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Principles and phases of multidisciplinary approach in orthodontics

Every year the number of adult patients who need orthodontic treatment is increasing. This is caused by the improving quality of life, increasing number of adult patients having an active social life and the progressive development of orthodontic and other dental technologies.

Distinctive features of adult patients’ treatment are determined by the following factors:

  • conducting treatment of the organism which is not growing, which limits in some cases the possibility of adequately affecting the skeletal structures and obtaining the desired result (the balance of aesthetics and function).
  • the presence of secondary deformation of dentition, as a result of edentia.

  • aggravating periodontal tissues disease (periodontitis and periodontosis).
  • reduced level of adaptation to stress and functional disorders with subsequent development of TMJ and mustication muscles dysfunction.
  • increased abrasion of the teeth
  • reduced permeability of the blood vessels of the alveoli and impeded blood flow, abnormal mineralization of bone tissue and increased stiffness of collagen related to aging which slows down the movement of the teeth.
  • availability of undertreated root canals and related to that chronic periodontal processes

Based on the above mentioned features of the development and course of maxillofacial pathology in adults, it becomes necessary to implement the principle of comprehensive treatment, including the following parameters:

Function: implies normalization of the TMJ function, masticatory muscles, nasal breathing and other functions of maxillofacial zone, and a perfect occlusion.

Aesthetics: harmonious balanced facial profile and a beautiful smile.

Health: healthy periodontium and periapical zones of the periodontium. All root canals should be cured competently and qualitatively, all periodontal pathologies should be eliminated (gingivitis, periodontitis, gum recession), and all hard dental tissues should be cured (caries, erosion, wedge-shaped defects and etc.)

Form: the correct form of each tooth, especially in case of teeth abrasion and other defects, such as the irregular shape of the teeth (spinous teeth), bad restorations, even the change in the size and shape of teeth, if there are inconsistencies, leading to the defect of both function and aesthetics of the bite and smile.

This principle is the key to success in the treatment of adult patients starting from the normalization of the function of the TMJ and masticatory muscles, creating an ideal occlusion, and finishing with the aesthetics of the face and perfect smile, guaranteeing stability (retention) of the function and aesthetics of the maxillo-facial complex.

It should be noted that the combined treatment principle should work as a precise timing mechanism in which the sequence of tasks leading to its implementation can vary depending on the individual plan for each patient.

For example, if the primary patient has problems with poorly treated tooth root canals and chronic pathological processes in the periodontal tissues, first of all it is necessary to provide treatment for periodontal pockets of infection, with any subsequent quality fillings of the canals. (health›function›form› aesthetics aesthetics›stability)