AOUAD TARIK
Aouad Tarik, one of new members from Morocco, has asked that we post his question below:i am general practioner beginner in orthodontics
i will have in few days patient who is 8 years old he has overcrowding in maxillary and mandible
for interception i will use MYOBRACE as assistive device
tell me if it gives effective result or no
thanks
Any comments or advice for this gentleman would be appreciated.
Replies
The MRC appliances are focussed mainly on helping the pt elimiate his/her own myofunctional habits, which are responsible for poor facial development and malocclusion.
Anyone who calls the Myobrace a 'placebo' firstly has never worked with one properly, and secondly, does not understand what a 'placebo' is.
Dimple Sharma Rohilla said:
i agree with dr ravi. moreover it depends on the case. does ur patient really need myobrace? is he the one indicated for arch expansion or the case is of tooth size arch length deficiency. because not all cases will benefit from myobraces. in fact sometimes u might end up worsening the the profile of the patient before fixed mechanotherapy. that is not wat u want.and personally speaking i do not feel using myobrace is anything more than a placebo.
Dr Dimple Rohilla.
Early treatment, then becomes CORRECTION of the STDys and INTERCEPTION of the malocclusion. The eventual need for orthodontic therapy depends on how early the STDys is corrected and how much of the dental and skeletal aberration has already occured at that time. Theoretically, it would be necessary to prevent the STDys itself to totally avoid orthodontics, and this means starting myofunctional work WAY BEFORE we are used to thinking about it - even for the early treatment people among us. Practically speaking, we need a patient's and parent's understanding and compliance with the trainer and excersizes. That usually puts us at an age where much of the problem has already occured. And, at least in my part of the world, (New Jersey), getting sufficient compliance over a long period of growth is the BIGGEST chanllenge of all. Despite what Dr. Farrell says, many kids will CHOOSE braces over something they have to be responsible for.
Nonetheless, I have joined the fray because I believe that a pound of prevention is better than a half-pound of cure (that's the way I see it....)
Sincerely, new WebDental member,
Barry Raphael
we have now two schools in philosophy of treatment in orthodontics
dr RAVI KUMAR school dr ROHAN WIJEY school
but i think in early age we should use phase I of treatment :
- myobraces
-propulsor universal light
- quadhelix.................
if that is sufisent and give good result i ask why not to use it ?
It is impossible to give you adivce on which appliance to use, because I have not seen the case in question; but judging by age alone, I would say that the I-2 Trainer would probably be best suited. If you want, you can e-mail me photos and an OPG of your pt and I may be able to help more.
As for Ravi Kumar's opinions, they are slightly misguided on a number of levels.
It seems he has mistaken myofunctional appliances for functional appliances. There is a clear distinction: functional appliances simply either widen the upper jaw or posture the mandible forward. Myofunctional appliances train the orofacial muscles to function correctly, thereby correcting the cause of underdeveloped jaws, faces and crooked teeth.
When the child is trained to eliminate its own myofunctional habits with the Trainers and myofunctional exercises, results are in fact more stable than anything else. Ravi's comment that 50% chance of relapse is simply false. I would like to see the research to back this up.
Ravi also quoted the Cochrane Review on how there is no much difference between Phase I and Phase II tx when it comes to tooth alignment. This Review only assessed functional, not myofunctional appliances, and the criteria only assess the teeth, not the face or jaws. It must be remembered that the range of Trainers are not concerned with aligning teeth at an early age - it is concerned with elimating myofunctional habits that have caused underdeveloped jaws, faces and crooked teeth. This is why our clinics regularly give pts a better face, better teeth and better stability.
Finally, I am rather troubled by Ravi's comment that "I do not believe in any kind of Phase I treatment with myofunctional appliances", but then says that "unquestionably this is a big practice builder. I get both the Phase I and Phase II treatment". Our appliances are not meant to be 'practice builders', especially for practitioners who don't believe in them. MRC appliances are used to give the patient the best, most stable result possible.
were significantly higher when compared with the changes observed in the control group. This study
demonstrates that the preorthodontic trainer application induces basically dentoalveolar changes that result
in significant reduction of overjet and can be used with appropriate patient selection. (Angle Orthod 2004;
74:605–609.)"
http://www.angle.org/doi/pdf/10.1043/0003-3219(2004)074%3C0605:TEOEPT%3E2.0.CO%3B2?cookieSet=1
The dentoalveolar changes achieved may give good results only in a few patients and only a very few need not go for Phase II treatment. Also many other studies have shown that the growth modifications achieved with myofunctional appliances are highly unstable.
1. And unquestionably this is a big practice builder. I get both the Phase I and Phase II treatment.
2. And this is way better than a functional appliance in patient compliance.
So go ahead and prescribe this to your patient and do tell him about the need (remember 50%) for later Phase II treatment.
:-)
http://www.myoresearch.com/cms/index.php?t4k
they supposed myobrace is effective in mixed dentition to solve the problem of overcrowding
Ravi Kumar said:
Myobraces are a kind of positioner device which may lead to some tooth alignment in the mixed dentition stage if there is enough growth later and space for the all the teeth to erupt into. I prescribe these to patients whose parents insists on some treatment and cannot wait for all the teeth to erupt. This treatment is always provided with the advice that there is only a 50% chance that this may reduce the necessity for fixed orthodontics later.
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