Orthopedics and orthodontics

Aligned teeth in harmony

Orthodontics is the part of dentistry that deals with the correction of teeth position. Today adult orthodontics is as frequent as children orthodontics.

Some cases can be treated with removable appliances, and other ones with fixed appliances. In general, the sooner a problem is discovered, the easier it will be to treat it. It is advisable to visit children since 4 years of age, to detect or prevent possible important alterations in the future.

People who can be treated orthodontically sometimes can benefit from the treatment of other related problems, like changes in the position and growth of the maxillae, in the facial profile or on the global posture of the face and body.

Techniques have evolved spectacularly, even with the use of microimplants to facilitate some movements, using white or transparent braces made with sapphire, lingual braces which are invisible from the outer part of the mouth, or the already known treatments with invisible splints, like Invisalign®

Microimplants (or microscrews) are small devices which can be screwed in bone to increase anchorage in orthodontic treatments. The development of these devices makes it possible to make orthodontic’ movements and achieve results which were unthinkable a few years ago. The placement of the microimplants is painless and does not interfere with everyday life.

It is paramount to place, after orthodontic treatment, a fixed retainer known usually as a fixed splint and also a transparent removable essix to use during night time, to avoid the relapse of treatment.

For all those things, it is very important to diagnose in an individualized way every case. In the unit of Orthodontics and Dentofacial Orthopedics of the Clinica Dental Padrós-Creus Muntaner, we have the upmost computer programs to evaluate face profile and the teeth, and diagnose the combined functional problems in three dimensions. We can also evaluate simulations of the prediction of the final result of treatment.

With the computerized evaluation of the cast models and the photographic and video elements, and applying the ideas of the DSD we will design a new smile, and recommend the best technique to achieve it.

Advancements in diagnosis

Among the last advancements which we have added, we have the Dolphin Imaging 3D program. Until not too long ago the orthodontic problems could only be diagnosed with 2D elements (x rays, photographs). Today it is possible to study the case with greater exactitude, as we can detect the 3D dimension of structures like the roots of the teeth, the bone thickness, the position of included teeth, etc. For that we apply 3D analysis on images taken by CBCT (Cone beam tomography).

Ortodoncia

Orthopedics

In young children we can improve shape, functional posture and growth alterations associated with the different malocclusions, and many times early intervention has a very big importance to obtain a stable result, both functionally and aesthetically. Most problems can be detected between 4 and 12 years of age. In this respect, some cases which require an early treatment would be open bites, or an excessive vertical growth of the face. Dentofacial orthopedics is a part of dentistry which is usually performed in combination with orthodontics. Using fixed or removable appliances, it applies stimuli which modify the skeletal growth pattern in patients who require it. We are pioneers in Spain in the applications of appliances like John Mew’s biobloc (Orthotropics), Waveney’s functional finishing appliance, Bill Clark’s Twin Block or Eganhouse class III appliance, among others. This area of dentistry allows to achieve the best results when it is practiced during active growth, because one of the main objectives it has is to modify the quantity and direction of growth of the lower facial third. There are different skeletal appliances, and using one or another depends on the problem that needs to be treated. Some of them make up the group of functional appliances, which normalize altered orofacial functions and guide facial global growth. Before deciding to use one appliance or another we will diagnose the case taking into account a series of clinical and functional examinations, following a detailed protocol.

Orthodontics

Usually, in adults we will have to perform an interdisciplinary treatment, where different specialties will be involved. For orthodontic treatment we use many times self-ligating braces (Damon, Damon Clear, In Ovation, Lotus Plus, White Shark, H4), which allow us to obtain spectacular smiles once treatment has finished, or the invisible orthodontic technique (Inivsalign, Spark) which best adapts to every patient, and it includes clear aligners or lingual orthodontics. We have the official certification to use most of the existing invisible techniques (Kurz brackets, Incognito brackets, WIN brackets, Invisalign, Spark, Orthocaps, Alineadent, F2.2…)

Damon and damon clear

Damon technique uses self-ligating brackets. This way, the orthodontic force does not require elastic ligatures, and this way friction is avoided and teeth are less forced. The applied forces are much inferior than the ones applied with conventional brackets, and treatment times can be reduced significatively.

Invisible orthodontics

Invisible orthodontics implies that nobody will notice that you are wearing it. The personal image that we transmit to others through it, is getting more and more important every day, and having an aligned and healthy mouth is part of that self-image. It is a very valid alternative to treat different teeth malposition problems. Recent computer and 3D developments, and also the evolution of plastic materials have caused invisible orthodontics to be a fantastic alternative for many patients. There are two types of invisible orthodontics: Lingual orthodontics (with the brackets bonded to the lingual part of the teeth), and orthodontics with aligners (with undetectable appliances). In both cases there are many different techniques and options for every malocclusion. Among lingual orthodontic techniques we can use Kurz’s brackets, Hiro’s Brackets, Wiechmann’s Incognito and WIN techniques, CLO 3 and Social Six. Among aligner techniques, we have the certifications to use almost every existing technique (Invisalign, Spark, Orthocaps, F22, Alineadent, etc…) using mainly the first two due to their experience and proved fiability. This type of orthodontics corrects teeth malposition using a series of plastic trays which have been individualized. The patient will be able to remove them both to eat and to brush their teeth. You will be able to see how the final position of the teeth will be through a 3D computerized program (ClinCheck) before starting treatment. It is important to wear the aligners as much as possible (a minimum of 22 hours every day is recommended), removing them only to eat, and attend the periodic visits to control the evolution in the office. The aligners will be modified sequentially to adapt to the new position of the teeth and keep aligning them. We are pioneers in all those techniques, and we can offer any of them to treat every case as needed. In Clínica Dental Padrós-Creus Muntaner we want that you have the smile you always dreamed of. We will perform a previous evaluation and study of your denture to stablish an individualized treatment plan which will determine the time you will need to wear it, the number of aligners and even if you will have to wear orthodontics in both arches or only in one of them.

Inman aligner

Among aesthetic or invisible techniques, some classic removable appliances, including Inman’s Aligner or Mew’s Biobloc.

Inman’s aligner is able to align anterior teeth offering a rapid treatment and, for this reason it may be the best option for relapse in adults.

It is a logic alternative, because it works rapidly and efficiently. Many cases can finish in 6-16 weeks.

Ortodoncia

Acceledent

To be able to finish orthodontic treatments quicker, whatever the technique used, we can use the Acceledent® system. This curious instrument, through a series of comfortable vibrations applied every day, is able to finish the cases between 30 % and 40% before. Normally this device needs to be worn around 20 minutes every day.

Orthognathic surgery

Orthognathic surgery includes the necessary surgical techniques to place the mandible and the maxilla in the best position, so that combined with precise orthodontic manoeuvres will be able to obtain an ideal result for a good mastication, facial aesthetics, etc.

Those problems are relatively frequent. It is considered that between 8% and 12 % of the population have those dentofacial disharmonies, Orthognathic surgery is usually performed in patients who have already finished growth.

The procedure is done between the orthodontist and the specialist surgeon, who will be in charge of mobilizing the bone structures to achieve a correct positioning between the maxillae, and a good aesthetics.

Around one day after surgery, the orthodontist starts to apply the orthodontic forces, usually with elastics and wires, and proceeds to the finishing of the case, which is usually achieved between 6 and 12 months after surgery.

Ortodoncia