What do the Eight Goals of Treatment look like?? 1. Attractive Smile 2. Facial Balance 3. Healthy TMJ (temporomandibular joint) 4. Healthy Occlusion (tooth fit) 5. Healthy gums and supporting bone 6. Clear Airway 7. Stability 8. Patient s Chief Complaint(s)
Goal #1 : The Great Smile The edges of the anterior teeth should form an arc that harmonizes with the lower lip The upper lip should harmonize with the gum line of the anterior teeth A small amount of gum showing looks ok in females
Goal # 2 : Excellent Facial Balance Believe it or not, facial beauty can (to a large extent) be quantified. Orthodontics often has an affect on Facial Balance There are certain facial proportions and guidelines that can be utilized to increase beauty and facial balance during treatment planning.
Goal # 2 : Excellent Facial Balance 1/3 x 2x 1/3 1/3 Orthodontics can have a significant affect on the lower 1/3 of the face
Goal # 2 : Excellent Facial Balance Reference Line Upper lip: 2 4 mm ahead of line Lower lip: 0 to +2 mm ahead of line Chin: 0 to -4 mm behind the line
Goal # 2 : Excellent Facial Balance A line tangent to lips is tangent to chin and slopes backward about 10 degrees
Goal # 3 : Healthy TMJ (Temporomandibular Joint) The muscles that close the jaw are designed to position the ball of the joint all the way up into the socket, thus.
Goal # 3 : Healthy TMJ (Temporomandibular Joint) the teeth must be positioned so they do not interfere with this healthy path of closure in the joint. This is IMPORTANT and not an easy task!
Goal # 4 : Healthy Occlusion (how the teeth fit) Nature has designed the upper & lower teeth to fit together in a certain way Every tooth should occupy a certain position in all 3 dimensions
Goal # 4 : Healthy Occlusion (how the teeth fit) Each tooth has a slight inclination It is crucial that the front teeth overlap because they guide the movements of the lower jaw and thereby protect the jaw joint NOTE: The braces we use are the most sophisticated in the world, and are designed to aid Dr. G in attaining these tooth positions efficiently. With most braces (especially clear aligners) achieving these tooth positions is impossible or very inefficient.
Goal # 5 : Healthy Periodontium (supporting gums & bone) If the joints are correctly positioned when the teeth come together and the front teeth overlap adequately (goals 3 & 4), then the amount and direction of the forces delivered to the system are not harmful. Incorrect tooth and/or jaw positions result in adverse forces and damage to supporting bone and gum.
Goal # 6 : Healthy Airway An adequately sized and clear airway is very important for a healthy and stable bite. Orthodontic treatment can improve the airway. A good example is expansion of the upper jaw in younger patients. Dr. G studies the airway in all patients, often with high tech cone beam imaging. Cone beam image Measurements of patient s airway Obviously there are factors beyond the scope of orthodontics, eg allergic blockage of the nasal passages. Still, we can refer you to helpful literature and/or professionals.
Goal # 7 : Stability When the goals of form and function (# s 3,4) and airway (#6) are achieved, then there is an excellent opportunity for long term stability. -----See chapter 18 In Goal-Directed Orthodontics
Goal # 8 : Patient s Chief Complaint We listen to our patient s desires! Most patients and parents want an attractive smile that is healthy and long lasting. However, patients sometimes prefer only some of the goals. We can customize treatment to satisfy those needs. For example, an adult patient may just want their front teeth aligned. In most cases it is a short and simple process
The 8 Goals are crucial guidelines along the Pathway to Excellence 1. Attractive Smile 2. Facial Balance 3. Healthy TMJ (temporomandibular joint) 4. Healthy Occlusion (tooth fit) 5. Healthy gums and supporting bone 6. Clear Airway 7. Stability 8. Patient s Chief Complaint(s) Perfection (Goals). EXCELLENCE (approaching perfection) Reality