RESUMEN
Introduction: In orthodontics, we need to solve very diverse clinical situations. Classical situations for which the treatment plan will be, with experience, quite quickly carried out. More complex clinical situations for which we are led to think differently. Sometimes, we must modify a treatment plan along the way because unforeseen factors make our original goals unattainable. Faced with these atypical situations, the choice of anchorage arises with even more acuity. Methods: Through the presentation of two atypical treatment cases, we will discuss the development of the treatment plan, the alternatives, and the choice of anchorage. Conclusion: In recent years, the advent of mini screws and other bone anchorages have widened the range of possibilities. If, at first glance, conventional anchorage systems might seem to belong to 20th century orthodontics, we believe that they remain an option to consider when establishing even atypical treatment plans, as much for their contribution on the functional and aesthetic level as on the level of the patient journey.
Introduction: En orthodontie, nous sommes conduits à résoudre des situations cliniques très diverses. Pour les plus classiques, l'élaboration du plan de traitement s'effectuera, avec l'expérience, assez rapidement. Pour les plus complexes, nous sommes amenés à réfléchir autrement. Parfois, nous sommes contraints de réviser, en cours de route, un plan de traitement parce que des facteurs imprévus rendent nos objectifs initiaux inaccessibles. Face à ces situations atypiques, le choix de l'ancrage se pose avec beaucoup d'acuité. Méthodes: Au travers de la présentation de deux cas de traitement atypiques, nous discuterons de l'élaboration du plan de traitement, des alternatives et du choix de l'ancrage. Conclusion: Ces dernières années, l'avènement des ancrages osseux a élargi notre périmètre d'action. Si, de prime abord, les systèmes d'ancrage conventionnels peuvent sembler appartenir à l'orthodontie du 20e siècle, nous pensons qu'ils demeurent une option à considérer lors de l'établissement de plans de traitement mêmes atypiques, tout autant pour leur apport sur le plan fonctionnel et esthétique que sur le plan du parcours de notre patient au cabinet.
Asunto(s)
Métodos de Anclaje en Ortodoncia , Ortodoncia , Humanos , Tornillos Óseos , Estética Dental , Implantación Dental EndoóseaAsunto(s)
Ortodoncia Correctiva/tendencias , Procedimientos Quirúrgicos Ortognáticos/tendencias , Investigación Dental , Estética , Cara/anatomía & histología , Mentoplastia/métodos , Humanos , Maloclusión/cirugía , Mandíbula/cirugía , Avance Mandibular/métodos , Osteotomía Mandibular/métodos , Ortodoncia Correctiva/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Osteogénesis por Distracción/métodos , Planificación de Atención al PacienteRESUMEN
When a patient presents with TMJ pain, it could be all too easy for the orthodontists to turn the other way claiming that their occlusion has no connection with their symptoms and that they are suffering from a biopsychosocial disorder. This abundantly illustrated article attempts to demonstrate that patients can appear to display a stable occlusion even though their TMJ situation is unstable. This can give rise to dental abrasion, articular adaptations and pain. Orthodontics allows us to treat patients in pain provided that the treatment plan takes into account the need to restore a stable TMJ as well as a stable occlusion.
Asunto(s)
Cóndilo Mandibular/patología , Trastornos de la Articulación Temporomandibular/diagnóstico , Adolescente , Adulto , Relación Céntrica , Oclusión Dental Céntrica , Dolor Facial/diagnóstico , Dolor Facial/prevención & control , Dolor Facial/terapia , Femenino , Humanos , Maloclusión Clase II de Angle/diagnóstico , Maloclusión Clase II de Angle/terapia , Maloclusión de Angle Clase III/diagnóstico , Maloclusión de Angle Clase III/cirugía , Cóndilo Mandibular/fisiopatología , Osteotomía Mandibular/métodos , Músculo Masetero/fisiopatología , Ferulas Oclusales , Procedimientos Quirúrgicos Ortognáticos/métodos , Osteotomía Le Fort/métodos , Retrognatismo/diagnóstico , Retrognatismo/cirugía , Trastornos de la Articulación Temporomandibular/fisiopatología , Trastornos de la Articulación Temporomandibular/prevención & control , Trastornos de la Articulación Temporomandibular/terapia , Técnicas de Movimiento Dental/métodosAsunto(s)
Ortodoncia/historia , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Estados UnidosRESUMEN
The objectives of the orthodontic treatment that we provide are to re-establish functional occlusion and a harmonious facial appearance, taking the individual anatomic features of each patient into account as well the potential changes that will come with ageing. As a pre-treatment first step we analyze the position of the incisor teeth within the face. Next we pose several questions. Should we preserve a slight bi-maxillary protrusion or correct it? Should we decide to voluntarily maintain a slight supraclusion? When should we correct a gummy smile? What should we do about black holes? In this article we propose treatment approaches, illustrating them with clinical situations and focus on the critical role played by the central incisor in establishing smiles that are suitable for each patient, integrating them with the ageing patterns that we know the future will bring.