Treatment, after growth is concluded. This philosophy has been well-established by the bioprogressive group of Ricketts, Gugino, Bench, and Langlade, as well as many others including Doyle, Frankel, Graber and McNamara. These folks propose consideration of the conse-quences of the many disadvan-tages to waiting for the perma-nent dentition, such as: the lack of ability to eliminate or change adverse growth and the func-tional matrix, and the loss of the opportunity to guide not only orofacial development, but devel-opment of the occlusion. This article will look at the concept of iOrtho treatment, whose primary goal is to eliminate or minimize adverse skeletal and dental growth, and their impacts on function, esthetics and the psychological well-being of the child patient. What do we know? We know that modern medical thought is, that it is better to prevent than to cure. Certainly dentistry has as its hallmark, prevention of disease. Yet for generations dentistry has viewed orthodontic treatment differently. Conventionally, orthodontics has been provided in the permanent dentition. Orthodon-tic treatment should be in harmony with modern medicine and dentistry. We should not treat the signs and symptoms -we should treat the causes. We should prevent. Over 50 years ago Melvin Moss introduced the functional matrix theory which said simply, “form follows function.” Studies have tested his theory, and we now know that indeed, the environ-ment (function) is an important factor in the resultant growth and development of the child. We know that with a diastema there is the failure of fibers to migrate apically and the diastema is borne. 13 We know that with habits, tongue position and mouthbreath-ing, adverse growth occurs, often excess vertical growth, though not always, and malocclusion and less-than pleasing esthetics are borne. 11 We know that neuronal function underlies abnormal development of the cranial synchondroses and midface retrusion follows. 5, 8 The functional matrix is at the heart of malocclusion and of lessened esthetics. We should be at the fore-front of prevention. We know that 20-35% of adult patients have signs and symptoms of occlusal dysfunction, 4 many of them having had orthodontic treatment in permanent dentition. We know that the younger the child, the faster and more the growth. We know that as Dr. Carl Gugino says, “The earlier treat-ment begins, the more the face will adapt to your standards; the www.orthodontics.com July/August 2012 79
Journal of the American Orthodontic Society July-August 2012 Buyer's Guide: Page 79
