Kluemper G T, Beeman C S, Hicks E P
University of Kentucky, College of Dentistry, Orthodontic Graduate Program, Lexington 40536-0297, USA.
J Am Dent Assoc. 2000 May;131(5):613-20. doi: 10.14219/jada.archive.2000.0235.
Then authors provide a critical review of the issues involved in determining the appropriate timing of orthodontic treatment. Both single- and two-phase treatments are discussed and guidelines are offered to assist in formulating treatment plans.
In providing orthodontic care for pediatric patients, clinicians often question whether to begin treatment early--during the primary or early-transitional dentition--or wait until all or most of the permanent teeth are present. The authors review the most current literature (from 1991 to 1999), including several recently completed and ongoing randomized clinical trials, to critically evaluate the effectiveness of each approach.
The controversy surrounding early vs. late orthodontic treatment is often confusing to the dental community. This article reviews both sides of the issue for orthodontic treatment of Class II and III malocclusions, as well as for the management of Class I crowding and problems in the transverse dimension. Early orthodontic treatment is effective and desirable in specific situations. However, the evidence is equally compelling that such an approach is not indicated in many cases for which later, single-phase treatment is more effective. Therefore, clinicians must decide, on a case-by-case basis, when to provide orthodontic treatment. For many patients, delaying treatment until later in their dental and skeletal development may be advisable.
作者对确定正畸治疗合适时机所涉及的问题进行了批判性综述。讨论了单期治疗和两期治疗，并提供了指导方针以协助制定治疗计划。
在为儿童患者提供正畸护理时，临床医生常常会问是应在乳牙期或早期恒牙萌出过渡期尽早开始治疗，还是等到所有或大部分恒牙萌出后再开始。作者回顾了最新文献（1991年至1999年），包括几项最近完成和正在进行的随机临床试验，以批判性地评估每种方法的有效性。
围绕正畸治疗早与晚的争议常常让牙科界感到困惑。本文回顾了二类和三类错颌畸形正畸治疗问题的正反两方面，以及一类牙列拥挤和横向维度问题的处理。早期正畸治疗在特定情况下是有效且可取的。然而，同样有充分证据表明，在许多情况下这种方法并不适用，后期的单期治疗可能更有效。因此，临床医生必须根据具体情况决定何时进行正畸治疗。对许多患者来说，将治疗推迟到其牙齿和骨骼发育的后期可能是明智的。
