Facial and dental changes in adolescents and their clinical implications

Assessment and Prediction of Dentofacial growth are perhaps the most essential, yet to a great extent the most subjective, aspects of clinical orthodontics. Although the percentage of adult patients has increased in recent years, the majority of treatment is still directed toward pre-adolescent and adolescent patients. These individuals are undergoing significant growth changes in their occlusions, facial skeletons, and profiles. The purpose of this paper is to review pertinent longitudinal facial growth data and some of the methods used to predict facial growth. The clinical implications of the available information is also discussed. The ability to forecast or predict growth lies at the very heart of contemporary clinical orthodontics. The orthodontist in formulating a treatment plan relies largely upon subjective criteria in conceiving the outcome of treatment. This intuitive perception is necessary, but the overall approach should be based on the available scientific information. There are several components to be dealt with in the prediction of craniofacial changes: the direction, the magnitude, the timing, the rate of change, and the effects of treatment. Orthodontists, in general, are well informed regarding the effects of orthodontic treatment on the patient, but are not yet able to accurately predict the direction, timing, and magnitude of the facial changes that occur with growth in any single individual.