Orthodontics primarily uses various corrective devices to adjust the coordination between the facial bones, teeth, and the nerves and muscles of the maxillofacial region. This involves correcting any abnormal relationships between the upper and lower jaws, the upper and lower teeth, the teeth and jaws, and the nerves and muscles that connect them, ultimately achieving a balanced, stable, and aesthetically pleasing stomatognathic system. The effectiveness and duration of correction vary depending on age, oral condition, and treatment method. Generally speaking, younger individuals, those in good health, and with good oral health, achieve better results.
Applicable people
Orthodontics is suitable for people with abnormal conditions such as crowded teeth, buck teeth, and maxillary protrusion.
Taboo groups
1. Patients with periodontal disease.
2. Patients with poor oral hygiene habits or prone to dental caries.
3. People with chronic wasting diseases such as tuberculosis, blood diseases, hyperthyroidism, diabetes and those with severe malnutrition.
4. Those suffering from mental illness, severe mental weakness and unstable psychological quality.
5. Those who have unrealistic fantasies about the treatment effects.
6. Women who are menstruating, pregnant or breastfeeding.
7. Patients with hypertension, heart disease, cerebrovascular disease and damage to important organs.
Technical/surgical risks
1. Pain: Mild pain and swelling may occur after orthodontic treatment, but excessive pain and swelling will cause great suffering to the patient, affect postoperative healing, and increase the chance of infection. At this time, you should go to the hospital for diagnosis and treatment in time.
2. Loose Teeth: Under normal circumstances, each tooth has a certain degree of physiological mobility to cushion the pressure of chewing and prevent tooth trauma. During orthodontic treatment, increased tooth mobility is normal and generally resolves after the teeth are corrected to their normal position. If tooth mobility is significant, or even affects tooth function, discontinue use of force and seek prompt medical attention. The doctor will provide appropriate treatment based on the individual’s circumstances.
3. Infection: Improper operation may cause oral infection, which is more common in surgical correction. Standard operation, cleaning and disinfection can effectively prevent infection. If infection occurs, seek medical treatment promptly.
4. Damage to the braces: Poor material, improper operation or poor maintenance of the braces after surgery may cause damage to the braces and irritation to the oral soft tissue. In this case, you should seek medical attention immediately.
5. Damage to periodontal tissue: Tooth movement and reconstruction of periodontal tissue must follow certain biological forces. Incorrect orthodontic force may cause permanent damage to periodontal tissue.
6. Pulp reaction: In the early stages of orthodontic treatment, a mild, temporary inflammatory reaction will occur in the pulp. The patient may feel pain or discomfort. This is a normal phenomenon and there is no need to worry too much. It can usually be relieved on its own.
7. Mucosal ulcers: In the early stages of treatment, ulcers sometimes occur in the mucosa after contact with orthodontic brackets. In addition, irritation from the ligature or archwire ends can also cause ulcers, which usually resolve on their own after a period of adaptation.
8. Enamel demineralization and tooth decay: During the orthodontic process, since there are more corrective devices in the mouth, if they are not cleaned properly, it may cause irreversible demineralization of the tooth surface (the tooth surface becomes chalky), and in severe cases, tooth decay may occur.
9. Root resorption, loosening, or loss of teeth: Orthodontic treatment involves the gradual remodeling of the alveolar bone surrounding the tooth roots. During treatment, osteoblasts and osteoclasts are active around the alveolar bone, causing a certain degree of root resorption. The degree of resorption often increases with the distance the tooth needs to be moved. Generally, this does not affect the stability of the tooth. However, due to individual differences, in rare cases, root resorption may occur specifically, causing loosening or loss of the tooth.
Postoperative care
Taking maxillary protrusion orthognathic surgery as an example, postoperative care includes local care, medication management, diet conditioning and lifestyle behavior habit management.
1. Local care: Keep the wound area clean and dry after surgery and do not get it wet within 7 days; do not touch the surgical incision before removing the stitches, and avoid squeezing or massaging the surgical area after removing the stitches.
2. Medication management: Oral or intravenous antibiotics can prevent infection; scar removal ointment can be applied to lighten scars.
3. Diet adjustment: Avoid eating spicy, irritating, and very hard foods; eat more vegetables and fruits, and supplement protein appropriately.
4. Management of lifestyle habits: Do not do facial beauty massage for 3 months after surgery, and try to avoid long-term strenuous exercise.
Preoperative precautions
1. Necessary clinical examinations are required before orthodontics, including taking lateral skull radiographs and curved surface films, taking frontal photos, side photos and intraoral photos, etc., so that the doctor can grasp the detailed information and make a diagnosis and design.
2. Communicate fully with the doctor before the operation to understand the specific process, related risks, required costs, etc., and fully understand and agree to the treatment plan determined by the doctor.
3. Diagnose whether there is dysfunction of the temporomandibular joint.
4. Patients with periodontitis should receive treatment first and then correction.
5. Change bad living habits, such as quitting smoking and limiting alcohol consumption.
6. Women should try to avoid menstruation, lactation and pregnancy periods.
7. Eat a light diet and avoid spicy, sugary, greasy, seafood and other fishy foods.
8. Maintain a positive attitude and treat treatment correctly.
9. Keep your mouth clean and pay attention to oral hygiene.
Surgical procedure
Orthodontics is divided into auxiliary orthodontic treatment, comprehensive orthodontic treatment, and combined surgical and orthodontic treatment, including wearing braces, orthodontic surgery and other methods. Wearing braces is what we call “wearing braces” in daily life. Currently, commonly used braces mainly include metal bracket appliances, semi-invisible bracket appliances, and fully invisible bracket appliances. Orthodontic surgery includes tooth extraction, maxillary protrusion correction surgery, bimaxillary protrusion surgery, mandibular protrusion surgery, etc. This article mainly introduces maxillary protrusion correction surgery as an example. The surgical process mainly includes making incisions, stripping tissues, osteotomy, moving bones, suturing and other steps.