Orthotown November 2023 - 53

Did you miss Part 1 of this series?
To catch up on " Permission To Intercept, "
Dr. Michael DeLuke's first course in this
series, head to orthotown.com/ce.
BY DR. MICHAEL K. DELUKE
Short course description
Part 1 of this series described the need
for a shift in our approach to the interceptive
orthodontic treatment of preadolescent
patients, in which we move
from treating the patient's symptoms
to treating the etiology of the presenting
malocclusion. In this installment,
the traditional approach of using rapid
maxillary expansion (RME) to address
a transverse maxillary defi ciency
will be evaluated and contrasted
with slow maxillary expansion (SME)
using lighter, more physiologic forces.
Expansion of the mandibular arch
during interceptive treatment will also
be explored, as will the use of braces
and wires to predictably, safely and
comfortably address defi cient arch
width in the early mixed dentition.
Learning objectives
At the end of this course, the reader
should be able to:
* Explain why slow maxillary
expansion is preferable to rapid
maxillary expansion in younger
(i.e., preadolescent) patients.
* Describe the biological diff erences
between rapid and slow
maxillary expansion.
* Understand the importance of
addressing a transverse discrepancy
in the mandibular arch as
part of interceptive treatment.
* Determine which patients can
benefi t from interceptive treatment
to expand the maxilla and
the mandibular arch.
* Recognize the advantages of
using full-fi xed appliances over
traditional " expanders " when performing
interceptive treatment on
preadolescent patients in the early
mixed dentition.
Synopsis
Rapid maxillary expansion (RME)
is the traditional and most common
method of correcting a transverse
discrepancy in preadolescent patients,
whereby heavy forces are delivered
rapidly to the maxilla over a short
period of time. Yet numerous studies
have shown these heavy forces to
be dangerous and destructive to the
Farran Media is designated as an Approved PACE
Program Provider by the Academy of General
Dentistry. The formal continuing education
programs of this program provider are accepted
by the AGD for Fellowship/Mastership and
membership maintenance credit. Approval does
not imply acceptance by a state or provincial board
of dentistry or AGD endorsement. The current term
of approval extends from 1/1/2019 to 12/31/2023.
Provider ID# 304396
AGD
Code:
370
immature facial bones of younger
patients. Slow maxillary expansion
(SME), by contrast, delivers lighter,
safer, more physiologic forces over a
longer period of time. However, traditional
methods of SME are often cumbersome,
uncomfortable, imprecise
and diffi cult to adjust and calibrate.
Additionally, while it's extremely
common for the mandibular arch to
be constricted in younger patients,
many providers don't try to expand
the mandibular arch during interceptive
treatment. Th ose who do are
likely to fi nd mandibular expansion
appliances clinically challenging
for the provider and unpleasant for
the patient.
Full-fi xed appliances (braces and
wires) are an often overlooked yet
minimally invasive and well-tolerated
way to expand constricted arches in
preadolescent patients who present
in the early mixed dentition. Cases
will be presented to demonstrate the
effi cacy and stability of this technique,
and the need for additional research
into this approach will be discussed.
This print or PDF course is a
written self-instructional
article with adjunct images
and is designated for 1.5 hours
of CE credit by Farran
Media. Participants will
receive verification shortly
after Farran Media receives
the completed post-test.
See instructions on page 63.
Farran Media is an ADA CERP Recognized
Provider. ADA CERP is a service of the
American Dental Association to assist dental
professionals in identifying quality providers of
continuing dental education. ADA CERP does
not approve or endorse individual courses or
instructors nor does it imply acceptance of
credit hours by boards of dentistry.
NOVEMBER 2023 | 53 | ORTHOTOWN.COM
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Orthotown November 2023

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