Search

The aim of temporary retention is not to eliminate every causes of relapse and to ensure the stability of treatment, but to eliminate one cause of relapse: the periodontal reactions consecutive to the orthodontic displacement of teeth. The other causes of relapse must be eliminated by the treatment itself, and not by retention. To be effective the retention must be immediate, complete and prolonged. The most used temporary retainers are: the Hawley retainer, the vacuum-retainers and the bonded retainers. None of which is perfect. Only the permanent retention can ensure the stability whatever the cause of relapse. The risks of permanent retainers are not yet well known., (© EDP Sciences, SFODF, 2010.)

Cases of occlusal asymmetry detected in the temporary dentition are frequently associated with skeletal asymmetries of the cranial base. They should be corrected as soon as possible. Symmetry of these dental groups is achieved with the use of mini-screws implanted in designated sectors of the hard palate. When a new occlusal plane derived from the corrected maxilla is obtained, the mandible will re-center itself in relation to it. As a result cranial bones can remodel and the possibility of induced temporo-mandibular disorders is greatly reduced.

After evoking the characteristics of masticatory movements, their control and their adaptability, a review of the literature illustrates how the masticatory work and its variations can influence the dentoalveolar, as well as the maxillary growth, by adapting the morphological structures to the functional context. The conceptions of Planas, and especially his "neuro-occlusal rehabilitation", are widely explained: unilateral alternate mastication, "Planas' Functional Masticatory Angles (PFMA) and the vertical dimension, the "atrophies" of maxillary development resulting from reduced mastication, the "dominant unilateral mastication syndrome" and, of course, all the original treatments introduced by Planas. These specific orthodontic treatments can be applied as interceptive procedure as early as during the deciduous dentition. The selective occlusal grinding, implemented to reduce and balance the "PFMA", and the expansion devices using "running track plates" are described in concepts and clinical uses. Planas' Class II treatments of Class II, also using "direct occlusal bonded tracks" and several mandibular propulsion auxiliaries are explained as well as the early treatments of lateral cross-bite and the use of the "Equiplan". Mastication, the first of the functions assigned and carried out by the masticatory apparatus, is a genuine "functional matrix" able to stimulate the growth of the dental arches and of the maxillaries. When perfectly understood and applied, the "neuro-occlusal rehabilitation" according to Planas allows to restore a functional balance for the masticatory apparatus from an early age, and subsequently, reorientates growth to a morphological normalization.

Almost all the disorders seen in the mixed and adult dentitions were already present in the temporary dentition. We should ask ourselves what postural and dynamic role the tongue plays in defective development of the dental arches.

In this paper, the author presents his method of dealing with breathing problems when he conducts an orthodontic consultation. Because they can interfere with growth, the author believes that ventilation disorders should be dealt with promptly so that they cannot cause skeletal discrepancies. After having reviewed the literature, the author presents his clinical procedures for uncovering and treating breathing disorders and then shows treated cases to illustrate his techniques, one of the most important of which, palate splitting, is simple, effective and virtually without risk. In addition to its clear orthodontic benefits, rapid palate expansion can prevent the growth problems that frequently accompany breathing disorders. He believes that the Delaire's facial mask is the ideal preventive device for dealing with problems associated with skeletal Class III malocclusions. He asserts that, when indicated, the device can work well in conjunction with palatal expansion.

Why does the eruption of some incisors cease when overbite has reached 3 mm and continue in other cases? Eruption stops only when an opposing force confronts it; normally, this is what occurs when incisors erupt into end-to-end occlusion. Tongue thrusting between molar teeth plays an etiological role only when it interferes with vertical dimension. Incisal overbite diminishes when incisal inclination increases: orthodontists can eliminate incisal overbite by inclining the anterior teeth labially. But a low interincisive angle is no assurance against relapse, because retention, to be reliable, must include a dynamic element, natural or artificial, blocking over-eruption.

Relapse is a multi-factorial phenomenon to which, in the absence of universally accepted finishing criteria, each practitioner tries to oppose through some references which he is closely following to. The author lists his personal references.

The author reminds you that in 1956 he had the honour of being Chairman in the Congress of the S.F.O.D.F. here in Madrid. He, at that time, had insisted already, the if we want that a corrected mouth does not recidivate, it should be balanced and in a dynamic balance with which the parodontal problem is prevented and that is our purpose.

Since unilateral mastication causes asymmetry of mouth and face, a child's interincisal midline can reveal the first signs of alteration of masticatory function. Early detection of the functional pathology, preferably before it has established itself as such, allows the clinician to correct it by means that are relatively unburdensome for the patient, thereby forestalling severe organic alteration and favouring proper, balanced occlusal development. Centering the mandible in stable centric occlusion, together with simple treatment promoting alternating bilateral mastication, allows the correct development of the growing patient's stomatognathic system.