A to Z Orthodontics Vol 9 Preventive and Interceptive Orthodontics
Interceptive orthodontics - SRM University orthodontics ... – Jackscrew space regainer – Gerber...
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Transcript of Interceptive orthodontics - SRM University orthodontics ... – Jackscrew space regainer – Gerber...
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Interceptive orthodontics
Part II
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• Serial extraction
• Correction of developing cross bite
• Control of abnormal habits
• Space regaining
• Muscle exercises
• Interception of skeletal mal relation
• Removal of soft tissue or bony barrier to enable eruption of teeth 2
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Posterior cross bite
• Skeletal
• Dental
• Functional – Unilateral
– Bilateral
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UNILATERAL BILATERAL
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Treatment procedures
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Quad helix Micro screws
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Control of abnormal habits
• Thumb / digit sucking
• Mouth breathing
• Tongue thrusting
• Lip sucking / biting
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Treatment procedure
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TONGUE CRIB LIP BUMPER
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Space regainers
• Mesial tipping or drifting of permanent first molars on premature loss of deciduous second molar , reducing the arch length
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• Extensive caries
• Ecotopic eruption
• Premature extraction of primary molars
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Timing of distalization
• 7‐10 yrs of age– Incomplete root formation
– Second molars are not erupted
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Treatment procedures
• Fixed appliances– Open coil / herbst space regainer– Jackscrew space regainer– Gerber space regainer
• Removable appliance– Hawley’s appliance
• With helical spring• Split acrylic dumb‐bell spring• With sling shot elastic• Palatal spring• Expansion screws 11
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Herbst space regainer Jack screw space regainer
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Gerber space regainer
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Helical spring Split acrylic dumb bell spring
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Palatal spring Expansion screw
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Muscle exercises
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• To guide the development of occlusion
• To allow optimal growth patterns
• To provide retention and stability post orthodontically
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Lip exercises
• To obtain lip seal in hypotonic upper– Stretch the upper lip to overlap the lower lip
• Self• Parentral help
– Hold a piece of paper– Swishing of water– Massaging of lips– Play a reed musical instrument– Scotch tape– Oral screen– Button pull exercise– Tug of war exercise 17
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Oral screen
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Tongue exercises
• For swallow pattern– One elastic swallow
– Two elastic swallow
– Tongue hold exercise
• Tongue tie– Hold pull exercise
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Masseter muscle exercise
• Clench the teeth for a count of ten and relax.
• Repeat till it tires.
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Pterygoid muscle exercises
• Class II pts
• Protrude the mandible as much as possible and retract
• Improvement of the position of mandible gradually.
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limitations
• Does not drastically alter any growth pattern
• Not a substitute for corrective orthodontics
• Patient compliance
• Worsen
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Interception of skeletal malocclusion
• Class II
• Class III
• Functional appliances– Tooth borne
• Active
• Passive
– Tissue borne
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Class ii malocclusion
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Class ii malocclusion
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Visual treatment objective
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Class iii malocclusion
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Class iii malocclusion
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Cad/cam myofunctionalappliance
• Farrell in australia
• Flexible
• Inherent memory effects – non thermoplastic polyurethane
• Tooth guidance and functional effects too.
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• Soft Blue pre‐orthodontic trainer– Aberrant muscle movements
– Mild tooth movements
– 6 months
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• Firmer pink pre‐orthodontic trainer– Greater forces for the alignment of teeth
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indications
• Mandibular anterior crowding
• Class II div 1 and 2
• Anterior open bite
• Deep bite
• Mild Class III/Pseudo Class III
• Oral habits
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contraindications
• Posterior crossbite
• Sever Class III
• Nasal obstruction
• Non‐cooperative child
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• One hour in the day
• During sleep
• Blue trainer – 6 ‐ 8 months
• Pink trainer – 12 months
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adjustments
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• Narrow mouth‐trim distal ends
• Tongue tag area –V cut on either sides
• Extreme Class II cases – 2‐3 mm of distal ends are trimmed
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• Children less than 6 yrs of age – 4‐6 mm is trimmed
• Class III cases – upper labial bow is trimmed
• Lip bumper effect –lower labial bow is trimmed
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uses
• More economical
• More stable
• Improvement in facial profile and features
• Decrease the need for extractions
• Reduces the duration of corrective orthodontics
• Lateral expansion – Farrel bent wire system 37
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Removal of soft tissue / bony barrier
• Retained deciduous teeth
• Supernumerary teeth
• Fibrous / bony obstruction of the erupting tooth bud
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Thank you
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