14 to 17 years old – permanent dentition
Image adapted from CDC Gov.
Patients in this age group are normally just past their peak pubertal growth or have completed puberty. These patients are often most conscious about their self-appearance and they will actively seek orthodontic treatment. The full range of orthodontic problems need to be assessed in every patient of this age group and they should be addressed as comprehensively as possible.
Orthopaedic treatment may still be possible in selected cases. Late developers for mandibular growth may still have beneficial Class II orthopaedic treatment. Palatal expanders bonded to teeth may still work in some patients however less skeletal expansion and more dental expansion is to be expected. There is increasing evidence of TAD-based palatal expanders generating significant skeletal expansion with little adverse dental tipping in this age group.
Jaw surgeries for growth deficiency malocclusions (e.g. hypoplastic mandible Class II) can be considered in this younger age group, however jaw surgeries for growth excess (e.g. hyperplastic mandible Class III or long face) should be delayed until growth is completed in adulthood.
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