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Dentofacial Orthopedics

Dentofacial orthopedics is a specialized field within orthodontics that focuses on the guidance and development of the facial structures, not just the teeth.

Dentofacial orthopedics aims to achieve optimal facial harmony, balance, and function by addressing underlying skeletal and soft tissue issues using Functional Appliances. As there are many types of skeletal discrepancies, there are also various types of Functional Appliances to address this.

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  • Class II (‘overbites’) and Class III (underbite) dental malocclusions
  • Skeletal discrepancies such as underbites, ‘overbites’ and asymmetries
  • Airway issues and breathing disorders
  • Improved facial aesthetics and harmony
  • Enhanced stability of orthodontic results
  • Avoid dental extractions 
  • Avoid jaw surgery in the future 
  • Positive impact on overall oral and systemic health
  • Positive impact on self-esteem and confidence 
  • Open the airway to improve breathing
  • Improve speech and eating efficiency
  • Simplifies future treatment

Treating the skeletal discrepancies of the face is a complex form of orthodontic treatment and requires careful planning and staging for successful outcomes.

Early detection is important:

Do not ‘miss the boat’! Please have your child assessed by our Orthodontic Team at MyBracesClinic at age 7 so that our Orthodontic Team can pick up problems early and start planning.

Correct Diagnosis:

Our Orthodontic Team has many years of experience and is trained to diagnose skeletal issues in young growing children early. After all, it is impossible to have a good outcome without a correct diagnosis. 

Timing of treatment:

Different types of skeletal discrepancies have different ideal treatment start times. For example, Cl III underbite dentofacial orthopedics should start early, between 7-9.5 years old, while Cl II ‘overbite dentofacial orthopedics starts close to the pubertal growth spurt of the child. Therefore, it is important to have early detection so that our Orthodontic team at MyBracesClinic can start tracking your child’s growth to plan efficient treatment.

Cooperation and Compliance:

Different skeletal discrepancies will require different treatment methods over a period of time. Often, this will require parents to assist in implementing the treatment at home. Our young patients need to understand why they are undergoing treatment, and our Orthodontic Team is on hand to explain the process in simple, easy-to-understand terms.

Growth:

Humans all follow the same growth curve trend, but this varies greatly between individuals regarding onset, magnitude, and duration. Genetics also plays a major role in skeletal growth. Class III (underbite) and jaw asymmetry patients often present with larger growth over a longer duration than their peers with harmonious growth patterns. Accelerated growth, especially during puberty, will be discussed and highlighted by our Clinicians.

There are various types of Functional Appliances, and this list is not exhaustive. Each patient is unique, and it is best to consult with our experienced Orthodontic Team for a recommended Functional Appliance that can be successfully implemented at home.

Class II Functional Appliances (‘Overbites’)

Class II Functional Appliances (‘Overbites’)This treats patients with a skeletal, short lower jaw and large ‘overbites.’ The guiding principle of Class II functional appliances is to redirect existing growth forward by posturing the lower jaw forward in a series of ‘jumps’ and allowing the jaw joints to remodel and adapt to this new forward position. Expansion of the upper arch may be needed to complement this movement. The timing of treatment for Class II skeletal patterns should target the growing patient’s peak pubertal growth spurt for effective treatment. Starting too early will result in unnecessary long, drawn treatment times that tax a patient’s compliance. Starting treatment too late may result in ineffective, limited treatment due to missing out on the ideal peak pubertal growth spurt. Consult MyBracesClinic early so our Orthodontic Team can correctly chart your child’s growth and treatment time.

Examples of Class II Functional Appliances:

Removable Class II Functional Appliance:

  • Invisalign with Mandibular Advancement (Invisalign MA)
  • Class II Bionator


Fixed Class II Functional Appliance:

Mandibular Anterior Repositioning Appliance (MARA):

Class III Functional Appliances (Underbites)

This treats patients with a skeletal, short upper jaw and large underbite. Class III functional appliances expand the upper jaw and reposition the upper jaw forward and downward to correct an underbite. The best time to treat using a Class III functional appliance is 7-10 years old to take advantage of firm baby teeth as a foundation and open maxillary sutures. Note that skeletal underbites caused by excessive lower jaw growth will express growth during the pubertal years and continue growing until late teens and early adulthood.

Examples of Class III Functional Appliances:

Fixed-Removable Functional Appliance:

  • Expansion Splint with Protraction facemask
  • Expansion Splint with Bollard plates


Removable Functional Appliance:

  • Class III Bionator

Conclusion

Dentofacial orthopedics is a specialized field that goes beyond traditional orthodontics to address the underlying skeletal and soft tissue structures for optimal facial harmony and function using Functional Appliances. If you are seeking a comprehensive approach to enhance your child’s facial aesthetics and address functional concerns, consult MyBracesClinic today.

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Mandibular Advancement Splint

Mandibular Advancement Splint

A mandibular advancement device (MAD) is a custom-fitted oral appliance designed to treat obstructive sleep apnea (OSA) by repositioning the lower jaw (mandible) forward during sleep, thereby enlarging the airway and reducing airway collapse.

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