be said that the orthodontic-orthopaedic problems that we see in the 6-8
year old children, have their genesis at a much earlier age.
article I will show instances where problems are present in the early
dentition, which require immediate attention. Case 1 (Fig 1) shows
a three year old child with a severe Class III malocclusion. Treatment
at this early age is relatively simple, the prognosis excellent, and the
treatment time less than six months.
Figure 1. Case 1, Pretreatment - CLASS III,
3 year old
years much activity is taking place in the condylar area, and the posterior
fibres of the temporalis muscle are relatively more powerful than the
anterior fibres of the temporalis, and the masseter. These facts are very
important in facilitating the posterior movement of the mandible, relative
to the skull base.
the muscles of the craniofacial system with the Myomunchie (U.S. Patent
No. 5163840) for one month. Begin with 2 minutes chewing twice daily for
second week increase the time to 10 minutes daily, thereafter - 20 minutes
daily until treatment is complete.
one month (Fig 2) it will be observed that the child has now little
difficulty in placing the anterior teeth in an edge to edge position.
The posterior fibres of temporalis are horizontally positioned and exert
a distal force on the mandible.
Figure 2. Case 1,1 month of Myomunchie
20 minutes per day.
one month take an impression of the upper arch, and make a simple sagittal
appliance with thin posterior cover, with molar band retention on the
deciduous second molar.
nitrous oxide and tender loving care.
to the child in whispers how good they are and how good the happy gas
is. Ask the child if they like it, and almost everytime the child with
nod their head.
when taking the impression that the water is warm, the mix is thick, such
that the setting time is no longer than fifteen seconds. The dentist should
supervise the mixing of the alginate, never use a runny mix.
the appliance under nitrous at the next appointment, and adjust the deciduous
canines, which most frequently are a major factor in the malocclusion.
assumes a normal relationship after another six weeks, (Fig 3)
however treatment is continued until it can be seen that the child is
comfortable in the new position.
Figure 3. Post-treatment after 6 months
of sagittal appliance.
Figure 4. finished happy patient
series of slides (Fig 5 & 6) shows a four-year-old child in a Class III
relationship. In this instance treatment was effected over a six month
period after substantial adjustment to the lower deciduous canines. The
child was encouraged to exercise with the Myomunchie for 20 minutes daily.
This result was achieved without resort to an orthopaedic plate.
results remained stable, but correction is expedited by use of an appliance.