Languages
Pages
Legal
Treatment
Page 2
Definition:
Is the treatment provided to a patient during the mixed dentition and occasionally late primary dentition (6-12 years). “Preventive and interceptive orthodontics” were terms used in the past to describe orthodontic treatment in children.
Page 3
Benefits of early treatment:
1)Influence jaw growth in positive manner.
2)Harmonize width of dental arches.
3)Improve eruption patterns.
3)Lower risk of trauma.
4)Correct bad oral habits.
5)Improve esthetics.
6)Shorten and simplify treatment.
7)Reduce impaction.
8)Improve speech problems.
9)Preserve or gain space.
Page 4
Clinical problems include
Dento-alveolar problems(non-skeletal)
-Space problems.
-Eruption problems.
-Occlusal RS.
Skeletal problems:
-Skeletal (cl.II & III).
-Skeletal posterior
crossbite.
-Skeletal openbite.
Page 5
Treatment
Dento-alveolar problems:
Space problems’ treatment include:
A) Space maintenance.
B) Space loss treatment.
C) Spacing treatment.
Page 6
A- Space maintenance
Space maintenance for missing primary teeth with adequate space.
- Indicated in:
1- Adequate space.
2- All unerupted teeth present.
3- More than six-month delay before successor erupt.
Page 7
Appliances include:
1) Band and loop space maintainers
Page 8
- Indicated when E is lost before
the eruption of 6.
- The shoe will guide the
eruption of the first molar
preventing it from occupying
the space of the second molar.
2) Distal shoe space maintainer:
Page 9
3) Lingual arch space maintainer
Indicated when multiple posterior teeth are missing.
Page 10
4) Partial denture
Indicated for bilateral posterior space maintenance with loss of 1ry incisors (esthetics).
Page 11
B) Space loss treatment
Crowding could be due to:
- Space deficiency.
or - Space loss.
Page 12
ManagementManagement of space deficiencyof space deficiency
Moderate(3-5mm)
��Arch expansion
Severe(5-9mm)
Expansion/Extraction
V.Severe(7-10mm)
Serial extraction
Mild(2-3mm)
Interproximal reduction ofB & C
Minimal(<2mm)
No treatment
Page 13
Arch expansion for moderate crowding
Removable expansion appliance with screw
Fixed W-arch expansion appliance
Page 14
Serial extraction
Def:
“Is an interceptive measure in the form of a planned sequence of tooth removal to reduce crowding. It is done during the transition from 1ry to permanent dentition.”
Page 15
•Criteria for serial extraction:
1)No skeletal Discrepancy.
2)Class I molar RS.
3)Normal overbite.
4)Space deficiency of 10mm or more.
5)No congenitally missing teeth.
Page 16
CLASS I MIXED DENTITIONSEVERE CROWDINGSERIAL EXTRACTION
PRETREATMENT
ORTHOGNATHICSTRAIGHT/SLIGHTLY CONVEXLIPS RELAXED
Page 17
SERIAL EXTRACTION
PRETREATMENTMIDDLE MIXED DENTITIONCLASS IAVERAGE OVERJET+
ANTERIOR CROSSBITEAVERAGE OVERBITEPOSTERIOR CROSS-BITE(RIGHT MOLARS)
Page 18
POSTERIOR MOLAR CROSSBITE(RIGHT SIDE)MIDLINES COINCIDE
SEVERE CROWDING-MAXILLARY ARCHMOLAR ROTATION
SERIAL EXTRACTION
Page 19
SERIAL EXTRACTION
SEVERE CROWDINGMANDIBULAR ARCH
EXCESSIVE CURVE OF SPEE(DEEP OVERBITE)
Page 20
SERIAL EXTRACTION
INTRA-ORAL (PERI-APICAL)RADIOGRAPHS
CEPHALOMETRICRADIOGRAPH
Page 21
SERIAL EXTRACTION
PROGRESSPRIMARY CANINES EXTRACTEDAWAITING ERUPTION OF FIRST PREMOLARS
Page 22
SERIAL EXTRACTION
FIRST PREMOLARS ERUPTING
Page 23
SERIAL EXTRACTION
INTRA-ORAL RADIOGRAPHS
PROGRESS
Page 24
SERIAL EXTRACTION
EXTRACTION OF FIRST PREMOLARSAND ERUPTION OF CANINES
LOWER LINGUAL HOLDING ARCH
Page 25
Management of space loss(space regaining)
Localized space loss (3mm or less):
*Maxillary include:
-Removable/fixed space regainer appliance.
-Headgear.
*Mandibular include:
-Lingual arch.
-Lip bumper
Page 26
Maxillary space regainers
a) Removable space regainer
b) Fixed space regainer
Page 27
c) High-pull headgear
Page 28
Mandibular space regainers
a) Lingual arch
Page 29
b) Lip bumper
Page 30
CREATE SPACEHOLD/DISTALIZE LOWER MOLARADVANCE INCISORSTRANSVERSE EXPANSION (DENTAL)
MANDIBULAR LIP BUMPER
Page 31
CREATE SPACEDISTALIZE UPPER MOLAR
SPACE LOSSPENDULUM APPLIANCEUNILATERAL/BILATERAL
POST TREATMENTNANCE HOLDING ARCH
Page 32
PENDULUM APPLIANCE-Unilateral
Page 33
TRANSPALATALBAR- Unilateral
REMOVABLEAPPLIANCE-Sectional screw
Page 34
Space loss >3mm:
Extraction should be evaluated against space
regaining. Consultation with orthodontist is
necessary.
Page 35
Page 36
Page 37
Anterior dentoalveolar crossbite
Caused by:
- Over retention of upper 1ry incisor.
- Lack of space.
- Lingual development of permanent incisor
tooth bud.
Must be ttt as soon as diagnosed.
Page 38
Treatmentof cross-bite
Removable appliancewith finger spring
Removable appliancewith finger spring
If space inadequate;Space regaining then crossbite
correction
If space inadequate;Space regaining then crossbite
correction
Page 39
Cross-bite appliance with double palatal spring (arrow)
Pre-treatment
Post-treatment
Page 40
Transverse RS problems
Causes:
- Cheek sucking habit.
- Mouth breathing habit.
Treatment:
- Removable appliance with acrylic plate
with screw.
- Fixed appliance (W- arch).
Page 41
Removable appliance with screw
Unilateral posterior cross-bite
Page 42
5 MONTHS
2 TURNS/WEEK
Page 43
MAXIMUM INTERCUSPATION
INITIAL CONTACT POSITION
TRANSVERSE DIMENSIONRIGHT UNILATERAL POST. CROSSBITEFUNCTIONAL SHIFT
Page 44
DENTAL+?SKELETAL EXPANSIONQUADHELIX EXPANDER
FIXED BANDS AND REMOVABLE WIRE
Page 45
DENTAL+?SKELETAL EXPANSIONREMOVABLE EXPANDER
FULL COVERAGE ACRYLICCLASPSMIDLINE EXPANSION SCREW
EXPANSION KEY
Page 46
FIXED ACRYLICEXPANDER
Page 47
Vertical RS
Page 48
Anterior openbite
Caused by finger sucking habit
Is the failure of anterior teeth to
overlap
Page 49
Fixed habit breaking appliance
Top Related