What Is an Orthodontic Retainer?

The main method of orthodontic treatment is to use various appliances to correct the abnormalities of the teeth and jaws. Moving the teeth is the main content in the treatment process. The effect of orthodontic treatment on bone morphology is very limited. Therefore, it is difficult to correct orthodontic treatment with severe skeletal deformity by using only orthodontic treatment methods, and it must be combined with surgical methods to complete the treatment, that is, Method for surgical orthodontics. In recent years, the discipline of orthodontics at home and abroad has developed rapidly.

Orthodontics

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The main method of orthodontic treatment is to use various appliances to correct the abnormalities of the teeth and jaws. Moving the teeth is the main content in the treatment process. The effect of orthodontic treatment on bone morphology is very limited. Therefore, it is difficult to correct orthodontic treatment with severe skeletal deformity by using only orthodontic treatment methods, and it must be combined with surgical methods to complete the treatment, that is, Method for surgical orthodontics. In recent years, the discipline of orthodontics at home and abroad has developed rapidly.

Orthodontics is a method of orthodontics combined with surgery to make severe dental and jaw deformities correct. It does not simply change the shape of the jawbone, but includes the meaning of restoring the normal function of the facial and jaw system. That is, after surgical orthodontics, good jaw function was restored and skeletal deformities were corrected. Both of these are indispensable, so orthodontics is done in collaboration with orthodontists and maxillofacial surgeons.

Chinese name

Orthodontics

Foreign name

Surgical orthodontics

Treat illness

Dental jaw abnormalities

1. Jaw deformities with severe skeletal deformities are difficult to complete with orthodontic correction alone, such as severe mandibular protrusion and maxillary protrusion. Open jaw and so on.

2. The craniofacial growth and development of the patient are basically completed. If the operation is performed while the growth and development are in childhood, the recurrence of deformities may occur after surgery.

1. Analysis of the mechanism of malformations Malocclusions can be formed by different mechanisms. Severe Class III malocclusions are used as the columns, which can be caused by mandibular anterior protrusion, or by maxillary retraction or maxillary protrusion. The mechanism and position of the malocclusion caused by the mechanism are also different. Therefore, analyzing the mechanism of deformity is very important to determine the method of surgical orthodontics. An X-ray image of the lateral position of the skull was taken before the operation, and the head shadow measurement analysis was performed to determine the mechanism of the deformity.

2. Determining the treatment design The treatment design should include the method of surgery, the location and amount of osteotomy, and preoperative orthodontics that require dental treatment before surgery.

The purpose of preoperative orthodontics is to create conditions for jaw surgery. Most of the orthognathic surgery requires the upper or lower jaw to be cut and displaced to correct jaw deformities. However, if the teeth are not aligned properly, such as individual tongues being misaligned, etc., it can affect the movement of the jaw during surgery. Therefore, the teeth should be aligned orthodontically before surgery, and the teeth will not be interfered when the jaws are moved. Another important significance of pre-operative orthodontics is to establish a good occlusal relationship after orthognathic surgery, while correcting the teeth to the normal type after surgery, the teeth have a good jaw relationship. Preoperative orthodontics is the same as orthodontic treatment in the use of orthodontic methods, but the purpose and requirements of orthodontics are sometimes different from general orthodontic treatment. For example, in a surgical orthodontic patient with severe mandibular protrusion, the anterior teeth are covered by 2mm, and the incisor is compensated for tongue tilting. The position of the lower jaw is measured and analyzed as the anterior protrusion of 8mm. This is a 6mm deep overlay relationship between the upper and lower front teeth. Therefore, for this patient, preoperative orthodontics should be carried out to lower the incisor to the lip, change the tongue inclination of the long sleeve, and increase the degree of repetition, so that a good anterior teeth coverage relationship can be obtained after mandibular posterior surgery.

1. Maxillary anterior process Orthognathic surgery of the maxillary anterior process is mainly to make a Lefort I type osteotomy of the upper jaw. The upper jaw is moved backward to reduce the anterior process. Sometimes the upper jaw needs to be adjusted due to the inconsistency between the width of the maxillary bone and the dental arch. Multiple osteotomy displacements. At the same time, the left and right first premolars were removed.

2. The bimaxillary anterior process mainly presents the upper and lower dental arches. The common method is to remove the first and the left and right 4 first premolars, and the anterior osteotomy of the upper and lower jaws. In order to coordinate the width of the upper and lower dental arches, it is often cut at the same time Interdental segmentation.

3. Mandibular protrusion The common surgical method for mandibular protrusion is to cut the jaw from the ascending branch of the mandible to move the mandible backward, and the ascending branch of the mandible.

There are two kinds of operations: ascending branch oblique split and ascending branch sagittal longitudinal split. After the ascending branch is truncated, the mandible is moved backward to correct the mandibular anterior process. At this time, the ascending branch of the mandible partially overlaps.

4. Mandibular retraction is usually performed using the sagittal longitudinal split of the ascending branch of the mandible to advance the mandible.

5. Orthognathic surgery for open jaw and open jaw According to different mechanisms, osteotomy correction is performed on the jaw bone or alveolar.

The formation mechanism of severe bony dental and maxillofacial deformities is often a comprehensive frontal, with simultaneous abnormalities of the upper and lower jaws, as well as abnormalities involving the alveolar. Some operations are performed in multiple locations such as the maxillary, mandibular alveolar, and sacral regions. Coordination of craniofacial and maxillofacial and establishment of normal jaw relationship.

In surgical orthodontics, a fixture is needed to maintain the stability of the dental and jaw relationship after surgery.

1. After completing the orthodontics and bending the upper and lower lip arches that are consistent with the shape of the dental arch before surgery, the upper and lower lip arches are fixed to the posterior teeth and the remaining teeth are attached to the brackets. The upper and lower lip arches are respectively inserted into the end tube and inserted into the brackets for ligation and fixation. In this way, the upper and lower lip arches respectively connect the upper and lower dental arches into a whole. At the positions of the anterior teeth and the premolar areas of the upper and lower lip arches, small hooks directed to the gingival end are respectively welded for preparation for intermaxillary fixation between the upper and lower lip arches. After the operation is completed, according to the predetermined good dental-jaw relationship obtained, the wire or rubber elastic ring is ligated and fixed between the traction hooks on the upper and lower lip arches.

2. Full-tooth arch and jaw pad holders In more orthodontic cases of jaw surgery, in addition to the upper and lower lip arch holders, the full-arch jaw pad holders need to be added. The position of the jaw is often changed due to the muscle contraction and other forces after the broken jaw bone and dental arch. The upper and lower lip arches are not enough to maintain the jaw relationship. This will easily cause the disorder of the jaw relationship after surgery, and all teeth The arch jaw pad fixator is used to ensure a good jaw relationship after surgery.

Full-arch arch and jaw pads should be made on a good business relationship with a dental model that has completed model surgery. The jaw pads do not have a base and any fixing devices, and only cover the full-arch arch jaw surface. The thickness of the jaw pad is about 2mm. A deep groove in the maxillofacial surface of the jaw pad is required to cover the cusp and incisor edge, and small holes are drilled in the anterior teeth and premolar area on the lip and buccal side of the jaw pad. During the operation, the upper and lower dental jaw relationship on the jaw pad is used as the positioning relationship of the dental jaw. The jaw pad is fixed by ligating the lip arch with a hole in the cheek margin. At the same time, the intermaxillary fixation of the upper and lower lip arch fixtures is also added, so that the good jaw relationship designed by model surgery can be obtained after surgery.

Holders are generally worn for 8-10 weeks

After the fixator is removed, the jaw relationship should be checked. For jaw interference or poor jaw contact of other teeth, jaw adjustment or supplemented with simple orthodontic treatment is needed to achieve perfect jaw relationship. In order to maintain the stability of the jaw relationship, a retainer is required. The retainer is generally worn for about 1 year. Hawley retainers are often used for holding. If the maintenance of the post-operative dental-jaw relationship is neglected, the malformation often occurs.