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Module 1 Case
Discussion for Module 1: Week 1 Case
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7 Replies
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testing tags
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Hi,
First off, thank you for this amazing course it has been a godsend preparing for this exam!
I am curious why for Case 1 Prompt 8 the answer states to expect normal growth in the mandible in the AP and VERT but for the maxilla instead of “normal” the answer is “allow for minimal growth expected.” in the AP and VERT.
I know not to expect any transverse growth and that females often complete vertical growth by around age 14, but I am not sure how to be able to distinguish when minimal growth is expected in the maxilla.
Also, I am thinking this patient is CVMS Stage 2 (which could be incorrect).
Thank you!!
Elizabeth
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Elizabeth, so glad to have you in the class! Thanks for posting a question to help discussion along. We are thankful that it is helping you prepare. Remember pacing in studying! This isn’t a test to cram for (like many of us may have for previous exams).
Great thoughts about growth. I agree she is CVMS 2 (maybe edging towards 3). Spot on.
I’m going to refer back to Chapter 4 of Proffit’s Contemporary Orthodontics here to answer the “normal” vs “minimal growth expected”.
Our CVMS is about timing peak height velocity which helps us out because the mandible tends to follow somatic growth trends on the Scammon curves (see image posted below).
The maxilla on the other hand follows more closely the neurocranium (I just think of it as closer to the brain, moving with the eyes and sinuses as they all grow…I got to keep it simple for me). When we write “minimal growth expected for the maxilla” we are qualifying for the examiners that we understand the maxilla is about where it will be in the end; it is past the bulk of it’s growth. Now let’s get ahold of that mandible and see if we can guide the growth that we land a beautiful occlusion!
Does that make sense? Keep the good discussion coming!
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Elizabeth… Another response from Dan Chartrand I’m posting here –
“I would just know the general concept of growth patterns for the patient, and that during periods of accelerated growth we could potentially use that information to help us correct various malocclusion I would also know how varying growth patterns may impact growth. For example, Hyperdivergent patients are expected to grow more vertical so it is crucial to control the vertical dimension especially during periods of accelerated growth. Hypodivergent patients are expected to have more horizontal growth and knowing how that will play out during treatment. I think it was Buschang who said that facial patterns are established by age 5 and do not change during growth.”
Good luck with the studying!
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Thank you for your replies, this makes perfect sense. I think I was curious why we could not say simply “normal growth” expected. I see now it is important to ensure the examiners know we understand when growth is expected to be minimal etc in terms of when to intervene etc. Thank you!
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Spot on and great way to summarize the concept!
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