Rubber toy technique and orthodontic appliances

26 Rubber toy technique and orthodontic appliances




INITIAL PRESENTATION


Malocclusion – left lower canine occluding with palate.



PATIENT DETAILS


A 6-month-old, female, bearded collie.



CASE HISTORY


The case was referred to us for evaluation and treatment of the malocclusion. The owner was active in the show ring and thus concerned about the malocclusion. While the owner was concerned about the developing pathology (palatal trauma), she was most concerned about the aesthetics and the effect on the dog’s show career. She was adamant that tooth shortening would not be an option.



ORAL EXAMINATION – CONSCIOUS


This was one of the most docile and cooperative dogs that I have ever met. She readily allowed thorough oral examination and occlusal evaluation, which identified the following:


1. Mild generalized gingivitis

2. Wide spacing of teeth in the upper jaw, indicating that the upper jaw is long (Fig. 26.1)

3. Lower jaw slightly too short and narrow with respect to the upper jaw (Fig. 26.2)

4. Lower canines not yet fully erupted

5. Right lower canine flared out laterally and fitted in the diastema between 103 and 104 (Fig. 26.1)

6. Left lower canine upright in position, occluding with hard palate medial to the upper canine, causing a non-ulcerated indentation and hindering full mouth closure (Fig. 26.2)

7. Diastema between 203 and 204 of adequate size for 304 to fit (if it was moved slightly rostrally and laterally).

image

Figure 26.1 Oblique lateral photograph of the right rostral occlusion. The upper jaw is long (as evidenced by the wide spaces between the teeth and the width of the diastema) and the lower jaw is short with respect to the upper jaw. Tooth 404 is caudal in position, but has flared laterally and fits in the diastema between 103 and 104.


image

Figure 26.2 Head-on photograph of the rostral occlusion. While 404 has flared laterally and fits into the diastema, 304 is trapped medial to 104, occluding with the palate and preventing full mouth closure.



THEORY REFRESHER


Malocclusion can result from jaw length and/or width discrepancy (skeletal malocclusion), from tooth malpositioning (dental malocclusion), or a combination of both. This case is a skeletal malocclusion (mandibular brachygnathia) and is thus inheritable.


A mandibular brachygnathic bite, often called ‘overshot’, occurs when the mandible is shorter than normal. The degree of malocclusion varies as follows:


• The upper incisors are rostral to the lower incisors by 0.5 mm to 5 cm or more.

• The upper canines are caudal to but touching the mandibular canines, level with the lower canines, or rostral to the mandibular canines.

• The mandibular premolars are caudally displaced relative to the maxillary premolars, disrupting the ‘pinking shear’ effect. The degree of displacement is similar to that of the incisors and canines.

This case was classified as a mild relative mandibular brachygnathism, i.e. the mandible is too short (and narrow) with respect to the upper jaw. The cause of the malocclusion is the long upper jaw. The left lower canine was causing trauma to the hard palate. Malocclusion causing discomfort and pathology always needs treating.




CLINICAL TIPS



• Malocclusion can result from jaw length and/or width discrepancy (skeletal malocclusion), from tooth malpositioning (dental malocclusion), or a combination of both.

• Wide spacing of teeth in the upper jaw may indicate that the upper jaw is too long.

• Orthodontic treatment is not always straightforward.

• Maintenance of oral hygiene is extremely important while an orthodontic appliance is in place.

• Orthodontic treatment may cause iatrogenic injuries.

Related posts:

  1. The tooth and its periodontium
  2. Multiple tooth and jaw fracture
  3. Natural progression of disease
  4. Iatrogenic tooth damage

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Sep 3, 2016 | Posted by in SMALL ANIMAL | Comments Off on Rubber toy technique and orthodontic appliances

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