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Dental Diseases

Orthodontia is a dental branch specialized on correction of irregularities between lower and upper chins and developmental disorders of the chin as well as abnormally aligned teeth.  Orthodontic treatments have been performed to correct anterior teeth which are apparent years ago; then relations of the teeth on the opposite chin and mandible are started to be corrected.  Today, correction of position of chin bones on the face skeleton are dominantly aimed by the orthodontists. Also, orthodontic correction of congenital abnormalities such as Cleft palate, Cleft lip are included in this branch.

Dentist specialized on orthodontia is called “Orthodontist”. Physicians who had completed residency or doctorate degree on Orthodontia are also called “Orthodontists” briefly.  A residency period for 4 to 6 years should be completed after dental school and presentation of thesis and passing the test are required to obtain this title.

Your dentist will inform you whether you need an orthodontic treatment, however, details, duration and cost of the treatment will be explained by an Orthodontist in detail and sufficiently.  After an comprehensive interview with the Orthodontist as well as a detailed examination including your medical and dental history, mouth and teeth examination, creation of chin models, taking some radiographies and photos, it may be determined whether you need an orthodontic therapy, type of the treatment, its duration and necessity of tooth removal.  Your physician will suggest different options and samples about Orthodontic treatment and draw an Orthodontic treatment plan according to your or children’s condition and she/he will make you to approve this.

As you may see in a warning/information form published by World’s Society of Orthodontists to draw attention to Orthodontia: If one of the following conditions exists on you or on somebody close to you; there is a need for Orthodontic treatment.

Some orthodontic Treatment Terms Are:

Overjet: It is one of the most common orthodontic problems.  It is mostly originated from finger sucking or adenoid problem. Anterior upper teeth were positioned very prominent than anterior lower teeth. Teeth are so prominent that the mouth can not be closed in some cases.
Crossbite: Lower anterior teeth are positioned more anterior than upper anterior teeth or upper teeth are positioned more posterior than lower teeth. The patient group which has the earliest orthodontic treatment is this group.
Openbite: Lower and upper anterior teeth do not contact each other during closing. This is the condition which affects speaking most.
Laterognathi: Midline of your anterior upper teeth do not corresponds to midline of lower anterior teeth.  Or it does not corresponds with the midline of the face; this Orthodontic abnormality affects further face aesthetic negatively.
Diastema: Slides due to removal of teeth or natural gaps between the teeth naturally. This orthodontic condition appears if the individual has taken small teeth from the mother and big chin from the father genetically.
Crowding: Crowding appears when the chins do not grow enough for alignment of teeth or crossing genetically.  Removal of baby teeth are among important factors.  It is the most common orthodontic abnormality.
Harmful Habits: Wrong and harmful habits such as finger sucking, wrong swallowing, tongue oushing, pencil biting, nail eating affect teeth and chin development negatively.
Young and Adult patients have orthodontic treatment as well as children today.

Brackets

Small materials which provide to push the power produced by the wires onto the teeth and are stuck onto the teeth are called “bracket” in orthodontia.  Although very different types are produced according to the company and techniques, metal or porcelain brackets are used in the practice.

Metal brackets: They are used commonly.  Like all orthodontic materials, they are disposable materials which are not harmful for the health.  They may be colored with rubbers in each session if requested.
Porcelain brackets:  They have the color of teeth and they are preferred for young and adult patients who have aesthetic concerns about visibility of such brackets during orthodontic treatment and patients where very heavy forces are not required.
Bracket placement: Despite the common belief, Orthodontic bracket application is  not a painful procedure. Brackets are applied onto the teeth with a special technique and a tissue-friendly material; wires are passed along the brackets and force is applied onto the teeth.  So, regular positioning of teeth by moving them with wires which change In stage.  Orthodontic Treatment may last for several months or years and adjustments are performed each month and teeth are aligned as desired.  Brackets used today are smaller in shape and include less metal.

Since the appearance may be prominent with rubbers in different colors to motivate the children, transparent brackets may be produced for adults.
Samples of Orthodontic Treatment Procedures:

Special Fixed Procedures: These apparatus are attached onto the teeth with bands to avoid finger sucking habit.  It may be performed via mobile apparatus.  To remove during meals because they are not very comfortable during eating.
Fixed maintainers: In cases where baby teeth are lost earlier, a maintainer is used to prevent sliding of the teeth along the gap until growth of permanent tooth. Preventive Orthodontic Treatment is applied.

Clear Aligners: Treatments performed with transparent plaques without brackets.  As an alternative to fixed orthodontic treatment performed by bracket application, it is used to align teeth. They consist of some transparent and flexible plaques.  It is demanded by many patients because no brackets and wires exist. Aligners are transparent and they are removed during eating, teeth brushing and tooth flossing.  Although they are demanded strongly by the patients lately, it may be insufficient for severe Orthodontic disorders.  Your Orthodontists will decide on this and make the required explanation to you.
Mobile Space Maintainers:  They have the same function with fixed space maintainers.  It consists of an acrylic base settled into the chin and it fills the gap between certain teeth with plastic extensions and they are attached onto the teeth with wires.

Splints: They are apparatus developed to position the chin again. These devices called splint are placed onto the upper or lower chin orthodontically and they help to close the chin on a better position.  They are mostly used to correct Temporomandibular Joint disorders.

Lip and Cheek Bumper: They orthodontic materials which push the teeth back and prevent lips and cheek entering into the teeth.  Lip and cheek muscles may apply a negative force onto the teeth and Bumpers prevent this force.

Function Regulators FR I-II-III: They are used for early mixed tooth growing period in skeletal Orthodontic abnormalities such as prominent lower chin or over development of upper chin.  They support fixed Orthodontic treatment techniques that will be applied during advanced stages of the treatment and they are very effective for permanency of the treatment.

Chin Enlargers: For patients who have orthodontic chin narrowness.  They are screw devices which provide enlargement of upper and lower chin.  It is made of a special plastic material called acrylic settled onto the palate.  Through the force applied with screws, chin bones under the palate and teeth grow and enlarge.  They are used commonly during mixed teeth growth period while starting to Orthodontic treatment. Mobile Intensifiers: Passive apparatus used to protect places of the teeth after termination of the treatment and to prevent return to old status are called intensifiers.  It is the last stage of orthodontic treatment.

Fixed Intensifiers: They are wires which are applied onto interior sides of lower anterior teeth after completion of Orthodontic treatment. They may be left for lifetime or the orthodontist may remove during annual controls.

Head Gear: It is an Orthodontic treatment material which consists of an extraoral cushion placed behind the head (nape or scalp) and an introral part connected to upper molar teeth with a metal wire. Head Gear decelerates development of upper chin and keeps posterior teeth on place and pushes anterior teeth to back.  They are applied during nights and evenings within periods determined by the dentist.  They have types such as cervical, High Pull or Reverse Head gear (MASK).  The type is selected by the physician according to the type of orthodontic abnormality and your orthodontist also determined placement duration according to the orthodontic treatment age as well.

Details of Orthodontic treatment is shared in each stage and required information are provided by the Orthodontist.

Which treatment is applied and When?

If relations of lower and upper chin bones carrying the teeth are normal, if the problem is on the teeth only, this kind of Orthodontic Abnormalities may be treated in any age.  However, treatment of problems on chin-face skeleton in particular is possible during growth and development period.

The stage of growth and development period is determined via Panaromic, Cephalometric or Hand-Wrist and even 3D tomographic images by orthodontists.  Because bone age and chronological age of the patient do not correlate every time.  Severe skeletal problems where active growth and development period of the patient ends are treated via orthodontic and Surgical treatment combinations called “orthogantic Surgery”.
Although Orthodontic Treatment is possible in any age today, to start the treatment as earlier as possible and to follow a long term treatment are essential. The most suitable age is between 9 and 14.

Purposes of orthodontia

Protective orthodontia: The first duty of an orthodontist is to protect orthodontic abnormality in the child.  Preserving places of baby teeth removed in early age is very important for regular alignment of permanent teeth.

Interceptor Orthodontia: If abnormality occurrence is not prevented in the child, the purpose is to stop the abnormality and prevent appearance of Orthodontic problems.  It includes controlled tooth removal performed to stop bad habits (such as finger sucking) and to prevent crowding in the future.

Therapeutic Orthodontia: These are treatments performed after appearance of orthodontic abnormality.  Treatment should be planned by an Orthodontist.

Aims of orthodontic Treatment

* orthodontic Treatment should provide a well chewing, speaking and respiratory function.
* A well teeth, chin and face aesthetics and smiling should be provided at the end of Orthodontic Treatment.
* The final status at the end of Orthodontic Treatment should be kept permanent.

What is Implant?

Total prosthesis have been beyond to be the only option for mouth without teeth.  Implants are artificial teeth roots which were prepared from titanium in a tooth root form and are placed onto the mandible with a small operation.  Implants placed on the mandible and prosthesis prepared by getting support from these provide the sense to the patients that they chew with their own teeth; therefore they are preferred frequently.

Why Titanium Implants?

Titanium is a metal which has a perfect tissue compliance and has been used in many fields of medicine reliably for centuries.  When this attachment is completed ( 2 to 6 months), the prosthesis preparation procedure that we call upper structure is started.  Implants are the best alternatives to the natural teeth today with no doubt.

 

In Which Cases Are Implants Suggested?

On upper and lower chins without teeth; for cases where the patient can not use her/his prosthesis as a result of severe osteoporosis.  The prosthesis is settled onto the implants placed and increase on attachment is provided.

In loss of large grinders; if the posterior area ends without any teeth; a fixed bridge may be done with several implants instead of a partial prosthesis that may be placed and removed.

In case of loss a single tooth; the teeth around the lost tooth are preserved and a single implant may be placed instead of this tooth.

For long gaps without teeth; since long bridge body may create a problem in a fixed bridge, one or several implants that will be applied onto the area without teeth may increase strength and support of the bridge.

Are Implants Safe and Long termed?

Studies conducted to create a reliable and qualified implant have been performed since 1809.  Today, implants with a 35 year clinical follow-up which are almost perfect in the market as well as relatively new implant brands are introduced into the market.  Your dentist will inform you in detail about this subject.

What Are Benefits of Implant procedure?

As a result of teeth losses or traumas appeared, physiological osteoporosis cause decrease on level and volume of the mandible.  This prevents the prosthesis to function completely.  So, it is inevitable eventually for appearance of chewing and speaking.

The basic purpose of dentistry is to replace the teeth lost with natural teeth functionally and aesthetically.  Functions such as chewing, speaking, laughing are more important than face value.  Since chewing has been developed perfectly by the nature, it is not possible to repair this completely with an artificial material as a result of loss of an individual tooth.  Implant provides the definite and healthiest solution for any problems that tooth losses will cause as a special procedure used instead of a natural tooth.

 

Bleaching

Bleaching of which we suggest for individuals who are not pleased with their teeth color as a cosmetic solution is a procedure to dissolve colorful organic and inorganic substances on porous enamel structure on teeth surfaces to bleach the teeth color with several color tones via bleaching gels.

Teeth staining appears excessive use of teeth coloring substances (smoking, tea, coffee, cola etc.), old teeth filling, prosthesis and covering, antibiotic (tetracycline) or excessive florid consumption.

The bleaching method applied to remove such stains is performed in two ways.

  • A bleaching medication is placed into the area by a specialist in the clinic and a white light is applied for  certain period.  The result is noticed at the end of the procedure.
  • The second method is a method where the patient may apply at home following this procedure.  The dentist prepares a mould by scaling the mouth.  The patient places the bleacher into this special mould and applies this for a period advised.

 

How Long Are Teeth Bleached remain White?

Teeth bleached with different bleaching methods remain white for several years.  However, this period depends on the individual.  Eating-drinking habits, smoking and brushing habits affect whiteness period of the teeth.

teeth-bleached-white

Lips and gums are closed with a special material.

Dentist apply the bleaching gel onto the teeth.  She/he provides to fix gum barrier via Special Bleaching beams and performed the Bleaching procedure.

Doctors in this department.

Dr. Arzu Kardeşler

Dr. Arzu Kardeşler
Oral and Dental Diseases Specialist

Dt. Uğur M. Gültekin

Dt. Uğur M. Gültekin
Oral and Dental Diseases Specialist