Summary of webinar from the AAO, looking at lower incisor change and orthodontics

Expanding the Lower Arch Is it Really a Forbidden Frontier: Flavia Artese

· 4 indications to change lower incisor position:

1. Good profile with arch length discrepancy

2. Level lower arch curve of Spee

3. Class 3 dentoalveolar decompensation

4. Class 2 compensation

· 3 Factors which determine gingival recession for orthodontic patients

o Visible plaque – most important

o Amount of proclination – least understood

o Periodontal biotype / phenotype – can be altered

· 3 biotypes

o Thick -flat : Broad zone of KT, thick gingiva, square teeth

o Thick- scalloped: Narrow zone of KT, Thick gingiva, Slender teeth

o Thin – scalloped: Narrow one of KT, thin ginviva, triangular teeth

· Assessment of biotype

o Clinical, including probe to assess translucency

o CBCT

§ CBCT studies show greatest recession in Canine and Premolar region

Conclusion

o Avoid expanding / proclining lower arch, if required then indication for periodontal surgery

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