What is a Diastema? Under normal circumstances, the upper jaw teeth slightly cover the lower jaw teeth. In a few cases, the lower jaw teeth cover the upper jaw teeth, and this is called “ingrown teeth”. There are two types of “geodontia”: true (i.e. bony geodontia) and pseudo (functional or dental) geodontia, but here we will focus on bony geodontia. In true bony cases, the patient often has a long chin and a concave face, which is unattractive. In addition, the occlusion is not normal, which can affect the chewing function. This is why “ingrowth” should be treated. The early treatment of “Geodesic” is divided into three categories of common misshapen jaws, and Geodesic is the third category, which is also the most difficult to treat. Some orthodontists, called the orthodontic emergency, that is to say, it should be treated early. Generally, malocclusion is treated in the late alternate teeth and early permanent teeth (9 to 14 years old, see my other popular article: “Basic knowledge of orthodontics (2): the age of orthodontic patients”), while “encrustation” should be considered for treatment as soon as it is found. The first thing to do is to remove the bad habits that caused the “geodesic”, such as biting the upper lip, bad breastfeeding posture, etc.. Active treatment can be done after the age of three, as long as the child is more compliant. After the age of 3 and before the age of 6, when the child has not yet started to change teeth, is a better time for orthodontic treatment, but after the age of 6, when the child starts to change teeth, the treatment is sometimes interfered with by the change of teeth, which can be a bit troublesome. This early treatment, called Phase I treatment, can generally be lifted in 6 months to a year, after which it should be reviewed regularly to see if there is a recurrence so that timely action can be taken. In most cases, after the replacement teeth are completed, the second stage of treatment should be carried out, which is to further treat the eruption, align the upper and lower teeth, and fine-tune the bite in order to achieve a stable result. In a small number of patients, or in cases where the condition itself is more severe, or where severe relapses occur despite the above-mentioned treatment and cannot be controlled by outpatient orthodontic treatment alone, only post-adult surgical treatment is available. In addition, it should be noted that some doctors also believe that since bony geodesis is so difficult to treat and the possibility of recurrence is crucial, it is better to leave it alone and let it develop naturally, and wait until adulthood (usually 18 years old) or combined orthodontic surgery or orthodontic treatment alone. This is still controversial in academic circles. Recent international and national studies have shown that timely treatment of bony clubfoot before the age of 10 will greatly reduce the likelihood of reconstructive surgery later. About a dozen percent of the patients with geodesic asthma can eventually only be treated surgically. Second, the treatment of adult ingrowth If the ingrowth is not treated as a child, or the results are poor. Treatment is still possible in adults. Mild bony ingrowns can be treated with non-surgical dental substitution. Severe cases are treated with orthognathic surgery. This surgery is usually performed in three steps, with the combination of two departments (orthodontics and orthognathic surgery): the first step is a joint consultation between the two departments to develop a treatment plan and complete the alignment of the teeth in the orthodontics department; this step will take 6 to 12 months depending on the condition, and in severe cases it may take longer. The second step is hospitalization for surgery, which takes about two weeks. The third step is to return to the orthodontics department to continue treatment (about 6 months). The majority of patients who undergo orthognathic surgery are treated for a year and a half to two years. It is important to note that a number of patients do not understand why orthodontic treatment is necessary for the majority of surgeries for geodontia. This is because patients with severe diastemas also have abnormalities in the dentition. The most common ones are the labial tilt of the upper anterior teeth and the lingual tilt of the lower anterior teeth, which are the natural compensatory behaviors of the body for the bony irregularities, and these compensations should be removed by orthodontics before surgery (surgery itself cannot solve the dental compensations), in order to reveal the real bony problems and facilitate a perfect solution of the surgery. In addition, patients with diastemas can also have problems such as posterior zone width imbalance and misalignment of teeth. These problems cannot be solved surgically either, but can only be dealt with by orthodontics. In a sense, orthodontics is the solution to the dental problem and surgery is the solution to the bone problem. Some people may ask, can I solve only the bone problem without solving the dental problem? The answer is that it is more difficult. Because the teeth are not aligned to the ideal position, it is difficult to form a good occlusal relationship with surgery, and it is difficult to solve the bony problems. In clinical practice, the percentage of cases where standardized orthognathic treatment can be directly operated without orthodontic treatment is very small. Finally, I would like to suggest 4 points to the patients with “Diastemas”: 1, “Diastemas” are found and treated early. 2. If you have parents with “geodesic”, please pay close attention to your children. 3. or adolescents, do not easily do tooth extraction in lieu of treatment, so as not to lead to irreparable problems. 4. At present, there are very few hospitals in China that can perform orthognathic surgery, so patients and parents should be cautious.