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Two-Phase Orthodontic Treatment
Two-phase orthodontic treatment is a specialized process that can encompasses tooth straightening and/or physical, facial changes. The initial phase often includes orthopedic repositioning of the bones of the jaws. The major advantage of a two-phase treatment is to maximize the opportunity of growth potential to accomplish the most ideal, healthy, functional and aesthetic result possible.
The disadvantage of waiting for complete eruption of permanent teeth, and having only one phase of treatment, for someone with a jaw discrepancy, is that they are missing out on the opportunity to use growth potential. They are also facing the possibility of a compromised result or the need for jaw surgery to provide the needed correction.
First phase treatment goals are to develop the jaw size in order to accommodate 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.
Because they grow 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 the 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 just braces alone.
Orthodontic records are 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, 3D X-rays, and photographs.
In this phase, the remaining permanent teeth are allowed to erupt. Dr. Leonard will monitor the eruption your child's remaining teeth to give his team the opportunity to correct any remaining orthodontic problems. 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 the best way 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 12 to 24 months. Retainers are worn after this phase to ensure you retain your beautiful healthy smile.