IMPACTED TEETH

An impacted tooth is one that has somehow gotten stuck and cannot come in. Red arrows show over-retained baby teeth. Yellow arrows show recovered permanent teeth and blue arrows show the impacted teeth in the panoramic x-ray.

SUBSTITUTION

Substitution is replacing missing teeth with otherwise crowded back teeth. Blue arrows point to baby teeth with no permenant teeth underneath (congenitally missing). Red arrows point to permenant cainines moved forward to take the place of the missing lateral incisors.

IMPLANTS

Implants can be used when there is too much space for substitution to be effective or if there is a missing tooth. The yellow arrow points to an implant replacing a missing lateral incisor.

ASYMMETRIES (Midline Shift)

An asymmetry exists when the center spaces between the two upper and lower teeth do not align vertically with each other. Yellow arrows show the alignment before treatment. Blue arrows show the alignment after treatment.

TRANSPOSITION

These teeth were impacted and somehow exchanged places, but cannot be switched back. The blue arrows point to the cuspid and bicuspid that have switched positions. The red arrows show a first bicuspid on the right side and a cuspid on the left side (both are in the cuspid position). Treatment sometimes requires reshaping or restorations to complete cosmetics.

UPPER JAW TOO FAR BACK (RETROGNATHIC MAXILLA)

Depending on the severity, growth modification appliances, extractions, or surgery in adults may be required. In the photos above, a facemask (reverse headgear) was used to pull the upper jaw forward before the palatal sutures (site where the upper jaw grow) closed at the age of 9.

LOWER JAW TOO FAR BACK (RETROGNATHIC MANDIBLE)

Depending on the severity, growth modification appliances, extractions, or surgery in adults may be required. In the photos above, growth modification appliance, the Twin Blocks were instituted and the lower jaws were directed to grow forward during the patient’s pubertal spurt.