Growth and its relation to orthodontic treatment

Surgery has become an invaluable adjunct to orthodontic therapy. However, before embarking on surgical procedures, particularly in growing individuals, it is necessary to appraise each case carefully to determine whether the dentofacial dysplasias can be corrected by orthodontic or orthopedic means. It is possible by the use of investigative procedures to determine the extent and severity of malocclusions and any associated dentofacial dysplasias. General growth rates, increments, and directions can be predicted with some degree of accuracy. Likewise, favorable and unfavorable growth patterns can usually be identified. However, there are those cases in which, for reasons unknown, the growth patterns do not follow the usual trends. These cases often do not respond satisfactorily to treatment because of bizarre or unanticipated growth patterns. Science, unfortunately, has not progressed sufficiently so that such patterns can be identified ahead of time. Until the secrets of such growth patterns are uncovered, treatment procedures, response to the therapy, and growth predictions, of necessity, must be based on average growth trends.