Two-Phase Orthodontics: A Special Kind of Orthodontic Treatment
Phase I Treatment
The goal of Phase I treatment is to develop the jaw size in order to accommodate all the permanent teeth and to relate the upper and lower jaws in balanced relationship to each other.
Children sometimes exhibit early signs of jaw problems as they grow and develop. An upper and/or lower jaw that is growing too much or not enough can be recognized at an early age. If children after age 6 are found to have this jaw discrepancy, they are candidates for early orthodontic treatment.
Because they are growing rapidly, children can benefit enormously from an early phase of orthodontic treatment utilizing appliances that direct the growth relationship of the upper and lower jaws. Thus, a good foundation can be established, providing adequate room for eruption of all permanent teeth. This early correction may prevent later removal of permanent teeth to correct overcrowding and/or surgical procedures to align the upper and lower jaws. Leaving such a condition untreated until all permanent teeth erupt could result in a jaw discrepancy too severe to achieve an ideal result with braces.
Orthodontic diagnostic records are necessary to determine the type of appliances to be used, the duration of the treatment time, and the frequency of visits. Records consist of models of the teeth, x-rays, and photographs.
Resting Period
After the Phase I treatment is completed, there is usually a resting period. In this phase, the remaining permanent teeth are allowed to erupt. Retainers are usually worn during this period for several months. It is best to allow the existing permanent teeth some freedom of movement while final eruption of teeth occurs. A successful first phase will have created room for teeth to find an eruption path. Otherwise, they may become impacted or severely displaced.
At the end of the first phase treatment, teeth are often not in their exact positions. This will be determined and accomplished in the second phase of treatment. Periodic recall appointments for observation are necessary during this resting phase.
Phase II Treatment
Each tooth has a precise location in the mouth where it is in harmony with lips, checks, tongue, and other teeth. When this equilibrium is established, the teeth will function together properly. They will stay healthy and look attractive. This is the goal for the second and final phase of treatment.
At the beginning of Phase I, orthodontic records were made and a diagnosis and treatment plan established. Certain types of appliances were used in Phase I, as dictated by the problem. Phase II is initiated about the time all permanent teeth have erupted, and usually requires braces on all the teeth for an average of 12-15 months. Retainers are worn after this phase.
Advantages of Two-Phase Orthdontic Treatment
Two-phase orthodontic treatment is a very specialized process that encompasses tooth straightening and physical, facial changes. The emphasis today on living longer, staying healthy, and looking attractive requires optimum treatment results. The major advantages of a two-phase treatment are to maximize the opportunity to accomplish an ideal healthy, functional esthetic result that is stable.
The disadvantage of waiting for complete eruption of permanent teeth and having only one phase of treatment, for someone with a jaw discrepancy, is having to face the possibility of a compromised result that may not be completely functionally healthy and may not remain stable.