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               What maturational information is important for successful timing
                     of orthodontic functional appliance and Herbst appliance



             The 'Maturational Patient Report' supplied by GrowthTek clearly
                assists and guides the clinician in formulating a well-timed treatment
                plan.  It is very important not to rely on chronologic age in
                determining whether a functional or Herbst appliance will benefit
                the patient.

                Functional and Herbst appliance treatment depends of the 
                correlation of treatment timing and good facial growth velocity,
                particularly relative to mandibular repositioning.  The general
                theory behind these treatment modalities is that the occlusion is
                disarticulated for significant periods of time, thereby allowing
                the mandible to be 'free' to establish a more downward and 
                forward relationship within the face.  This will not occur if 
                treatment is not timed well. 

                The following illustrations compare an example of less than ideal 
                timing of 13 months of functional appliance treatment with ideal 
                timing of 13 months of functional appliance treatment.  The first
                patient was treated at a very early adolescent period of develop-
                ment ( SMI 1-2 ) which is characteristic of an accelerating but 
                relatively low mandibular growth rate.  The second individual was 
                treated during a period of very high velocity mandibular growth
                ( SMI 4-7 ).          


             If Herbst and functional appliance treatment are not properly
                timed relative to the individualized growth velocity patterns
                of the patient, less than satisfactory results will be achieved.
                Regardless of the patient's chronologic age, it is extremely
                important to take into consideration the patient's maturational
                stage and maturational level so that growth estimations and growth
                timing can be estimated.


            Note: Please refer to the other questions in this 'Clinical Applications'
                     section of this web site for specific clinical information regarding
                     maturational timing of treatment.     Also refer to the 'Background
                     Information' section of this web site for additional information.

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