Comprehensive reference providing an evidence-based approach to the early treatment, recognition, and correction of developing malocclusions Recognizing and Correcting Developing Malocclusions, Second Edition provides an evidence-based approach to early treatment of developing malocclusions, presenting treatment protocols for mixed-dentition patients with various malocclusions and other orthodontic problems. Class I, Class II, and Class III malocclusions are covered extensively, along with eruptive deviations and different malocclusions. The literature is comprehensively reviewed to ensure that the reader thoroughly understands the development, phenotypic characteristics, and etiology of each type of malocclusion. Taking a problem-oriented approach, the authors provide detailed information for each case, develop comprehensive problem lists, and then present evidence-based treatment solutions. This newly revised and updated Second Edition contains comprehensive updates to all chapters and sections, including dental trauma and its consequences and sleep apnea in children. Containing figures, tables, patient pictures, and 3D rendered illustrations throughout to elucidate key concepts, Recognizing and Correcting Developing Malocclusions, Second Edition explores topics including: Assessing the degree of severity of a developing malocclusion and recognizing and correcting intra-arch deviations Genetics of dental occlusions and malocclusions and mixed dentition orthodontic mechanics Strategies for managing missing second premolar teeth in young patients and principles and techniques of premolar autotransplantation Abnormal eruption, function, and aesthetics, congenitally missing teeth, autotransplantation, and habits Construction of a diagnosis, treatment plan, and estimation of prognosis based on available diagnostic records produced by both old and new technologies Practical in approach but grounded in the literature, Recognizing and Correcting Developing Malocclusions, Second Edition is equally useful as a patient-side guide for clinicians and as a detailed reference for orthodontic and pediatric specialists and residents.

Table of Contents:
List of Contributors xiii Foreword xv Preface xvii 1 A guide for timing orthodontic treatment 1 Eustáquio A. Araújo, DDS, MDS and Bernardo Q. Souki, DDS, MSD, PhD 1.1 Occlusal deviations with indications for interceptive orthodontic treatment 3 1.2 Ideal timing for early treatment 5 1.2.1 Psychological aspects 5 1.2.2 Severity of the malocclusion 5 1.2.3 Effectiveness and efficiency concepts 6 1.2.4 Maturational stage of development 7 References 7 2 Development of the occlusion: what to do and when to do it 9 Bernardo Q. Souki, DDS, MSD, PhD 2.1 Stage 1—eruption of deciduous teeth 9 2.1.1 Biogenesis of the deciduous dentition 9 2.1.2 Dimensional changes of the dental arches at stage 1 11 2.1.3 Management of occlusal development at stage 1 11 2.2 Stage 2—completion of the deciduous dentition 11 2.2.1 Dimensional changes in the dental arches at stage 2 13 2.2.2 Management of occlusion development at stage 2 14 2.3 Stage 3—eruption of first permanent molars 16 2.3.1 Management of occlusion development at this stage 17 2.4 Stage 4—eruption of permanent incisors 18 2.4.1 Dimensional changes in the dental arches at this stage 18 2.4.2 Management of occlusal development at this stage 19 2.5 Stage 5—eruption of mandibular canines and first premolars 20 2.5.1 Management of occlusal development at this stage 21 2.6 Stage 6—eruption of second premolars 21 2.6.1 Management of occlusal development at this stage 23 2.7 Stage 7—eruption of maxillary canines and second molars 23 2.7.1 Management of occlusal development at this stage 23 2.8 Conclusions 24 References 24 3 Mixed dentition diagnosis: assessing the degree of severity of a developing malocclusion 27 Eustáquio A. Araújo, DDS, MDS 3.1 Assessing treatment need, complexity, and outcome 27 3.1.1 Summers’ Occlusal Index 28 3.1.2 Dental Aesthetic Index (DAI) 28 3.1.3 Peer Assessment Rating (PAR) 28 3.1.4 Index of Orthodontic Treatment Need (IOTN) 28 3.1.5 Index of Complexity, Outcome, and Need (ICON) 29 3.1.6 The American Board of Orthodontics complexity index and outcome assessment 29 3.2 Assessing interceptive treatment outcome 31 3.2.1 Class I 31 3.2.2 Class II 31 3.2.3 Class III 32 References 33 4 The genetics of the dental occlusion and malocclusion 35 Robyn Silberstein, DDS, PhD and Mary MacDougall, PhD 4.1 Introduction 35 4.1.1 Personalized medicine 35 4.1.2 Clinical examination 35 4.1.3 Principles of dysmorphology: variable expressivity and etiologic heterogeneity 36 4.2 Chromosomal abnormalities 37 4.3 Single gene defects 38 4.4 Multifactorial inheritance 38 4.5 Genetics of nonsyndromic malocclusion 40 4.6 Altered tooth number 42 4.7 Altered tooth structure 43 4.8 Altered eruption 43 4.9 Radiographic deviations associated with genetic conditions 45 4.10 Conclusion 47 References 47 5 Class I: Recognizing and correcting intraarch deviations 51 5.1 Section I: The development and etiology of a Class I malocclusion 51 Peter H. Buschang, MA, PhD 5.1 Introduction 51 5.2 Prevalence of Class I malocclusion and changes in arch form 52 5.3 Class I malocclusion and the dental compensatory mechanism 58 5.4 What is anterior mandibular malalignment is related to? 60 5.4.1 Predisposing factors 60 5.4.2 Eruption problems associated with space loss 61 5.4.3 Contact displacements associated with relapse and tooth movements 62 References 63 5.2 Section II: Intercepting developing Class I problems 67 Eustáquio A. Araújo, DDS, MDS 5.5 Tooth size arch length discrepancy (TSALD) 67 5.6 The assessment of crowding in the mixed dentition 68 5.6.1 Zero to minor TSALD 68 5.6.2 Small to moderate TSALD 69 5.6.2.1 Taking advantage of the transitional dentition 69 5.6.3 Gaining spaces in the dental arches 71 5.6.3.1 The importance of the leeway space/E space 71 5.6.3.2 Etiology of maxillary transverse deficiency 72 5.6.3.3 Maxillary expansion and headgear 73 5.6.3.4 Gaining space in the mandibular arch 83 5.6.3.5 Arch dimensions changes 84 5.6.3.6 Arch length and mandibular molar/MP 84 5.6.3.7 Arch length and mandibular incisors/MP 84 5.6.3.8 Transverse changes 84 5.6.3.9 Incisor irregularity changes 84 5.6.3.10 The Schwarz appliance 86 5.6.3.11 Two-by-four fixed therapy 86 5.6.4 Severe TSALD: fundamentals of serial extraction 92 5.6.5 Indications and contraindications for serial extraction (SE) 93 5.6.5.1 Additional important fundamentals in serial extraction 94 5.6.5.2 Sequence and timing of extractions 95 5.6.5.3 Alternative extraction sequences 95 References 102 6 Recognizing and correcting Class II malocclusions 107 6.1 Section I: The development, phenotypic characteristics, and etiology of Class II malocclusion 107 Peter H. Buschang, MA, PhD 6.1 Introduction 107 6.1.1 Prevalence 109 6.2 Characterization of the Class II, division 2 phenotype 110 6.3 Characterization of the Class II division 1 phenotype 111 6.3.1 Hyperdivergent vs. hypodivergent Class II division 1 malocclusion 114 6.4 Developmental changes of Class IIs 115 6.5 Class II developmental changes 118 6.6 Etiology 119 References 123 6.2 Section II: Class II treatment: problems and solutions 131 Eustáquio A. Araújo, DDS, MDS 6.7 Early Class II adjustment 132 6.8 Treatment 136 References 158 7 Recognizing and correcting Class III malocclusions 161 7.1 Section I: The development, phenotypic characteristics, and etiology of Class III malocclusion 161 Peter H. Buschang, MA, PhD 7.1 Introduction 161 7.2 Characterization of the Class III phenotype 163 7.3 Class III development 168 7.4 Etiology 170 References 175 7.2 Section II: Class III treatment: problems and solutions 179 Eustáquio A. Araújo, DDS, MDS 7.5 Diagnosis 183 7.5.1 Facial diagnosis 183 7.5.2 Cephalometric diagnosis 183 7.5.3 Dental diagnosis 183 7.5.4 Functional diagnosis 184 7.5.5 Hereditary diagnosis 185 7.6 Communication 187 7.7 Early intervention 188 7.8 Orthopedic maxillary expansion 188 7.9 Face mask and/or chincup orthopedics 191 7.9.1 The face mask 191 7.9.2 The chincup 193 7.10 Leeway space control 194 7.11 Orthodontic mechanics 194 7.12 Finishing 194 7.13 Retention 194 7.14 Growth reevaluation 195 References 221 8 Special topics 225 8.1 Section I: Habit control: the role of function in open-bite treatment 225 Ildeu Andrade, Jr., DDS, MS, PhD and Eustáquio A. Araújo, DDS, MDS 8.1 Nutritive vs. nonnutritive sucking habits 225 8.2 Tongue physiology 226 8.3 Tongue thrusting and forward resting posture of the tongue 227 8.4 Breaking the habit 227 8.4.1 How and when should a clinician intervene? 227 8.4.2 The Araújo approach 227 8.5 Treatment 229 References 235 8.2 Section II: Eruption deviations 239 Bernardo Q. Souki, DDS, MSD, PhD and Eustáquio A. Araújo, DDS, MDS 8.6 Eruption deviations 239 8.7 Eruption deviation and PIOM: what are the most frequent eruption disturbances in each stage of dental development? 241 8.7.1 Stage 2 – Completion of deciduous dentition 241 8.7.2 Stage 3 – Eruption of the first permanent molars 241 8.7.3 Stage 4 – Eruption of the permanent incisors 241 8.7.4 Stage 5 – Eruption of the mandibular canines and the first premolars 242 8.7.5 Stage 6 – Eruption of the second premolars 247 8.7.6 Stage 7 – Eruption of maxillary canines and second molars 247 References 253 8.3 Section III: Strategies for managing missing second premolar teeth in the young patient 255 David B. Kennedy, BDS, LDS (RCSEng), MSD, FRCD(C) 8.8 General concepts 255 8.9 Longevity of the second deciduous molar, resorption, and infraocclusion 256 8.9.1 Resorption 256 8.9.2 Infraocclusion 257 8.10 The alveolar ridge in extracted deciduous molars 257 8.11 Overall dental health and cost 258 8.12 Case histories 258 8.13 Summary 270 References 270 8.4 Section IV: Principles and techniques of premolar autotransplantation 273 Ewa M. Czochrowska, DDS, PhD and Paweł Plakwicz, DDS, PhD 8.14 Class II malocclusion with congenitally missing lower second premolars 274 8.15 Traumatic loss of upper incisor/s 274 8.16 Uneven tooth distribution with multiple agenesis 274 8.17 Surgery 277 8.18 Selection of anesthesia (local vs. general) 277 8.19 Premolar to premolar transplantation 277 8.20 Premolar to anterior maxilla transplantation 279 8.21 Postoperative instructions 279 8.22 Follow-up 279 8.23 Pulp healing 280 8.24 Periodontal healing 281 8.25 Root growth 281 8.26 Reshaping to incisor morphology 281 8.27 Alveolar bone after autotransplantation 281 References 282 8.5 Section V: Dental trauma: revisiting posttrauma protocols and long-term follow-ups 285 Eustaquio A. Araújo, DDS, MDS and Gabriel Miranda, DDS, MS 8.28 An overview of dental trauma 285 8.29 Orthodontic treatment and dental trauma 286 8.30 Managing traumatized teeth and preserving bone width – The decoronation approach 288 8.31 Final considerations 295 References 297 8.6 Section VI: Sleep-disordered breathing (SDB) in the growing child 299 Juan Martin Palomo, DDS, MDS and Luciane M. de Menezes, PhD 8.32 The need for sleep 299 8.33 Diagnosis and management of sleep-disordered breathing (SDB) and obstructive sleep apnea (OSA) in children 300 8.34 Risk factors for OSA in children 302 8.34.1 Enlarged tonsils and adenoids 302 8.34.2 Obesity 304 8.34.3 Allergies and respiratory infections 304 8.34.4 Structural abnormalities and craniofacial anomalies 305 8.35 Consequences of SDB in children 305 8.36 Treatment options for the dental and skeletal consequences of SDB in children 309 8.37 New technologies: the use of apps and devices for SDB and OSA in children 310 8.38 Conclusion 310 References 311 8.7 Section VII: Mixed dentition orthodontic mechanics 313 Gerald S. Samson, DDS 8.39 Definitions and terminology 314 8.39.1 Center of mass and center of resistance 315 8.39.2 Orders of tooth movements and orthodontic terminology 316 8.39.3 Force systems 316 8.39.4 Single-point force and moment of force 316 8.39.5 Additive and subtractive couples 316 8.39.6 Equilibrium and tooth movement – Newton’s third law 317 8.39.7 Force systems and tooth movements 318 8.39.8 Mixed dentition example of one tube (bracket) and one couple system 319 8.39.9 Mixed dentition: maxillary anterior root convergence 320 8.39.10 Orthodontic treatment of teeth with open apices 320 8.39.11 Two brackets – two equal and oppositely directed couples 320 8.39.12 Two brackets – two unequal oppositely directed couples 321 8.39.13 Two brackets – two “same direction, additive” couples including increased anterior incisor root torque 322 8.39.14 Clinical application – mixed dentition openbite, two “same direction, additive” couples including increased anterior incisor root torque 324 References 326 Index 327