Overjet treatment Approach

Joined
Mar 13, 2016
Messages
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Hi. My almost-14 y/old son has significant overjet. We have gotten two widely divergent opinions on treatment.

[1] One doc says the lower jaw growth is basically done, so we will put a pin anchor in upper, extract upper molars to make room, and then pull upper incisors back. This is a partial solution, not likely to fully correct, and eventually adult jaw surgery will be necessary. Takes about two and a half years. This doc uses traditional elastic binder brackets for braces. [Extract upper juvenile secondary molars - note: he was born without adult teeth for that one].

[2] Other doc says the we will harness the remaining lower jaw growth and repair it now. He will place Herbst appliance and push lower jaw forward. No extractions. Done in two years, appliance for first year only. This doc uses Damon system brand slide braces. [This doc says the upper teeth look good, incl juvenile secondary, and no reason to go in and extract and move them around].

So, opposite philosophies and opposite treatments.
Insights welcome, please thanks.

Patient has a significant skeletal malocclusion, and significantly deficient chin due to very short jaw. Excessive overjet. He basically can't close his lips due to misalignment. Shows 7 mm of upper incisor at rest. He is also born without upper primary adult second molars, baby is still in and looking strong. He is a nasal breather and night grinder.
 

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