Extraction or non-extraction?  What maturational factors are
   
                            related to this decision?  What about retention?

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             Extractions:

                The important decision whether to extract teeth in a particular
                    case is often facilitated by understanding the anticipated
                    developmental patterns of the patient in question.  For example,
                    it is not unusual to have a situation whereby extractions can be
                    avoided if a good head-gear result is achieved.  This would be
                    the true in a Class II skeletal case where good downward and
                    forward skeletal growth of the mandible would achieve a Class I
                    molar relationship.  But will this patient express this much growth?

                    GrowthTek provides the clinician with this information by
                    identifying the individualized maturational profile of the
                    patient and projecting future growth patterns.  The important
                    percentage of total maxillary and mandibular growth values vary
                    considerably relative to the 23 maturational stages ( SMIs ) and
                    the 14 maturational levels,  The time periods between all of the
                    maturational stages and the time of growth termination also vary
                    relative to the maturational levels.

                    For example, an advanced maturer demonstrates significantly less
                    mandibular growth after SMI 7 as compared to a delayed maturer.
                    Even if these two individuals demonstrated the same maturational
                    stage, the delayed maturer would undoubtedly benefit more from
                    the head-gear since delayed maturers try to 'catch-up' and express
                    considerably more mandibular growth.  In this situation, depending
                    on the degree of skeletal discrepancy, the clinician may choose to
                    initially have teeth extracted for the advanced maturer and choose
                    to initiate head-gear treatment for the delayed maturer.

                    Every growing individual demonstrates unique maturational patterns
                    of development.  The challenge to the clinician is to understand how
                    the patient is developing and to apply this information to the
                    process of diagnosis and treatment planning.
       
                   Retention:

                    It is very important in growth related problems for the clinician
                    to retake a hand-wrist film just prior to the retention phase of
                    treatment.  It can usually be assumed that the growing individual
                    will continue to express the same basic growth patterns that were
                    detected before active treatment was initiated. 

                    If the patient is going to continue growing during the retention
                    phase of treatment, then it is clearly advisable to continue with
                    head-gear treatment during retention.  This decision depends on
                    the maturational age of the patient at that point in time and the
                    amounts of expected future maxillary and mandibular growth
                    expected.  In this type of situation, skeletal and dental relapse
                    can be significantly reduced or eliminated.  The maturational
                    report provided by GrowthTek can assist in making this type of
                    decision.

                    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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