Interceptive Orthodontics

Interceptive Orthodontics

in Preadolescent Children

!"#$%&!'&!#(#)%*+!,&--.$!/%0123"4,&-123"56!

Friday, February 4, 2011

© Shadi S

amawi 2

011

The Purpose Of This Presentation..

7&85.92.:".28&;9&;23";$;<3%/&%<3.2/.=3%>.&

/;</.=3:&?&32.#3(.<3&(;$#@%3%.:&%<&

=2.#$;@.:/.<3&/"%@$2.<'


© Shadi S

amawi 2

011

Aims..

A !"#$%"&'()*+,-#.%(/0%(-%%)(1#"(2+-+,%2%-/(#1(/0%()%3%&#$*-,(#44&5.*#-

A 6-#7(/0%(*-)*4+/*#-.(+-)(4#-/"+*-)*4+/*#-.(#1(3+"*#5.(*-/%"4%$/*3%(2%+.5"%.8(/"%+/2%-/(2#)+&*/*%.(9(+$$&*+-4%.:


© Shadi S

amawi 2

011

Concept

"Guidance of the development of the dentition through minimal intervention, with the aim of preventing, reducing or correcting existing or potential abnormal tooth positions."

F. Van der Linden Orthodontic Concepts and Strategies. 2004


© Shadi S

amawi 2

011

Concept

"Any treatment procedure which eliminates or reduces the severity of a developing malocclusion, as this may reduce the need for further treatment or make it simpler."

Chung CK & Kerr WJ. 1987 Interceptive orthodontics: application and outcome in a demand population.

BDJ, 162;73-76


© Shadi S

amawi 2

011

!B/"&CB%$#</.&:";B@$&/;<32%DB3.&3;&3".&

$.>.@;=(.<3&;9&#&=.2(#<.<3&$.<3%3%;<&

3"#3&%:&%<&#&"#2(;<%;B:,&9B</3%;<#@&#<$&

.:3".3%/#@@E&#//.=3#D@.&;//@B:%;<'


© Shadi S

amawi 2

011

Limitation

“ .. Interceptive treatment can be very helpful in reducing the severity of problems, but rarely is so successful that later stages of treatment are unnecessary ! ”

William R. Proffit “Contemporary Orthodontics”


© Shadi S

amawi 2

011

Timing

The Late Mixed Dentition Stage ?

A ;%%7+'(.$+4%.(./*&&($"%.%-/::

A <+-'(4+.%.(2+'(./*&&(=%(/"%+/%)(#-(+(-#->%?/"+4/*#-(=+.*.(

A @/*&*A+/*#-(#1(B"#7/0

A C0#"/%"(#3%"+&&(/"%+/2%-/(/*2%D(*:%E(F-%>!0+.%

Bjork, TEOS, 1972Nimri & Richardson, BJO, 1997


© Shadi S

amawi 2

011

Advantages Of Early Tx

A F:E/";G:;/%#@&#$>#<3#C.:'&Shaw et al, BJO, 1980

A 5.$B/.&;9&2%:H&;9&%</%:;2&;2&C%<C%>#@&32#B(#'&Todd & Dodd, HMSO, 1985

A I(=2;>.$&6;;=.2#3%;<'

A 62#<%;9#/%#@&3%::B.:&(;2.&(#@@.#D@.&J


© Shadi S

amawi 2

011

Drawbacks Of Early Tx

A K;::&;9&=#3%.<3&/;;=.2#3%;<&LL&F2;@;<C.$&MNO

A PN32#/3%;<&/";%/.&%:&$%99%/B@3&)"%@:3&E;B<C'

A K#3.&:;93&3%::B.&(#3B2%3E&#<$&/;<3%<B.$&C2;)3"'&Vig & Cohen, AJO, 1979

A K;::&;9&(;:3&#2/"&@.<C3"&C#%<:&)".<&%<&=.2(#<.<3&$.<3%3%;<'&Little et al, AJODO, 1990


© Shadi S

amawi 2

011

Diagnostic Knowledge

Q;2(#@&[email protected]#@&?&+.<3#@&+.>.@;=(.<3

P#2@E&5./;C<%3%;<&;9&7D<;2(#@%3%.:

7<3%/%=#3%;<&;9&F;3.<3%#@&RB3B2.&6;(=@%/#3%;<:


© Shadi S

amawi 2

011

What is "Normal" Anyway??Friday, February 4, 2011

© Shadi S

amawi 2

011

" The Dental Norm "

A 6;([email protected].&$./%$B;B:&$.<3%3%;<&

A -%@$&:=#/%<C&G&F2%(#3.&:=#/%<C'

A R@B:"G3.2(%<#@&2.@#3%;<:"%=&;9&P:'

A P$C.G.$C.&%</%:;2&2.@#3%;<:"%=&0@#3.2&:3#C.:4

A Q;&62;::GD%3.:'

G"#5-)(G,%(H>I


© Shadi S

amawi 2

011

" The Skeletal Norm "

A 6@#::&I&:[email protected]#@&=#33.2<&8#==.#2#</.8''

A Q;&>.23%/#@,&32#<:>.2:.&<;2&7<3.2;G=;:3.2%;2&$%:/2.=#</%.:'


© Shadi S

amawi 2

011

"The Functional Norm"

A Q;2(#@&:)#@@;)%<C&D."#>%;2'

A Q#:#@&D2.#3"%<C'

A R2..&92;(&"#D%3:S&3"B(D&;2&$%C%3&:B/H%<C,&3;<CB.G3"2B:3%<C,&.3/''


© Shadi S

amawi 2

011

Indications J#"(

F"/0#)#-/*4(K-/%"4%$/*#-


© Shadi S

amawi 2

011

Types of Problems

A [email protected]#@L

A M2#<:>.2:.&=2;D@.(:

A T.23%/#@&=2;D@.(:

A 7GF&=2;D@.(:

A 6;(D%<.$&=2;D@.(:

A R#/%#@&7:E((.32E

A L%-/#>#@>.;@#2E

A P2B=3%;<&=2;D@.(:

A P/3;=%/&.2B=3%;<

A !=#/.G2.@#3.$&=2;D@.(:

A 1//@B:#@&=2;D@.(:


© Shadi S

amawi 2

011

Eruption Problems

U'1>.2G2.3#%<.$&F2%(#2E&M..3"

''&(#E&/#B:.&

$.9@./3.$&.2B=3%;<&

=#3":&2.:B@3%<C&%<&

/2;)$%<C&#<$V;2&

@;/#@%W.$&/2;::GD%3.:'


© Shadi S

amawi 2

011

Eruption Problems

U'1>.2G2.3#%<.$&F2%(#2E&M..3"

G(!%"2+-%-/(/##/0(.0#5&)("%$&+4%(*/.(

$"%)%4%..#"(70%-(MNO(#1(*/.("##/(0+.(1#"2%):

Proffit, 2007


© Shadi S

amawi 2

011

Eruption Problems

U'1>.2G2.3#%<.$&F2%(#2E&M..3"

-#<#C.(.<3L

P?/"+4/*#-(#1(#11%-)*-,($"*2+"'(/##/0N/%%/0:

*XML

M#H.&5#$%;C2#="&RI5!MO


© Shadi S

amawi 2

011

Eruption Problems

Y'!B=.2<B(.2#2E&M..3"

A Z[\&%<&#<3.2%;2&(#N%@@#,&DiBiase, 1969

A 6#B:.&:=#/%<C&0(%$@%<.&$%#:3.(#4&%<&ZU\&;9&/#:.:,&Ranta, 1986

A +.@#E.$&.2B=3%;<&;9&#<3.2%;2&3..3"&=#23%/B@#2@E&/.<32#@&%</%:;2:'

A !%<C@.&0(#E&.2B=34&;2&(B@3%=@.&0B<@%H.@E&3;&.2B=34


© Shadi S

amawi 2

011

Eruption Problems

]'!B=.2<B(.2#2E&M..3"

I' !%(=@.&6#:.:L

A -#<#C.(.<3& %<>;@>.:&. N 3 2 # / 3 % ; <& ; 9& 3 " .&:B=.2<B(.2#2E& 3;;3"& %9&:B=.29%/%#@& ;2& .2B=3.$,&) % 3 " ; B 3& # 9 9 . / 3 % < C&#$^#/.<3&3..3"'


© Shadi S

amawi 2

011

Eruption Problems

Y'!B=.2<B(.2#2E&M..3"

II' 6;(=@%/#3.$&6#:.:L

A -#<#C.(.<3&(#E&%<>;@>.&8'''&$.@#E%<C&.N32#/3%;<&;9&3".&:B=.2<B(.2#2E&3;;3"&0;2&3..3"4&B<3%@&/;<3%<B.$&C2;)3"&"#:&%(=2;>.$&D;3"&#//.::&#<$&/"%@$_:&#D%@%3E&3;&3;@.2#3.&:B2C.2E8

Proffit, 2007


© Shadi S

amawi 2

011

Eruption Problems

Y'!B=.2<B(.2#2E&M..3"

As a General Rule:The earlier the supernumerary teeth are

removed, the more likely normal teeth will erupt without intervention.


© Shadi S

amawi 2

011

Eruption Problems

]'+.@#E.$&I</%:;2&P2B=3%;<

A 1>.2G2.3#%<.$&=2%(#2E&%</%:;2:

A !B=.2<B(.2#2E&3..3"

A M"%/H.<%<C&;9&;>.2@E%<C&H.2#3%<%W.$&3%::B.&%<&@;<CG:3#<$%<C&.$.<3B@;B:&:=#/.:'

DiBiase D., 1970


© Shadi S

amawi 2

011

Eruption Problems

]'+.@#E.$&I</%:;2&P2B=3%;<

A -#<#C.(.<3L

A !B=.29%/%#@L&!%(=@.&:;93&3%::B.&%</%:%;<

A +..=.2L&7=%/#@@EG2.=;:%3%;<.$&9@#=&#<$&/2;)<&.N=;:B2.'''

A T.2E&+..=L&PN=;:B2.&#<$&;23";$;<3%/&32#/3%;<&)%3"&D;<$.$&#33#/"(.<3&0=2.9.2#D@E&#&C;@$G/"#%<&#33#/"(.<34'''


© Shadi S

amawi 2

011

Surgical Exposure & Orthodontic Traction


© Shadi S

amawi 2

011

Eruption Problems

`'7<HE@;:.$&F2%(#2E&M..3"

A !%(%@#2&.99./3:&3;&#<E&;>.2G2.3#%<.$&=2%(#2E&3;;3"

A -#<#C.(.<3&$.=.<$:&;<&)".3".2&=.2(#<.<3&:B//.::;2&%:&=2.:.<3&;2&<;3''


© Shadi S

amawi 2

011

Eruption Problems

`'7<HE@;:.$&F2%(#2E&M..3"

A !B//.::;2&=2.:.<3L&

(#%<3#%<&B<3%@&%<3.29.2.</.&)%3"&.2B=3%;<&;2&$2%93%<C&;9&#$^#/.<3&3..3"&;//B2:,&3".<&.N32#/3&#<$&=@#/.&:=#/.G(#%<3#%<.2&;2&9%N.$&#==@%#</.:'


© Shadi S

amawi 2

011

Eruption Problems

`'7<HE@;:.$&F2%(#2E&M..3"

A !B//.::;2&<;3&=2.:.<3L&

PN32#/3&#<HE@;:.$&3;;3"&D.9;2.&#&@#2C.&>.23%/#@&;//@B:#@&$%:/2.=#</E&;//B2:,&#<$&3;&#>;%$&@;<CG3.2(&=.2%;$;<3#@&=2;D@.(:&JJJ

Kurol & Thilander, 1984Angle Orthodontist


© Shadi S

amawi 2

011

Eruption Problems

`'7<HE@;:.$&F2%(#2E&M..3"

A !B//.::;2&<;3&=2.:.<3L&

<#"%("%4%-/&'8(7*/0(/0%(+)3+-4%2%-/.(*-(K2$&+-/(L%-/*./"'E(

<+*-/%-+-4%(#1(/0%(+-Q'&#.%)($"*2+"'(/##/0D

>(K1(-#(.5=2%",%-4%(#"(#44&5.+&(*-/%"1%"%-4%.(%3*)%-/:

>(K1(/0%'(+"%(1*"2(9(-#/("%.#"=*-,(='(/0%2.%&3%.R

>(K1(#44&5.*#-(9(.Q%&%/+&($+//%"-($%"2*/:


© Shadi S

amawi 2

011

Ankylosed Primary 2nd Molars


© Shadi S

amawi 2

011

Ectopic Eruption

''&a".<&#&=.2(#<.<3&3;;3"&/#B:.:&2.:;2=3%;<&;9&#&=2%(#2E&3;;3"&%3&%:&<;3&

:B==;:.$&3;&2.=@#/.&

15&

2.:;2=3%;<&;9&#<&#$^#/.<3&=.2(#<.<3&3;;3"'


© Shadi S

amawi 2

011

Ectopic Eruption

U'K#3.2#@&I</%:;2:

A S%.#"$/*#-(#1($"*2+"'(4+-*-%.(*.(4#22#-

A ;#..(#1(#-%(#"(=#/0($"*2+"'(4+-*-%.(/0*.(7+'(*-)*4+/%.(+(&+4Q(#1(.$+4%(1#"(+&&($%"2+-%-/(*-4*.#".(*-(2#./(4+.%.:

A C$+4%(2+*-/%-+-4%(9N#"(=+&+-4*-,(%?/"+4/*#-.(5.5+&&'(-%%)%)(/#($"%3%-/(2*)&*-%(.0*1/.(+-)(15"/0%"(.$+4%(&#..


© Shadi S

amawi 2

011

Ectopic Eruption

Y'-#N%@@#2E&R%2:3&-;@#2:

A L5%(/#(.2+&&8()*./+&&'>&#4+/%)(2+?*&&+(T

A C/%%$&'(+-,5&+/%)(&+",%($%"2+-%-/(U./(2#&+".(T(Pulver, J Dent Child, 1968

A V#(.Q%&%/+&("%&+/*#-.0*$.(1#5-)T(Bjerklin & Kurol, Am J Orthod, 1983


© Shadi S

amawi 2

011

Ectopic Eruption

Y'-#N%@@#2E&R%2:3&-;@#2:

A F=.%"3+/*#-

A I9&<;&;2&:(#@@&#(;B<3&;9&P&2.:;2=3%;<

A K-/%"3%-/*#-

A *@;/H#C.&=.2:%:3.<3&b&c&(;<3":

A 5.:;2=3%;<&%</2.#:%<C'''


© Shadi S

amawi 2

011

Ectopic Eruption

K#/H&;9&3%(.@E&%<3.2>.<3%;<&(#E&/#B:.&@;::&

;9&=2%(#2E&Y-)&(;@#2&#<$&/;<:%$.2#D@.&:=#/.&

@;::&#:&U./&=.2(#<.<3&(;@#2&.2B=3:&(.:%#@@E'


© Shadi S

amawi 2

011

Ectopic Eruption

Y'-#N%@@#2E&R%2:3&-;@#2:

A K-/%"3%-/*#-

A *2#::&)%2.&V&:3..@&:=2%<C&/@%=&V&.@#:3;(.2%/&:.=#2#3;2&(;$B@.:

A !.>.2.&/#:.:L&9%N.$&#==@%#</.:&)%@@&D.&<..$.$'


© Shadi S

amawi 2

011

Ectopic Eruption

]'-#N%@@#2E&6#<%<.:

A <#./(1"%W5%-/(%4/#$*4(%"5$/*#-($+//%"-:

A S%&+/%)(/#(.2+&&(N(2*..*-,(&+/%"+&(*-4*.#".

A S%&+/%)(/#(&#-,(/#"/5#5.($+/0(#1(%"5$/*#-

A C/"#-,(%3*)%-4%(#1(+(,%-%/*4(=+.*.

Baccetti TA. , Angle, 1998Brin et al, EJO, 1986


© Shadi S

amawi 2

011

Ectopic Eruption]'-#N%@@#2E&6#<%<.:

A <+*-($"#=&%2.E

A I(=#/3%;<&19&F.2(#<.<3&6#<%<.:&

A I</%$.</.&d&ZY&J&e&R0Zf\4&b&-0Z]\4

A F#@#3#@&0Z[g4&L&*B//#@&0ZUg4

A 5.:;2=3%;<&19&5;;3:&19&K#3.2#@&I</%:;2:&

A I<&ZUY&;9&/#:.:&e&R&b&-

Bishara SE , Semin Orthod, 1998 Ericson & Kurol , Angle, 1998Ericson & Kurol , AJODO, 1987Mossey et al, BJO, 1994


© Shadi S

amawi 2

011

Ectopic Eruption

]'-#N%@@#2E&6#<%<.:

A F!B(*-)*4+/%)(+/(G,%(X>UYE

A I9&=2%(#2E&/#<%<.:&<;3&(;D%@.,

A *B@C.&;9&=.2(#<.<3&/#<%<.:&<;3&>%:%D@.&;2&=#@=#D@.&@#D%#@@E&%<&3".&:B@/B:'

Ericson & Kurol , Commnity Dent Oral Epidemiol, 1986


© Shadi S

amawi 2

011

Ectopic Eruption

]'-#N%@@#2E&6#<%<.:

K1(/0%($%"2+-%-/(4+-*-%(4"#7-(#3%"&+$.(0+&1(#"(2#"%(#1(&+/%"+&(*-4*.#"("##/("+)*#,"+$0*4+&&'(

Ericson & Kurol , Eur J Orthod, 1988

High risk of resorption of lateral incisors root!


© Shadi S

amawi 2

011

Ectopic Eruption


Z(XU([0+-4%(F1(V#"2+&*A+/*#-

a".<&=.2(#<.<3&/#<%<.&/2;)<&;>.2@#==%<C&"#@9&;9&@#3.2#@&%</%:;2:&2;;3

-;:3&P99./3%>.&*.3)..<&7C.:&U\GU]

Interceptive Extraction Of Primary Canines:


© Shadi S

amawi 2

011

Ectopic Eruption


Interceptive Extraction Of Primary Canines:

Z(IO([0+-4%(F1(V#"2+&*A+/*#-

a".<&=.2(#<.<3&/#<%<.&/2;)<&;>.2@#==%<C&b&"#@9&;9&@#3.2#@&%</%:;2:&2;;3

-;:3&P99./3%>.&*.3)..<&7C.:&U\GU]


© Shadi S

amawi 2

011

U'P#2@E&K;::&19&+./%$B;B:&M..3"

A !"%2+/5"%(%?1#&*+/*#-

A !&+--%)(%?/"+4/*#-

A [+"*%.R(0#==2;N'&Zcf&%<&h;2$#<O4

Space-related Problems


© Shadi S

amawi 2

011

P#2@E&K;::&19&+./%$B;B:&M..3"

A P?/%-/(#1(*/.(%11%4/(*.("%&+/%)(/#E

A \0%(.*/%(#1(/##/0(&#..

A \0%(]+7

A !"%>%?*./*-,()%,"%%(#1(4"#7)*-,

A G,%



© Shadi S

amawi 2

011

Early Loss Of Deciduous Teeth

7i*

6

+

P

-.:%#@&+2%93 -%$@%<.&!"%93

??? ?


© Shadi S

amawi 2

011

!=#/.&-#%<3.<#</.V5.C#%<%<C

^+"*#5.(1*?%)(9("%2#3+=&%(.$+4%(2+*-/+*-%".;*-,5+&(+"40(N(V+-4%(_5//#-(N(J*?%)(G$$&*+-4%.(T


Management


© Shadi S

amawi 2

011


© Shadi S

amawi 2

011

Lip Bumper

O'Donell et al, Am J Orthod, 1998

Nevant et al, Am J Orthod, 1991


© Shadi S

amawi 2

011

Balancing Extractions

PN32#/3%;<&;9&3".&/;<32#@#3.2#@&3;;3"&%<&3".&:#(.&#2/"'

Space-related ProblemsManagement


© Shadi S

amawi 2

011

Compensating Extractions

PN32#/3%;<&;9&3".&;==;:%<C&3;;3"&%<&3".&;==;:%<C&#2/"'

Space-related ProblemsManagement


© Shadi S

amawi 2

011


Serial Extractions ?

A&!.jB.<3%#@&PN32#/3%;<&;9&6:,&+:&3".<&`:&)".<&.2B=3.$'

A&7%(:&3;&2.@%.>.&#<3.2%;2&/2;)$%<C''

Kjellgren, Acta Odonto Scand, 1948


© Shadi S

amawi 2

011


Indications for Serial Extractions

A&-%@$&3;&(;$.2#3.&7<3.2%;2&/2;)$%<CB<$&#C.&[Gk

A&6@#::&I&(#@;//@B:%;<

A&Q;2(#@&1>.2D%3.

A&7@@&=.2(#<.<3&3..3"&=2.:.<3&?&;9&C;;$&=2;C<;:%:

A&`:&#".#$&;9&]:&%<&.2B=3%;<


© Shadi S

amawi 2

011


Drawbacks of Serial Extractions

A&X<=2.$%/3#D@.&2.:B@3:O

A&!"%93:&/2;)$%<C&=;:3.2%;2@E

A&!.>.2#@&.=%:;$.:&;9&.N32#/3%;<&9;2&#&E;B<C&=#3%.<3

A&&R%N.$&#==@%#</.:&:3%@@&<..$.$&9;2&9%<%:"%<C&?&/;22./3%;<&

;9&#D<;2(#@&3;;3"&#<CB@#3%;<:&0.:=./%#@@E&/#<%<.:4

Stephens, Dent Update, 1989


© Shadi S

amawi 2

011


F"E:%;@;C%/#@&

7D<;2(#@&

Y'&-.$%#<&+%#:3.(#:

Zk[&;9&c&E.#2G;@$:

Z`k&;9&UU&E.#2G;@$:

Zf&;9&UYGU[&E.#2G;@$:


© Shadi S

amawi 2

011


A X=&3;&Y((''

A `@,&'(L54Q&*-,`(./+,%

A b&Y((''

A a'$#N<*4"#)#-/*+(T

A C5$%"-52%"+"'(/##/0(N(<%.*#)%-.(T

A ;#7>+//+40%)(#"(1&%.0'(J"%-52(T


© Shadi S

amawi 2

011


A 6@%<%/#@@E,&/"./HL

A _&+-40*-,(#1(*-4*.*3%($+$*&&+%(5$#-(./"%/40*-,(#1(/0%(5$$%"(&*$(T

A _#-'(-#/40(*-(*-4*.*3%(+"%+("+)*#,"+$0*4+&&'(T

Low-attachment frenum ?


© Shadi S

amawi 2

011


A L%/%"2*-%(%?+4/(%/*#&#,'(

A S%2#3%(+-'($0'.*4+&(#=./"54/*#-.T

A [&#.%(5.*-,("%2#3+=&%(#"(1*?%)(+$$&*+-4%.

A !#./>/"%+/2%-/(J"%-%4/#2'T

A S%/+*-(7*/0(=#-)%)("%/+*-%".

1B3@%<.&;9&+%#:3.(#:_&-#<#C.(.<3&


© Shadi S

amawi 2

011


]' 6;<C.<%3#@@EG-%::%<C&K#3.2#@&I</%:;2:

A&ZY&;9&=;=B@#3%;<

A&R#(%@%#@&3.<$.</E&9;2&(%::%<C&?&=.CG:"#=.$&@#3.2#@:

A&193.<&#::;/%#3.$&)%3"&./3;=%/&.2B=3%;<&;9&/#<%<.:

Zilberman et al, EJO, 1990Brin et al, EJO, 1986


© Shadi S

amawi 2

011


]' 6;<C.<%3#@@EG-%::%<C&K#3.2#@&I</%:;2:

A&F.2(#<.<3&/#<%<.&.2B=3:&%<&@#3.2#@&%</%:;2&=;:%3%;<

A&F.2(#<.<3&/#<%<.&.2B=3:&<;2(#@@E&#<$&=2%(#2E&

@#3.2#@&%</%:;2&2.3#%<.$'

Two Main Scenarios...


© Shadi S

amawi 2

011

Occlusal Problems

U'62;::D%3.:

A &+.<3#@&;2%C%<A&[email protected]#@&;2%C%<

A 7<3.2%;2A&F;:3.2%;2

7==2;N'&Zf'f&;9&=;=B@#3%;<

Q;3&:.@9G/;22./3%<C&#<$&.#2@E&%<3.2>.<3%;<&2.jB%2.$

Ninou & Stephens Dent Update, 1994


© Shadi S

amawi 2

011

A 7<3.2%;2&62;::D%3.

A 1<.&GM);&%</%:;2:&%<&/2;::D%3.&15&P$C.G.$C.&%</%:;2:

Occlusal Problems

+.<3#@&6;(=;<.<3&J7<3.2%;2&+%:=@#/.(.<3&J


© Shadi S

amawi 2

011

A 7<3.2%;2&62;::D%3.

A ]&;2&(;2.&%</%:;2:&%<&/2;::D%3.

Occlusal Problems

[email protected]#@&6;(=;<.<3LM2B.&6@#::&III


© Shadi S

amawi 2

011

U'62;::D%3.:

7&RB@@G/B:=&D%@#3.2#@&/2;::D%3.&%:&(;:3&@%H.@E&:[email protected]#@&%<&;2%C%<''

7&B<%@#3.2#@&=;:3.2%;2&/2;::D%3.&%:&(;:3&@%H.@E&$.<3#@&%<&;2%C%<&J

I9&(B@3%=@.&#<3.2%;2&3..3"&#2.&%<&/2;::D%3.,&

%3:&(;:3&@%H.@E&:[email protected]#@&%<&;2%C%<&%'.L&6@#::&III&J

Important Dif ferentiation Criteria

Proffit, 2007

Occlusal Problems


© Shadi S

amawi 2

011

U'62;::D%3.:

Should be corrected as early as possible.

Occlusal Problems

!+"/*45&+"&'(*-(/0%($"%.%-4%(#1(+()*.$&+4%2%-/:

Thilander et al, EJO, 1984Richardson A., Interceptive Orthodontics, 2nd Ed, 1989


© Shadi S

amawi 2

011

A(C%&%4/*3%(B"*-)*-,T

A(@SG(b<*)&*-%(P?$+-.*#-c

A(d5+)(a%&*?(#"(e>G"40

A(a'"+?(P?$+-.*#-(bS<Pc

Occlusal Problems

U'62;::D%3.:


© Shadi S

amawi 2

011

&!3#D%@%3E&;9&7<3.2%;2&/2;::D%3.&/;22./3%;<&

$.=.<$:&(#%<@E&;<&#/"%.>%<C&

#&l;;$&1>.2D%3.'

Occlusal Problems

Houston et al, 1993


© Shadi S

amawi 2

011

&!3#D%@%3E&;9&F;:3.2%;2&/2;::D%3.&

/;22./3%;<&$.=.<$:&(#%<@E&;<&#/"%.>%<C&

l;;$&*B//#@&I<3.2/B:=#3%;<'

Occlusal Problems

Houston et al, 1993


© Shadi S

amawi 2

011

Occlusal Problems

Harrison & Ashby, 2001 "Orthodontic Treatment of Posterior Crossbites"

Cochrane Database Systematic Review


© Shadi S

amawi 2

011

Y'&12#@&m#D%3:

Occlusal Problems

A&M"B(DVR%<C.2&!B/H%<C

A&M;<CB.&M"2B:3%<C&J

A&7D<;2(#@&!)#@@;)%<C&

*."#>%;2&J


© Shadi S

amawi 2

011

A M"B(DVR%<C.2&:B/H%<C

Occlusal Problems

@$(/#(H>I('%+".(#1(G,%

little or no Effect on permanent dentition and skeleton


© Shadi S

amawi 2

011

Occlusal Problems

I<&3".&-%N.$&#<$&F.2(#<.<3&+.<3%3%;<

A(@$$%"(K-4*.#"(!"#4&*-+/*#-

A(;#7%"(K-4*.#"(S%/"#4&*-+/*#-

A(F3%"=*/%(*:%E(G.'22%/"*4(GF_(

A(CQ%&%/+&()%3%&#$2%-/E

%'.L&-#N%@@#2E&6;<:32%/3%;<&#<$&F;:3.2%;2&62;::D%3.

A M"B(DVR%<C.2&!B/H%<C


© Shadi S

amawi 2

011

Skeletal Problems...

A M2#<:>.2:.&+%(.<:%;<

A T.23%/#@&+%(.<:%;<

A 7<3.2;G=;:3.2%;2&+%(.<:%;<

A 6;(D%<#3%;<:&19&1<.&12&-;2.&19&M".&7D;>.


© Shadi S

amawi 2

011

Recommended Reading

*(+,-&"./,$0$'(1$&2,3,-&%456(78(9$,::%&6(;<<=(+28(>;?>@

*(A$%5&,B(C-%#"$5%&'(D0-3E,,FG(9,5&H$03I0&"(J,&"5(%-(1$&2,3,-&%45

*(K%420$35,-(L86(M-&"$4"/&%#"(1$&2,3,-&%456(;-3(N36(>OPO


© Shadi S

amawi 2

011

Interceptive Orthodontics

Documents

Transcript of Interceptive Orthodontics