Facial and Jaw Growth Modification
Timely guidance for optimal facial and jaw growth
Growth modification procedure involves early identification, accurate diagnosis and timely treatment of any discrepancy seen in the growing and developing facial and jaw bones in preadolescent and adolescent children.
Understanding Growth Modification
Principles
- Most commonly seen discrepancies in jaw growth are deficient or excessive growth of either the upper or lower jaw.
- The best way to treat these discrepancies would be to get the patient to grow out of this faulty pattern of growth.
- Growth modification treatment aims to correct jaw discrepancies through skeletal changes. This requires inducing differential growth of one jaw relative to the other, either stimulating one jaw to grow faster or restraining one jaw so the other jaw can catch up.
Timing
- The basic principle related to timing of growth modification treatment is that whatever the kind of growth modification effect that is desired, if growth is to be modified, the patient must be growing.
- Growth modification has to be done before the adolescent growth spurt ends.
- Orthodontic treatment for such skeletal problems are best done in the mixed dentition period from 7-11 yrs.
- Depending upon the kind of skeletal discrepancy in the jaw growth, the timing for treatment varies.
Types of Growth Modification Appliances
Palatal Expanders
- Constricted or narrow upper arch is commonly seen in kids due to habits like thumb sucking, mouth breathing etc or due to a deficient growth pattern.
- It is seen clinically as unilateral (one side) or bilateral (both sides) posterior crossbite where the lower back teeth are placed outside the upper back teeth when the patient bites.
- Depending upon the severity of the problem, different types of palatal expanders are used to widen the upper jaw, creating more space for teeth to erupt properly and to improve the bite.
- In severe cases of constricted upper arch, a procedure called as Rapid Maxillary Expansion (RME) is carried out. This appliance is used to widen the upper arch by opening the palatal sutures before they fuse completely. This procedure can be carried out in a non-invasive manner while the child is still growing and hence the importance of early diagnosis and treatment. Palatal expansion in adults is a difficult and invasive process.
Myofunctional Appliances
- Myofunctional appliances are passive removable appliances that use the natural forces of the patient’s oral and facial muscles. They encourage proper tongue posture, lip closure, and breathing through the nose.
- They are designed to correct improper muscle function and promote optimal growth and development of the jaw and facial structures.
- These appliances work on two principles. First principle is force application through the appliance to alter the growth of the jaws.
- The second principle is force elimination which involves elimination of the abnormal and restrictive forces of the oral and facial muscles to allow for the optimal growth of the jaws.
- Commonly used Myofunctional appliances are Twin Block, Lip Bumper, Oral screen etc.
Orthopaedic Appliances
- Orthopaedic appliances are appliances designed to bring about skeletal changes in the growing upper and lower jaws.
- Orthopaedic appliances use teeth as “handles” to transmit heavy forces to the underlying jaw and skeletal structures to alter their growth in the desired direction.
Amount of Force
- These appliances use heavy forces which maximize the skeletal changes.
- This heavy forces unable the teeth to move and hence minimize any unwanted dental effects from the appliance.
Duration of Force
- Orthopaedic appliances work on the principle of applying intermittent forces by wearing the appliance for 12-14 hrs a day.
- This is very important for the desired results to be achieved.
Commonly used Orthopaedics appliances are:
Headgear
- This appliance is used in cases where there is excessive growth of the upper jaw in the forward direction.
- It is used to restrict the forward growth of the upper jaw.
Facemask
- This appliance is used in cases where there is a combination of excessive growth of the lower jaw and deficient growth of the upper jaw.
- It acts by restricting the growth of the lower jaw and it aids in pulling the upper jaw forward.
Benefits of Preventive and Interceptive Orthodontics
Simplifies Future Treatments
Early intervention for skeletal problems involving the upper and lower jaws during the growing years prevents and reduces the need for more invasive procedures, such as jaw surgery, in the future.
Predictable Results
Growth modification procedures take advantage of natural growth spurts to redirect the growth of the jaws in the desired direction. This helps to achieve more predictable and stable results.
Positive Psychosocial Impact
By guiding the jaw growth favourably, these treatments enhance the overall facial profile and appearance of the kid. This has a very positive psychosocial impact on the child’s overall well-being.
Schedule a Consultation
Growth modification procedures have a very small window during the growing years to favourably affect your child’s facial and jaw growth. Early evaluation by an orthodontist can help determine the need, appropriate timing and type of treatment needed for your child. Schedule a consultation now with our expert Orthodontist Dr. Vidhi Shah if you want to get your child evaluated.