Extraction vs. nonextraction. A second opinion.
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Biomedical subjects
Publications and source records attributed to L J Carapezza.
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Presently there are several controversial areas in the clinical practice of dentistry. One area which presents an ethical dilemma to the clinician is the delivery of quality and sufficiency of treatment of malocclusion. The mode of treatment of malocclusion by orthodontists, pediatric dentists, generalists represents a classic turf battle with its potential ethical problems. The author calls for objectified standards of care which help to preserve ethical values related to our patients. Clinical research is presented to help focus on this ethical dilemma.
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A most common type of early malocclusion that the pediatric dentist comes in contact with daily is the developing Class II Division 2 malocclusion (Fig 1-a,b). It is the malocclusion that the parents of the children we serve bring to our attention. Parental concern is the early crowding that develops in the anterior of the lower arch with risk of periodontal involvement. This malocclusion is readily amenable to interception at age 7 or 8 and can proceed with a protocol of defined objectives and predictable outcomes (Fig 2). With efficient and effective utility arch wire (UAW) mechanics a state of normalcy can be achieved within six to eight months of treatment.
Opportunities for preventive orthodontic treatment of children arise during all stages of oral growth and development. It is in the best interest of the child to achieve a state of normalcy in the neuromuscular, skeletal, and dental structures. This article provides a guide for treating malocclusion with utility archwire appliances in the mixed dentition and finishing the permanent dentition with a fully adjusted appliance.