Orthodontic Treatment Modalities


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Orthodontic Treatment Modalities

  1. 1. Orthodontic Treatment Modalities Done by: Dr. Mohamad Ghazi Kassem
  2. 2. Orthodontic Treatment Modalities Preventive orthodontics: Interceptive orthodontics Corrective orthodontics • Removable appliances • Fixed appliances Orthognathic Surgery “Jaw Surgery”
  3. 3. Preventive orthodontics Preventive Orthodontics is the action taken to preserve the integrity of what appears to be normal at a specific time. Any procedure that attempt to ward off untoward environmental attacks or anything that would change the normal course of events, e.g. 1. Early connection of proximal caries that might change the arch length 2. Early recognition and elimination of oral habits that might interfere with the normal development of the teeth and jaws 3. Placing of a space maintainer to maintain proper position of contiguous teeth It is defined as the action taken to preserve the integrity of what appears to be a normal occlusion at a specific time.
  4. 4. 1960 : Kesling stated that “some case should be referred as early as 3 or 4 years of age and all cases by the age of 8 or 9 years” there by lying the foundation of preventive and interceptive orthodontics. 1977: Begg stated that “proper time to begin the treatment is as the beginning of the variation from the normal, in the process of development of dental apparatus, as possible” 1980: Profit and Ackermann has defined it as a prevention of potential interference with occlusal development.
  5. 5. Various Preventive procedures are : 1. Pre-dental procedures 2. Care of deciduous dentition 3. Patient and parents education programs 4. Supernumerary teeth 5. Early loss of deciduous teeth 6. Proximal caries 7. Oral habits 8. Space maintainers
  6. 6. 1. Pre-dental procedures: • Proper nutrition of the child. • Proper nursing care of the infant. • Bottle feeding should be discouraged.
  7. 7. 2. Care of deciduous dentition: 3. Patient and parent’s education programs: Need of maintaining good oral hygiene should be explained to the patient and the parents. Demonstration of brushing methods and diet counseling etc are also important.
  8. 8. 4. Supernumerary teeth: Supernumerary teeth and supplemental teeth can interfere with the eruption of nearby teeth. Presence of mesiodens prevents the two maxillary central incisors from approximating each other. They should be removed at appropriate time.
  9. 9. 5.Oral habits: Abnormal oral habits should be recognized and patient should be helped by motivation or by fitting a suitable habit breaking appliance.
  10. 10. digit sucking Methods to prevent tongue thrusting Mouth breathing
  11. 11. 6.Space maintainers: Premature loss of deciduous teeth can cause drifting of the adjacent teeth into the space. Space maintainers must be inserted in appropriate cases after the loss of teeth, particularly after the loss of deciduous molars in inadequate arches. Fixed Space Maintainers Removable space maintainers
  12. 12. Interceptive orthodontics Richardson (1982) defined interceptive orthodontics as the prompt treatment of unfavorable features of a developing occlusion that may make the difference between achieving a satisfactory result by simple mechanics later, thus reducing overall treatment time and providing better stability and functional and aesthetic results . The percentage of children who would benefit from interceptive orthodontics has been reported from 14% to 49% .
  13. 13. Interceptive orthodontics procedures will help to correct or reduce the severity of malocclusion are: 1. Developing anterior cross bite. 2. Ectopically erupted teeth. 3. Anterior diastema and abnormal labial fraenum. 4. Disking / slicing of teeth. 5. Space regainer. 6. Serial extraction. 7. Cleft lip and or palate. 8. Muscle exercise. 9. Removal of soft tissue or bony barrier to eruption of teeth.
  14. 14. 1. Developing anterior cross bite.
  15. 15. 2.Ectopic eruption Eruption is ectopic when a permanent tooth causes either: Resorption of a primary tooth other than the one it is supposed to replace OR resorption of an adjacent permanent tooth.
  16. 16. Ectopic eruption of Lateral incisors remove the contralateral canine or maintain the position of the lateral incisor on the side of the canine loss, using a lingual arch with a spur
  17. 17. Ectopic eruption of Maxillary First Molars A simple fixed appliance can be fabricated to move the molar distally An Arkansas spring
  18. 18. 3. Anterior diastema and abnormal labial fraenum.
  19. 19. 4.The ugly duckling phase
  20. 20. 5.Serial extraction Indications: 1.Straight profile 2.Class I malocclusion 3.Arch length discrepency in maxilla should be 11 mm while in mandibular arch 10.5 mm Contraindications: 1. Convex profile 2. Class II malocclusion 3. Low angle case 4. High angle case
  21. 21. Advantages of serial extraction • • • Reduces the severity of malocclusion Reduces the extent of mechanotherapy Reduces the duration of treatment Disadvantages of serial extraction • • • Chances of increasing overbite Canines may fail to migrate distally Anterior teeth may tip lingually Methods of serial extraction • • Dewel’s method (cd4) Tweed’s method (d4c)
  22. 22. Comprehensive Orthodontics Comprehensive procedures are those that involve growth modification for skeletal correction and procedures that require banding more than 6 teeth per arch. Treatment usually utilizes fixed orthodontic appliances and may include functional and /or orthopedic appliances. Adjunctive procedures, such as extractions, maxillofacial surgery, myofunctional or speech therapy and restorative or periodontal care, may be coordinated disciplines. Optimal care requires long-term consideration of patient’s needs and periodic reevaluation. Treatment may incorporate several phases with specific objectives at various stages of dentofacial development.
  23. 23. Comprehensive Orthodontics fixed orthodontic appliances
  24. 24. Functional appliance A removable or fixed appliance that alters the posture of the mandible and transmits the forces created by the resulting stretch of the muscles and soft tissues and by the change of the neuromuscular environment to the dental and skeletal tissues to produce movement of teeth and modification of growth. They can bring about the following changes: 1.An increase or decrease in jaw size. 2.A change in spatial relationship of the jaws. 3.Change in direction of growth of the jaws. 4.Acceleration of desirable growth.
  25. 25. Classification of functional appliances
  26. 26. palatal expander Bionator
  27. 27. Herbst Telescopic Appliance Fränkl Appliance
  28. 28. Headgear
  29. 29. Forsus Jasper Jumper
  30. 30. Orthognathic Surgery “Jaw Surgery” Indication: 1. In severe malocclusion . 2. Unaesthetic appearance of a dentofacial deformity resulting in undesirable psychological effects. Orthognathic procedures are divided into three categories: a. Maxilla b. Mandible c. Bimaxillary
  31. 31. • Research & Reviews: A Journal of Dentistry • Volume 2, Issue 1, April, 2011, Pages 6- 9 . • A to Z ORTHODONTICS Volume: 09 Dr. Mohammad Khursheed Alam BDS, PGT, PhD (Japan) • http://www.gulatisclinic.com/orth_treat.php • http://www.columbia.edu/itc/hs/dental/D5300/SCOPE%20OF%2 0PREDOCTORAL_BW.pdf