Airway OrthodonticsA lecture series prepared byDr. Barry RaphaelOf theRaphael Center for Integrative OrthodonticsClifton, ...
•Animations are not included in this archive and mayaffect the meaning or intent of the slide•As the information in these ...
A String of Pearls“The mind is like aparachute:it’s best when it’s open”3Thursday, June 6, 13
Pearl #1Malocclusion is a SYMPTOM of a greater imbalance•Malocclusion is a relatively new phenomenon•Since it takes over 2...
Pearl #2•The conditions to which the face must adapt begin at birth(and even before).•These conditions have a cumulative e...
Pearl #3•The Maxilla is usually RETRUSIVE•The mandible adapts to this environment•It may be retruded more than the maxilla...
Pearl #4Retraction and Extrusion aggravate the situation• Open mouth posture is THE critical element in theformation of th...
Pearl #5•Maxillary Dysmorphia encroaches on the nasopharyngeal airway•The airway is related to breathing and sleep disorde...
Conclusions: The pharyngealairway size became narrower afterthe treatment. Extraction of fourpremolars with retraction ofi...
Pearl #6•Malocclusion is a Solution to provide Equilibrium andHomeostasis10Thursday, June 6, 13
Nature’s Solution:Adaptation (Malocclusion)11Thursday, June 6, 13
Pearl #6•Malocclusion is a Solution to provide Equilibrium andHomeostasis•If we “rebalance” the occlusion, we disturb the ...
Orthodontic’s SolutionRetainer13Thursday, June 6, 13
Pearl #6•Malocclusion is a Solution to provide Equilibrium andHomeostasis•If we “rebalance” the occlusion, we disturb the ...
Pearl #6•Malocclusion is a Solution to provide Equilibrium and Homeostasis•If we “rebalance” the occlusion, we disturb the...
MyoFunctional OrthoTeeth and OcclusionTongue, MM,TMJCranial,Cervical,PostureWhole Body (resp,circ, musc-skel, etc)16Thursd...
Pearl #6•Malocclusion is a Solution to provide Equilibrium and Homeostasis•If we “rebalance” the occlusion, we disturb the...
The OrthodonticUncertainty PrincipleIs ortho a cosmetic service ?Is ortho a health service?18Thursday, June 6, 13
The OrthodonticUncertainty PrincipleIs ortho a corrective service ?Is ortho a curative service?19Thursday, June 6, 13
The OrthodonticUncertainty PrincipleIs ortho a mechanical service ?Is ortho a behavioral service?20Thursday, June 6, 13
The OrthodonticUncertainty PrincipleIs ortho a mechanical service ?Is ortho a behavioral service?Can it be both?(That depe...
Orthodontics in the21st CenturyConventionalOrthodonticsAirwayOrthodonticsGeneticTooth-FocusedDental Model: PerfectionEsthe...
Upcoming SlideShare
Loading in...5
×

Airway ortho 9 string of pearls

349

Published on

A series of lectures by Dr. Barry Raphael on Airway-focused orthodontics from 2013.
Chapter 9: A summary of key concepts in Airway-focused Orthodontics

Published in: Health & Medicine
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
349
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
0
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

Airway ortho 9 string of pearls

  1. 1. Airway OrthodonticsA lecture series prepared byDr. Barry RaphaelOf theRaphael Center for Integrative OrthodonticsClifton, NJ.www.alignmine.comwww.myobracenj.com“A String of Pearls” - 20131Thursday, June 6, 13
  2. 2. •Animations are not included in this archive and mayaffect the meaning or intent of the slide•As the information in these presentations isconstantly evolving, please consider the date of creationwhen reviewing the material.2Thursday, June 6, 13
  3. 3. A String of Pearls“The mind is like aparachute:it’s best when it’s open”3Thursday, June 6, 13
  4. 4. Pearl #1Malocclusion is a SYMPTOM of a greater imbalance•Malocclusion is a relatively new phenomenon•Since it takes over 20,000 years for a gene change tobecome incorporated into the genome, malocclusioncannot be genetic•Malocclusion is due to a mismatch of our geneotype withour environment•Malocclusion is one of many CNCDC4Thursday, June 6, 13
  5. 5. Pearl #2•The conditions to which the face must adapt begin at birth(and even before).•These conditions have a cumulative effect that will likely resultin some DEVIATION from ideal.•90% of these Effects will be permanent by Age 12•“Orthodontic Treatment” is just one more condition thataffects adaptation•Even when we do “nothing”, the face is still being“treated”.Treatment must focus on the problem when it startsOne Phase treatment is Early Treatment by Neglect5Thursday, June 6, 13
  6. 6. Pearl #3•The Maxilla is usually RETRUSIVE•The mandible adapts to this environment•It may be retruded more than the maxilla due tomuscle pull or constricted space (Class II)•It may be as retruded as the maxilla, with dentalcompensations for lack of space (Class I)•It may grow normally, and leave the maxilla behind(Class III)•But the MAXILLARY DYSMORPHIA is the same for allDeviationsAngle Classification is Misleading6Thursday, June 6, 13
  7. 7. Pearl #4Retraction and Extrusion aggravate the situation• Open mouth posture is THE critical element in theformation of the maxilla.• Maxillary changes (dysmorphia) are in all threedimensions of space•Transverse deficiency• Sagitall retrusion•Vertical excess• Currently, there are no mainstream protocols to reversethis condition7Thursday, June 6, 13
  8. 8. Pearl #5•Maxillary Dysmorphia encroaches on the nasopharyngeal airway•The airway is related to breathing and sleep disorders.• Hampering adaptation predisposes to airway issues.•This may include conditions which:• Prevent the airway from growing properly (ie: open mouth posture)• Prevent the airway from being expanded properly (ie: distalizationmechanics)• Perpetuates damage already occured (ie: constriction mechanics,untreated soft tissue dysfunctionAll treatment, in the final analysis, is about the AIRWAY.8Thursday, June 6, 13
  9. 9. Conclusions: The pharyngealairway size became narrower afterthe treatment. Extraction of fourpremolars with retraction ofincisors did affect velopharyngeal,glossopharyngeal,hypopharyngeal, and hyoidposition in bimaxillary protrusiveadult patients.9Thursday, June 6, 13
  10. 10. Pearl #6•Malocclusion is a Solution to provide Equilibrium andHomeostasis10Thursday, June 6, 13
  11. 11. Nature’s Solution:Adaptation (Malocclusion)11Thursday, June 6, 13
  12. 12. Pearl #6•Malocclusion is a Solution to provide Equilibrium andHomeostasis•If we “rebalance” the occlusion, we disturb the equilibrium12Thursday, June 6, 13
  13. 13. Orthodontic’s SolutionRetainer13Thursday, June 6, 13
  14. 14. Pearl #6•Malocclusion is a Solution to provide Equilibrium andHomeostasis•If we “rebalance” the occlusion, we disturb the equilibrium•There are always unintended consequences, even if subclinicalRelapseOcclusal WearOcclusal TraumaBruxismJoint DerangementReferred PainSleep ApneaAssorted physical ailments14Thursday, June 6, 13
  15. 15. Pearl #6•Malocclusion is a Solution to provide Equilibrium and Homeostasis•If we “rebalance” the occlusion, we disturb the equilibrium•There are always unintended consequences, even if subclinical...•...Unless we make compensations elsewhere (respiratory,musculo-skeletal, neurological, circulatory systems)15Thursday, June 6, 13
  16. 16. MyoFunctional OrthoTeeth and OcclusionTongue, MM,TMJCranial,Cervical,PostureWhole Body (resp,circ, musc-skel, etc)16Thursday, June 6, 13
  17. 17. Pearl #6•Malocclusion is a Solution to provide Equilibrium and Homeostasis•If we “rebalance” the occlusion, we disturb the equilibrium•There are always unintended consequences, even if subclinical...•...Unless we make compensations elsewhere (respiratory,musculo-skeletal, neurological, circulatory systems)We must broaden the scope of our concern beyond teeth17Thursday, June 6, 13
  18. 18. The OrthodonticUncertainty PrincipleIs ortho a cosmetic service ?Is ortho a health service?18Thursday, June 6, 13
  19. 19. The OrthodonticUncertainty PrincipleIs ortho a corrective service ?Is ortho a curative service?19Thursday, June 6, 13
  20. 20. The OrthodonticUncertainty PrincipleIs ortho a mechanical service ?Is ortho a behavioral service?20Thursday, June 6, 13
  21. 21. The OrthodonticUncertainty PrincipleIs ortho a mechanical service ?Is ortho a behavioral service?Can it be both?(That depends on your point of view…)21Thursday, June 6, 13
  22. 22. Orthodontics in the21st CenturyConventionalOrthodonticsAirwayOrthodonticsGeneticTooth-FocusedDental Model: PerfectionEsthetics PrimaryTreating SymptomsAirway IgnorantAdaptationMuscle-FocusedMedical Model: BetterEsthetics SecondaryTreating CausesAirway Concious22Thursday, June 6, 13

×