Prof.ssa Paola Cozza
Topic of the lecture:
Early treatment with clear aligners for a proper management of developing occlusion: clinical protocols for predictable outcomes
Abstract:
Dental crowding in the mixed dentition represents one of the most frequent malocclusions. Understanding the etiology of crowding can help clinicians in identifying potential needs for early intervention. The early mixed dentition stage represents a critical occlusal development phase since the eruption of permanent incisors requires space in both arches, especially in the mandible. Crowding conditions are considered more severe when incisor eruption is associated with the early loss of primary teeth. Early loss of primary lower canines and upper lateral incisors often induces a reduction of the arch length perimeter, the mesial migration of posterior arch segments, a worsening of the deep bite, and a displacement of the midline towards the side of the loss with sagittal asymmetry of the arch perimeter.
Interceptive orthodontic treatment in early mixed dentition has the objective to recover a more favorable management of the dentition and of the arch form. From a biomechanical and treatment planning point of view, dentoalveolar crowding requires the combination of several strategies, including transversal expansion, recovery of crown inclination, space management, and possible planned extractions. The application of clear aligners has resulted in particularly advantageous results. The clinical protocol is designed to maximize the developing arch form, as well as recover the loss of space, solve anterior crowding, and manage the anterior limit of dentition throughout a controlled labio-inclination of lower incisors. Thus, the use of clear aligners can be considered an additional treatment strategy for severe crowding cases to obtain transversal dentoalveolar expansion, to align the lower incisors by controlling labio-inclination movements, and for the recovery of non-coincident midlines in mixed dentition.
Biosketch:
Full Professor at the Departmental Faculty of Medicine and Surgery at Saint Camillus International University of Health Sciences
Director of the Second Level Master's Program in Orthognathodontics at Saint Camillus International University of Health Sciences
