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Introduction by: Dr.Neal C.Murphy,Professor of Orthodontics
Someone once told me that the measure of a person is not what they accomplish in life but rather the influence they have on the lives of others. Approximately 35 years ago I started teaching in an effort to influence how dentists practiced orthodontics.
The majority of the orthodontic profession was mainly concerned with straightening teeth in the permanent dentition and bicuspid extraction was the main technique employed when the patient presented with any overjet and/or crowding. I was initially exposed to this treatment philosophy 40 years ago but soon adopted a functional philosophy of early orthodontic treatment. Rather than focus mainly on the teeth, the functional philosophy diagnoses and treats functional problems, skeletal problems and then finally dental problems.
Initially functional problems are addressed including the elimination of harmful habits and the establishment of a patent airway. This involves referral to ear, nose and throat specialists for the removal of the enlarged tonsils and adenoids. Clinicians must eliminate mouth breathing habits and establish normal nasal breathing. Habit breaking appliances such as Myobrace® and Maxillary Banded Hyrax with a crib are utilized in the beginning of treatment.
The next objective would be to treat all skeletal Class II malocclusions in the mixed dentition to create a Class I skeletal malocclusion.
Since most Class II skeletal malocclusions involve underdeveloped mandibles this involves using various lower jaw repositioning appliances to move the mandible forward to the correct position.
Another treatment of choice would be to convert all Class III skeletal malocclusions to Class I skeletal in the mixed dentition. Since most Class III skeletal patients have underdeveloped maxillae, functional appliances are utilized in younger children to solve this problem.
The advantages of the functional philosophy will be explained in great detail throughout this book. This treatment philosophy will eliminate the need for the extraction of permanent teeth, reduce the need for orthognathic surgery at age 17, create beautiful broad smiles, outstanding profiles, healthy temporomandibular joints and patent airways.
The functional philosophy can also prevent children, and later, adults from suffering from sleep apnea and ADHD (Attention Deficit Hyperactivity Disorder).
One of the main advantages of treating early is that 80% of the malocclusion can be corrected in the mixed dentition when cooperation is the best. Many parents and
teenagers like the idea of less time in fixed braces when they are in high school. Our objective is to try and finish the cases with functional appliances and fixed braces or
clear aligners before the patient starts high school.
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