Download PDF
CC BY 4.0 · Eur J Dent 2024; 18(01): 086-096
DOI: 10.1055/s-0043-1768974
Review Article

Optimal Treatment Timing in Orthodontics: A Scoping Review

Mohammad A. Hamidaddin 
1   Department of Preventive Dental Sciences, College of Dentistry, King Faisal University, Al Ahsa, Saudi Arabia
› Author Affiliations Funding None.
› Further Information
   Permissions and Reprints

Abstract

The appropriate timing for orthodontic intervention has been a subject of debate for a long time, concerning not only the immediate effects but also the long-term benefits of such treatment. This review aimed to find the appropriate treatment timing for the intervention of various orthodontic problems. A literature search was performed in all major databases, including PubMed and Cochrane Library, until February 20, 2023. All observational and experimental studies published in English that compared early versus late orthodontic treatment in different types of orthodontic problems were included. Data selection and charting were undertaken by a single investigator. A total of 32 studies were identified that discussed various aspects of interventions, including Class II and Class III malocclusion, pseudo-Class III malocclusion, anterior and posterior crossbite, extractions, and long-term benefits. Overall, early intervention was not found to be superior in terms of effectiveness, overall duration of appliances, and cost–benefit ratio. Early intervention should be reserved for specific conditions or localized malocclusions that have psycho-social benefits, or to significantly reduce the severity of problems to be dealt with in comprehensive treatment in the permanent dentition.

Keywords

early orthodontic treatment - Early intervention - late treatment

Data Availability Statement

Study data are available from the corresponding author on request.




Publication History

Article published online:
13 June 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Wahl N. Orthodontics in 3 millennia. Chapter 12: two controversies: early treatment and occlusion. Am J Orthod Dentofacial Orthop 2006; 130 (06) 799-804
    CrossrefPubMedGoogle Scholar
  • 2 Gianelly AA. One-phase versus two-phase treatment. Am J Orthod Dentofacial Orthop 1995; 108 (05) 556-559
    CrossrefPubMedGoogle Scholar
  • 3 Pangrazio-Kulbersh V, Kang HK, Dhawan A, Al-Qawasmi R, Pacheco RR. Comparison of early treatment outcomes rendered in three different types of malocclusions. Angle Orthod 2018; 88 (03) 253-258
    CrossrefPubMedGoogle Scholar
  • 4 Fleming PS. Timing orthodontic treatment: early or late?. Aust Dent J 2017; 62 (Suppl. 01) 11-19
    CrossrefPubMedGoogle Scholar
  • 5 American Association of Orthodontists. When should your child see an orthodontist? Accessed April 22, 2023 at: https://www3.aaoinfo.org/blog/when-should-your-child-see-an-orthodontist/
  • 6 Schneider-Moser UE, Moser L. Very early orthodontic treatment: when, why and how?. Dental Press J Orthod 2022; 27 (02) e22spe2
    CrossrefPubMedGoogle Scholar
  • 7 Khurshid Z, Tariq R, Asiri FY, Abid K, Zafar MS. Literature search strategies in dental education and research. J Taibah Univ Med Sci 2021; 16 (06) 799-806
    PubMedGoogle Scholar
  • 8 Page MJ, McKenzie JE, Bossuyt PM. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372: n71
    CrossrefPubMedGoogle Scholar
  • 9 O'Brien K, Wright J, Conboy F. et al. Effectiveness of early orthodontic treatment with the Twin-block appliance: a multicenter, randomized, controlled trial. Part 1: dental and skeletal effects. Am J Orthod Dentofacial Orthop 2003; 124 (03) 234-243 , quiz 339
    CrossrefPubMedGoogle Scholar
  • 10 O'Brien K, Wright J, Conboy F. et al. Effectiveness of early orthodontic treatment with the twin-block appliance: a multicenter, randomized, controlled trial. Part 2: psychosocial effects. Am J Orthod Dentofacial Orthop 2003; 124 (05) 488-494 , discussion 494–495
    CrossrefPubMedGoogle Scholar
  • 11 Dolce C, McGorray SP, Brazeau L, King GJ, Wheeler TT. Timing of Class II treatment: skeletal changes comparing 1-phase and 2-phase treatment. Am J Orthod Dentofacial Orthop 2007; 132 (04) 481-489
    CrossrefPubMedGoogle Scholar
  • 12 Tulloch JF, Phillips C, Koch G, Proffit WR. The effect of early intervention on skeletal pattern in Class II malocclusion: a randomized clinical trial. Am J Orthod Dentofacial Orthop 1997; 111 (04) 391-400
    CrossrefPubMedGoogle Scholar
  • 13 Cha J-Y, Kennedy DB, Turley PK. et al. Outcomes of early versus late treatment of severe Class II high-angle patients. Am J Orthod Dentofacial Orthop 2019; 156 (03) 375-382
    CrossrefPubMedGoogle Scholar
  • 14 von Bremen J, Pancherz H. Efficiency of early and late Class II Division 1 treatment. Am J Orthod Dentofacial Orthop 2002; 121 (01) 31-37
    CrossrefPubMedGoogle Scholar
  • 15 Oh H, Baumrind S, Korn EL. et al. A retrospective study of Class II mixed-dentition treatment. Angle Orthod 2017; 87 (01) 56-67
    CrossrefPubMedGoogle Scholar
  • 16 Baccetti T, Franchi L, Toth LR, McNamara Jr JA. Treatment timing for twin-block therapy. Am J Orthod Dentofacial Orthop 2000; 118 (02) 159-170
    CrossrefPubMedGoogle Scholar
  • 17 Faltin Jr KJ, Faltin RM, Baccetti T, Franchi L, Ghiozzi B, McNamara Jr JA. Long-term effectiveness and treatment timing for bionator therapy. Angle Orthod 2003; 73 (03) 221-230
    PubMedGoogle Scholar
  • 18 Quintão C, Helena I, Brunharo VP, Menezes RC, Almeida MA. Soft tissue facial profile changes following functional appliance therapy. Eur J Orthod 2006; 28 (01) 35-41
    CrossrefPubMedGoogle Scholar
  • 19 Singh S, Singh M, Saini A, Misra V, Sharma VP, Singh GK. Timing of myofunctional appliance therapy. J Clin Pediatr Dent 2010; 35 (02) 233-240
    CrossrefPubMedGoogle Scholar
  • 20 Cha KS. Skeletal changes of maxillary protraction in patients exhibiting skeletal class III malocclusion: a comparison of three skeletal maturation groups. Angle Orthod 2003; 73 (01) 26-35
    PubMedGoogle Scholar
  • 21 Yüksel S, Uçem TT, Keykubat A. Early and late facemask therapy. Eur J Orthod 2001; 23 (05) 559-568
    CrossrefPubMedGoogle Scholar
  • 22 Baccetti T, Franchi L, McNamara Jr JA. Treatment and posttreatment craniofacial changes after rapid maxillary expansion and facemask therapy. Am J Orthod Dentofacial Orthop 2000; 118 (04) 404-413
    CrossrefPubMedGoogle Scholar
  • 23 Wendl B, Kamenica A, Droschl H. et al. Retrospective 25-year follow-up of treatment outcomes in Angle Class III patients: success versus failure. J Orofac Orthop 2017; 78 (02) 129-136
    CrossrefPubMedGoogle Scholar
  • 24 Gu Y, Rabie AB. Dental changes and space gained as a result of early treatment of pseudo-Class III malocclusion. Aust Orthod J 2000; 16 (01) 40-52
    PubMedGoogle Scholar
  • 25 Haruki T, Little RM. Early versus late treatment of crowded first premolar extraction cases: postretention evaluation of stability and relapse. Angle Orthod 1998; 68 (01) 61-68
    PubMedGoogle Scholar
  • 26 O'Shaughnessy KW, Koroluk LD, Phillips C, Kennedy DB. Efficiency of serial extraction and late premolar extraction cases treated with fixed appliances. Am J Orthod Dentofacial Orthop 2011; 139 (04) 510-516
    CrossrefPubMedGoogle Scholar
  • 27 Wilson JR, Little RM, Joondeph DR, Doppel DM. Comparison of soft tissue profile changes in serial extraction and late premolar extraction. Angle Orthod 1999; 69 (02) 165-173 , discussion 173–174
    PubMedGoogle Scholar
  • 28 Wagner M, Berg R. Serial extraction or premolar extraction in the permanent dentition? Comparison of duration and outcome of orthodontic treatment. J Orofac Orthop 2000; 61 (03) 207-216
    PubMedGoogle Scholar
  • 29 Brin I, Bollen A-M. External apical root resorption in patients treated by serial extractions followed by mechanotherapy. Am J Orthod Dentofacial Orthop 2011; 139 (02) e129-e134
    CrossrefPubMedGoogle Scholar
  • 30 Baccetti T, Franchi L, Cameron CG, McNamara Jr JA. Treatment timing for rapid maxillary expansion. Angle Orthod 2001; 71 (05) 343-350
    PubMedGoogle Scholar
  • 31 Petrén S, Bondemark L. Correction of unilateral posterior crossbite in the mixed dentition: a randomized controlled trial. Am J Orthod Dentofacial Orthop 2008; 133 (06) 790.e7-790.e13
    CrossrefPubMedGoogle Scholar
  • 32 Sari Z, Uysal T, Usumez S, Basciftci FA. Rapid maxillary expansion. Is it better in the mixed or in the permanent dentition?. Angle Orthod 2003; 73 (06) 654-661
    PubMedGoogle Scholar
  • 33 Mohan CN, Araujo EA, Oliver DR, Kim KB. Long-term stability of rapid palatal expansion in the mixed dentition vs the permanent dentition. Am J Orthod Dentofacial Orthop 2016; 149 (06) 856-862
    CrossrefPubMedGoogle Scholar
  • 34 Bicakci AA, Agar U, Sökücü O, Babacan H, Doruk C. Nasal airway changes due to rapid maxillary expansion timing. Angle Orthod 2005; 75 (01) 1-6
    PubMedGoogle Scholar
  • 35 Lippold C, Stamm T, Meyer U, Végh A, Moiseenko T, Danesh G. Early treatment of posterior crossbite–a randomised clinical trial. Trials 2013; 14 (01) 20
    CrossrefPubMedGoogle Scholar
  • 36 Baccetti T, Franchi L, Giuntini V, Masucci C, Vangelisti A, Defraia E. Early vs late orthodontic treatment of deepbite: a prospective clinical trial in growing subjects. Am J Orthod Dentofacial Orthop 2012; 142 (01) 75-82
    CrossrefPubMedGoogle Scholar
  • 37 Franchi L, Baccetti T, Giuntini V, Masucci C, Vangelisti A, Defraia E. Outcomes of two-phase orthodontic treatment of deepbite malocclusions. Angle Orthod 2011; 81 (06) 945-952
    CrossrefPubMedGoogle Scholar
  • 38 Chen DR, McGorray SP, Dolce C, Wheeler TT. Effect of early Class II treatment on the incidence of incisor trauma. Am J Orthod Dentofacial Orthop 2011; 140 (04) e155-e160
    CrossrefPubMedGoogle Scholar
  • 39 Koroluk LD, Tulloch JF, Phillips C. Incisor trauma and early treatment for Class II Division 1 malocclusion. Am J Orthod Dentofacial Orthop 2003; 123 (02) 117-125 , discussion 125–126
    CrossrefPubMedGoogle Scholar
  • 40 Pavoni C, Lombardo EC, Lione R. et al. Treatment timing for functional jaw orthopaedics followed by fixed appliances: a controlled long-term study. Eur J Orthod 2018; 40 (04) 430-436
    CrossrefPubMedGoogle Scholar
  • 41 Fareen N, Alam MK, Khamis MF, Mokhtar N. Treatment effects of reverse twin-block and reverse pull face mask on craniofacial morphology in early and late mixed dentition children. Orthod Craniofac Res 2017; 20 (03) 134-139
    CrossrefPubMedGoogle Scholar
  • 42 Alhammadi MS, Halboub E, Fayed MS, Labib A, El-Saaidi C. Global distribution of malocclusion traits: A systematic review. Dental Press J Orthod 2018; 23 (06) 40.e1-40.e10
    CrossrefPubMedGoogle Scholar
  • 43 Seehra J, Fleming PS, Newton T, DiBiase AT. Bullying in orthodontic patients and its relationship to malocclusion, self-esteem and oral health-related quality of life. J Orthod 2011; 38 (04) 247-256 , quiz 294
    CrossrefPubMedGoogle Scholar
  • 44 Shaw WC, Addy M, Ray C. Dental and social effects of malocclusion and effectiveness of orthodontic treatment: a review. Community Dent Oral Epidemiol 1980; 8 (01) 36-45
    CrossrefPubMedGoogle Scholar
  • 45 Johal A, Cheung MY, Marcene W. The impact of two different malocclusion traits on quality of life. Br Dent J 2007; 202 (02) E2
    CrossrefPubMedGoogle Scholar
  • 46 Silva LFG, Thomaz EB, Freitas HV, Pereira AL, Ribeiro CC, Alves CM. Impact of malocclusion on the quality of life of Brazilian adolescents: a population-based study. PLoS One 2016; 11 (09) e0162715
    CrossrefPubMedGoogle Scholar
  • 47 Dugoni SA, Chee SO, Harnick DJ. Mixed-dentition treatment. Am J Orthod Dentofacial Orthop 1992; 101 (06) 501-508
    CrossrefPubMedGoogle Scholar
  • 48 Brierley CA, DiBiase A, Sandler PJ. Early Class II treatment. Aust Dent J 2017; 62 (Suppl. 01) 4-10
    CrossrefPubMedGoogle Scholar
  • 49 Proffit WR, Fields Jr HW, Moray LJ. Prevalence of malocclusion and orthodontic treatment need in the United States: estimates from the NHANES III survey. Int J Adult Orthodon Orthognath Surg 1998; 13 (02) 97-106
    PubMedGoogle Scholar
  • 50 McIntyre GT. Treatment planning in Class III malocclusion. Dent Update 2004; 31 (01) 13-20
    CrossrefPubMedGoogle Scholar
  • 51 McNamara J, McClatchey L, Graber L. Optimizing orthodontics and dentofacial orthopedics: Treatment timing and mixed dentition therapy. In: Graber L, Vanarsdall R, Vig K, Huang G. eds. Orthodontics: Current Principles and Techniques. St. Louis: Elsevier; 2017: 403-436
    Google Scholar
  • 52 Kim JH, Viana MA, Graber TM, Omerza FF, BeGole EA. The effectiveness of protraction face mask therapy: a meta-analysis. Am J Orthod Dentofacial Orthop 1999; 115 (06) 675-685
    CrossrefPubMedGoogle Scholar
  • 53 Miao W, Zhou D, Li C. et al. Dental developmental stage affects the treatment outcome of maxillary protraction in skeletal Class III children: a systematic review and meta-analysis. Aust Orthod J 2021; 37 (01) 37-49
    Google Scholar
  • 54 Wang J, Wang Y, Yang Y. et al. Clinical effects of maxillary protraction in different stages of dentition in skeletal class III children: A systematic review and meta-analysis. Orthod Craniofac Res 2022; 25 (04) 549-561
    CrossrefPubMedGoogle Scholar
  • 55 Proffit WR, Fields Jr HW, Sarver DM. Contemporary Orthodontics. Amsterdam, The Netherlands: Elsevier Health Sciences; 2006
    Google Scholar
  • 56 Mitani H. Early application of chincap therapy to skeletal class III malocclusion. Am J Orthod Dentofacial Orthop 2002; 121 (06) 584-585
    CrossrefPubMedGoogle Scholar
  • 57 Deguchi T, Kitsugi A. Stability of changes associated with chin cup treatment. Angle Orthod 1996; 66 (02) 139-145
    PubMedGoogle Scholar
  • 58 Sharma PS, Brown RV. Pseudo mesiocclusion: diagnosis and treatment. ASDC J Dent Child 1968; 35 (05) 385-392
    PubMedGoogle Scholar
  • 59 Graber T, Vanarsdall R, Vig K. Current Principles and Techniques. Mosby-Year Book; 1994: 685
    Google Scholar
  • 60 Shaw WC, Meek SC, Jones DS. Nicknames, teasing, harassment and the salience of dental features among school children. Br J Orthod 1980; 7 (02) 75-80
    CrossrefPubMedGoogle Scholar
  • 61 Rakosi T, Schilli W. Class III anomalies: a coordinated approach to skeletal, dental, and soft tissue problems. J Oral Surg 1981; 39 (11) 860-870
    Google Scholar
  • 62 Hägg U, Tse A, Bendeus M, Rabie AB. A follow-up study of early treatment of pseudo Class III malocclusion. Angle Orthod 2004; 74 (04) 465-472
    PubMedGoogle Scholar
  • 63 Lopes Filho H, Maia LH, Lau TC, de Souza MM, Maia LC. Early vs late orthodontic treatment of tooth crowding by first premolar extraction: a systematic review. Angle Orthod 2015; 85 (03) 510-517
    CrossrefPubMedGoogle Scholar
  • 64 Ugolini A, Agostino P, Silvestrini-Biavati A, Harrison JE, Batista KB. Orthodontic treatment for posterior crossbites. Cochrane Database Syst Rev 2021; 12 (12) CD000979
    PubMedGoogle Scholar
  • 65 O'Byrn BL, Sadowsky C, Schneider B, BeGole EA. An evaluation of mandibular asymmetry in adults with unilateral posterior crossbite. Am J Orthod Dentofacial Orthop 1995; 107 (04) 394-400
    CrossrefPubMedGoogle Scholar
  • 66 Pinto AS, Buschang PH, Throckmorton GS, Chen P. Morphological and positional asymmetries of young children with functional unilateral posterior crossbite. Am J Orthod Dentofacial Orthop 2001; 120 (05) 513-520
    CrossrefPubMedGoogle Scholar
  • 67 da Silva Filho OG, Valladares Neto J, Rodrigues de Almeida R. Early correction of posterior crossbite: biomechanical characteristics of the appliances. J Pedod 1989; 13 (03) 195-221
    Google Scholar
  • 68 Nanda R. The differential diagnosis and treatment of excessive overbite. Dent Clin North Am 1981; 25 (01) 69-84
    CrossrefPubMedGoogle Scholar
  • 69 Bollen AM. Effects of malocclusions and orthodontics on periodontal health: evidence from a systematic review. J Dent Educ 2008; 72 (08) 912-918
    CrossrefPubMedGoogle Scholar
  • 70 Alexander TA, Gibbs CH, Thompson WJ. Investigation of chewing patterns in deep-bite malocclusions before and after orthodontic treatment. Am J Orthod 1984; 85 (01) 21-27
    CrossrefPubMedGoogle Scholar
  • 71 Petti S, Glendor U, Andersson L. World traumatic dental injury prevalence and incidence, a meta-analysis—one billion living people have had traumatic dental injuries. Dent Traumatol 2018; 34 (02) 71-86
    CrossrefPubMedGoogle Scholar
  • 72 Petti S. Over two hundred million injuries to anterior teeth attributable to large overjet: a meta-analysis. Dent Traumatol 2015; 31 (01) 1-8
    CrossrefPubMedGoogle Scholar