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Orthodontic treatment in the mixed dentition for the general dentist.

Mixed dentition treatment is an important subject because early treatment could not only correct the occlusion but also may ensure normal development of the teeth. Proper arch form and dental relationships in the mixed dentition lessen the need for additional orthodontic treatment. The objectives in mixed dentition orthodontic therapy are to correct dental arch irregularities, occlusal and jaw relation abnormalities, and to eliminate functional interferences.

Child

[Prosthetic measures in the mixed dentition].

Prosthetic measures in the mixed dentition must allow for the actualities of this developmental phase. Traumatic or developmental injuries to enamel and dentine, accidental tooth loss and hypodontia or oligodontia are indications for prosthetic treatment in school children, at which orthodontic aspects should always be considered. The prosthetic approach is characterized by the respect to preventive aspects related to the further biomorphosis of the dentition. With reference to the different phases of mixed dentition, methodical suggestions are given in the form of tables.

Anodontia

An analysis of three mixed dentition analyses.

The accuracy of prediction of three mixed dentition analyses was compared. Hixon and Oldfather's method was found to be the most accurate. A simplified version of the analysis obviates referral to a table, allowing assessment of the size of the unerupted teeth prior to eruption of the lateral incisor.

Bicuspid

Prediction of breadth of permanent canines and premolars in the mixed dentition.

Multiple stepwise regression was used in the selection of mixed dentition variables capable of predicting the total breadth of the unerupted permanent canine and premolars. The material consisted of 77 children. Stone casts were made before and after eruption of the canine and premolars. At the first examination when the children were, on the average, 10 years old, intraoral roentgenograms were obtained of the canine and the premolars. To predict the total breadth of the upper canine and premolars the buccolingual breadth of the upper first permanent molar and measurements on roentgenograms of the breadths of the upper canine and premolars proved most useful. In the prediction of the total breadth of the lower canine and premolars the best results were obtained with measurement of the breadths of the teeth in the roentgenograms. The breadth of the incisors proved less useful as a predictor of the breadths of unerupted canines and premolars.

Bicuspid

Early or late cervical traction therapy of Class II malocclusion in the mixed dentition.

It was the purpose of this investigation to evaluate the effect of cervical traction in Class II malocclusions in which treatment was started either early or late in the mixed dentition. Evaluation of the data indicated that the amount and direction of growth were of the greatest importance for effective treatment. Vertical growth appeared to be of particular importance and correlated to the anteroposterior improvement of the relationship between the maxilla and the mandible. Cervical traction, as advocated in this study, was more favorable in the early mixed dentition. A greater amount of growth and a subsequent increased reduction in the ANB angle was recorded during this period. The effect of treatment upon the maxilla, as revealed in posterior movement of the maxillary molar and the pterygomaxillary fissure, was more evident in early treatment. Great individual variability was observed, but in cases in which there was a severe discrepancy in the relationship between the maxilla and the mandible treatment in the early mixed dentition may be essential.

Cephalometry

The functional compensation: an interceptive procedure in the mixed dentition.

Functional compensation, like the morphologic one which accompanies it, is to be encountered naturally in each system or organ. It facilitates the performance of the required activities in spite of the defectiveness of one or more of their biocomponents. If the pathologic forms of compensation or simply their perturbing effects are noticed early enough, deleterious and irreversible effects on growth and development of the orofacial zone may be avoided. Instead of simply supervising dental evolution or limiting intervention to early procedures (extractions) until the time for corrective treatment, we propose functional interception. Inducing a therapeutic compensation by removable appliances, this therapy aims to modify the equilibrium of displaying forces and to favor a more physiologic alveolar and sutural growth. The proposed appliances are able to intervene in the postural and dynamic position of the mobile organs in the oral cavity. They compensate their action; that is, they correct, complete, or replace it. The bimaxillary appliance is called bioactivator "biprax". Based simultaneously on the principles of the activator and bionator, it exploits a normal display of the two praxisms-speech and deglutition. Being worn day and night, it is able to guide efficiently the evolution of dental, alveolar, and even basal relationships. Its interceptive use does not interfere in any way with the onset of a corrective treatment in the adult dentition.

Activator Appliances