Hereditary malocclusion

HEREDITARY

MALOCCLUSIOS” L.D.S., BERKSHIRE,

D. S. HAYTON-WILLIAMS,

ENGLAND

I

T HAS often struck me that there is very little in orthodontic literature or printed discussion to give an indication as to the best method of treating cases showing a very decided tendency to develop a malocclusion similar to that present in one or both parents. While admitting that hereditary factors are a cause in nearly all malocclusions-may I suggest, diffidently, they are #me main cause-I am more concerned at the moment wit,h those similar irreg&&-

Fig.

I.-Case

1. the

mother.

ties in parent and child obvious even to the layman. In practically any case teeth can be so moved as to obtain a perfect occusion, but it is quite another matter to be certain they will stay there. In these cases of strong similarity between parents and child particular care should be t,aken to keep tooth movement biological and not merely mechanical. By which I mean not only the gradual movement of the teeth, but a knowledge that the disposition of the musculature of the child’s mouth will allow them t,o stay there. I find it difficult to explain lucidly my own ideas on the subject, but I feel sure that the number of factors operating in these cases-such as peculiarly *Transactions

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D. S. Ha?ltotl-Il;ill%cl,rrs

to nlnsclrs--exe~cisc~ high cheek bones and narrow mandibles giving attachment diffe ‘rent pressures from those in a more characteristic skull. .Ilao the len$h and disposition of the lips generally might hr obviously characteristic of ti fami lY.

I: should imagine you will find little difficulty in CASE L-The mother. memorizing the apDearance of these models. There is an instanding p and partially erupted Zi ; q is missing. The extractions in the maxilla were not done with the idea of alleviating the crowding. (Fig. 1.)

CASE 2.--1%~: younger ch.iltL It, is at once obvious that immediate treatment was called for, and bearing in mind the mother’s mouth and also her statement that such narrowness of t,he arches was usual in her family, I decided to extract the mandibular deciduous canines. One year later I extracted relief, but with the maxillary deciduous canines. Of course, only temporary periodical observation I can decide when to extract any permanent premolars. (Figd. 2 and 3.) CASE 3.-The elder child was brought to me at a later age. Narrowness in the mandibular incisor and canine region is apparent and also commencement of a.n overlap in the maxillary incisors. I waited six mont,hs and Figs. 4 and 5

Fig.

6.

show the condition then. I extracted the four first premola,rs simultaneously, as immediate action was called for in the mandible, and I felt it opportune in the maxilla, as the permanent canines were erupting. Fig. 6 shows the case twelve months later-spaces to close, granted, but I think they will. All these patients have tight lips and cheeks. In each of these cases I treated, I felt that mere mechanical treatment would not give a permanent pleasing result. I am open to criticism from older and more experienced members, and trust I shall have a clearer conception of these cases as a result of any discussion. DISCUSSION The President said that he thought Mr. Hayton-Williams was quite ing the teeth in these cases. The case of the mother was a good example mouth. He was quite right in reducing the size of the arches.

correct in of a very

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