
Two-phase orthodontic treatment is a very specialized process
that encompasses tooth straightening and physical, facial
changes. We try to utilize Two-Phase Treatment only when
changes in the bite and arches are the most beneficial during
the growing years. Not everyone benefits from this type of
treatment. The major advantage of a two-phase treatment is to
maximize the opportunity to accomplish the ideal healthy,
functional, aesthetic result that will remain stable throughout
your life.
The disadvantage of waiting for complete eruption of permanent
teeth in someone with a jaw discrepancy is facing the
possibility of a compromised result that may not be
stable.
The goal of first phase treatment is to develop the jaw size in
order to accommodate all the permanent teeth and to relate the
upper and lower jaws to each other. Children sometimes exhibit
early signs of jaw problems as they grow and develop. An upper
and lower jaw that is growing too much or not enough can be
recognized at an early age. If children after age 6 are found
to have this jaw discrepancy, they are candidates for early
orthodontic treatment.
Because they are growing rapidly, children can benefit
enormously from an early phase of orthodontic treatment
utilizing appliances that direct the growth relationship of the
upper and lower jaws. Thus, a good foundation can be
established, providing adequate room for eruption of all
permanent teeth. This early correction may prevent later
removal of permanent teeth to correct overcrowding and/or
surgical procedures to align the upper and lower jaws. Leaving
such a condition untreated until all permanent teeth erupt
could result in a jaw discrepancy too severe to achieve an
ideal result with braces.
Orthodontic records will be necessary to determine the type of
appliances to be used, the duration of treatment time, and the
frequency of visits. Records consist of models of the teeth,
x-rays, and photographs.
In this phase, the remaining permanent teeth are allowed to
erupt. Retaining devices are not usually recommended since they
may interfere with eruption. It is best to allow the existing
permanent teeth some freedom of movement while final eruption
of teeth occurs. A successful first phase will have created
room for teeth to find an eruption path. Otherwise, they may
become impacted or severely displaced.
In other words, at the end of the first phase of treatment,
teeth are not in their final positions. This will be determined
and accomplished in the second phase of treatment. Selective
removal of certain primary (baby) teeth may be in the best
interest of enhancing eruption during this resting phase.
Therefore, periodic recall appointments for observation are
necessary, usually on a six-month basis.
The goal of the second phase is to make sure each tooth has an
exact location in the mouth where it is in harmony with the
lips, cheeks, tongue, and other teeth. When this equilibrium is
established, the teeth will function together properly.
At the beginning of the first phase, orthodontic records were
made and a diagnosis and treatment plan established. Certain
types of appliances were used in the first phase, as dictated
by the problem. The second phase is initiated when all
permanent teeth have erupted, and usually requires braces on
all the teeth for an average of 24 months. Retainers are worn
after this phase to ensure you retain your beautiful
smile.
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