Periodontal pathogenesis is a multi-factorial process and the orthodontist must recognize the clinical forms of inflammatory periodontal disease. Orthodontics is the most conservative and predictable treatment to improve numerous local etiological factors that contribute to periodontal disease including periodontal breakdown. Proper occlusal function and masticatory function are stimulatory to the gingival tissue and the attachment apparatus, while, conversely, a lack of function predisposes to disease that increases plaque retention and calculus formation along with gingival inflammation leading to increased loss of bony support. No matter how talented the orthodontist, a magnificent orthodontic correction can be destroyed by failure to recognize periodontal susceptibility. Therefore, identifying periodontally susceptible patients is critical for the outcome of the treatment. This chapter will highlight the importance of the short-term and long-term outcomes of orthodontic treatment, which are influenced by the patient’s periodontal status before, during and after active orthodontic therapy.
Part of the book: Periodontology
In orthodontics there has been a change in the treatment plan of crowding cases from extraction protocol. This was mainly due to the introduction of self-ligating bracket and temperature activated wires. Even though there are certain exceptions, the self-ligating bracket have evolved in orthodontics because of its advantages such as low friction, shorter treatment duration and increased efficacy. Damon’s self-ligating system has been in existence since 1930 but it has been well developed in the past 30 years with the introduction of newer systems. Damon’s self-ligating brackets have been designed to overcome the drawbacks of conventional bracket system and are often considered as the pinnacle of bracket technology. The main advantage of Damon’s system was low friction and shorter treatment duration. But the efficiency of the appliance is influenced by several factors such as Biomechanics, frequency of dental visits and patient comfort. The chapter will highlight the efficiency of the appliance, the various possible outcomes and its influence on the ease of orthodontic therapy.
Part of the book: Current Trends in Orthodontics
As all practitioners are aware, the prevalence and incidence of dental caries keep increasing constantly and therefore early diagnosis and cessation of further progression would greatly help in maintaining the sound tooth structure. One of the earliest signs of dental caries is a white spot lesion, which is mostly missed, and only treated when the condition worsens. WSL are areas of demineralized enamel that occur due to a prolonged period of retained microbial biofilms most commonly associated in patients with poor oral hygiene and fixed orthodontic appliances. If caught early and intervened, WSLs can be reversed. Therefore, the diagnosis and treatment of WSL are of outmost importance, and this chapter will explain in detail various methods of diagnosing WSLs, its treatment protocol with the significance of remineralization of the same.
Part of the book: Oral Health Care