James Nudera,
DDS, MS
Robert Nudera, DDS, MS
81 S. McLean Blvd. Unit B
South Elgin, Illinois 60177
TEL: 847.760.6353
Fax: 847.760.6356
nuderaorthodontics@gmail.com
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Two-phase orthodontic treatment is a very specialized process
that encompasses tooth straightening and physical, facial changes.
The major advantage of a two-phase treatment is to maximize the
opportunity to accomplish the ideal healthy, functional, aesthetic
result that will remain stable throughout your life.
The disadvantage of waiting for complete eruption of permanent
teeth and having only one phase of treatment for someone with a
jaw discrepancy is facing the possibility of a compromised result
that may not be stable.
The goal of first phase treatment is to develop the jaw size in
order to accommodate all the permanent teeth and to relate the
upper and lower jaws to each other. Children sometimes exhibit
early signs of jaw problems as they grow and develop. An upper
and lower jaw that is growing too much or not enough can be recognized
at an early age. If children after age 6 are found to have this
jaw discrepancy, they are candidates for early orthodontic treatment.
Because they are growing rapidly, children can benefit enormously
from an early phase of orthodontic treatment utilizing appliances
that direct the growth relationship of the upper and lower jaws.
Thus, a good foundation can be established, providing adequate
room for eruption of all permanent teeth. This early correction
may prevent later removal of permanent teeth to correct overcrowding
and/or surgical procedures to align the upper and lower jaws.
Leaving such a condition untreated until all permanent teeth
erupt could result in a jaw discrepancy too severe to achieve
an ideal result with braces.
Orthodontic records will be necessary to determine the type
of appliances to be used, the duration of treatment time, and
the frequency of visits. Records consist of models of the teeth,
x-rays, and photographs.
In this phase, the remaining permanent teeth are allowed to erupt.
Retaining devices are not usually recommended since they may interfere
with eruption. It is best to allow the existing permanent teeth
some freedom of movement while final eruption of teeth occurs.
A successful first phase will have created room for teeth to find
an eruption path. Otherwise, they may become impacted or severely
displaced.
In other words, at the end of the first phase of treatment,
teeth are not in their final positions. This will be determined
and accomplished in the second phase of treatment. Selective
removal of certain primary (baby) teeth may be in the best interest
of enhancing eruption during this resting phase. Therefore, periodic
recall appointments for observation are necessary, usually on
a six-month basis.
The goal of the second phase is to make sure each tooth has an
exact location in the mouth where it is in harmony with the lips,
cheeks, tongue, and other teeth. When this equilibrium is established,
the teeth will function together properly.
At the beginning of the first phase, orthodontic records were
made and a diagnosis and treatment plan established. Certain
types of appliances were used in the first phase, as dictated
by the problem. The second phase is initiated when all permanent
teeth have erupted, and usually requires braces on all the teeth
for an average of 24 months. Retainers are worn after this phase
to ensure you retain your beautiful smile.
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What is the advantage of two-phase orthodontic treatment?