In the realm of orthodontics, the interplay between airway health and occlusal alignment is a topic of growing importance. Understanding the distinctions between Class I and Class II occlusions, especially in the context of clear aligner treatments, is crucial for optimising patient outcomes.
Is Class II Becoming the New Normal?
The increasing prevalence of Class II occlusions raises the question of whether it is becoming the new standard. Traditionally, achieving a Class I occlusion has been the primary goal. However, there is a shift towards a more comprehensive approach that considers not just the teeth but also the overall functionality and comfort of the mouth. This includes ensuring proper breathing and providing adequate space for the tongue, which can significantly enhance a patient’s quality of life.
Should Class I Always Be the Goal?
While digital tools make it look easier to achieve a Class I occlusion, it is not always the best or most feasible goal for every patient. Class I alignment does facilitate fitting teeth together more seamlessly, but orthodontic treatment must consider individual patient limitations and preferences. In some cases, achieving a perfect Class I occlusion may not be possible without surgical intervention, which some patients may wish to avoid. Instead, treatments like maxillary expansion can greatly improve breathing and overall health, even if a perfect Class I alignment is not achieved.
The Role of Surgery in Improving Quality of Life
Surgery can play a role in addressing severe occlusal issues, but its necessity can often be reduced through proactive orthodontic management. Effective orthodontic treatment can manage the bite, breathing, and aesthetic aspects, reducing the need for later surgical interventions. The focus should be on addressing developmental milestones missed during growth rather than relying on surgery as a corrective measure. This is a task that should be performed by orthodontists and not general dentists as orthodontists have all the needed knoweldge about growth, growth intervention and adaptation. A knowledge that is not to be underestimated by general dentists. General dentists should be able to identify and refer children and teenagers showing signs of breathing disorders as they are often reflected in the development of the midface, the maxilla and thereby the occlusion.
Current Research and Clinical Practice
There is ongoing debate about the impact on the airways when distalizing the anterior segment in combination with maxillary premolar extractions. While some argue that such procedures can be detrimental, they are not inherently harmful if done with proper consideration of the patient's overall function, including their breathing patterns. Diagnosing and treating maxillary transverse deficiencies is crucial and should not be overlooked in favour of simpler extraction methods.
Don't be fooled by the software
Please be aware that extraction cases look so easy in the virtual treatment plan on the computer screen. In reality however they are really, really challenging to handle clinically. Our recommendation in these cases is always to refer to an orthodontist or to a colleague with expereience from more than 3-400 clear aligner treatments. Including premolar extraction cases.
Airway Awareness in Orthodontics
Understanding and addressing airway issues is becoming a critical component of orthodontic practice. Incorporating airway assessments into routine evaluations and forming interdisciplinary teams can help address these concerns more effectively. General dentists, given their regular patient interactions, are increasingly seen as key players in managing airway health.
Conclusion
Balancing occlusal goals with overall patient health and functionality is essential in clear aligner treatments. By prioritising airway health and adopting a comprehensive approach, orthodontists can significantly improve treatment outcomes and enhance patients' quality of life. This comprehensive perspective ensures that treatments are not just focused on achieving perfect alignment but also on fostering long-term health and well-being.
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Sincerely
Dentist, co-founder & business advisor
Jesper Hatt DDS
Phone: +41 78 268 0078
AlignerService helps dentists create realistic, safe and predictable treatment plans with clear aligners.
Currently, we help1500 dental practices in 19 different countries. AlignerService is a preferred partner of ClearCorrect.
In addition AlignerService clear aligner experts work with Invisalign, SureSmile, TrioClear, Angel Aligners and Spark.
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