Introduction

Two-phase orthodontic treatment is a specialized process that combines tooth

straightening, physical and facial changes. The purpose of two-phase treatment is to
maximize the opportunity to accomplish the ideal healthy, functional, and aesthetic
result that will remain stable through this child along his life.
2 phases treatment
-If an appliance is used in Phase One care, it could be a form of braces
or another fixed appliance, or could be a removable appliance. The type
of appliance used depends on the needs of the individual patient.
-then a resting period follows Phase One orthodontic treatment in this
phase, the remaining permanent teeth are allowed to continue their
development. Retaining devices may not be recommended
if they would interfere with eruption. It is best to allow the
existing permanent teeth some freedom of movement.
A successful first phase will have created room for
permanent teeth to find an eruption path. Otherwise, they
may become impacted or severely displaced..
- Phase Two of orthodontic treatment usually begins when
most or all of permanent teeth erupted The goal of
Phase-Two treatment is to make sure each tooth has an
exact location in the mouth where it is in harmony with the
lips, cheeks, tongue, and other teeth. When this equilibrium
is established, the teeth will function together properly.
Phase-Two usually involves full upper and lower braces.
At the beginning of the first phase, orthodontic records
were made and a diagnosis and treatment plan established.
Certain types of appliances were used in phase-one to
correct and realign the teeth and jaw.
 Advantages
• May reduce the need to pull permanent • Intervene in a child’s prolonged sucking or
teeth in the future. abnormal swallowing.

• Some problems that can be treated quite • Tuck in upper front teeth that stick out
well in a growing child but may require “protrude” to reduce the risk of those teeth
corrective surgery if treatment occurs after being broken or knocked out.
growth ends.

• Normalize the relationship of the upper jaw

to the lower jaw, especially in the case of an
underbite.
* Younger patients may be more cooperative and follow the orthodontist’s
instructions on appliance wear and oral hygiene. And the desired changes that result
from a first phase treatment may contribute to long-term stability, meaning that teeth
stay where the orthodontist has moved them. PHASE 1

Benefits patients reduces the risk

physically, enabling improves the
of breaking
them to bite or self-esteem in
front teeth that
chew more some kids.
effectively. protrude.
 PHASE 2

Retainers will be
worn after this
make sure teeth
moves permanent are in their
teeth into their phase to ensure
final positions. the patient keeps proper places
his beautiful new for good
smile for a lifetime. function, a
healthy bite.
 Disadvantages of one-phase orthodontic treatment

 In early treatment : not all the teeth are accessible

 Genetic tendencies are not changeable so they might reappear with growth

 Habits can cause relapse

 Not all orthodontic techniques are usable for deciduous dentition

 Follow the disadvantages of phase 1

1. Decreased oral hygiene during treatment

2. Patient burn out from orthodontic treatment
3. Every child’s personality does not mesh well with early treatment
4. Early orthodontic treatment requires a substantial financial commitment
5. Early orthodontic treatment requires a substantial time commitment
6. Treatment may be uncomfortable at times
7. Early orthodontic treatment requires food restrictions
8. Potential to miss school days for treatment appointment
Difeerence between phase 1 vs phase 2
Phase 1
• the goal is to correct one major
problem
• usually last about 12 months
and happen when baby teeth
are still present and/or loose.
phase2
• goal of addressing multiple
problems with the teeth and bite
• can last between 12-36 months
depending on how severe the
case is.
• Most comprehensive
orthodontic cases generally
begin when all the permanent
teeth are present
FaceMask ( reverse-pull headgear)
• The purpose Of facemask is to correct
the sagittal and transverse arch
discrepancies through stimulation of
maxillary growth and redirection of
mandibular growth
• correct the anterior and posterior
crossbites; and obtain Class I molar and
canine relationships with correct
overbite and overjet.
• early protraction facemask therapy
could effectively reduce the skeletal
discrepancy, simplifying orthodontic
treatment and reducing the tendency to
relapse.
Hyrax Appliance
-Attached to the upper molars through bonding or by
cemented bands, it is an orthodontic device used to create a
wider space in the upper jaw. It is typically used when the
upper jaw is too narrow for the lower jaw or when the upper
teeth are crowded or blocked out of the dental arch.
Hyrax Appliance
-used in the treatment of transverse maxillary deficiencies in order to
re-direct growth of the basal bone into a normal pattern
-can produce orthopaedic expansion affecting the skeletal structures
rather than movement of teeth through alveolar bone
-The best age to use it is from 9 to 15 years old
Reference
• McGill J. S. Orthopedic alterations induced by rapid maxillary
expansion and face mask therapy [M.S. thesis] Ann Arbor, Mich, USA:
University of Michigan; 1995
• McGill J. S., McNamara J. A., Jr. Treatment and post-treatment effects
of rapid maxillary expansion and facial mask therapy. In: McNamara J.
A., editor. Growth Modification: What Works What Doesn't and
Why. Vol. 36. Ann Arbor, Mich, USA: Center for Human Growth and
Development; 1999. (Monograph, Craniofacial Growth Series)

• https://academic.oup.com/ejo/article/33/2/185/486949