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INTERCEPTIVEORTHODONTICS


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INTERCEPTIVE

ORTHODONTICS

Definitions:

Any procedure that eliminates or reduces the

severity of malocclusion in the developingdentition.(Popovich and Thompson 1979, Hiles

1985.)

All simple measures that eliminate the developing

mal occlusion. (Ackerman and Proffit 1980)


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INTERCEPTIVE

ORTHODONTICS

The aetiology of malocclusion could be:

1- Skeletal discrepancy

2- Soft tissue

3- local factors

4- Crowding and spacing

5- Displacements


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INTERCEPTIVE

ORTHODONTICS

Local factors: DELAYED ERUPTION OF UPPER

PERMANENT CENTRAL INCISOR.

Definition: 1 is considered to be delayed if thecontra-lateral tooth was fully erupted or if teethlater in the usual eruption sequence were present.

Interceptive treatment: removal of supernumerary

with or without tooth exposure. Treatment timing: as soon as the supernumerary

tooth is detected.


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INTERCEPTIVE

ORTHODONTICS

Local factors:RETAINED DECIDUOUS

TEETH.

Definition: the deciduous tooth is

considered to be over retained if it made

enamel contact with its successor.

Interceptive treatment: extraction.


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INTERCEPTIVE

ORTHODONTICS

Local factors: INFRAOCCLUSION

Definition: the tooth loses its vertical position

relative to the adjacent teeth and assumes aposition below the occlusal plane

Frequent site: lower 2ndand 1stprimary molars.

Interceptive treatment: nothing unless thepermanent successor was absent or the

infraoccluded tooth is likely to disappear .


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INTERCEPTIVE

ORTHODONTICS

Local factors: UNILATERAL RETAINED

DECIDUOUS CANINE.

Definition: premature loss of one deciduouscanine as a result of early root resorption bya crowded lateral incisor.

Interceptive treatment: extraction of theprimary canine on the opposite side of thearch to preserve the midline.


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INTERCEPTIVE

ORTHODONTICS

Local factors: DOUBLE TEETH

Definitions:

Gemination: the attempt of a single tooth

bud to form two distinct morphological

entities.

Fusion: the result of joining two adjacent

tooth buds.


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INTERCEPTIVE

ORTHODONTICS

Local factors: DOUBLE TEETH

In the deciduous dentition double teeth are usually

associated with absent permanent successor, orectopic or delayed eruption of the permanent

successor if it was present. Treatment therefore

involve the extraction of the malformed tooth.

In the permanent dentition treatment options are:

Mask, Split and Extract


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INTERCEPTIVE

ORTHODONTICS

Local factors: ECTOPIC ERUPTION OF

THE PERMANENT FIRST MOLAR.

Definition: the molar erupts at an angle

mesial to its normal path of eruption.

Types : reversible and irreversible

Treatment: extraction of E or distalisation

of permanent molar


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INTERCEPTIVE

ORTHODONTICS

Local factors: Hypodontia

Definition: Absent teeth.

Common teeth: lower 2ndpremolar & upper

lateral incisor.

Treatment: space closure or space

maintenance for future prosthesis.


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INTERCEPTIVE

ORTHODONTICS

Local factors:DIASTEMA

Definition: space between the two upper

central incisors.

Treatment if indicated: removal of

pathology (supernumerary, odontome,

fraenum?.)


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INTERCEPTIVE

ORTHODONTICS

Local factors: ECTOPIC UPPER CANINE

Definition: the canine erupts out of its

normal eruption path.

Diagnosis: If the 3 was not palpable in the

buccal sulcus after the age of 10 years.

Treatment: Extraction of the deciduous

canine.


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INTERCEPTIVE

ORTHODONTICS

Local factors:ECTOPIC UPPPER CANINE

Rate of eruption of the permanent canine after

the extraction of the deciduous caninedepends on the amount by which thepermanent canine overlap the lateral incisor:

overlap < 1\2 of lateral root: success rate 91%overlap > 1\2 of lateral root: success rate 64%

(Ericson & Kurol 1988)


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INTERCEPTIVE

ORTHODONTICS

Local factors:THUMB SUCKING

Effect: no malocclusion 14.6%

anterior open bite 48.1%

posterior cross bite 07.2%

ant OB +post X-bite 30.1%(Da Silva et al. 1991)


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INTERCEPTIVE

ORTHODONTICS

Local factors: THUMB SUCKING

At what age should treatment be started?

-Da Silva et al (1991) from the 5thyear of age

-Proffit (1993) before the eruption of

permanent incisors

-Houston (1993) by 7-8 years of age -Mills (1982) before permanent dentition

-Larsson (1987) before pubertal growth spurt

C


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INTERCEPTIVE

ORTHODONTICS

Local factors: THUMB SUCKING

Treatment:

1- Adult approach.

2- Deterrent appliance.

INTERCEPTIVE


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INTERCEPTIVE

ORTHODONTICS

Local factors: TRANSPOSITION

Definition: unusual type of ectopic eruption were

two permanent teeth have interchanged theirlocation in the dental arch.

Frequent sites: upper canine and first premolar

lower canine and lateral incisor.

Interceptive treatment: extract transposed tooth.align before canine eruption

Treatment timing: before eruption of canine.


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INTERCEPTIVE


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INTERCEPTIVE

ORTHODONTICS

Crowding:

Treatment:

1-Space management.2-Molar distalisation.

3-Serial extraction.

4-Premolar extraction.

5-First molar extraction.

6-lower incisor extraction.

7-Second molar extraction.

INTERCEPTIVE


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INTERCEPTIVE

ORTHODONTICS

Crowding: SPACE MANAGEMENT.

Definition: utilization of Lee Way space to

relieve anterior crowding.

Indications:1- Cl I molar relation ship.

2- E,s are still present in the.

crowded side(s).

3- Mild crowding.

INTERCEPTIVE


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INTERCEPTIVE

ORTHODONTICS

Crowding:SPACE MANAGEMENT

Methods:1-Space maintainer extract E,s

Or

2- Slice the mesial surface of the

deciduous canine and molars

before the eruption of permanent

canine and premolars.

INTERCEPTIVE


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INTERCEPTIVE

ORTHODONTICS

Crowding:SERIAL EXTRACTION

Definition: .. The early recognition or

anticipation of a deformity that will occur

unless teeth are removed at a strategic

interval to relieve in intensity the

developing malocclusion.

INTERCEPTIVE


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INTERCEPTIVE

ORTHODONTICS


Indications:

- The incisors are substantially crowded.- Age 8-9 years.

- Normal arch relation ship.

- Reduced or normal overbite.

- All permanent teeth are present.

- The first molars should have a good prognosis.

- The first premolars should be closer to eruption

than canines.

INTERCEPTIVE


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INTERCEPTIVE

ORTHODONTICS


Disadvantages:

1- Increasing the overbite.

2- Lingual tipping of lower incisors

3-Retarding future development in arches.4-Lack of aesthetic fullness of the lips.

5-Rotated incisors do not align spontaneously.

INTERCEPTIVE


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INTERCEPTIVE

ORTHODONTICS


Methods:

1-When the lateral are erupting in a crowdedposition, all deciduous canines are removed.

2-When the roots of the first deciduous molars

are half resorbed. They are removed.3-As soon as the first premolars erupt they are

removed.


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FIRST MOLAR EXTRACTION

As an interceptive orthodontic

measure


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Indications:

-At least one permanent first molar have poorprognosis.

-Crowding in the relevant quadrant.

-The development of second molar roots did notreach more than half way.

-No other missing teeth in the same quadrant.

-Normal arch relation ship.

-The overbite is not deep.

-The second premolar is contained within the E roots


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Advantages:

No need for future prosthesis

Reduce incisor crowding

Eliminate buccal segment crowding

Less chance for third molar impaction.


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Disadvantages:

The uncertainty of the final contact point

between the second molar and second premolar.


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2468

1

Thuno ld Th ilander

goodpoor

Contact point:

Good result could be

expected in patients: Having buccal segment

crowding.

having third molars.

First molars wereextracted early.


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Compensatory extraction:

Extraction of upper first molar does not

necessitate the compensatory extractionof lower first molar

Extraction of lower first molar

necessitates the compensatory extractionof upper first molar

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