Wednesday, December 21, 2016

contents become compressed - scoliosis. conventional braces at the end of treatment.

ALF Orthopedic Expansion - Non-Extraction 2.3 Years Treatment

Conventional orthodontic treatment recommended extraction of four healthy bicuspid teeth for a 12-year-old, Melissa T. to make room for the crowded remaining teeth. The crowding was created by under development of the patient's dental arches. By removing teeth the genetic potential for growth of the patient's jaws would be compromised. When teeth are extracted and then the upper front six anteriors are retracted, the skull becomes jammed. Since the sutures, spaces between the skull bones, are viable structures (nerves, blood vessels and fibers) the contents become compressed creating neurologic (potential for chronic pain) and structural problems (scoliosis, disc compression and herniation).
A viable alternative is the use of ALF (Alternative Lightwire) appliances. Since there is no bulky plastic there is no speech problem. It is easy to clean. The patient does not remove it. The forces generated are light therefore reducing pain. The concept is very simple: with light gentle forces, the skull bones will expand and growth stimulated. With increased jaw space there is now room to guide the crowed teeth into a corrected position with conventional orthodontic braces. The other major key is that the ALF appliance must be adjusted at each visit to realign the skull bones. By so doing the foundation of the skull (maxillae- upper dental arch) is leveled. This leveling is important in reducing the amount of relapsing of the teeth into their old crooked position. Balancing the skull bones helps insure a more normal neurologic and spinal function through out the patient's life.


It is not often a major breakthrough occurs in our professional lifetime that has a monumental impact on patient treatment. The ALF appliance represents just such a discovery. Thanks to the genius and perseverance of Dr. Darick Nordstrom and laboratory technician Heather Ashton the ALF appliances are custom designed to help correct cranial base and cranial distortions present in the chronic pain, orthopedic/orthodontic type patient.
Dental orthopedics and orthodontic programs focus primarily on aligning the teeth and jaw misalignments. The fact remains that cranial lesions and the cranial base must first be corrected inorder to establish long term stability to the stomatognathic system, spine and pelvis. As Major DeJarnette, founder of the SOT chiropractic concept, stated " the anvil (maxillae) must be balanced inorder for the hammer (mandible) and TMJ's to function properly." Other than elongating a pre-maxilla or widening a narrowed maxillae or disimpacting a retruded maxillae with reverse headgear little if any treatment is directed toward correcting transverse or sagittal cants of the maxillae, a torsioned maxillae, high sphenoid, side bending or rotation lesions of the sphenobasilar symphysis. Addressing these cranial issues are critical to resolving the patient's neurophysiologic symptoms and structural imbalances.
Diagnosing abnormal cants of the maxillae is now easily accomplished by means of an invaluable diagnostic instrument, the Accu-Liner articulator. This device provides an accurate, reproducible assessment of the position of the maxillae in relation to Camper's Plane (Hamular Notch/Incisive Papilla Plane). This instrument provides an invaluable tool in orthopedic/orthodontic analyses. Complementary data will also include cephalometric analysis and cranial evaluation: an assessment of the sphenobasilar junction, side bending and/or rotational lesions, torsions and internal and external temporal bone rotations. This data provides a structural configuration of the distortions and provides the basis for designing the ALF appliances. Designing appliances just to correct teeth when cranial base and other distortions exist is really treating the symptom rather than the underlying cause.
The physiologic action of the ALF appliance is consistent with the Arndt-Schulz Law: "Weak stimuli increase physiological activity and very strong stimuli inhibit or abolish activity." The light .025to .028 Elgiloy body wire provides the needed flexibility to allow the cranium to unfold during treatment. The following are additional advantages:
  • ALF appliances are much easier to adjust and do not require the expertise
  • ALF provides excellent development of the intercuspid area while also
  • ALF functions as a continuous unit from molar clasp to molar clasp making the
  • ALF is easily inserted without the need to place spacers two days before
  • ALF provides constant light forces for more effective cranial movement.
  • ALF appliances do not hamper speech, are totally esthetic, can easily be worn
  • ALF is a universal treatment system that is custom designed to meet each
  • ALF is powerful enough to make rapid corrections yet unobtrusive to allow long-term function necessary for true bony changes.
  • Auxiliary wires can be soldered on during later stages of treatment to meet specific needs. Such examples are: elastic hooks, Hawley bow, arms to distalize molars, anterior or posterior acrylic bite planes, fingersprings, lip bumper, buccal tubes to tie into a conventional bracket system, Class III arms for either elastics or reverse pull headgear, twin block acrylic pads and others.

Case Study

A 16 year-old male hit the left side of his head on a basketball pole while going up for a shot. Eventhough the pole was padded the impact was sufficient to cause a concussion and the patient was knocked unconscious for 3 minutes. As a result of the head trauma, the patient suffered severe left sided symptoms: constant headaches, retrobulbar eye pain, tinnitis, facial pain in the region of the cheek, shooting neck and shoulder pain. The patient also had hyperacusis, insomnia and dizziness. Extensive medical work ups by neurologists, ENT, internists and psychiatrists produced no definitive diagnosis. Various medications were prescribed with no resolution of symptoms. These symptoms were present for a seven month period and prevented the patient from attending school.
Cranial Evaluation

The impact had caused a reversal of sphenobasilar motion, decreased amplitude on the left side of the cranium, left internal rotation of the temporal and malar bones, high right sphenoid with torsion in relationship to the occiput.
Dental Evaluation

A mild Class III skeletal discrepancy was present with a mild right posterior crossbite. This malocclusion existed prior to the incident but was accompanied without any symptoms. Extensive spasms were present in the following muscles: right and left external pterygoids, left masseter at the zygoma, right and left anterior temporalis, left scalenes and left upper trapezius.
Treatment Sequencing
  • Cranial manipulation was performed to correct the reversed sphenobasilar motion, free up the left temporal and malar and increase amplitude.
  • Micro-current stimulation combined with myofascial release techniques were used to release the spastic muscles.
  • ALF upper and lower appliances to correct cranial distortions.
  • Glutathione was used to detoxify the patient's liver from all the medications that were used.

References
  • Frymann,Viola M.: Cranial Osteopathy and Its Role in Disorders of the Temporomandibular Joint. Dental Clinics of North America, W.B. Saunders, Vol. 27, No.3, pp.595-611, 1983.
  • DeJarnette, Major B.: Cranial Technique 1979-1980, p.23.

Prognosis: Excellent

The hyperacusis resolved and the headaches greatly reduced following the third cranial adjustment. Following two months of treatment with ALF appliances the cervical and shoulder symptoms and insomnia cleared.The appliances were discontinued following resolution of symptoms.
Use of the ALF appliances affords the dentist a means to non-invasively correct structural distortions which in turn have the potential to cause neurologic and physiologic changes throughout the body. No other medical specialty has the modalities to make these types of changes. Use of the ALF appliance complements the osteopath, chiropractor, physical therapist, psychiatrist, orthopedist and neurologist as well as the podiatrist.
ALF stands for 'Advanced Lightwire Functionals'.
  • It is a method to align teeth and improve the bite without braces (orthodontic treatment).
  • It addresses alignment of the bones (orthopedic treatment) using principles of cranial osteopathy.
  • It brings about changes in muscle function to achieve stable results.
  • ALF is a whole-body-and-mind approach to improve overall health and performance in every realm.

The STRENGTHS of ALF are
  • cosmetics - barely visible from the outside
  • gentle - far less discomfort than with braces
  • stable - no need for life-long retention
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Monday, December 19, 2016

MEAW - root resorption



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ALF might fix chronic lower back pain. natural vitamin supplements is better. conventional braces might be needed

http://www.tripleodentallabs.com/laboratory/advanced-lightwire-functional

A New Treatment Concept For The Correction of T.M.J. Pain, Misaligned Teeth and Jaws, Chronic Headaches and Facial Pain, and Neck and Low Back Pain

History of A.L.F. Appliances


The A.L.F. appliance was originated and designed by Dr. Darick Nordstrom of Hollister, California in the early 1980’s. Dr. Nordstrom recognised the need to provide more than just an aesthetic alignment of the teeth. From his extensive knowledge of how the body works, Dr. Nordstrom saw the need to correct the other structures that were attached to the teeth: upper jaw (maxillae) and skull bones. He soon discovered that by correcting these other components patients noted relief and disappearance of chronic headaches, neck, shoulder and lower back pains and other seemingly unrelated symptoms: PMS, fatigue, digestion problems, ringing in the ears, hearing loss, etc. This major breakthrough establishes dentistry’s role in restoring patient function, health and improving their quality of life. Since discovering the A.L.F. appliance, Dr. Nordstrom has dedicated his professional career to perfecting the A.L.F.’s design and treatment approach.

A.L.F. Treatment Philosophy

Dr. Nordstrom’s belief was that a less bulky, light wire removable appliance would prove more beneficial than existing devices. The A.L.F. appliance could be fitted to the dental arches and apply a continuous light force to the skull bones and teeth. Orthodontic treatment has proven clinically that continuous light forces applied to the teeth and skull bones have a more beneficial effect than applying heavy continuous forces. The Arndt-Schulz Law is well stated in the 26th edition of Dorland’s Illustrated Medical Dictionary: “Weak stimuli increase physiological activity and very strong stimuli inhibit or abolish activity.” This concept is supported and has been clinically verified by use of homeopathic medicines (more dilute substances cause a strong healing change”, micro-currents (extremely low levels of electrical currents cause a greater healing response), natural vitamin supplements cause a better healing response), etc. The A.L.F. appliance follow the Arndt-Schultz Law by applying a light, continuous force to the teeth and skull bones.

Purpose of the A.L.F. Appliances

The A.L.F. appliance has a three fold purpose: (1) Correct distortions of the skull; (2) Correct distortions of the maxillae (bone that supports the upper teeth); and (3) Correct the alignment of the upper and lower teeth to improve the bite. Structural distortions of the skull bones can develop from birthing trauma, genetics, misalignments that result from loose teeth or premature loss of teeth, auto accidents and contact sports or any trauma to the head. The appliance can also be used to treat upper neck, shoulder or even lower back problems since malposition of the teeth directly affect these areas as well as many other body functions.

Benefits of the A.L.F. Appliances


  • Aesthetics and Comfort
  • Less frequent adjustments and surgery visits
  • Unhampered speech
  • Reduced tooth soreness during tooth movement
  • Quicker results since appliances are constantly worn
  • Easy to clean

Special Post-Graduate Training

A Post-graduate course is required to successfully learn the neurology, functional anatomy, dental-body interrelationships and manual dexterity needed to carry out the mechanical skills of this state of the art technology. Dentists who have completed such training have gone that extra mile to provide their patients with one of the best dental treatment approaches to have ever been developed in the field of dentistry and the entire profession of the healing arts!

Patient Evaluation

Examination of the patient may involve taking a combination of special x-ray views (cephalometric x-ray - lateral view of the skull; panoramic view – full jaw survey or full mouth series), diagnostic casts of the patient’s teeth, photographs of the face and teeth; visual observation of the oral cavity, body posture and evaluation of the patient’s skull. Once these diagnostic records are complete, the dentist will formulate a custom treatment plan to carry out correction of the misaligned teeth, jaws and skull.

Patient Treatment

Treatment duration and technique varies from one patient to another depending on the complexity of their dental abnormality. In general, active treatment times range anywhere from 18 to 36 months. Actual treatment focuses on three phases. The first phase of therapy involves correcting cranial distortions by means of the A.L.F. appliance. The second phase also uses the A.L.F. appliance to correct the structural distortions of the upper jaw (base of the skull). The third phase of treatment may require use of the A.L.F. appliance and / or conventional orthodontic braces to realign the teeth, improve jaw and teeth function and enhance the patient’s smile.
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side effects of regular orthodontic - root resorption

ALF is a name of an orthodontic appliance. ALF also labels an appliance family. ALF also means a treatment philosophy. ALF is comfortable, invisible, can be used as a useful tool for early treatments arch developments, pre-aligner treatments and functional treatments. There are different courses about ALF. Now we can hear the authentic source. The inventor of the ALF Appliance Family and the Nordstrom Treatment Concept starts his new curriculum in Europe.
20-22 November 2014
Hotel Aquincum, Budapest Hungary
www.aquincumhotel.com
- If you think that an orthodontic treatment should work with the human body instead of moving teeth and bones forcefully according to some structural norms, you are a functional orthodontist. - If you believe that being a functional orthodontist is not equal to putting a so called functional appliance into your patient’s mouth, than you are not alone
Darick Nordstrom DDS, a pioneer dentist in CA, USA had been introduced to a bodywork called osteopathy early of his career. As a dual trained practitioner (osteopath and dentist) he had the opportunity to see what an orthodontic treatment can cause to the human body. He experienced that the side effects of regular orthodontic forces are much deeper beyond gum recess and root resorption. He recognized that another approach is necessary. Than he started to investigate what the appropriate appliance design and appropriate treatment protocol should be. This happened in the 80s. He was much more ahead of his generation. With osteopathic monitoring he developed first the original ALF design and later all the other appliances belonging to the ALF Appliance Family. Also he developed the most functional orthodontic approach ever. He had been the first in history of orthodontics starting implementing osteopathy in form of interdisciplinary cooperation. Also he as one of the first started to involve orofacial myotherapy into his dental, orthodontic treatments. He talked about breathing and sleeping much earlier than the sleep apnea dentistry started to be published and got its current popularity. He developed a new curriculum. In a series of courses he will teach his ALF Appliance Family and Nordstrom treatment concept from the very beginning to the most advanced level. ALF has been taught by some lecturers for years, however, the real essence of Nordstrom Treatment Concept is not transmitted most of the time. Due to the fact that ALF can be interpreted at different levels, the real functional concept is not understood well.
Participant following this introductory course will be able to select basic appliance design to their orthodontic cases, use them for conventional orthodontic purposes, like early treatments, arch development, mandibular advancement and orofacial functional training. In addition to this during the first course, participants will be introduced to Nordstrom Treatment Concept and to the highest level on which orthodontic treatment will work and treat the whole body. So those, who are fine with the basic features of the ALF will be able to use these appliances for conventional orthodontics. Others who want to be as functional as possible will be able to continue their curriculum on next courses.
ALF is a name of an orthodontic appliance. ALF also labels an appliance family. ALF also means a treatment philosophy. ALF has been distinguishing functional orthodontist from conventional structural oriented orthodontist for many years. The beauty of ALF is that this appliance can be used on 2 very different levels. On the one hand this is very comfortable, mostly invisible, but conventional orthodontic appliance. Removable, so hygienic, but still in the mouth for almost 24/7, so works with continues and low forces. This appliance is a very useful tool for early treatment, arch development, cross-bite correction, mandibular advancement, molar distalization, and pre-treatment for invisible aligners. However, on the other hand ALF is a functional orthodontic appliance which can be intentionally used according to the body’s need. When an osteopath will ask for a support of the body treatment by changing the intra-oral structures, ALF will get another meaning. Throughout the curriculum participants will learn how to cooperate with a body worker, being an osteopath, craniosacral therapist, chiropractor, or myofascial release therapist.
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active vertical corrector cannot achieve effective molar intrusion in adult patients

http://www.slu.edu/Documents/cade/thesis/Thesis%20-%20Shuka%20Moshiri.pdf

Skeletal anchorage systems

Many investigators contend that maxillary incisor
extrusion in adult patients may compromise the periodontal
structures, lead to root resorption and ultimately
jeopardize smile esthetics.54 Other authors have shown
extruded teeth to be less stable than intruded teeth55 and
have, instead, turned their efforts towards posterior
intrusion.
Molar intrusion is often needed if a skeletal open
bite is to be corrected non-surgically.
56 The use of
skeletal anchorage systems, such as mini-implants and
miniplates, has been promoted for closure of anterior open
bites via molar intrusion. The studies conducted have
shown promise, with true maxillary and mandibular molar
intrusion leading to counterclockwise rotation of the
mandible and, consequently, closure of the bite.54, 56
Concomitant reduction of the mandibular plane angle and
anterior face height usually follow.
Other advocated treatment alternatives such as highpull
headgear, vertical chin cup, vertical holding
30
appliance, or an active vertical corrector cannot achieve
effective molar intrusion in adult patients due to lack of
rigid anchorage.56 Presumably, open bite closure through
posterior intrusion and little to no anterior extrusion
leads to more stable outcomes.
55 Baek et al.57 investigated
the long term stability of anterior open bite correction
after intrusion of maxillary posterior teeth; they observed
22.88% relapse of the maxillary molars and 17% relapse of
the incisal overbite after a three year follow up period.
Unfortunately, the majority of literature involving
skeletal anchorage and open bites are case reports lacking
long-term follow up studies examining stability.20

Fixed appliance therapy
Most of the literature evaluating the dento-skeletal
effects of open bite therapy is centered on early treatment
of growing patients. With the exception of case reports,
there is a lack of sound data examining the effects of
fixed appliance therapy in adult anterior open bite
patients. When Remmers et al.58 evaluated treatment results
and stability in a large group of anterior open bite
adolescent patients, they discovered mean overbite
increased from -3.2 mm pre-treatment to .4 mm posttreatment,
with 71% of the sample obtaining a positive
31
overbite. Mean values for MP-PP and SN-MP decreased
insignificantly, while the mean value for SN-PP increased
insignificantly post-treatment. There were no appreciable
differences in these angular measurements over five years
post-treatment. The relapse rate was 27% five years posttreatment
and, overall, 44% of the sample had an open bite
at five years follow-up. The authors admit, “The poor
treatment response between Ts and T0 in the present study
raises the question whether conventional edgewise treatment
can adequately control the vertical dimension.”58
One variation of the MEAW technique uses upper
accentuated-curve and lower reverse-curve NiTi arch wires
with intermaxillary elastics; this theoretically offsets
the anterior intrusive forces of the wire and allows the
posterior intrusive forces to take effect while extruding
the anterior teeth. Once incisal overlap is achieved,
stainless steel wires are placed and patients are directed
to wear box elastics. Kucukkeles et al.59 observed the
dentofacial effects of this method on adult anterior open
bite patients and found that LAFH increased significantly
by 2.5 mm (p < .001) post-treatment, which the authors
believed to be a consequence of molar extrusion.
Interestingly, the mandibular plane angle was maintained
throughout treatment. SN to the functional occlusal plane
32
(FOP) decreased by 2.09˚ (p <.01) and the FOP-MP increased
by 2.38˚ (p <.001). The counterclockwise rotation of the
FOP can be accounted for by the extrusion of the lower
premolars and uprighting of the lower molars. Upper and
lower incisors and first molars were all extruded while
being uprighted. As compared to the MEAW technique, this
method proves to be more efficient, hygienic and
comfortable for the patient. However, bite-closure is
primarily achieved through extrusion of the incisors which
is not always ideal, particularly in those individuals
already presenting with excess gingival display at the
outset of treatment.

Surgery
If patients present with a true skeletal open bite, a
combined surgical-orthodontic approach is often encouraged
to attain an esthetic and stable treatment result. A common
surgical technique utilized for skeletal open bites is
posterior maxillary impaction. Superior repositioning of
the maxilla allows for autorotation of the mandible,
closure of the bite, and a decreased LAFH.
60 If the open
bite it not severe, however, it is hard to justify the
risks and trauma involved with surgery to achieve a
correction with no guaranteed stability.
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Thursday, December 15, 2016

due to extreme difficulty in establishing a rigid anchorage for molar intrusion.

thesis cairo university

Skeletal Anterior Open Bite is one of the most challenging malocclusion to correct. The complexity of this malocclusion is usually attributed to its multifactorial nature, where combinations of skeletal, dental, soft tissue and sometimes functional factors interact. Open bite is defined as a state in which the upper and lower teeth are separated when the jaws are closed completely, and generally refers to an anterior open bite in which the upper and lower anterior teeth do not occlude at a centric occlusion. Anterior open bite is often caused by a downward rotation of the mandible and/or by excessive eruption of posterior teeth. It is characterized by longer vertical dimensions and steep mandibular plane.
Control of the vertical dimension by intruding both maxillary and mandibular molars and facilitating counter-clockwise rotation of the mandible is the key to manage anterior open bite malocclusion treatment.
Traditional biomechanical techniques such as the use of the fixed mechanics and vertical elastics, passive bite-block, an extra-oral anchorage such as high pull head gear or vertical pull chin cup as well as posterior active vertical corrector with magnets, have several disadvantages such as rely on patient co-operation and ineffective control of the molars intrusion, especially in adult patients due to extreme difficulty in establishing a rigid anchorage for molar intrusion.
In the recent years, numerous publication have introduced novel way of reinforcing anchorage using a variety of temporarily anchored
16

Introduction 
devices in bone and were collectively named skeletal anchorage system (SAS). The use of such skeletal anchorage system, is now growing in popularity because of their ability to provide absolute anchorage, lack of patient‘s compliance, their relatively small size offering a versatility of insertion sites, ease of insertion and removal, ability to be immediately loaded, as well as their few complications and low cast.
Concurrently, the use of such devices has expanded the boundaries of orthodontic treatment, where they are now heavily applied to many clinical situations, including anterior segment retraction, mesial/distal movement of multiple posterior teeth, anterior teeth intrusion, posterior teeth intrusion, intermaxillary traction as well as orthopedic traction.
Despite the fact that many reports have been published regarding the successful use of SAS in the treatment of skeletal open bite.
The present study was undertaken to compare and investigate the use of two different miniscrew anchorage assemblies as anchorage units for intruding maxillary posterior teeth in adults and their subsequent effects on closing skeletal anterior open bite.
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magnetic bite blocks and rapid molar intruder comparison

https://synapse.koreamed.org/DOIx.php?id=10.4041/kjod.2015.45.1.38
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appropriate treatment for skeletal open bite is to intrude the molars (though difficult)

http://www.aensiweb.com/old/jasr/jasr/2012/497-505.pdf

Some  of  the  proposed  methods  in  growing  patients  are  high-pull  headgear  for  the  maxilla  or  cervical-pull 
headgear for the mandible, posterior bite blocks, the vertical chin cap and occlusal splints as well as the active
vertical corrector appliance (AVC) which uses repelling magnets embedded in acrylic to produce an additional
posterior occlusal force and posterior bite planes. Also functional appliances which are specifically designed and
fabricated with posterior bite blocks to accomplish posterior segment intrusion may be used. Unfortunately most
of  these  systems  are  limited  by  many  factors  including  patients'  compliance,  relative  number  of  dental 
anchorage  units  available,  allergy  as  well  as  unfavorable  reactionary  tooth  movement.  A  passive  system 
achieves  relative  intrusion  of  the  posterior  teeth  either  by  interfering  with  or  reducing  the  potential  of  molar 
eruption during growth.
While an active system, on the other hand, attempts to physically intrude the molars into
their  bony  support  (Owen  AH.,  1985;  Pfeiffer  JP  and  Grobety  D.,  1972;  Pfeiffer  JP  and  Grobety  D.  1982;   
Teuscher U., 1978; Iscan HN
et al.,
 2002; Woods MG and Nanda RS, 1988; Kiliaridis S
et al.,
 1990).
Compromised  esthetics  and  a  less  stable  outcome  than  for  intrusion  of  posterior  teeth  have  been  also 
considered drawbacks of incisor extrusion in these patients. So the most appropriate treatment for skeletal open
bite is to intrude the molars though molar intrusion is difficult.
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Tuesday, December 13, 2016

Active Vertical Corrector - reducing anterior facial height, appraches the problem at its cause

A clinical assessment of the Active Vertical Corrector—A nonsurgical alternative for skeletal open bite treatment
Eugene L. Dellinger, D.D.S., M.S.D.correspondencePress enter key for correspondence information
Fort Wayne, Ind., USA
DOI: http://dx.doi.org/10.1016/0002-9416(86)90075-8

    Abstract
    References

Abstract

This article describes the Active Vertical Corrector (AVC), which is a simple removable or fixed orthodontic appliance that intrudes the posterior teeth in both the maxilla and mandible by reciprocal forces. By the use of effective posterior intrusion of teeth, the mandible is allowed to rotate in upward and forward directions. The uniqueness of this appliance is that it allows the clinician to correct anterior open bite problems by actually reducing anterior facial height. This treatment approaches the problem at its cause (overeruption of posterior teeth) and provides better facial balance and esthetics than most conventional orthodontic treatment procedures. Problems formerly thought to require orthognathic surgery can now be treated successfully with the AVC.
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Active vertical corrector 상악 구치부의 intrusion을 일어 났으나 하악에서는 거의 일어나지 않아

7.Active vertical corrector

 델링거는 구치 바이트 블럭 형태에 자석을 부착한 장치를 소개 했다. 자석의 반발력으로 구치를 intrusion시키는 것이다.예비 결과는 좋아 보였으나 문제점을 만나게 되었다.

환자는 장치의 두께에 의해 야기된 수직 고경의 증가를 견디어 내기가 힘들며 어떤 환자는 자석의 반발력으로 하악이 측방으로 밀리게 되기도 하였다. 1991년 높이를 감소 시켜 이러한 문제를  보완 하였으며 buccal shield를 만들어 측방으로 밀리는 현상을 개선 하였다. 카바노가 행한 임상 실험에 의하면 상악 구치부의 intrusion을 일어 났으나 하악에서는 거의 일어나지 않아 이 장치가 개교합의 치료에는 도움이 되지 않는다는 결론을 얻었다.
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Saturday, December 3, 2016

Active Vertical Corrector (approaches the problem at its cause (over eruption of posterior teeth)

CASE REPORT

 

http://healthsciences.ac.in/jan-mar-14/4A.CaseReport.html

Clinical evaluation of the active vertical corrector – an in vivo study of 3 cases

ABRAHAM THOMAS1, FAIZAL C PEEDIKAYIL2, KEERTHI KIRAN1, RAJU SUNNY3 AND SAMEER3 
1 Department of Orthodontics, Malabar Dental College and Research Centre, Edappal, Malappuram. 2 
Department of Pedodontics and Preventive Dentistry, Kannur Dental College, Anjarakandy, Kannur, 3 
Department of Pedodontics, Malabar Dental College and Research Centre, Edappal, Malappuram. 5 
Department of Pedodontics, Malabar Dental College and Research Centre, Edappal, Malappuram, Kerala.
Correspondence to: drabrahamthomas@yahoo.com

  • Abstract
    In this article we describe the clinical evaluation in of Active Vertical Corrector (AVC), which is a removable or fixed orthodontic appliance that intrudes the posterior teeth by reciprocal forces. By the use of magnets for posterior intrusion of teeth, the mandible is allowed to rotate in upward and forward directions. The uniqueness of this appliance is that it corrects anterior open bite problems by reducing anterior facial height. This appliance treats the cause (over eruption of posterior teeth) and provides better facial balance and esthetics than most conventional orthodontic treatment procedures.
    Introduction
    Correct force application is the prescription of orthodontic tooth movement.1,2 Skeletal open bites are caused mainly by over eruption of the upper posterior teeth and, or vertical over growth of the posterior dentoalveolar complex. These could be due to posterior rotation of the mandible, superior repostioning of the glenoid fossa due to under development of the anterior portion of the maxilla, or a combination of these effects.2,3
    Surgical intervention such as Lefort I procedure is the treatment of choice for a severe skeletal open bite. Orthodontically, early correction can be achieved through high pull headgears, activators, combined headgear and upper plate, open bite bionator, activator headgear combinations active and passive bite blocks and vertical chin cups.3-5
    Treatment of the malocclusion is either by extrusion of anterior teeth or intrusion of posterior teeth. Extrusion of anterior teeth posed aesthetic problems like a gummy smile.5 Other than the conventional force systems a new force system has been introduced in orthodontics. This is the magnetic force system.
    The Active Vertical Corrector is an adaptation of the bite block therapy, introduced in 1986 by Dr. Eugene. L. Dellinger.4 The Active Vertical Corrector (AVC) works as an energized bite block. The Active Vertical Corrector is a simple removable appliance which consists of posterior occlusal bite blocks containing repelling magnets (Figure 1). It intrudes the posterior teeth causing the mandible to rotate upward and forward in much the same way that it would if the maxilla were surgically impacted. Hence Active Vertical Correctors are now used as an alternative to orthognathic surgery in anterior open bite cases in patients of all ages.6
    A clinical evaluation of three cases treated with Active Vertical Correctors is presented. This treatment approaches the problem at its cause (over eruption of posterior teeth) and provides better facial balance and esthetics than most conventional orthodontic treatment procedures.
    The aim and objectives of our study was to clinically evaluate the skeletal and dental changes that occur during treatment with the Active Vertical Corrector (AVC) and its effectiveness in treating anterior open bite malocclusions.
    Materials and Methods
    The Active Vertical Corrector is a patented appliance of Allessee Orthodontic Appliances (AOA). It consists of two posterior occlusal splints, one for the upper and one for the lower jaw. Samarium cobalt magnets are incorporated into the acrylic splints over the occlusal region of the teeth to be intruded (Figure 1). One magnet per distal quadrant is used. The magnets in the upper splints are incorporated in a mode to repel the magnets in the lower splints therefore the appliance is a combination of acrylic posterior bite blocks and repelling magnetic forces.
    To prevent unwanted crossbite development due to the shearing forces of repelling magnets, angled buccal flanges are added to the lower occlusal splint to stabilize the appliance during lateral jaw movements.
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Friday, December 2, 2016

Epigenetic Orthodontics - straighten without force brackets - front teeth further up palate taking away gummy smile



Epigenetic Orthodontics (also called Functional Orthodontics) is a specialized field in dentistry dealing with correcting the narrow palates, poorly aligned bites, facial asymmetries and small jaws that so many of us are afflicted with (it can also deal with crooked teeth). It takes a look at where our development went wrong and looks at the dental structure in the context of the whole face and how it all functions, rather than just looking at whether or not the teeth are straight.
The objective is to allow the craniofacial structure to develop in the way they would have, had our gene expression been optimized. Epigenetic Orthodontics stimulates a person’s genes to correct and straighten the teeth without the use of force brackets, affecting craniofacial, dental, and airway structures so that natural developmental processes are evoked by the use of orthodontic appliances. In simpler terms, the appliance makes room by causing new palate and jaw growth and the teeth naturally move into a healthy position.

Unlike traditional orthodontics, where the main objective is to simply straighten the teeth at all costs, (how many of you had teeth yanked before you got your braces?), it addresses the foundational issues. It's like the difference between "flipping" a house by doing cosmetic fixes and doing a real renovation, addressing the structural issues. Other issues with traditional orthodontics are that the teeth often shift and somewhat revert back to their original positions, unless a retainer is worn and the shape of the face and profile can be negatively affected due to extractions and pulling the upper row of teeth back, creating a pinched appearance or a receded chin.

Epigenetic Orthodontics uses removable palate expanding retainers, usually worn at night, that use light biological force, making it a much more comfortable process. It's not only more comfortable, it's also safer, as high forces from traditional orthodontic palate wideners can exert unhealthy pressure on the cranial bones (even affecting mental function in children.) There's no way you can put s much pressure on the cranial bones and NOT affect brain signaling.

The result of treatment is horizontal bone tissue growth resulting in better facial symmetry, nicer bone structure, healthy orthodontic alignment, better airways and better TMJ alignment.



Identical twins. The one on the right received palate expanding treatment and the other did not. Note the drastic difference in facial structure! The twin on the right has a much wider face- an example of proper horizontal growth, rather than the vertical facial growth that is so common these days.


Getting Treatment
[Edit: you can find lists of practitioners on each of the treatment option sites listed below.]

It used to be thought that you could only change the palate during childhood, but it's now been demonstrated that the palate can be expanded in adults even into their 70's, so there's hope for all of us. There are a number of different orthodontic appliances being used to accomplish adult palate expansion:

The pioneer in this still relatively obscure (at least in the U.S.) field is Dr. G. Dave Singh, DDS, creator of the DNA Appliance. You can listen to an interview with Dr. Singh. The DNA Appliance is worn while sleeping and works with the circadian rhythms (night is when most of the body's repair goes on).


Another appliance also worn only at night is the Homeoblock appliance, developed by Dr. Theodore Belfor, DDS. This was used in the treatment of the young man pictured at the top of this article (this change is after only 6 months of treatment). You can see that his facial structure became wider- that's what horizontal growth looks like. There are some fascinating videos on the website of people's faces morphing from "before" to "after" and some of the facial changes are absolutely amazing. Definitely check them out!

Here's a woman after 6 months of treatment. You can see the improvement in symmetry- the right side of her face is now less drooping and she almost looks like she's had a subtle lower face lift. Her cheekbones are slightly more prominent and less flat (and no, it's not just because she's wearing makeup in the second shot):


More effects on symmetry:
After 4 months of treatment:


There are many skeptics in the dental community claiming that Functional Orthodontics don't actually change the bone structure, but when you look at the cases presented in the Facial Development Newsletter, complete with computer imaging of areas of bone growth and expansion, it's pretty clear that they do indeed change bone structure and increase bone growth.



A slightly different type of orthodontic appliance that is less bulky, but worn continuously is Advanced Lightwire Functionals (ALF), developed by Dr. Darick Nordstrom.
Dr. Raymond Silkmanm, DDS, who uses ALF appliances, did a fantastic 2 part interview that I highly recommend listening to. Here's Part 1 and Part 2.


What about treating children?

Early Orthotropic growth guiding

 treatment during childhood, when development issues first surface, is ideal, but treatment can be done at any point during childhood, usually avoiding the need for braces. There are early signs that parents can look for to determine if their child's jaw and bite are developing improperly.

Here's an example of Orthotropic-guided growth:





So, I've given you an overview of the effects of poor jaw development and some of the treatment options. I hope to try this technology out for myself one day, as I could definitely benefit from bite correction and better airway development (and, let's be honest, more sculpted cheekbones sound pretty good, too!)


Erin, I think I'll send this off to my orthodontist, who is using the Damon System on me. Damon seems to be achieving some similar results because it also expands the palate.
So far, the braces have moved my front teeth further up into the palate, which took away some of the gummy smile that I had. I still see gums, but not quite as much. Also, I know that there was some palate expansion because I suddenly had huge gaps between some teeth. Since there is no room between the teeth to start with, the newfound space is proof of the expansion.
So sad all this, however. Dr. Price was right: we were meant to have perfectly formed palates and faces WHEN WE ADHERE TO A NUTRIENT DENSE TRADITIONAL DIET!
Sorry for cyber screaming, but that's how frustrating it feels. Thanks for the very interesting post!
http://www.nourishingnancy.com/2011/05/11/new-video-damon-braces-progress/
Reply

Exteneded breastfeeding definitely helps , but it doesn't necessarily prevent poor development (I was breastfed for a year and a half). A lot of it has to do with preconception and prenatal nutrition (and existing deficiencies), as well as the foods the child is eating as they develop (again, I ate whole "healthy" foods as a child, but grains do not agree with me and I have a gluten intolerance, so that likely affected growth).
We also have to remember that our soil is MUCH more nutrient depleted than it was a century ago, so it takes extra effort to get the nutrients needed.
Nutrients for bone that most don't get enough of these days are D3 (not everyone makes enough from the sun and we wash it off before it's done forming in our skin- it takes 48 hours), Vitamin A (retinol)- not everyone converts beta carotene to retinol efficiently, K2 (fermented foods and grass fed butter) magnesium (very important for bones) and silica (the forgotten bone matrix/connective tissue mineral!)
Bone broths, rich in gelatin and collagen are important, too, as well as organ meats!




Firstly, the only difference that I can tell between functional orthodontics and the dna appliance (epigenetic orthodontics) is that patients are asked to wear the dna appliance fewer hours. Supposedly this invokes some kind of circadian rhythym or growth factor and helps the skeleton grow. This is pure conjecture.

All palatal expansion appliances, whether they are fixed or removable, rapid or slow produce very similar results. While some studies have shown alveolar expansion (the bone around the teeth)in adults, I have not been able to find a study showing expansion of the mid palatal suture in adults. One study looked for this and the only expansion was dental-alveolar. No magic stimulus at the suture has ever been demonstrated, no change in our epigenome has ever been demonstrated. Again, pure conjecture. No change in the skeleton has been measured with either dna appliances or functional appliances.

I read a comment from a PhD in epigenetics and genomics who stated that the epigenetics and orthodontic treatment are completely unrelated and that perveyors of this treatment were ripping people off.

The upper dna appliance is nearly identical to what is known as Schwarz/Sagittal Active Plate and this has been around for at least 50 years.
This appliance might cost someone about 4-500 dollars. You could get this and wear it fewer hours....and presto....it's a dna appliance!! You just saved $7500!!!


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Molar Intrusion Techniques in Orthodontics: A Review Article (PDF Available) · February 2016 

https://www.researchgate.net/publication/300853119_Molar_Intrusion_Techniques_in_Orthodontics_A_Review

Abstract
Molar intrusion has always been a complex and difficult treatment modality. It can be approached for treating open bite patients or over erupted molar tooth/teeth. Through the decades, various treatment strategies have been developed to intrude molar teeth, ranging from non-surgical to surgical approaches, and utilizing various appliances, some which rely on patient compliance. The aim of this article is to compile and summarize the existing molar intrusive techniques and appliances with respect to their advantages and disadvantages, and their possible clinical effectiveness.
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