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Expanding the Lower Arch Is it Really a Forbidden Frontier AAO: Flavia Artese. Episode 6. May 10th 2020

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Farooq Ahmed

Expanding the Lower Arch Is it Really a Forbidden Frontier: Flavia Artese

Summary of webinar from the AAO, looking at lower incisor change and orthodontics

4 indications to change lower incisor position:

  1. Good profile with arch length discrepancy
  2. Level lower arch curve of Spee
  3. Class 3 dentoalveolar decompensation
  4. Class 2 compensation

3 Factors which determine gingival recession for orthodontic patients

  1. Visible plaque – most important
  2. Amount of proclination – least understood
  3. Periodontal biotype / phenotype – can be altered

3 biotypes

  1. Thick -flat : Broad zone of KT, thick gingiva, square teeth
  2. Thick- scalloped:  Narrow zone of KT, Thick gingiva, Slender teeth
  3. Thin – scalloped: Narrow one of KT, thin gingviva, triangular teeth

Assessment of biotype

  • Clinical, including probe to assess translucency
  • CBCT
  • CBCT studies show greatest recession in Canine and Premolar region

Conclusion

Avoid expanding / proclining lower arch, if required then indication for periodontal surgery

 

 

#orthodontics #farooqahmed #almuzian  #morth #omg

 

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