Diagnosis and treatment of upper arch stenosis
Fengya said
Case: Zihao's teeth are crooked after replacement, and there are a bit of buckteeth, which affects the appearance very much, his mother brought him to the orthodontist to consult orthodontics, and was told by the doctor that his upper arch is too narrow and needs arch expansion treatment, so what is arch stenosis? Let's find out together!
1. What is upper arch stenosis?
Upper arch stenosis refers to the fact that the width of the maxillary arch is significantly smaller than the width of the mandibular arch due to congenital or acquired factors during the development of the maxilla, which makes the bone mass of the upper and lower arches unbalanced. This condition may result in misaligned teeth and a misaligned relationship between the upper and lower jaws, which may affect the aesthetics of the face.
2. Causes of upper arch stenosis
Genetic factors
Underdeveloped maxilla in the family may increase the risk of superior arch stenosis in offspring.
Bad habits
For example, long-term mouth breathing, finger sucking, lip biting and other bad oral habits may affect the normal development of the maxilla.
Illness or trauma
Certain diseases (e.g., rickets), inflammation of the nasopharynx, or trauma to the maxilla may lead to dysplasia of the maxilla, which in turn can lead to stenosis of the upper arch.
3. Treatment of upper arch stenosis
The main treatment for upper arch stenosis is to match the upper and lower jaws by opening the middle palatal suture by expanding the upper arch. Maxillary arch expansion can not only enlarge the maxilla and reshape the soft and hard tissues of the maxillofacial area, but also increase the volume of the airway and improve ventilation, thereby treating facial problems caused by long-term mouth breathing.
The specific treatment plan should be considered according to the patient's age, severity of the condition, and in general, childhood and adolescence (6 to 12 years old) is the best time for the upper dental arch to be expanded. Common ways to expand the bow are as follows:
(1) Maxillary movable arch expander
This is a removable expander that is attached to the tooth by a snap ring. The orthodontic force dilates the midpalatal slit through the base and teeth, and it is suitable for children in the deciduous stage and adolescents in the replacement stage.
(2) Maxillary fixed arch expander
This is a fixed type of arch expansion that is retained by bonding to the teeth. The middle palatal suture can be effectively opened by the arch expansion, and then the middle palatal suture will be slowly filled with new bone, and it is suitable for adolescents who have erupted from the permanent bicuspids.
(3) Orthodontic archwire-assisted arch expansion
This is a treatment that uses the elasticity and high tension of the archwire to apply buccal and forward components to the congested dentition in the mouth. It is indicated for patients with mild crowding of the dentition, mild narrowing of the dental arch, leaning of the posterior teeth, straight or concave type.
(4)微种植辅助扩弓(MSE)
This is a type of arch expansion that uses a combination of four micro-implants and a spiral expander. It is suitable for adolescents and adults with transverse disalignment of the dental arch and closed midpalatal seam.
(5) Surgery-assisted arch expansion
This is a combination of surgery and orthodontics, and is mainly suitable for adolescents and adults who have closed the middle palatal suture.
In conclusion, upper arch stenosis is a common oral malformation that may affect the patient's quality of life and facial aesthetics. Patients who already have upper arch stenosis should seek medical attention and follow their doctor's recommendations for treatment.