Treatment of lower jaw protrusion is easy in the early stages of growth and difficult in the late stages. In these malocclusions, as in others, the treatment method is determined by the skeletal growth period and the etiology of the malocclusion, from which components the malocclusion arises.
Treatment of lower jaw protrusion, which occurs due to various bad habits in the early stages, is done with simple habit-breaking appliances. If the growth has ended and cannot be corrected by compromise treatment, orthognathic surgical methods are used. It has been shown by many researchers with the results of studies and treatment conducted with different methods and methods that the growth period, the treatment to be applied and the result to be obtained are interrelated. However, there are two different opinions in the literature about whether it is more appropriate to intervene in this anomaly in the early stages of growth or whether radical invasive methods performed after growth is completed will yield more valid results. balance can be established. In addition, early treatment contributes positively to both neuromuscular adaptation and the maintenance of the results obtained with treatment. In addition, one of the most critical goals of early orthopedic treatment is to ensure that the individual feels like his/her peers with normal facial structure in psycho-social terms. On the other hand, early treatment requires long-term patient motivation and difficulties in retention, so that growth is completed. There are also researchers who argue that it should be postponed to the following period.
Now let's talk about the treatment of protrusion of the lower jaw
1.Functional Devices
The effects of orthopedic forces on the dentofacial system date back to ancient times. has been known since . The lower jaw is treated by utilizing the functions and tone changes of the chewing, tongue and lip muscles. This section will continue by talking about these devices in more detail.
1.2. Functional Regulator III – Frankel III It aims to correct the anomaly by achieving physical changes.
Muscular treatment is performed with the help of upper lip pads and sublipal plates within the Frankel III appliance. In upper jaw retardation, the increased upper lip muscle tone, which prevents the upper jaw from growing forward, is transmitted to the bone through the lip muscles in the Frankel III apparatus, thus accelerating bone formation in this region.
1.2 Bionator III
Conversely, the bionator also This device called has a design with an omega twisted loop in the palate area and wires localized in the cheek muscle area, called "buccinator wings", which reduces the cheek pressure. Apart from these, the material is reduced as much as possible to ensure that the tongue fits comfortably on the palate. For guidance, the omega loop is positioned at the molar level. It is used in the treatment of lower jaw protrusion with correct muscular and linguistic positioning.
1.3 Reverse Twin Block-Class III Twin Block
Reverse Twin Block, which is used in the treatment of lower jaw protrusion, is used in the upper jaw and lower jaw. The reversely angled ramps in the piece receive support from the lower jaw during closing and force the upper jaw to close forward. Thus, while the development of the lower jaw is kept under control, the development of the upper jaw is accelerated.
1.4 Chin cup
The chin rest was first used in England by Prince Charles's dentist in 1836. It was used by Kneisel in patients with protrusion of the lower jaw. It is used for reasons such as stopping and braking the development of the lower jaw. The chinrest, whose effects on lower jaw development are still a matter of debate, generally shows its effect by uprighting or even retracting the lower jaw incisors, bringing the upper jaw incisors forward and directing the lower jaw to rotate downwards and backwards.
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