RESUMEN
The Royal London Space Planning process has evolved since 1985 to ensure a disciplined approach to diagnosis and treatment planning and to provide a record to justify treatment decisions for professional accountability. The analysis takes into consideration most aspects of a given malocclusion and aims to quantify the space required in each dental arch to attain the treatment objectives. Space planning also helps determine whether the objectives are likely to be attainable and helps in the planning of treatment mechanics and the control of anchorage. The process of analysis is divided into 2 sections. The first part consists of assessing the original malocclusion according to various component parts, any of which may have an effect on space if altered during treatment. These components are crowding and spacing, occlusal curves, arch width, anteroposterior position of labial segments, mesiodistal angulation, and incisor inclination. The second part of the analysis, which will be published in a separate article, deals with the effect of treatment procedures, such as extractions, tooth-size modifications, distal or mesial molar movements, as well as natural growth, on the space required. Space planning should be regarded only as a useful guide, as many areas of orthodontics-including growth, biological response, and patient compliance-cannot be controlled with total accuracy.
Asunto(s)
Maloclusión/diagnóstico , Planificación de Atención al Paciente , Cefalometría , Toma de Decisiones , Arco Dental/patología , Objetivos , Humanos , Odontometría , Diente/patología , TorqueRESUMEN
The Royal London Space Planning process is carried out in 2 stages. The first stage, assessing the space required to attain the treatment objectives, was described in Part I of this report, published earlier. In Part II, the process of integrating space analysis with treatment planning continues with consideration of the effects other treatment procedures have on space. These procedures include tooth enlargement or reduction, tooth extraction, the creation of space for prosthetic replacement, and mesial and distal molar movement. The effects of favorable and unfavorable growth are also considered. A brief case report is presented to demonstrate use of the Royal London Space Planning.
Asunto(s)
Maloclusión/terapia , Ortodoncia Correctiva/métodos , Planificación de Atención al Paciente , Cefalometría , Niño , Toma de Decisiones , Esmalte Dental/cirugía , Femenino , Humanos , Arcada Parcialmente Edéntula/terapia , Maloclusión Clase II de Angle/terapia , Desarrollo Maxilofacial , Odontometría , Aparatos Ortodóncicos , Ortodoncia Correctiva/instrumentación , Extracción Dental , Técnicas de Movimiento DentalRESUMEN
The aim of this study was first to investigate the relationship between maxillary arch expansion and change in arch depth (overjet), and secondly to quantify the reduction in maxillary arch depth following extraction of 4\4 with complete space closure. A model of maxillary typodont teeth was constructed to allow expansion and premolar removal. Arch dimensions were recorded using a reflex microscope. A linear relationship was found between arch expansion and reduction of the arch depth. When the premolars were removed, there was a greater reduction in arch depth than the mesio-distal width of these teeth.
Asunto(s)
Arco Dental/anatomía & histología , Ortodoncia Correctiva/métodos , Diente Premolar/cirugía , Cefalometría , Humanos , Modelos Dentales , Técnica de Expansión Palatina , Valores de Referencia , Procesamiento de Señales Asistido por Computador , Extracción DentalRESUMEN
This ex vivo study was designed to investigate Andrews' hypothesis that there is a space implication when incisors are torqued correctly. A working model was constructed to allow acrylic typodont incisors of varying known values of inclination to be substituted into the model. The arch lengths of the various 'set-ups' were measured using a reflex microscope linked to a PC. In order to quantify the space requirement of clinical relevance for adequate incisor torque, the method was repeated by substituting replicas of patients' 'natural' incisors. For both acrylic and natural incisors it was found that, as the inclination of the teeth increased, there was an increase in all arch lengths, this being greater for the natural incisors. This larger increase for the natural incisors was related not only to their increased size, but was also dependent on the morphology of the incisor. Those incisors which were parallel-sided showed the greatest increase in arch length, whereas the incisors that were relatively triangular in shape showed the smallest increase. When the inclination of an 'average' set of 21/12 is increased by 5 degrees, an increase in the arch length of approximately 1 mm may be expected.