aligners

MOST OF THE ADULT PATIENTS WHO WANT BRACES WANT TO BE DISCREET OF THEIR ORTHODONTIC TREATMENT(BRACES).WITH GAINING POPULARITY WITH ADULT ORTHODONTICS USE OF ALIGNERS FOR CORRECTION OF TEETH IS INCREASING.

ClearPath Aligners are removable medical grade plastic appliances which patient wears instead of brackets and wires to correct malocclusion. Dental aligners are a modern alternative to braces, teeth that are in need of straightening.

A Clear change to the concept of Adult Orthodontic treatment without using conventional methods of wires and brackets. Adults wouldn't have asked for a better choice to correct their malocclusion without social inhibitions.

HOW DOES CLEARPATH ALIGNERS WORK?


The key to the CLEARPATH ALIGNERS system is that it is designed entirely with the customer in mind. Through a combination of WELL DEFINED IMPRESSION OF UPPER AND LOWER TEETH, X-rays and photography, your dentist will build up a ‘photofit’ of your teeth and jaw structure. He then transfers these images to the CLEARPATH ALIGNERS laboratory where a highly-trained technician, working closely with your dentist, will develop a computer-generated model of how you want your teeth and your smile to look. By using advanced computer packages, they can evaluate different scenarios and ensure that your teeth are being moved in the most efficient way, to the ideal positions.

Therefore, you can see before the treatment begins where you teeth will move to and how your smile will look after the treatment. That gives a lot of patients the reassurance they need before they commit to the cost of the full procedure. Once you and your dentist are both happy that the computer-generated model is showing the right results for you, your dentist will commission the production of the transparent aligners. The aligners, therefore, are designed and built specifically for you and to the exact specification agreed with your dentist. So you can simply look forward to the results.


WHAT ARE THE ADVANTAGES OF CLEARPATH ALIGNERS?


The method of treatment offers patients who choose it a number of significant advantages:

1) TIME-LESS CHAIRSIDE TIME AND SHORTER APPOINTMENTS.

2) AESTHETICS
This is probably the primary reason why most people choose ALIGNERS and it is another example of how this product is designed to minimize disruption to everyday life. Aligners are made of thin, discrete and transparent plastic, so they are barely visible while you are wearing them. It’s a huge contrast with conventional braces, where the metal brackets are virtually the first thing that people notice when they meet you.


3)COMFORT

Finally, conventional braces also cause disruption to your everyday life because they can be so uncomfortable. Conventional braces are fixed, so it can make it difficult to chew and food can easily get trapped around your braces, brackets, elastics and wires. Also, your dentist has to tighten the braces on a regular basis, to ensure that they are still moving the teeth effectively. This can be uncomfortable – not to mention the inconvenience of so much time spent in the dentist’s chair.


In the majority of cases, aligners are used to realign teeth, correct a smile and to provide a fast, discrete cosmetic enhancement. Any more significant issues may require a treatment that is perhaps less comfortable to wear, but which in the long run will provide far more sustainable results. Aligners is primarily suited to individuals who require relatively minor orthodontic work. If we apply the above decision-making process, its cost and the fact that the aligners are removable probably means that most dentists would recommend this treatment to adults who are interested in a fast, low maintenance cosmetic solution.

From clearpath aligners

TOOTH ERRUPTION CHART

From spacing

The tooth erruption chart shows the mean age at which the milk teeth(decidious teeth) falls and the permanent teeth comes into the oral cavity.In some children there may be a delay in the milk teeth to fall and the permanent teeth to errupt.In such situation please consult your dentist who will be the best person to advise you.

THUMBSUCKING

From spacing

THUMB SUCKING HABIT
Thumb sucking is a common habit among many children. It is common with children under two and is associated with the need to seek food. In some infants it can signal fatigue, sleep, hunger, teething and shynes.If the child continuous the habit after the age of 5 ie when the permanent teeth is erupting then it is harmful as they can develop malocclusion like open bite. The intensity of thumb sucking is a factor which determines whether or not dental problems may occur. Vigorous thumb suckers will have more dental problems.
It is done to comfort your child when they are:
1) Bored
2) Tired
3) Worried
4) Feeling stressed .

The possible effects of thumb sucking for children after the age of three is:
1) Reshape the jawbone because their jawbones are still soft and pliable
2) Teeth grow out of aliment and position
3) Narrows dental arches which cause the next problem
4)Upper front teeth will flare out and tip upward
5) Lower teeth will move inward

Affect growth of child's palate (roof of the mouth) causing:
1) Poor tongue placement
2) Problems chewing
3) Problems with learning to swallow properly. The tongue plays a major role in swallowing. For people who don't suck their thumb or finger, their tongue goes up behind the roof of their mouth as they swallow and this causes a seal. But, when trying to swallow while sucking the thumb or finger, the tongue is thrust forward, in between the front teeth. This action makes swallowing difficult and will require re-training to correct the tongue movement.
4) Problems speaking
5) Overbite or open bite
6) Make tonsils collapse to cause snoring
7)The skeletal deformities which can develop can lead to insecurities and self-image problems, particularly in children.
8) Cause infections to develop around fingernails to spread infectious diseases.

Kids who continue to suck their fingers or thumb by the age of 4 to 5 were more likely to develop:
1) develop protruding front teeth
2) an irregular bite
3) affect the development of the jaw
4) influence the placement of developing teeth.

TREATMENT

It is important to stop the thumb sucking habit BEFORE permanent teeth come in. Breaking the habit sooner will make it easier for you, the parent, your child and their mouth!
If they can not stop on their own, by the ages of two to four, they may need help:
• Don't pressure your child to stop, this can reinforce the habit .
• Talk to them about the reasons and ways to work together to stop the habit.
• Praise them when they do not suck their thumb
• Don't get frustrated with your child; this tends to make the habit worse.
• If they suck because they feel insecure, focus on eliminating the cause of the anxiety or if they do it for comfort, offer them comfort instead of sucking their thumb.
• If your child is older, involve them in choosing the method of stopping.
• Remind your child of his habit by bandaging his thumb or putting a sock on his hand at bedtime .
• Ask your dentist to explain to your child the effects of thumb sucking and encourage him to quit.
• The Thumbguard is a device that is attached to a child's wrist using a colorful bracelet. When attached properly, a child can not remove T-Guard. The children must wear the appliance whenever they may be tempted to suck. It comes in different bright colors.
• See your orthodontist and learn about a “ fence” which is an appliance that will help your child to stop sucking their thumb.(see the picture below)

From spacing

TONGUE THRUSTING HABIT

From spacing

Tongue thrust (also called reverse swallow or immature swallow) is the common name of orofacial muscular imbalance, a human behavioral pattern in which the tongue protrudes through the anterior incisors during swallowing, speech, and while the tongue is at rest. Nearly all young children exhibit a swallowing pattern involving tongue protrusion, but by the age of six most have switched to a normal swallowing pattern. People who tongue thrust do it naturally and are usually unaware of the behavior.

No one specific cause has actually been determined for the tongue thrust problem.

Any of the following may cause tongue thrust:

1)Certain types of artificial nipples used in feeding infants

2)Thumbsucking

3)Allergies, nasal congestion or obstructions contributing to mouth breathing causing the posture of the tongue to be very low in the mouth

4)Large tonsils, adenoids, or many sore throats which cause difficulty in swallowing

5)An abnormally large tongue

6)Hereditary factors within the family, such as the angle of the jaw line

7)Neurological, muscular, or other physiological abnormalities

8)Short lingual frenum (tongue tied).

There are several different types of tongue thrust and resultant orthodontic problems:

1)Anterior open bite - the most common and typical type of tongue thrust. In this case, the front lips do not close and the child often has his mouth open with the tongue protruding beyond the lips. In general, it has been noted that a large tongue usually accompanies this type of tongue thrust.

2)Anterior thrust - upper incisors are extremely protruded and the lower incisors are pulled in by the lower lip. This particular type of thrust is most generally accompanied by a strong mentalis (muscle of the chin).

3)Unilateral thrust - the bite is characteristically open on either side.

4)Bilateral thrust - the anterior bite is closed; however the posterior teeth from the first bicuspid to the back molars may be open on both sides. This is the most difficult thrust to correct.

5)Bilateral anterior open bite - the only teeth that touch are the molars with the bite completely open on both sides including the anterior teeth. Once again a large tongue is also noted.

6)Closed bite thrust - typically shows a double protrusion meaning that both the upper and lower teeth are flared out and spread apart.
"Tongue thrust" has been noted that a significant number of school-age children have tongue thrust. For example as many as 67 to 95 percent of the children 5 to 8 years old exhibit tongue thrust which may be associated with or contributing to an orthodontic or speech problem.

What are the consequences?

The force of the tongue against the teeth is an important factor in contributing to malformation ("bad bites"). Many orthodontists have had the discouraging experience of completing dental treatment, with what appeared to be good results, only to discover that the case had relapsed because the patient had a tongue thrust swallowing pattern. If the tongue is allowed to continue its pushing action against the teeth, it will continue to push the teeth forward and reverse the orthodontic work.

Is speech affected by tongue thrusting?

Speech is not frequently affected by the tongue thrust swallowing pattern. The "S" sound (lisping) is the one most affected. The lateral lisp (air forced on the side of the tongue rather than forward) shows dramatic improvement when the tongue thrust is also corrected. However, one problem is not always associated with the other.

At what age does a child usually exhibit a tongue thrust swallowing pattern?

A child exhibits a tongue thrust pattern from birth. Up to the age of four, there is a possibility that the child will outgrow the tongue thrust pattern and develop the mature pattern of swallowing. However, statistics have shown that if the tongue thrust swallowing pattern is retained, it may be strengthened beyond the age of four. In all probability, the child will need some type of training program to develop the mature swallowing pattern.

Treatment for the tongue thrust swallowing pattern may be handled in two ways:

1)An appliance that is placed in the mouth by the dentist (mechanical method).

2)Correction by oral habit training - an exercise technique that re-educates the muscles associated with swallowing by changing the swallowing pattern. This method must be taught by a trained therapist. Therapy has proven to give the highest percentage of favorable results, however the appliance is still used and is successful in some cases

MIDLINE DIASTEMA

From spacing

MIDLINE DIASTEMA
Diastema (Gap between Teeth)
A diastema is a space or gap between two teeth. It appears most often between the two upper front teeth. However, gaps can occur between any two teeth.

A mismatch between the size of the jaw bones and the size of the teeth can cause either extra space between teeth or crowding of teeth. If the teeth are too small for the jaw bone, spaces between the teeth will occur. If the teeth are too big for the jaw, teeth will be crowded.
Sometimes some teeth are missing or undersized. This happens most often with the upper lateral incisors (the teeth next to the two upper front teeth). That can cause the upper central incisors to develop a space.

A diastema also can be caused by an oversized labial frenum. The labial frenum is the piece of tissue that normally extends from the inside of your upper lip to the gum just above your two upper front teeth. In some situations, the labial frenum continues to grow and passes between the two front teeth. If this happens, it blocks the natural closing of the space between these teeth.

Habits can also lead to gaps between the teeth. Thumb sucking tends to pull the front teeth forward, creating gaps. A diastema that occurs because of a mismatch between the teeth and the jaw does not have symptoms. However, spaces caused by a tongue thrust habit or periodontal disease will tend to expand or grow with time. The teeth may become loose, and discomfort or pain may occur, particularly during biting or chewing. You may notice a space when brushing or flossing. Your dentist can see spaces during an examination.
Prevention

Not all spaces can be prevented. For example, if the reason for a space is a missing tooth or a mismatch between the teeth and the jaw size, the spaces cannot be prevented without treatment.

Maintaining your gum health is essential to good oral health. Regular flossing and brushing will help to prevent periodontal disease and its related bone loss.

People with a tongue thrust habit can re-learn to swallow by pushing their tongue up against their palate. Breaking this habit can prevent widening of the spaces between teeth.
Treatment

Sometimes, a diastema is part of a set of problems that require orthodontic treatment. In other cases, a diastema is the only problem. However, some people may seek treatment for reasons of appearance.

Some people get braces, which move the teeth together. Often, no matter where the diastema is, you must wear a full set of braces — on both your upper and lower teeth. That's because moving any teeth affects your entire mouth.

If your lateral incisors are too small, your dentist may suggest widening them using crowns, veneers or bonding.

If you have a space because you are missing teeth, you might need more extensive dental repair. This might include dental implants, a bridge or a partial denture.

If a large labial frenum is causing the gap, the frenum can be reduced through surgery called a frenectomy. If a frenectomy is done in a younger child, the space may close on its own. If it is done in an older child or an adult, the space may need to be closed with braces.