Odontologo

3 July 2006 | The Aetiology of Malocclusion

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The Aetiology of Malocclusion
by Dr John Flutter BDS (London)

Table of Contents
The Aetiology of Malocclusion

2

Form

3

Function

6

Soft Tissue Dysfunction Analysis

9
12

The Influence of Posture on the Cranium and the Dentition

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Conclusions

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Why is there so much variation in treatment results?

19Stability and Relapse: three choices.

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References

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John Flutter Dental Pty Ltd A BN 86 010 596 166

Brisbane Surgery:

6 Barry Street, Gladstone QLD 4680 Australia.
T 07 4978 4572 F 0 7 4972 8330 E john@jfdental.com

36 Jephson Street, Toowong QLD 4066
For appointments T 0 7 3839 3637

w ww.jfdental.com

Posture

3 July 2006 | The Aetiology of Malocclusion

2The Aetiology of Malocclusion
For thirty-three years I have been practicing orthodontics and dentofacial orthopaedics. I have
observed abnormal muscle habits and breathing patterns that the child adopts in the first years
of life. These habits can have an adverse influence on the growth and development of the jaws
and the dentition. I have helped children modify these patterns and as a resulthave seen an
improvement in the growth and development of the face, the jaws and the dentition.
The orthodontic teaching that I received as an undergraduate was based on the assumption that
the shape and size of the jaws are fixed. We were taught that orthodontics is limited to moving
teeth within the jaws. Any attempt to change the skeletal structure would later result in relapse
withdisappointment for the patient and practitioner.

Today, I like to see children in the mixed dentition, while they are still growing. When I observe
habits and patterns that are having an adverse influence on growth and development I try to
help the child modify those patterns and try to re-establish normal growth. When I succeed
facial appearance improves.
I have studied with teachers who show thatwe can influence jaw shape, size and relationship.
Also, I have learned that the bones of the jaws are an integral part of the cranium and we need
to consider the whole cranium when diagnosing a malocclusion. The cranium is supported on
the spine which itself is supported on the pelvis and feet. An imbalance or distortion in any part
of the system will be reflected throughout the system.
Mypractice of orthodontics has changed in recent years. Today, when I look at the distortions of
the jaws I see them as reflections of the distortions in the cranium and body and treat them
accordingly. When diagnosing and preparing a treatment plan I consider form, function and
posture in order to establish the aetiology and treatment of the malocclusion.
Form:

The shape and size of theupper and lower jaws.

Function: The effects of breathing, swallowing, chewing and talking on the dentition.
Posture:

Balance of the entire skeletal system or how the dentition is supported in space.

John Flutter Dental Pty Ltd A BN 86 010 596 166

Brisbane Surgery:

6 Barry Street, Gladstone QLD 4680 Australia.
T 07 4978 4572 F 0 7 4972 8330 E john@jfdental.com

36 Jephson Street,Toowong QLD 4066
For appointments T 0 7 3839 3637

w ww.jfdental.com

We looked at the aetiology of malocclusion but there was no attempt when treatment planning
to correct the cause of the problem. We would watch the child growing and developing in the
mixed dentition but not start treatment until the patient was in the permanent dentition and
most of the growth of the head and neck wascomplete.

3 July 2006 | The Aetiology of Malocclusion

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Form
The ideal form of the upper jaw is a Gothic arch shape.

Figure 1. An anatomical view of the maxillae showing a healthy arch form

The upper arch comprises four separate bones: two maxillae and two palatine bones. These
bones are separated by sutures that are normally open throughout life. This is significant in
therapy...