11: Correction of Malocclusion: Orthodontics

CHAPTER 11 Correction of Malocclusion



Orthodontics (from the Greek ortho = straight; and odons = tooth) is the specialist branch of dentistry that aims to produce: (i) ideal tooth positioning in relation to the lips, teeth and jaws within the face and (ii) improved occlusion. All these ultimately aim to achieve improved facial aesthetics (appearance) and function.

Most orthodontic patients are children or teenagers, but adults are increasingly seeking orthodontic treatment and even older individuals may seek it. Teenagers and adults are also often more interested in cosmetic alternatives such as lingual orthodontics or aesthetic brackets, to traditional orthodontic appliances.

There is often a conflict between the real need for, and a person’s wish to have, orthodontic treatment. To put things in perspective the Index of Orthodontic Treatment Need (IOTN) was developed.

Index of orthodontic treatment need

The IOTN is a tool used by the clinician to help decide which patients really need orthodontic treatment, that is whether there will be a benefit to dental health by having treatment. The index is designed so that a malocclusion may be quickly assessed clinically or from dental models (see Figure 9.2). Because treatment needs to be justified on either dental health or aesthetic needs, there are two components to the IOTN:


Malocclusion is the term used for the misalignment of teeth and/or incorrect relationship between the maxillary and mandibular teeth. The most common malocclusions requiring orthodontic treatment are:

Malocclusion can be accompanied by disharmony between the jaw bones themselves, that is, where the relationship between the upper and lower jaw is not appropriate. In these patients, the dental problem of malocclusion is usually due to the skeletal disharmony.

Classification of Malocclusion

The Angle classification is the most common classification of malocclusion. It is based on the relative position of the maxillary first molar to the mandibular first molar as measured from front to back (the sagittal plane).

There are three categories in this classification. The Class II malocclusion has two subdivisions.

Orthodontic assessment

Apart from a full clinical assessment as usual, the following are taken:

Study models (also called casts) of the upper and lower teeth are used to analyse the tooth and jaw relationships in detail. Thus they must be of good (diagnostic) quality. For this reason:

Study models are part of the patient record and thus must be kept until:

Jan 8, 2015 | Posted by in Dental Nursing and Assisting | Comments Off on 11: Correction of Malocclusion: Orthodontics
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