However, one may depart from the “Gold Standard” if there is prolonged growth unfavorably or there is persistent anterior open bite due to excessive eruption of posterior teeth relative to the vertical growth of the ramus. This is because there will be some growth remaining to assist in the treatment and permanent dentition will be available for positioning of occlusion. The “Gold Standard” of starting orthodontic treatment is in the late mixed dentition or early permanent dentition. However, if you are parents, you will agree with me that all 8-year-old children should have a beautiful smile. The American Orthodontist Association recommends an orthodontic consultation for all children by the age of 7 years. In the literature, there is no universal agreement as to which type of early treatment will achieve the best outcome. Hence, clinicians are still debating as to which type of treatments are most beneficial to initiate in the mixed dentition. The fact is that there is a delicate balance between the benefit of early orthodontic or orthopedic treatment and the biological and financial cost of having another phase of treatment. However, there is still an ongoing discussion among dentists and orthodontists as to the optimal time to initiate orthodontic or orthopedic treatment under various clinical conditions. The use of this protocol was illustrated with two case reports to enable clinicians to routinely achieve a beautiful smile on a young patient by timely alignment of the maxillary incisors.Īn estimate of 25% of malocclusions can be intercepted at an early age. In specific, the authors will present a contemporary protocol using a bonded maxillary expander as anchorage for treatment of unerupted maxillary laterals. In this paper, the authors will focus on early maxillary expansion to facilitate the eruption of maxillary laterals. It may also be indicated in children with anteroposterior jaw discrepancy that requires chin cup or maxillary protraction. Early timely treatment may benefit young patients with a maxillary transverse deficiency with or without a posterior crossbite that requires maxillary expansion. In addition, there is a need for more information as to which treatments are the most effective and less costly if they are initiated timely in the mixed dentition. There is no universal agreement as to which type of orthodontic or orthopedic treatment deserves early intervention.
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