The report is available in English with a a French summary - KCE

More documents

Recommendations

Info

10 Orthodontics KCE Reports 77 Protrusion Tooth that are placed too far forward in the jaw. Radiograph A type of photograph using x-rays which shows the teeth and jaws. Relapse The return of features towards the original malocclusion following orthodontic treatment. Retainer A fixed or removable appliance for maintaining the positions of the teeth and jaws after orthodontic treatment. Retruded Further back than ideal Reverse overjet Lower front teeth bite in front of upper front teeth Space maintainer An appliance used to prevent adjacent and opposing teeth from moving into the space left by the loss of a deciduous tooth. Speech therapist A person specialised in correcting speech deviations and disorders Supernumerary tooth An extra tooth Temporomandibular Joint The joint formed by the mandibular condyle and the base of the (TMJ) skull Tooth displacement Abnormal or incorrect position of a tooth Tracing A drawn line of a cephalometric X-Ray which helps the orthodontist in diagnosis and treatment planning Trauma An injury of the teeth or jaws Treatment plan An outline of the clinical steps which will be followed to correct the initial malocclusion towards a normal occlusion. The third molars Wisdom teeth OVERVIEW OF USED RIZIV/INAMI CODES 305594-305605 Orthodontic treatment demand 305631-305642 305675-305686 305616-305620 305653-305664 305712-305723 Appliance - at the start of the treatment - after 6 months of treatment Monthly regular treatment: - max 2 per calendar month and 6 per six calendar months - regular treatment after which an interruption starts of more than 6 months - regular treatment after which non-reimbursable regular treatment follows 305830-305841 Orthodontic advice or investigation, with report 305852-305863 305896-305900 Contention check - max. 4 per calendar year - check after which an interruption of more than 6 months follows
KCE Reports 77 Orthodontics 11 1 GENERAL INTRODUCTION 1.1 THE FIELD OF ORTHODONTICS The field of orthodontics comprises the development and growth of the face and the jaws, and the positioning of the teeth in the dental arches and the occlusion. Diagnostics, preventive treatment, and treatment of congenital or acquired malocclusions are included. Orthodontic treatment requires the use of fixed or removable orthodontic appliances to affect the jaws and their growth and to move teeth that are incorrectly positioned so that the dental arch fits betters with the “ideal” or “normal” occlusion. Orthodontic treatment can be carried out for functional reasons, providing the patient with a functionally improved bite, but it can also be carried out for purely aesthetic reasons, solely improving the general appearance of a patients' teeth and face. Orthodontic deviations seldom represent pathological conditions. Exceptions are when they form a subpart of congenital craniofacial deviations (e.g. congenital malformations or dysmorphic syndromes), or other oral handicapping conditions like cleft lip and palate or oligodontia. 1.2 HISTORICAL BACKGROUND Although 'modern' orthodontics with fixed appliances has its direct roots from the end of the 19 th century in the United States of America, archaeological excavations in Etruscan settlements lead to the discovery that orthodontic devices were already used in that era. While in the United States of America orthodontics was already defined and close to licensing as a specialisation of dentistry by the end of the 19 th century (first by Bonwill and later by E.H. Angle, who was well known through his article The Classification of Malocclusion in The Dental Cosmos of 1899). Parallel to this evolution, 'modern' orthodontics was also being developed in Europe by some visionaires like Andresen, Haupl, Petrik, Balters ... It would however take until after World War II before the first legal licensings became a fact in Europe, like this was the case in 1953 for orthodontics in The Netherlands. It was probably due to Edward H. Angle and due to favourable circumstances and coincidences that fixed appliances (with brackets) and headgears (extra-oral appliances) were first developed in the USA, while removable and functional appliances were being developed in "the old world" (Europe). A number of European pioneers, after having received an education in predominantly removable appliance therapy in Europe, after the WW II went to the USA, where they learned to work with fixed appliances and brought this back to "the old continent". Since then, extra-oral and functional appliances are often combined and in the meanwhile the education in all types of orthodontic treatment procedures in the European education centres have become at least as competitive as the education in the USA. Also, many new technological advances (e.g. intra-osseous anchorage systems, in - and onplants,...) have been introduced in the field. 1.3 IMPORTANCE OF THE STUDY In 2005, 6% of the dental care budget was spent on orthodontic care or 0.18% of the total national health insurance expenditures. From 1995 to 2005, national health insurance expenditures on orthodontics have increased by 56% from €19.8 million in 1995 to €30.9 million in 2005 (a compound annual growth rate of 4.6%). In the same period, the total expenditures for all RIZIV/INAMI nomenclature have increased by 64% from €10.2 billion in 1995 to €16.8 billion in 2005 (a compound annual growth rate of 5.1%). In order to investigate whether these public funds are well spent, it is the aim of this study to provide a comprehensive overview of the current evidence regarding orthodontics for children and young adolescents (for which patients can we speak of actual medical treatment need and for which patients is orthodontics a rather aesthetic matter?) and to analyze the current situation and practices of orthodontics in Belgium, compared to other countries.
Page 1 and 2: Orthodontie chez les enfants et ado
Page 3 and 4: Orthodontie chez les enfants et ado
Page 5: Comment citer ce rapport ? Carels C
Page 8 and 9: ii Orthodontie KCE Reports 77B OBJE
Page 10 and 11: iv Orthodontie KCE Reports 77B Tout
Page 12 and 13: vi Orthodontie KCE Reports 77B RECO
Page 15 and 16: KCE Reports 77 Orthodontics 1 Table
Page 17 and 18: KCE Reports 77 Orthodontics 3 3.8.6
Page 19 and 20: KCE Reports 77 Orthodontics 5 7.13
Page 21 and 22: KCE Reports 77 Orthodontics 7 OIIRR
Page 23: KCE Reports 77 Orthodontics 9 Erupt
Page 27 and 28: KCE Reports 77 Orthodontics 13 The
Page 29 and 30: KCE Reports 77 Orthodontics 15 Devi
Page 31 and 32: KCE Reports 77 Orthodontics 17 Thes
Page 33 and 34: KCE Reports 77 Orthodontics 19 Orth
Page 35 and 36: KCE Reports 77 Orthodontics 21 EMBA
Page 37 and 38: KCE Reports 77 Orthodontics 23 Figu
Page 39 and 40: KCE Reports 77 Orthodontics 25 2.3
Page 41 and 42: KCE Reports 77 Orthodontics 27 prim
Page 43 and 44: KCE Reports 77 Orthodontics 29 2.3.
Page 45 and 46: KCE Reports 77 Orthodontics 31 this
Page 47 and 48: KCE Reports 77 Orthodontics 33 Howe
Page 49 and 50: KCE Reports 77 Orthodontics 35 No s
Page 51 and 52: KCE Reports 77 Orthodontics 37 Also
Page 53 and 54: KCE Reports 77 Orthodontics 39 In t
Page 57 and 58: KCE Reports 77 Orthodontics 43 The
Page 59 and 60: KCE Reports 77 Orthodontics 45 CLAS
Page 61 and 62: Netherlands UK Sweden KCE Reports 7
Page 63 and 64: KCE Reports 77 Orthodontics 49 Pold
Page 65 and 66: KCE Reports 77 Orthodontics 51 Corr
Page 67 and 68: KCE Reports 77 Orthodontics 53 In t
Page 69 and 70: KCE Reports 77 Orthodontics 55 Meas
Page 73 and 74: KCE Reports 77 Orthodontics 59 Conc
Page 75 and 76:
KCE Reports 77 Orthodontics 61 •
Page 77 and 78:
KCE Reports 77 Orthodontics 63 3.3.
Page 79 and 80:
KCE Reports 77 Orthodontics 65 3.4
Page 81 and 82:
KCE Reports 77 Orthodontics 67 Orth
Page 83 and 84:
KCE Reports 77 Orthodontics 69 Ther
Page 85 and 86:
Page 87 and 88:
KCE Reports 77 Orthodontics 73 Thos
Page 89 and 90:
KCE Reports 77 Orthodontics 75 Tabl
Page 91 and 92:
Page 93 and 94:
KCE Reports 77 Orthodontics 79 Dent
Page 95 and 96:
KCE Reports 77 Orthodontics 81 Thes
Page 97 and 98:
KCE Reports 77 Orthodontics 83 In S
Page 99 and 100:
KCE Reports 77 Orthodontics 85 A pr
Page 101 and 102:
Page 103 and 104:
Page 105 and 106:
KCE Reports 77 Orthodontics 91 RATI
Page 107 and 108:
KCE Reports 77 Orthodontics 93 LICE
Page 109 and 110:
KCE Reports 77 Orthodontics 95 12 1
Page 111 and 112:
KCE Reports 77 Orthodontics 97 1,6
Page 113 and 114:
Page 115 and 116:
KCE Reports 77 Orthodontics 101 400
Page 117 and 118:
KCE Reports 77 Orthodontics 103 AVE
Page 119 and 120:
KCE Reports 77 Orthodontics 105 REI
Page 121 and 122:
KCE Reports 77 Orthodontics 107 CON
Page 123 and 124:
KCE Reports vol Orthodontics 109 3.
Page 125 and 126:
KCE Reports 77 Orthodontics 111 4 B
Page 127 and 128:
KCE Reports 77 Orthodontics 113 The
Page 129 and 130:
KCE Reports 77 Orthodontics 115 Loo
Page 131 and 132:
Page 133 and 134:
KCE Reports 77 Orthodontics 119 Tab
Page 135 and 136:
Page 137 and 138:
Page 139 and 140:
Page 141 and 142:
Page 143 and 144:
Page 145 and 146:
Page 147 and 148:
Page 149 and 150:
Page 151 and 152:
Page 153 and 154:
Page 155 and 156:
Page 157 and 158:
KCE Reports 77 Orthodontics 143 Ort
Page 159 and 160:
Page 161 and 162:
KCE Reports 77 Orthodontics 147 It
Page 163 and 164:
KCE Reports 77 Orthodontics 149 The
Page 165 and 166:
KCE Reports 77 Orthodontics 151 For
Page 167 and 168:
Page 169 and 170:
KCE Reports 77 Orthodontics 155 A n
Page 171 and 172:
KCE Reports 77 Orthodontics 157 In
Page 173 and 174:
Page 175 and 176:
KCE Reports 77 Orthodontics 161 AAN
Page 177 and 178:
Page 179 and 180:
Page 181 and 182:
Page 183 and 184:
KCE Reports 77 Orthodontics 169 If
Page 185 and 186:
KCE Reports 77 Orthodontics 171 Wit
Page 187 and 188:
Page 189 and 190:
Page 191 and 192:
KCE Reports 77 Orthodontics 177 35.
Page 193 and 194:
KCE Reports 77 Orthodontics 179 71.
Page 195:
Page 198 and 199:
Dépôt légal : D/2008/10.273/21
Page 200 and 201:
35. Etude relative aux coûts poten
show all

The report is available in English with a a French summary - KCE

Create successful ePaper yourself

Delete template?

Save as template?