Etiology and Development of Malocclusion Studied with Metallic Implants

With the many new developments in treatment mechanics and techniques it is understandable that orthodontist sometimes forget to pay attention to the role of facial growth and development when planning treatment for their young patients. The etiology of malocclusions is in many cases multifactorial, and a main component is facial growth. Muscle function and the soft tissues also play important roles in the development of the occlusion. Ignoring these factors when planning treatment can sometimes lead to problems later in treatment. In this review we shall investigate how these factors can contribute to the development of malocclusion. Changes seen during treatment can be caused by the soft tissues that unexpectedly have influenced the occlusal development. It is not uncommon to see undesirable changes despite all the good efforts. These problems can often be avoided or minimized with a better understanding of the individual’s facial growth pattern and stage of maturation at the completion of treatment. In this review we shall discuss the information on facial growth from studies using metallic implants and how the implant studies have contributed to a better understanding of the etiology and development of malocclusions. Understanding how the soft tissues and the facial muscles play important roles in the development of malocclusion will be reviewed and how these structures can affect the stability of treatment. We shall finally discuss how residual growth after treatment in some cases can result in relapse and when an individualized retention protocol is needed to ensure the long-term stability.