Fig. 5 Fig. 6 proper relationship to the maxilla, followed by the mandibular anterior teeth placed in proper relationship to the mandible. The resultant effect will be proper overbite and proper overjet relationship (Interincisal angle). Proper maxillary arch form and the uncoupling of the maxillary and mandibular incisors “un-locks the occlusion” and allows the mandible to come forward, on average, 2.0 or 3.0mm during normal growth and development. This provides an orthopedic response to early correction of the Class II problem. 7 In the context of these words, the hygienist can practice the 3 R’s: recognize, recommend or refer treatment for the appropriate dental care of their patients. Finally, the hygienist can use these proposed guide-lines to look in the mouth, or at study casts and within moments to know what needs to be done or what should have been done, or to know that treatment goals have been reached. 12 References 1. Angle EH. Treatment of Malocclusion of the Teeth, ed. 7. Philadel-phia: S.S. White Dental Manufacturing Company; 1907. 2. Andrews LF. The Six Keys to Normal Occlusion. Am J Orthod 1972; 62: 296-309. 3. Roth R. Five Year Clinical Evaluation of the Andrews Straight-Wire Appliance. J Clin Orthod 1976; 10: 836-850. 4. Anderson GM. Practical Orthodontics 144. St. LouisL C,V. Mosby Co.; 1960. 5. Carapezza LJ. The Early Treatment Class II Div. I. J Amer Orthod Soc. Spring 2006 Vol. 6 Issue 2. 6. Corbett MC. Slow and Continuous Maxillary Expansion, Molar Rotation and Molar Distalization, J Clin Orthod 1997; 31: 253-267. 7. Carapezza LJ. Early Treatment Class II Div. 2 Treatment. J Amer Acad Pediatr Dent 2000; 22: 68-70. 8. McNamara JA Jr. An Orthopedic Approach to the Treatment of Class III Malocclusion in Young Patients. J Clin Orthod 1987; 21: 598-608. 9. Steiner CC. The Use of Cephalometrics as an Aid to Planning and Assessing Orthodontic Treatment. Am J Orthod 1960; 46: 721-735. 10. Jacobsen A. The “Wits” Appraisal of Jaw Disharmony. Am J Orthod 1975; 67: 125-138. 11. Thompson T., R.D.H. Cephalometric Tracing. Institute for Growth and Development in Pediatric Dentistry (IGDPD). Email HYPER-LINK "mailto:drc@igdpd.com"drc@igdpd.com. 12. Carapezza LJ. Objectifying Treatment of Malocclusion. J Pedod 1990; 15: 5-12. Class Three Malocclusion The majority of early Class III problems are dento-alve-olar in nature, precipitated by airway problems or ectopic eruption. The resulting effect of these conditions can cause maxillary retrognathism. The maxilla is very amenable to protraction and modification at an early age. 8 A combined dental-orthopedic approach is indicated as a form of first phase treatment. Dramatic results can be obtained during the early mixed dentition. (Fig. 5) (Fig. 6) Knowledge of commonly used cephalometric land-marks 9,10 and the availability of computerized cephalo-metric programs offer an invaluable service 11 that the hygienist can provide in-house for the doctor’s assess-ment of skeletal problems in the different planes of space. Also, this service can aid in monitoring treat-ment to assure that the changes actually taking place by growth and mechanics are the most favorable for that individual patient. Skeletal Guidelines Summary “In studying a case of malocclusion, give no thought to the methods of treatment or appliances until the case has been classified and all peculiarities and variations from the normal type, occlusion and facial lines have been thoroughly comprehended, then the requirements and proper plan of treatment become apparent.” (Angle) 34 Winter 2017 JAOS
Journal of the American Orthodontic Society Winter 2017: Page 34
