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Growth (Somatic (Menarche, Voice change, CVS), DAC mechanism
Attempt to…
Growth
-
DAC mechanism
- Attempt to achieve inter-arch relationship
- With different SK jaw conditions
Malocclusion
Inadequacy in any 3 planes (Sagittal, Vertical, Transverse)
Forward
Backward
Adequate: Good inter-arch, Bad intra-arch
Inadequate: Good intra-arch, Bad inter-arch
Ceph Analysis
Steiner's analysis:
- ANB angle
- Inter-incisal angle: Chinese 125+/-5, Caucasian 130+/-5
-
Facial Skeleton
Method
Direction
- Maxilla: Centre Nasal cartilage
- Maxilla: Site Suture, Remodel
- Mandible:Site Condyle
Dimension
- Initial: Width > Height
- Subsequent: Height > Width
Differentiation
- Lymph node (adenoid)
- Scammon's curve
Mandibular Growth Rotation
- Muscles influence surface remodeling
- Surface remodel changes direction
-
-
Post-Natal Growth
Sequence & Eruption
-
Arch
- 0-12mnths increases width
- Henceforth increases depth
- Intercanine width doesn't really change
Problems
- Ectopic eruption of #6s
- Early loss of E
- Maxillary molar stacking #6,7,8 (lack of bone dev)
Developmental spaces
- 75% sufficient space
- 25% insufficient space
Types of spaces
- Inter-incisor: Inter-incisor
- Primate: Max (BC) Mand (CD)
- Leeway: Between CDE and #3,4,5
Patterns
Early mesial:
- Erruption of #6 Use Interincisal & Primate space
- Leewayspace mandibular > maxillary
- Errupts into flush terminal plane
- Mandibular 6 drift mesially (CL I/III) causes mesial step/Class I at 6y/o)
Late mesial:
- Erruption of #6 Uses Leeway space causes distal step (CL II)
- Leeway space mandibular > maxillary
- Errupts into flushed terminal plane
- No time to drift, FTP is Cl II
-
Red Flags
- Secondary delay
- Primary retain
- Displacement (unilateral)
- Primary premature loss
- FOP discrepancy