1. early treatment phase I treatment

Early Treatment

Orthodontic therapy in the mixed or primary dentition

Orthodontic treatment undertaken during the most active stages of dentofacial and craniofacial skeletal, growth.

Expectation of phase II of orthodontic treatment after the eruption of the permanent teeth

purpose/goals of early tx

Interceptive treatment

Tooth guidance

Preventive orthodontics (ex; crowding)

Growth guidance

one phase orthodontic treatment

phase II

Only comprehensive orthodontic treatment

Easier to begin when most of growth is already complete – Little possibility to modify growth

Predictable treatment outcome

Shorter treatment time

More extractions

all permanent teeth

two phase orthodontic treatment

(Phase I + Phase II)

Early treatment + comprehensive orthodontic Treatment

Eliminates/ modify deviation in skeletal growth and functional matrix

• Mouth breathing

• Atypical swallowing

• Other abnormal behavior

Reduce the need for later orthognathic surgery

• Due to growth modification

• Orchestrate dentoalveolar development

Less extractions

Two Phases of Orthodontic Treatment: Phase I

Early treatment

• Orthodontic therapy in late primary or early mixed dentition

• Expectation of phase II of orthodontic treatment after the eruption of the permanent teeth

Two Phases of Orthodontic Treatment: Phase II

Comprehensive orthodontic treatment

• Orthodontic treatment in the permanent dentition

Special Considerations in Early Treatment

Focus on “should be done” and obvious treatment

• Treatment must meet the patient’s need in many dimensions

Goals of early treatment must be clearly outlined

• Children with complex problems will need a second stage of treatment

• Mixed dentition treatment can extend over several years

• Patients can be “burned out” by the time they are ready for comprehensive treatment

• As treatment time increases chance of damage teeth/ supporting structures

Few available option with partial fixed appliances

• Primary molars with resorbing roots are not ideal for banding/bonding

• Removable appliances could be used

• Patient compliance is crucial

first 2 means # of bands or tubes bonded to 1st permanent molars

2,4,6 means brackets at central incisors

Be aware of unerupted teeth