In t e r c e p t i ve                                                   1                                                0...
The Purpose Of This                               Presentation..                                                        1 ...
Aims..                                                         1                                                      01  ...
Concept                                                               1                                                   ...
Concept                                                                    1                                              ...
1                                               01                                          i2                      !B/"&C...
Limitation                                                             1                                                  ...
Timing                                                          1                                                     01  ...
Advantages Of Early Tx                                                   1                                                ...
Drawbacks Of Early Tx                                                                1                                    ...
Diagnostic Knowledge                                                      1                                               ...
1                                        01                                        i2                                     ...
" The Dental Norm "                                                        1                                              ...
" The Skeletal Norm "                                                      1                                              ...
"The Functional Norm"                                                      1                                              ...
1                                        01           Indications                                        i2               ...
Types of Problems                                                      1                                                  ...
Eruption Problems                                               1                                            01           ...
Eruption Problems                                                           1                                             ...
Eruption Problems                                                            1                                            ...
Eruption Problems                                                                1                                        ...
Eruption Problems                                                                    1                                    ...
Eruption Problems                                                              1                                          ...
Eruption Problems                                                            1                                            ...
Eruption Problems                                                           1                                             ...
Eruption Problems                                                             1                                           ...
1                                           01                                        i2                                  ...
1                                           01                                        i2                                  ...
1                                           01                                        i2                                  ...
1                                           01                                        i2                                  ...
1                                           01                                        i2                                  ...
1                                           01                                        i2                                  ...
1                                           01                                        i2                                  ...
1                                           01                                        i2                                  ...
Eruption Problems                                                          1                                              ...
Eruption Problems                                                        1                                                ...
Eruption Problems                                                         1                                               ...
Eruption Problems                                                                  1                                      ...
1                                                01                                          i2                           ...
1                                                01                                          i2                           ...
1                                                01                                          i2                           ...
1                                                01                                          i2                           ...
1                                                01                                          i2                           ...
Ectopic Eruption                                                        1                                                 ...
Ectopic Eruption                                                            1                                             ...
Ectopic Eruption                                                                   1                                      ...
Ectopic Eruption                                                                1                                         ...
Ectopic Eruption                                                1                                             01          ...
Ectopic Eruption                                                                1                                         ...
Ectopic Eruption                                                               1                                          ...
Ectopic Eruption                                                              1                                           ...
Ectopic Eruption                                                                    1                                     ...
Ectopic Eruption                                                                  1                                       ...
Ectopic Eruption                                                             1                                            ...
Ectopic Eruption                                                              1                                           ...
Space-related Problems                                                                1                                   ...
Space-related Problems                                                     1                                              ...
Early Loss Of Deciduous Teeth                                                    1                                        ...
Space-related Problems                                                           1                                        ...
1                                        01                                        i2                                     ...
Lip Bumper                                                        1                                                      0...
Space-related Problems                                                        1                                           ...
Space-related Problems                                                    1                                               ...
Space-related Problems                                                              1                                     ...
Space-related Problems                                                        1                                           ...
Space-related Problems                                                             1                                      ...
Space-related Problems                                                        1                                           ...
Space-related Problems                                                         1                                          ...
Space-related Problems                                                            1                                       ...
Space-related Problems                                                     1                                              ...
Space-related Problems                                                      1                                             ...
Space-related Problems                                                   1                                                ...
Space-related Problems                                              1                                           01        ...
Space-related Problems                                              1                                           01        ...
Space-related Problems                                           1                                         01             ...
Space-related Problems                                           1                                         01             ...
Space-related Problems                                           1                                         01             ...
Space-related Problems                                           1                                         01             ...
Occlusal Problems                                                                    1                                    ...
Occlusal Problems                                                     1                                                   ...
Occlusal Problems                                                       1                                                 ...
Occlusal Problems                                                     1                                                  0...
Occlusal Problems                                                                 1                                       ...
Occlusal Problems                                                                   1                                     ...
Occlusal Problems                                           1                                          01              U 6...
Occlusal Problems                                                              1                                          ...
Occlusal Problems                                                             1                                           ...
Occlusal Problems                                                1                                             01         ...
Occlusal Problems                                          1                                          01                  ...
Occlusal Problems                                                           1                                             ...
Occlusal Problems                                                           1                                             ...
Occlusal Problems                                          1                                         01              A M"B...
Occlusal Problems                                         1                                        01              A M"B(D...
Occlusal Problems                                         1                                        01              A M"B(D...
Occlusal Problems                                         1                                        01              A M"B(D...
Skeletal Problems...                                                  1                                             01    ...
Recommended Reading                                                          1                                            ...
Thank You.. & Good Luck!                                         1                                        01              ...
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Interceptive Orthodontics

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A presentation presented as part of the Orthodontic Refresher Course for Applicants for the Jordanian Board in Orthodontics Examinations | February 2011

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Transcript of "Interceptive Orthodontics"

  1. 1. In t e r c e p t i ve 1 01 Or t h od o nt i c s i2 aw in Preadolescent Children m iSa ad !"#$%&!&!#(#)% Sh *+!,&--.$!/%0123"4,&-123"56! ©Friday, February 4, 2011
  2. 2. The Purpose Of This Presentation.. 1 01 i2 aw 7&85.92.:".28&;9&;23";$;<3%/&%<3.2/.=3%>.& m Sa /;</.=3:&?&32.#3(.<3&(;$#@%3%.:&%<& =2.#$;@.:/.<3&/"%@$2.< i ad Sh ©Friday, February 4, 2011
  3. 3. Aims.. 1 01 i2 aw A !"#$%"&()*+,-#.%(/0%(-%%)(1#"(2+-+,%2%-/( #1(/0%()%3%&#$*-,(#44&5.*#- m Sa A 6-#7(/0%(*-)*4+/*#-.(+-)(4#-/"+*-)*4+/*#-.( #1(3+"*#5.(*-/%"4%$/*3%(2%+.5"%.8(/"%+/2%-/( i ad 2#)+&*/*%.(9(+$$&*+-4%.: Sh ©Friday, February 4, 2011
  4. 4. Concept 1 01 "Guidance of the development of the dentition through i2 minimal intervention, with the aim of preventing, reducing aw or correcting existing or potential abnormal tooth positions." m i Sa ad F. Van der Linden Sh Orthodontic Concepts and Strategies. 2004 ©Friday, February 4, 2011
  5. 5. Concept 1 01 "Any treatment procedure which eliminates or reduces the i2 severity of a developing malocclusion, as this may reduce aw the need for further treatment or make it simpler." m i Sa ad Chung CK & Kerr WJ. 1987 Sh Interceptive orthodontics: application and outcome in a demand population. BDJ, 162;73-76 ©Friday, February 4, 2011
  6. 6. 1 01 i2 !B/"&CB%$#</.&:";B@$&/;<32%DB3.&3;&3".& aw $.>.@;=(.<3&;9&#&=.2(#<.<3&$.<3%3%;<& m 3"#3&%:&%<&#&"#2(;<%;B:,&9B</3%;<#@&#<$& Sa .:3".3%/#@@E&#//.=3#D@.&;//@B:%;< i ad Sh ©Friday, February 4, 2011
  7. 7. Limitation 1 01 “ .. Interceptive treatment can be very helpful in reducing i2 the severity of problems, but rarely is so successful that aw later stages of treatment are unnecessary ! ” m i Sa ad William R. Proffit Sh “Contemporary Orthodontics” ©Friday, February 4, 2011
  8. 8. Timing 1 01 The Late Mixed Dentition Stage ? i2 aw A ;%%7+(.$+4%.(./*&&($"%.%-/:: A <+-(4+.%.(2+(./*&&(=%(/"%+/%)(#-(+(-#-> m %?/"+4/*#-(=+.*.( Sa A @/*&*A+/*#-(#1(B"#7/0 i ad A C0#"/%"(#3%"+&&(/"%+/2%-/(/*2%D(*:%E(F-%>!0+.% Sh Nimri & Richardson, BJO, 1997 © Bjork, TEOS, 1972Friday, February 4, 2011
  9. 9. Advantages Of Early Tx 1 01 i2 A F:E/";G:;/%#@&#$>#<3#C.:&Shaw et al, BJO, 1980 aw A 5.$B/.&;9&2%:H&;9&%</%:;2&;2&C%<C%>#@&32#B(#& m Todd & Dodd, HMSO, 1985 A I(=2;>.$&6;;=.2#3%;< i Sa ad A 62#<%;9#/%#@&3%::B.:&(;2.&(#@@.#D@.&J Sh ©Friday, February 4, 2011
  10. 10. Drawbacks Of Early Tx 1 01 i2 A K;::&;9&=#3%.<3&/;;=.2#3%;<&LL&F2;@;<C.$&MNO aw A PN32#/3%;<&/";%/.&%:&$%99%/B@3&)"%@:3&E;B<C m A K#3.&:;93&3%::B.&(#3B2%3E&#<$&/;<3%<B.$& Sa C2;)3"&Vig & Cohen, AJO, 1979 i ad A K;::&;9&(;:3&#2/"&@.<C3"&C#%<:&)".<&%<& Sh =.2(#<.<3&$.<3%3%;<&Little et al, AJODO, 1990 ©Friday, February 4, 2011
  11. 11. Diagnostic Knowledge 1 01 7<3%/%=#3%;<&;9& i2 F;3.<3%#@&RB3B2.&6;(=@%/#3%;<: aw m i Sa ad Q;2(#@&!H.@.3#@&? P#2@E&5./;C<%3%;<& Sh &+.<3#@&+.>.@;=(.<3 ;9&7D<;2(#@%3%.: ©Friday, February 4, 2011
  12. 12. 1 01 i2 aw m Sa i ad Sh What is "Normal" Anyway?? ©Friday, February 4, 2011
  13. 13. " The Dental Norm " 1 01 A 6;(=@.3.&$./%$B;B:& i2 $.<3%3%;<& G"#5-)(G,%(H>I aw A -%@$&:=#/%<C&G& F2%(#3.&:=#/%<C m A R@B:"G3.2(%<#@& Sa 2.@#3%;<:"%=&;9&P: i ad A P$C.G.$C.&%</%:;2& 2.@#3%;<:"%=&0@#3.2& Sh :3#C.:4 © A Q;&62;::GD%3.:Friday, February 4, 2011
  14. 14. " The Skeletal Norm " 1 01 i2 aw A 6@#::&I&:H.@.3#@&=#33.2<&8#==.#2#</.8 m A Q;&>.23%/#@,&32#<:>.2:.&<;2&7<3.2;G Sa =;:3.2%;2&$%:/2.=#</%.: i ad Sh ©Friday, February 4, 2011
  15. 15. "The Functional Norm" 1 01 i2 aw A Q;2(#@&:)#@@;)%<C&D."#>%;2 m A Q#:#@&D2.#3"%<C Sa A R2..&92;(&"#D%3:S&3"B(D&;2&$%C%3& i ad :B/H%<C,&3;<CB.G3"2B:3%<C,&.3/ Sh ©Friday, February 4, 2011
  16. 16. 1 01 Indications i2 aw J#"( m F"/0#)#-/*4( K-/%"4%$/*#- Sa i ad Sh ©Friday, February 4, 2011
  17. 17. Types of Problems 1 01 A L%-/#>#@>.;@#2E A !H.@.3#@L i2 aw A P2B=3%;<&=2;D@.(: A M2#<:>.2:.&=2;D@.(: m A P/3;=%/&.2B=3%;< A T.23%/#@&=2;D@.(: i Sa A !=#/.G2.@#3.$&=2;D@.(: A 7GF&=2;D@.(: ad A 1//@B:#@&=2;D@.(: A 6;(D%<.$&=2;D@.(: Sh A R#/%#@&7:E((.32E ©Friday, February 4, 2011
  18. 18. Eruption Problems 1 01 U 1>.2G2.3#%<.$&F2%(#2E&M..3" i2 aw m &(#E&/#B:.& $.9@./3.$&.2B=3%;<&Sa =#3":&2.:B@3%<C&%<& i ad /2;)$%<C&#<$V;2& Sh @;/#@%W.$&/2;::GD%3.: ©Friday, February 4, 2011
  19. 19. Eruption Problems 1 01 U 1>.2G2.3#%<.$&F2%(#2E&M..3" i2 aw G(!%"2+-%-/(/##/0(.0#5&)("%$&+4%(*/.( $"%)%4%..#"(70%-(MNO(#1(*/.("##/(0+.(1#"2%): m i Sa Proffit, 2007 ad Sh ©Friday, February 4, 2011
  20. 20. Eruption Problems 1 01 U 1>.2G2.3#%<.$&F2%(#2E&M..3" i2 aw -#<#C.(.<3L m P?/"+4/*#-(#1(#11%-)*-,($"*2+"(/##/0N/%%/0: i Sa *XML ad M#H.&5#$%;C2#="&RI5!MO Sh ©Friday, February 4, 2011
  21. 21. Eruption Problems 1 01 i2 Y !B=.2<B(.2#2E&M..3" aw A Z[&%<&#<3.2%;2&(#N%@@#,&DiBiase, 1969 m A 6#B:.&:=#/%<C&0(%$@%<.&$%#:3.(#4&%<&ZU&;9& Sa /#:.:,&Ranta, 1986 i ad A +.@#E.$&.2B=3%;<&;9&#<3.2%;2&3..3"&=#23%/B@#2@E& /.<32#@&%</%:;2: Sh A !%<C@.&0(#E&.2B=34&;2&(B@3%=@.&0B<@%H.@E&3;&.2B=34 ©Friday, February 4, 2011
  22. 22. Eruption Problems 1 01 ] !B=.2<B(.2#2E&M..3" i2 aw I !%(=@.&6#:.:L m A -#<#C.(.<3& %<>;@>.:& . N 3 2 # / 3 % ; <& ; 9& 3 " .& Sa :B=.2<B(.2#2E& 3;;3"& %9& :B=.29%/%#@& ;2& .2B=3.$,& i ad ) % 3 " ; B 3& # 9 9 . / 3 % < C& #$^#/.<3&3..3" Sh ©Friday, February 4, 2011
  23. 23. Eruption Problems 1 01 i2 Y !B=.2<B(.2#2E&M..3" aw II 6;(=@%/#3.$&6#:.:L m A -#<#C.(.<3&(#E&%<>;@>.&8&$.@#E%<C& Sa .N32#/3%;<&;9&3".&:B=.2<B(.2#2E&3;;3"&0;2& 3..3"4&B<3%@&/;<3%<B.$&C2;)3"&"#:&%(=2;>.$& i ad D;3"&#//.::&#<$&/"%@$_:&#D%@%3E&3;&3;@.2#3.& :B2C.2E8 Sh Proffit, 2007 ©Friday, February 4, 2011
  24. 24. Eruption Problems 1 01 i2 Y !B=.2<B(.2#2E&M..3" aw As a General Rule: m Sa The earlier the supernumerary teeth are removed, the more likely normal teeth will i ad erupt without intervention. Sh ©Friday, February 4, 2011
  25. 25. Eruption Problems 1 01 i2 ] +.@#E.$&I</%:;2&P2B=3%;< aw A 1>.2G2.3#%<.$&=2%(#2E&%</%:;2: m A !B=.2<B(.2#2E&3..3" Sa A M"%/H.<%<C&;9&;>.2@E%<C&H.2#3%<%W.$&3%::B.& i ad %<&@;<CG:3#<$%<C&.$.<3B@;B:&:=#/.: Sh DiBiase D., 1970 ©Friday, February 4, 2011
  26. 26. Eruption Problems 1 01 ] +.@#E.$&I</%:;2&P2B=3%;< i2 aw A -#<#C.(.<3L m A !B=.29%/%#@L&!%(=@.&:;93&3%::B.&%</%:%;< Sa A +..=.2L&7=%/#@@EG2.=;:%3%;<.$&9@#=&#<$&/2;)<& .N=;:B2. i ad A T.2E&+..=L&PN=;:B2.&#<$&;23";$;<3%/&32#/3%;<& Sh )%3"&D;<$.$&#33#/"(.<3&0=2.9.2#D@E&#&C;@$G /"#%<&#33#/"(.<34 ©Friday, February 4, 2011
  27. 27. 1 01 i2 aw m Sa i ad Sh Surgical Exposure & Orthodontic Traction ©Friday, February 4, 2011
  28. 28. 1 01 i2 aw m Sa i ad Sh Surgical Exposure & Orthodontic Traction ©Friday, February 4, 2011
  29. 29. 1 01 i2 aw m Sa i ad Sh Surgical Exposure & Orthodontic Traction ©Friday, February 4, 2011
  30. 30. 1 01 i2 aw m Sa i ad Sh Surgical Exposure & Orthodontic Traction ©Friday, February 4, 2011
  31. 31. 1 01 i2 aw m Sa i ad Sh Surgical Exposure & Orthodontic Traction ©Friday, February 4, 2011
  32. 32. 1 01 i2 aw m Sa i ad Sh Surgical Exposure & Orthodontic Traction ©Friday, February 4, 2011
  33. 33. 1 01 i2 aw m Sa i ad Sh Surgical Exposure & Orthodontic Traction ©Friday, February 4, 2011
  34. 34. 1 01 i2 aw m Sa i ad Sh Surgical Exposure & Orthodontic Traction ©Friday, February 4, 2011
  35. 35. Eruption Problems 1 01 i2 ` 7<HE@;:.$&F2%(#2E&M..3" aw A !%(%@#2&.99./3:&3;&#<E&;>.2G2.3#%<.$& m =2%(#2E&3;;3" Sa A -#<#C.(.<3&$.=.<$:&;<&)".3".2& =.2(#<.<3&:B//.::;2&%:&=2.:.<3&;2&<;3 i ad Sh ©Friday, February 4, 2011
  36. 36. Eruption Problems 1 01 i2 ` 7<HE@;:.$&F2%(#2E&M..3" aw A !B//.::;2&=2.:.<3L& m (#%<3#%<&B<3%@&%<3.29.2.</.&)%3"&.2B=3%;<&;2& Sa $2%93%<C&;9&#$^#/.<3&3..3"&;//B2:,&3".<&.N32#/3& i #<$&=@#/.&:=#/.G(#%<3#%<.2&;2&9%N.$& ad #==@%#</.: Sh ©Friday, February 4, 2011
  37. 37. Eruption Problems 1 01 i2 ` 7<HE@;:.$&F2%(#2E&M..3" aw A !B//.::;2&<;3&=2.:.<3L& m PN32#/3&#<HE@;:.$&3;;3"&D.9;2.&#&@#2C.&>.23%/#@& Sa ;//@B:#@&$%:/2.=#</E&;//B2:,&#<$&3;&#>;%$& @;<CG3.2(&=.2%;$;<3#@&=2;D@.(:&JJJ i ad Kurol & Thilander, 1984 Sh Angle Orthodontist ©Friday, February 4, 2011
  38. 38. Eruption Problems 1 01 ` 7<HE@;:.$&F2%(#2E&M..3" i2 aw A !B//.::;2&<;3&=2.:.<3L& m <#"%("%4%-/&8(7*/0(/0%(+)3+-4%2%-/.(*-(K2$&+-/(L%-/*./"E( Sa <+*-/%-+-4%(#1(/0%(+-Q&#.%)($"*2+"(/##/0D i ad >(K1(-#(.5=2%",%-4%(#"(#44&5.+&(*-/%"1%"%-4%.(%3*)%-/: >(K1(/0%(+"%(1*"2(9(-#/("%.#"=*-,(=(/0%2.%&3%.R Sh >(K1(#44&5.*#-(9(.Q%&%/+&($+//%"-($%"2*/: ©Friday, February 4, 2011
  39. 39. 1 01 i2 aw m iSa ad Sh Ankylosed Primary 2nd Molars ©Friday, February 4, 2011
  40. 40. 1 01 i2 aw m iSa ad Sh Ankylosed Primary 2nd Molars ©Friday, February 4, 2011
  41. 41. 1 01 i2 aw m iSa ad Sh Ankylosed Primary 2nd Molars ©Friday, February 4, 2011
  42. 42. 1 01 i2 aw m iSa ad Sh Ankylosed Primary 2nd Molars ©Friday, February 4, 2011
  43. 43. 1 01 i2 aw m iSa ad Sh Ankylosed Primary 2nd Molars ©Friday, February 4, 2011
  44. 44. Ectopic Eruption 1 01 i2 &a".<&#&=.2(#<.<3&3;;3"&/#B:.:& aw 2.:;2=3%;<&;9&#&=2%(#2E&3;;3"&%3&%:&<;3& m :B==;:.$&3;&2.=@#/.& i Sa 15& ad 2.:;2=3%;<&;9&#<&#$^#/.<3&=.2(#<.<3&3;;3" Sh ©Friday, February 4, 2011
  45. 45. Ectopic Eruption 1 01 U K#3.2#@&I</%:;2: i2 A S%.#"$/*#-(#1($"*2+"(4+-*-%.(*.(4#22#- aw A ;#..(#1(#-%(#"(=#/0($"*2+"(4+-*-%.(/0*.(7+( m *-)*4+/%.(+(&+4Q(#1(.$+4%(1#"(+&&($%"2+-%-/( Sa *-4*.#".(*-(2#./(4+.%.: i ad A C$+4%(2+*-/%-+-4%(9N#"(=+&+-4*-,( %?/"+4/*#-.(5.5+&&(-%%)%)(/#($"%3%-/(2*)&*-%( Sh .0*1/.(+-)(15"/0%"(.$+4%(&#.. ©Friday, February 4, 2011
  46. 46. Ectopic Eruption 1 01 i2 Y -#N%@@#2E&R%2:3&-;@#2: aw A L5%(/#(.2+&&8()*./+&&>&#4+/%)(2+?*&&+(T m A C/%%$&(+-,5&+/%)(&+",%($%"2+-%-/(U./( Sa 2#&+".(T(Pulver, J Dent Child, 1968 i ad A V#(.Q%&%/+&("%&+/*#-.0*$.(1#5-)T(Bjerklin & Kurol, Am J Orthod, 1983 Sh ©Friday, February 4, 2011
  47. 47. Ectopic Eruption 1 01 i2 Y -#N%@@#2E&R%2:3&-;@#2: aw A F=.%"3+/*#- m A I9&<;&;2&:(#@@&#(;B<3&;9&P&2.:;2=3%;< A K-/%"3%-/*#- i Sa ad A *@;/H#C.&=.2:%:3.<3&b&c&(;<3": Sh A 5.:;2=3%;<&%</2.#:%<C ©Friday, February 4, 2011
  48. 48. Ectopic Eruption 1 01 i2 aw K#/H&;9&3%(.@E&%<3.2>.<3%;<&(#E&/#B:.&@;::& m ;9&=2%(#2E&Y-)&(;@#2&#<$&/;<:%$.2#D@.&:=#/.& Sa @;::&#:&U./&=.2(#<.<3&(;@#2&.2B=3:&(.:%#@@E i ad Sh ©Friday, February 4, 2011
  49. 49. Ectopic Eruption 1 01 i2 Y -#N%@@#2E&R%2:3&-;@#2: aw A K-/%"3%-/*#- m Sa A *2#::&)%2.&V&:3..@&:=2%<C&/@%=&V&.@#:3;(.2%/& :.=#2#3;2&(;$B@.: i ad A !.>.2.&/#:.:L&9%N.$&#==@%#</.:&)%@@&D.&<..$.$ Sh ©Friday, February 4, 2011
  50. 50. Ectopic Eruption 1 01 i2 ] -#N%@@#2E&6#<%<.: aw A <#./(1"%W5%-/(%4/#$*4(%"5$/*#-($+//%"-: m A S%&+/%)(/#(.2+&&(N(2*..*-,(&+/%"+&(*-4*.#". Sa A S%&+/%)(/#(&#-,(/#"/5#5.($+/0(#1(%"5$/*#- i ad A C/"#-,(%3*)%-4%(#1(+(,%-%/*4(=+.*. Sh Baccetti TA. , Angle, 1998 © Brin et al, EJO, 1986Friday, February 4, 2011
  51. 51. Ectopic Eruption 1 01 ] -#N%@@#2E&6#<%<.: i2 A <+*-($"#=&%2.E aw A I(=#/3%;<&19&F.2(#<.<3&6#<%<.:& m A I</%$.</.&d&ZY&J&e&R0Zf4&b&-0Z]4 Sa A F#@#3#@&0Z[g4&L&*B//#@&0ZUg4 i A 5.:;2=3%;<&19&5;;3:&19&K#3.2#@&I</%:;2:& ad A I<&ZUY&;9&/#:.:&e&R&b&- Sh © Mossey et al, BJO, 1994 Ericson & Kurol , AJODO, 1987 Bishara SE , Semin Orthod, 1998 Ericson & Kurol , Angle, 1998Friday, February 4, 2011
  52. 52. Ectopic Eruption 1 01 i2 ] -#N%@@#2E&6#<%<.: aw A F!B(*-)*4+/%)(+/(G,%(X>UYE m A I9&=2%(#2E&/#<%<.:&<;3&(;D%@., Sa A *B@C.&;9&=.2(#<.<3&/#<%<.:&<;3&>%:%D@.&;2& i =#@=#D@.&@#D%#@@E&%<&3".&:B@/B: ad Sh Ericson & Kurol , Commnity Dent Oral Epidemiol, 1986 ©Friday, February 4, 2011
  53. 53. Ectopic Eruption 1 01 i2 ] -#N%@@#2E&6#<%<.: aw K1(/0%($%"2+-%-/(4+-*-%(4"#7-(#3%"&+$.(0+&1(#"( m 2#"%(#1(&+/%"+&(*-4*.#"("##/("+)*#,"+$0*4+&&( i Sa ad High risk of resorption of lateral incisors root! Sh Ericson & Kurol , Eur J Orthod, 1988 ©Friday, February 4, 2011
  54. 54. Ectopic Eruption 1 01 Ericson & Kurol , Eur J Orthod, 1988 i2 aw Interceptive Extraction Of Primary Canines: m -;:3&P99./3%>.&*.3)..<&7C.:&UGU] Sa a".<&=.2(#<.<3&/#<%<.&/2;)<& ;>.2@#==%<C&"#@9&;9&@#3.2#@&%</%:;2:&2;;3 i ad Sh © Z(XU([0+-4%(F1(V#"2+&*A+/*#-Friday, February 4, 2011
  55. 55. Ectopic Eruption 1 01 Ericson & Kurol , Eur J Orthod, 1988 i2 aw Interceptive Extraction Of Primary Canines: m -;:3&P99./3%>.&*.3)..<&7C.:&UGU] Sa a".<&=.2(#<.<3&/#<%<.&/2;)<& ;>.2@#==%<C&b&"#@9&;9&@#3.2#@&%</%:;2:&2;;3 i ad Sh © Z(IO([0+-4%(F1(V#"2+&*A+/*#-Friday, February 4, 2011
  56. 56. Space-related Problems 1 01 U P#2@E&K;::&19&+./%$B;B:&M..3" i2 aw A !"%2+/5"%(%?1#&*+/*#- A !&+--%)(%?/"+4/*#- m Sa A [+"*%.R(0#==2;N&Zcf&%<&h;2$#<O4 i ad Sh ©Friday, February 4, 2011
  57. 57. Space-related Problems 1 01 P#2@E&K;::&19&+./%$B;B:&M..3" i2 aw A P?/%-/(#1(*/.(%11%4/(*.("%&+/%)(/#E m A 0%(.*/%(#1(/##/0(&#.. A 0%(]+7 i Sa ad A !"%>%?*./*-,()%,"%%(#1(4"#7)*-, Sh A G,% ©Friday, February 4, 2011
  58. 58. Early Loss Of Deciduous Teeth 1 01 -.:%#@&+2%93 -%$@%<.&!"%93 i2 7i* ? ? ? ? aw m 6 i Sa ad + Sh © PFriday, February 4, 2011
  59. 59. Space-related Problems 1 01 Management i2 aw !=#/.&-#%<3.<#</.V5.C#%<%<C m i Sa ^+"*#5.(1*?%)(9("%2#3+=&%(.$+4%(2+*-/+*-%". ad ;*-,5+&(+"40(N(V+-4%(_5//#-( Sh N(J*?%)(G$$&*+-4%.(T ©Friday, February 4, 2011
  60. 60. 1 01 i2 aw m Sa i ad Sh ©Friday, February 4, 2011
  61. 61. Lip Bumper 1 01 i2 aw m i Sa ad Sh Nevant et al, Am J Orthod, 1991 © ODonell et al, Am J Orthod, 1998Friday, February 4, 2011
  62. 62. Space-related Problems 1 01 Management i2 aw Balancing Extractions m i Sa ad PN32#/3%;<&;9&3".&/;<32#@#3.2#@&3;;3"& %<&3".&:#(.&#2/" Sh ©Friday, February 4, 2011
  63. 63. Space-related Problems 1 01 Management i2 aw Compensating Extractions m iSa ad PN32#/3%;<&;9&3".&;==;:%<C&3;;3"& %<&3".&;==;:%<C&#2/" Sh ©Friday, February 4, 2011
  64. 64. Space-related Problems 1 01 Serial Extractions ? i2 aw m Kjellgren, Acta Odonto Scand, 1948 Sa A&!.jB.<3%#@&PN32#/3%;<&;9&6:,&+:&3".<&`:&)".<&.2B=3.$ i ad A&7%(:&3;&2.@%.>.&#<3.2%;2&/2;)$%<C Sh ©Friday, February 4, 2011
  65. 65. Space-related Problems 1 01 Indications for Serial Extractions i2 aw A&-%@$&3;&(;$.2#3.&7<3.2%;2&/2;)$%<CB<$&#C.&[Gk A&6@#::&I&(#@;//@B:%;< m A&Q;2(#@&1>.2D%3. Sa A&7@@&=.2(#<.<3&3..3"&=2.:.<3&?&;9&C;;$&=2;C<;:%: i ad A&`:&#".#$&;9&]:&%<&.2B=3%;< Sh ©Friday, February 4, 2011
  66. 66. Space-related Problems 1 01 Drawbacks of Serial Extractions i2 aw A&X<=2.$%/3#D@.&2.:B@3:O m A&!"%93:&/2;)$%<C&=;:3.2%;2@E Sa A&!.>.2#@&.=%:;$.:&;9&.N32#/3%;<&9;2&#&E;B<C&=#3%.<3 i A&&R%N.$&#==@%#</.:&:3%@@&<..$.$&9;2&9%<%:"%<C&?&/;22./3%;<& ad ;9&#D<;2(#@&3;;3"&#<CB@#3%;<:&0.:=./%#@@E&/#<%<.:4 Sh Stephens, Dent Update, 1989 ©Friday, February 4, 2011
  67. 67. Space-related Problems 1 01 Y&-.$%#<&+%#:3.(#: i2 aw m F"E:%;@;C%/#@& i Sa ad Zk[&;9&c&E.#2G;@$: Z`k&;9&UU&E.#2G;@$: Sh Zf&;9&UYGU[&E.#2G;@$: © 7D<;2(#@&Friday, February 4, 2011
  68. 68. Space-related Problems 1 01 i2 A X=&3;&Y(( aw A `@,&(L54Q&*-,`(./+,% m A b&Y(( Sa A a$#N<*4"#)#-/*+(T i ad A C5$%"-52%"+"(/##/0(N(<%.*#)%-.(T Sh A ;#7>+//+40%)(#"(1&%.0(J"%-52(T ©Friday, February 4, 2011
  69. 69. Space-related Problems 1 01 Low-attachment frenum ? i2 aw A 6@%<%/#@@E,&/"./HL m A _&+-40*-,(#1(*-4*.*3%($+$*&&+%(5$#-(./"%/40*-,( Sa #1(/0%(5$$%"(&*$(T i ad A _#-(-#/40(*-(*-4*.*3%(+"%+("+)*#,"+$0*4+&&(T Sh ©Friday, February 4, 2011
  70. 70. Space-related Problems 1 01 1B3@%<.&;9&+%#:3.(#:_&-#<#C.(.<3& i2 aw A L%/%"2*-%(%?+4/(%/*#&#,( m A S%2#3%(+-($0.*4+&(#=./"54/*#-.T Sa A [&#.%(5.*-,("%2#3+=&%(#"(1*?%)(+$$&*+-4%. i ad A !#./>/"%+/2%-/(J"%-%4/#2T Sh A S%/+*-(7*/0(=#-)%)("%/+*-%". ©Friday, February 4, 2011
  71. 71. Space-related Problems 1 01 ] 6;<C.<%3#@@EG-%::%<C&K#3.2#@&I</%:;2: i2 aw A&ZY&;9&=;=B@#3%;< m A&R#(%@%#@&3.<$.</E&9;2&(%::%<C&?&=.CG:"#=.$&@#3.2#@: Sa A&193.<&#::;/%#3.$&)%3"&./3;=%/&.2B=3%;<&;9&/#<%<.: i ad Zilberman et al, EJO, 1990 Sh Brin et al, EJO, 1986 ©Friday, February 4, 2011
  72. 72. Space-related Problems 1 01 ] 6;<C.<%3#@@EG-%::%<C&K#3.2#@&I</%:;2: i2 aw Two Main Scenarios... m A&F.2(#<.<3&/#<%<.&.2B=3:&%<&@#3.2#@&%</%:;2&=;:%3%;< Sa A&F.2(#<.<3&/#<%<.&.2B=3:&<;2(#@@E&#<$&=2%(#2E& i ad @#3.2#@&%</%:;2&2.3#%<.$ Sh ©Friday, February 4, 2011
  73. 73. Space-related Problems 1 01 ] 6;<C.<%3#@@EG-%::%<C&K#3.2#@&I</%:;2: i2 aw m Sa i ad Sh ©Friday, February 4, 2011
  74. 74. Space-related Problems 1 01 ] 6;<C.<%3#@@EG-%::%<C&K#3.2#@&I</%:;2: i2 aw m Sa i ad Sh ©Friday, February 4, 2011
  75. 75. Space-related Problems 1 01 i2 aw m Sa i ad Sh ©Friday, February 4, 2011
  76. 76. Space-related Problems 1 01 i2 aw m Sa i ad Sh ©Friday, February 4, 2011
  77. 77. Space-related Problems 1 01 i2 aw m Sa i ad Sh ©Friday, February 4, 2011
  78. 78. Space-related Problems 1 01 i2 aw m Sa i ad Sh ©Friday, February 4, 2011
  79. 79. Occlusal Problems 1 01 U 62;::D%3.: i2 aw 7==2;N&Zff&;9&=;=B@#3%;< Q;3&:.@9G/;22./3%<C&#<$&.#2@E&%<3.2>.<3%;<&2.jB%2.$ m Ninou & Stephens Dent Update, 1994 i Sa ad A &+.<3#@&;2%C%< A 7<3.2%;2 Sh A&!H.@.3#@&;2%C%< A&F;:3.2%;2 ©Friday, February 4, 2011
  80. 80. Occlusal Problems 1 01 i2 aw A 7<3.2%;2&62;::D%3. m Sa A M2B.&6@#::&III&J i A F:.B$;G6@#::&III&J ad Sh ©Friday, February 4, 2011
  81. 81. Occlusal Problems 1 01 A 7<3.2%;2&62;::D%3. i2 A 1<.&GM);&%</%:;2:& aw +.<3#@&6;(=;<.<3&J %<&/2;::D%3.&15& 7<3.2%;2&+%:=@#/.(.<3&J P$C.G.$C.&%</%:;2: m i Sa ad Sh ©Friday, February 4, 2011
  82. 82. Occlusal Problems 1 01 A 7<3.2%;2&62;::D%3. i2 aw A ]&;2&(;2.&%</%:;2:& !H.@.3#@&6;(=;<.<3L %<&/2;::D%3. M2B.&6@#::&III m i Sa ad Sh ©Friday, February 4, 2011
  83. 83. Occlusal Problems 1 01 U 62;::D%3.: i2 aw Impo r tant Dif ferentiation Criteria m 7&RB@@G/B:=&D%@#3.2#@&/2;::D%3.&%:&(;:3&@%H.@E&:H.@.3#@&%<&;2%C%< Sa 7&B<%@#3.2#@&=;:3.2%;2&/2;::D%3.&%:&(;:3&@%H.@E&$.<3#@&%<&;2%C%<&J i ad I9&(B@3%=@.&#<3.2%;2&3..3"&#2.&%<&/2;::D%3.,& Sh %3:&(;:3&@%H.@E&:H.@.3#@&%<&;2%C%<&%.L&6@#::&III&J © Proffit, 2007Friday, February 4, 2011
  84. 84. Occlusal Problems 1 01 U 62;::D%3.: i2 aw Should be corrected as early as possible. m Sa !+"/*45&+"&(*-(/0%($"%.%-4%( #1(+()*.$&+4%2%-/: i ad Sh Thilander et al, EJO, 1984 © Richardson A., Interceptive Orthodontics, 2nd Ed, 1989Friday, February 4, 2011
  85. 85. Occlusal Problems 1 01 U 62;::D%3.: i2 aw A(C%&%4/*3%(B"*-)*-,T m A(@SG(b<*)&*-%(P?$+-.*#-c Sa A(d5+)(a%&*?(#"(e>G"40 i ad A(a"+?(P?$+-.*#-(bS<Pc Sh ©Friday, February 4, 2011
  86. 86. Occlusal Problems 1 01 i2 &!3#D%@%3E&;9&7<3.2%;2&/2;::D%3.&/;22./3%;<& aw $.=.<$:&(#%<@E&;<&#/"%.>%<C& m Sa #&l;;$&1>.2D%3. i ad Houston et al, 1993 Sh ©Friday, February 4, 2011
  87. 87. Occlusal Problems 1 01 i2 &!3#D%@%3E&;9&F;:3.2%;2&/2;::D%3.& aw /;22./3%;<&$.=.<$:&(#%<@E&;<&#/"%.>%<C& m Sa l;;$&*B//#@&I<3.2/B:=#3%;< i ad Houston et al, 1993 Sh ©Friday, February 4, 2011
  88. 88. Occlusal Problems 1 01 i2 aw Harrison & Ashby, 2001 m "Orthodontic Treatment of Posterior Crossbites" Sa Cochrane Database Systematic Review i ad Sh ©Friday, February 4, 2011
  89. 89. Occlusal Problems 1 01 Y&12#@&m#D%3: i2 aw A&M"B(DVR%<C.2&!B/H%<C m A&M;<CB.&M"2B:3%<C&J A&7D<;2(#@&!)#@@;)%<C& i Sa *."#>%;2&J ad Sh ©Friday, February 4, 2011
  90. 90. Occlusal Problems 1 01 A M"B(DVR%<C.2&:B/H%<C i2 aw @$(/#(H>I(%+".(#1(G,% m Sa little or no Effect i on permanent dentition and skeleton ad Sh ©Friday, February 4, 2011
  91. 91. Occlusal Problems 1 01 A M"B(DVR%<C.2&!B/H%<C i2 aw I<&3".&-%N.$&#<$&F.2(#<.<3&+.<3%3%;< m A(@$$%"(K-4*.#"(!"#4&*-+/*#- Sa A(;#7%"(K-4*.#"(S%/"#4&*-+/*#- i ad A(F3%"=*/%(*:%E(G.22%/"*4(GF_( Sh A(CQ%&%/+&()%3%&#$2%-/E %.L&-#N%@@#2E&6;<:32%/3%;<&#<$&F;:3.2%;2&62;::D%3. ©Friday, February 4, 2011
  92. 92. Occlusal Problems 1 01 A M"B(DVR%<C.2&!B/H%<C i2 aw Frequency m !"#"$%&()( iSa Duration ad Sh Intensity ©Friday, February 4, 2011
  93. 93. Occlusal Problems 1 01 A M"B(DVR%<C.2&!B/H%<C i2 aw m Sa i ad Sh ©Friday, February 4, 2011
  94. 94. Occlusal Problems 1 01 A M"B(DVR%<C.2&!B/H%<C i2 aw m Sa i ad Sh ©Friday, February 4, 2011
  95. 95. Occlusal Problems 1 01 A M"B(DVR%<C.2&!B/H%<C i2 aw m Sa i ad Sh ©Friday, February 4, 2011
  96. 96. Skeletal Problems... 1 01 i2 A M2#<:>.2:.&+%(.<:%;< aw A T.23%/#@&+%(.<:%;< m Sa A 7<3.2;G=;:3.2%;2&+%(.<:%;< i ad A 6;(D%<#3%;<:&19&1<.&12&-;2.&19&M".&7D;>. Sh ©Friday, February 4, 2011
  97. 97. Recommended Reading 1 01 i2 aw m *(+,-&"./,$0$(1$&2,3,-&%456(78(9$,::%&6(;<<=(+28(>;?>@ Sa *(A$%5&,B(C-%#"$5%&(D0-3E,,FG(9,5&H$03I0&"(J,&"5(%-(1$&2,3,-&%45 i ad *(K%420$35,-(L86(M-&"$4"/&%#"(1$&2,3,-&%456(;-3(N36(>OPO Sh ©Friday, February 4, 2011
  98. 98. Thank You.. & Good Luck! 1 01 i2 aw m Sa i ad Sh ©Friday, February 4, 2011
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