Orthotown March 2016 - (Page 34)

clinical orthodontics // message board I've Done a Tongue Guard...Now What? A Townie faces tough questions from a concerned mom. Can this young patient avoid extractions? Orthotown.com > Message Boards > Clinical Topic > Clinical Orthodontics > I've Done a Tongue Guard ... Now What? alicia85 Member Since: 10/19/15 Post: 1 of 7 Related Message Boards Transfer Case-Yikes! Transfer Case Thumb Habit Help Please Thumb Habit Introduction Hello, all. This patient is 10 years, 9 months old, and had a thumb-sucking habit. I placed a tongue guard about six months ago. The mom and patient say that she hasn't had the habit since it was inserted. I recommended to have the appliance removed at the next visit since the habit has stopped, and for us to observe until Phase II, but Mom wants more treatment now. She's concerned that there is crowding everywhere, especially the lower 3's. She asked if I could put in an upper expander to make room for the teeth, but there's no crossbite to warrant an RPE. The lowers look retroclined clinically, but they have a good angulation based on the ceph. Do you think a lower-lip bumper would help? I thought about maybe an upper Pendex (the left 6's are edge-to-edge but not in full crossbite) to distalize the 6's since they are Class II-ish, but I can't place that until the 4's come in. I did mention possible treatment with extractions in Phase II, and Mom wants to know if there is anything that could be done now to avoid extractions later. I couldn't come up with an answer today while she was staring at me so I said I would take progress records and give her some options at the next visit. Suggestions? Thanks in advance. ■ JAN 12 2016 Fenrisúlfr Member Since: 02/25/09 Post: 2 of 7 Other than extracting upper C's, I don't see any benefit of intervention at this stage, and I'd see her at six- or nine-month intervals to monitor the E's. I'd be leery about "preventing" extractions later on from two perspectives. There's no research to substantiate that, and if extractions are required during Phase II, you don't want to paint yourself into a corner. No reason for potential patient burnout, not to mention the additional cost and burden of treatment in this case. The expansion and extraction can be addressed in one phase and once all the teeth are in. ■ JAN 12 2016 Shwan Member Since: 08/02/10 Post: 3 of 7 You can place a lower lingual arch to benefit from the E-space, then of course at Phase II you have to address the Class II molars relationship. Also everything else can be addressed at Phase II, as Fenrisúlfr said. ■ JAN 12 2016 34 MARCH 2016 // orthotown.com http://www.Orthotown.com http://www.orthotown.com/MessageBoard/thread.aspx?a=11&s=6&f=693&t=179306&g=1 http://www.orthotown.com/MessageBoard/thread.aspx?a=11&s=6&f=693&t=162231&g=1 http://www.orthotown.com

Table of Contents for the Digital Edition of Orthotown March 2016

Orthotown.com Highlights
Embrace Progress: Organizing the Digital Office
Wired for Success: Google Voice: The Future of Patient Communication
Welcome, Dr. Edmund Khoo, to the Orthotown Advisory Board!
Industry News
Simplifi ed Correction of Class II Using PowerScope
Looking Toward the Social Media Horizon
What’s On Your Tray? Tray for Bonding Brackets
Herbst Fixed Functional Treatment for a Severe Class II
I’ve Done a Tongue Guard … Now What?
Modern-Day Retention
Retainer Clasps
Message Board: Retention
New Products
Software Showcase
Product Profile: Burleson
Poll
How to Manage Overhead Percentages in the Practice
Ad Index

Orthotown March 2016