[VARIOUS ASPECTS OF EARLY ORTHODONTIC TREATMENT].
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Traditional methods of model and cephalometric examination are often unreliable for diagnosis and treatment planning. This article presents soft tissue cephalometric analysis that measures the face, analyzes important dentoskeletal structures that determine facial appearance, and reveals the etiology of malocclusions. A technique for cephalometric treatment planning for guiding esthetic facial changes and the method of occlusal correction are also described. Vertical maxillary excess and vertical maxillary deficiency malocclusions are used to illustrate these techniques.
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Drooling in children with neurological dysfunction indicates neurogenic failure to coordinate the muscles of the tongue, soft palate, and face which act in the first stage of swallowing. This causes excessive pooling of saliva in the anterior part of the mouth and consequent overspill. Treatment for drooling includes behavioral, pharmacological, and surgical modalities. Correcting a malocclusion has also been reported to help eliminate drooling. This paper describes the treatment of a child with neurofibromatosis, psychomotor, developmental, and neurologic retardation, and difficulty with speech. The patient was referred to our clinic to correct his drooling. Simple orthodontic treatment succeeded in eliminating the drooling and improving his speech.
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This case report demonstrates how to use intraoral mechanics to correct facial planes that are not parallel, namely the eye plane, ear plane and occlusal plane. Currently, our protocol states that the cranial and occlusal planes are treated first, followed by expanding (transversely or sagittally), if necessary, the maxillary arch to accommodate the dentition. This creates the template from which the remaining treatment will be rendered, which would include, proper TMJ position, correction of mandibular facial asymmetries that result from ramus growth deficiencies, (both frontal and profile), and determining the correct posterior vertical. At this point the case is in a Class I osseous relationship with all expansion completed. The teeth are then erupted into the correct positions for the orthodontic finishing of the case.
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