ORTHODONTIC DIAGNOSIS – DEFINE THE
PROBLEM

INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalac...
DIAGNOSIS
DEFINE THE PROBLEM
ORGANIZED THINKING
THREE PLANES OF SPACE
ANTERO-POSTERIOR
VERTICAL
TRANSVERSE
INTRA-ARCH
GROW...
PROBLEM LIST
GENERAL: CARIES; PERIODONTAL;
IMPACTIONS; CONGENITAL
ABSENCE; PEG LATERALS ETC.
FACE : PROFILE + LIPS + SMILE...
PROBLEM LIST

VERTICAL
OVERBITE/OPENBITE
DOLICOFACIAL/BRACHYFACIAL
TRANSVERSE
MIDLINES
FUNCTIONAL SHIFT/ASYMMETRY
POSTERIO...
from OBJECTIVES
to TREATMENT PLAN
SPECIFIC OBJECTIVES
DENTAL = TOOTH MOVEMENTS
SKELETAL CHANGES
CEPHALOMETRICS
MOLARS AND ...
What are the possibilities for tooth
movements/skeletal changes in
three planes of space?
prioritize
OBJECTIVE: Expand the
upper arch dentally and/or
skeletally
PROBLEM
posterior crossbite
crowding-gain arch
length

APPLIAN...
TRANSVERSE
 UNILATERAL POSTERIOR
CROSSBITE
 BILATERAL POSTERIOR
CROSSBITE
MIDLINE DEVIATION
 TOOTH SHIFT ACROSS MIDLINE
 FUNCTIONAL (POSTURAL) SHIFT
OF THE MANDIBLE
 COMBINATION
TRANSVERSE DIMENSION

INITIAL CONTACT POSITION

RIGHT UNILATERAL
POST. CROSSBITE
FUNCTIONAL SHIFT

MAXIMUM INTERCUSPATION
DENTAL+?SKELETAL EXPANSION
QUADHELIX EXPANDER

FIXED BANDS AND REMOVABLE WIRE
DENTAL+?SKELETAL EXPANSION
REMOVABLE EXPANDER

FULL COVERAGE ACRYLIC
CLASPS
MIDLINE EXPANSION SCREW

EXPANSION KEY
5 MONTHS

2 TURNS/WEEK
FIXED ACRYLIC
EXPANDER
SKELETAL/DENTAL EXPANSION
RAPID MAXILLARY EXPANDER
TOOTH-BORNE (HYRAX)

PRE TREATMENT

POST-EXPANSION
MIDLINE DIASTEMA
SKELETAL/DENTAL EXPANSION
RME HYRAX

FIXED TO FOUR BANDS
SKELETAL EXPANSION
RME
TISSUE-BORNE (HAAS)

FOUR BANDS
BUCCAL + PALATAL WIRES
PALATAL ACRYLIC

MIDPALATAL SUTURE
OPENING
SKELETAL EXPANSION
RME
BONDED EXPANDER

PRE TREATMENT
BILATERAL POST. CROSSBITE
NARROW UPPER ARCH

POST TREATMENT
SKELETAL...
SKELETAL EXPANSION
BONDED RME

POST EXPANSION STABILIZATION
DENTAL EXPANSION

ONE TOOTH
POSTERIOR CROSSBITE
COINCIDENT MIDLINES

CROSSBITE ELASTIC
RECIPROCAL
TOOTH MOVEMENT
PROBLEM: Crowding (create arch
length); some A-P correction
A-P
OBJECTIVE
Derotate U molars
Hold/distalize U molar
Maintai...
CREATE SPACE
HOLD/DISTALIZE LOWER MOLAR
ADVANCE INCISORS
TRANSVERSE EXPANSION (DENTAL)

MANDIBULAR LIP BUMPER
CREATE SPACE
DISTALIZE UPPER MOLAR

SPACE LOSS
PENDULUM APPLIANCE
UNILATERAL/BILATERAL

POST TREATMENT
NANCE HOLDING ARCH
PENDULUM APPLIANCE-Unilateral
TRANSPALATAL
BAR- Unilateral

REMOVABLE
APPLIANCESectional screw
CREATE SPACE
DISTALIZE UPPER AND
LOWER MOLARS
MAINTAIN/ADVANCE LOWER INCISORS
TRANSVERSE DENTAL EXPANSION

TANDEM MECHANIC...
MAINTAIN SPACE
LATE MIXED DENTITION

EARLY PERMANENT DENTITION
ANTERIOR CROWDING
MANDIBULAR
LEEWAY (E SPACE)
LINGUAL HOLDI...
STRATEGIES TO RESOLVE
CROWDING
NON-EXTRACTION MECHANICS
INTERPROXIMAL ENAMEL
REDUCTION (STRIPPING)
PREMOLAR EXTRACTIONS
ON...
CROWDING
MIXED DENTITION
CRCRO
 NON-EXTRACTION: LEEWAY
SPACE AND HOLDING
ARCHES/FIXED APPLIANCES
 EXTRACTION: SERIAL
EXT...
MAJOR DECISIONMA
EXTRACTION
• EXCESS SPACE
• INCISOR
POSITION
• ANCHORAGE

NON-EXTRACTION
• ADVANCE INCISORS
• DISTALIZE
P...
Extraction/Non-extraction
Extraction/Non-extraction
decision is an important
consideration BUT
the specific objectives sho...
PROBLEM: Crowding - close
extraction spaces
OBJECTIVE
Lower incisors
maintain
retract
Lower molars
maintain
protract

MECH...
PROBLEM: Crowding - close
extraction spaces
OBJECTIVE
Upper incisors
maintain
retract
Upper molars
maintain
protract

MECH...
EXTRACTION MECHANICS
ANCHORAGE

RELATIVE ANCHORAGE
VALUES OF THE TEETH

MAXIMUM ANCHORAGE
EXTRA-ORAL ANCHORAGE
CERVICAL HE...
ANCHORAGE AUXILIARIES
-MODERATE ANCHORAGE

NANCE HOLDING ARCH

TRANSPALATAL BAR
(REMOVABLE)
CLASS I EXTRACTION CASE
CROWDING
DENTAL PROTRUSION

PRE TREATMENT

PROTRUSIVE LIPS
STRAINED ON CLOSURE
CLASS I EXTRACTION CASE
CROWDING
DENTAL PROTRUSION

PRETREATMENT
INCREASED OVERBITE
CLASS I (CLASS II TENDENCY)
INCREASED ...
CLASS I EXTRACTION

SLIGHT UPPER CROWDING
MODERATE LOWER CROWDING
EXTRACTION MECHANICS

ELASTOMERICS (C CHAIN)
PUSH COIL SPRING

CLOSING LOOPS
ELASTOMERICS
CLASS I MIXED DENTITION
SEVERE CROWDING
SERIAL EXTRACTION

PRETREATMENT

ORTHOGNATHIC
STRAIGHT/SLIGHTLY CONVEX
LIPS RELAXE...
SERIAL EXTRACTION

PRETREATMENT
MIDDLE MIXED DENTITION
CLASS I
AVERAGE OVERJET+

ANTERIOR CROSSBITE
AVERAGE OVERBITE
POSTE...
SERIAL EXTRACTION

POSTERIOR MOLAR CROSSBITE
(RIGHT SIDE)
MIDLINES COINCIDE

SEVERE CROWDING
-MAXILLARY ARCH
MOLAR ROTATIO...
SERIAL EXTRACTION

SEVERE CROWDING
MANDIBULAR ARCH

EXCESSIVE CURVE OF SPEE
(DEEP OVERBITE)
SERIAL EXTRACTION

INTRA-ORAL (PERI-APICAL)
RADIOGRAPHS
CEPHALOMETRIC
RADIOGRAPH
SERIAL EXTRACTION

PROGRESS
PRIMARY CANINES EXTRACTED
AWAITING ERUPTION OF FIRST PREMOLARS
SERIAL EXTRACTION

FIRST PREMOLARS ERUPTING
SERIAL EXTRACTION

PROGRESS
INTRA-ORAL RADIOGRAPHS
SERIAL EXTRACTION

EXTRACTION OF
FIRST PREMOLARS
AND ERUPTION OF CANINES

LOWER LINGUAL
HOLDING ARCH
OBJECTIVE: Advance upper and/or
lower incisors
PROBLEM
anterior crossbite
crowding - gain arch
length
Class II- mandibular...
ADVANCE UPPER INCISORS
ANTERIOR CROSSBITE

MIXED DENTITION
ANTERIOR CROSSBITE

REMOVABLE APPLIANCE
CLASPS; OCCLUSAL ACRYLI...
ANTERIOR CROSSBITE
LIMITED FIXED APPLIANCE

PRE-TREATMENT

POST-TREATMENT
ADVANDE INCISORS
ANTERIOR CROSSBITE

ANTERIOR CROSSBITE
(ALSO BILATERAL
POSTERIOR CROSSBITE)

PARTIAL FIXED APPLIANCE
QUADHELIX

RETAINER
ADVANCE INCISORS
ANTERIOR CROSSBITE
PSEUDO-CLASS III

MAXIMUM INTERCUSPATION
ANTERIOR CROSSBITE
UPPER ARCH CROWDING
UPPER ...
OBJECTIVE: Level lower arch;
increase compensating curve;
extrude post. teeth / increase vertical
PROBLEM
overbite
deep cu...
EXTRUDE POSTERIOR TEETH
(INCREASE THE VERTICAL DIMENSION)
DEEP OVERBITE

PRE-TREATMENT
DEEP OVERBITE

FIXED APPLIANCES
ANT...
EXTRUDE POSTERIOR TEETH
(INCREASE THE VERTICAL DIMENSION)
DEEP OVERBITE

INITIAL INSERTION OF
ANTERIOR BITE PLATE

EFFECT ...
OBJECTIVE: Intrude upper and/or
lower incisors
PROBLEM
deep overbite
high lip line
deep curve of Spee
vertical pattern
Cla...
INCISOR INTRUSION
DEEP OVERBITE

PRETREATMENT
DEEP OVERBITE

EFFECTS OF
INTRUSION ARCH WIRES
EXTRUDE UPPER INCISORS
ANTERIOR OPEN BITE
(THUMB/TONGUE HABIT)

THUMB/TONGUE CRIB
MIDDLE MIXED DENTITION
ANTERIOR OPEN BIT...
EXTRUDE UPPER/LOWER INCISORS
ANTERIOR OPEN BITE
(THUMB/TONGUE HABIT)

FOLLOWING TONGUE CRIB
SPONTANEOUS
INCISOR ERUPTION

...
OBJECTIVE: Control/maintain
vertical dimension-intrude
dimension-intrude
upper/lower posterior teeth
PROBLEM
open bite
ver...
CONTROL VERTICAL DEVELOPMENT
ANTERIOR OPEN-BITE
VERTICAL SKELETAL PATTERN

ANTERIOR OPEN BITE

VERTICAL
SKELETAL PATTERN
CONTROL VERTICAL DEVELOPMENT
ANTERIOR OPEN-BITE
VERTICAL SKELETAL PATTERN

HIGH-PULL HEADGEAR

VERTICAL PULL CHIN-CUP
INTRUDE/HOLD
POSTERIOR TEETH
VERTICALLY

LOWER POSTERIOR BITE BLOCK
(OCCLUSAL SPLINT)
OBJECTIVE: Growth
modification (orthopedics)(orthopedics)Maxillary retraction/protraction
Mandibular protraction/retractio...
www.indiandentalacademy.com
Leader in continuing dental education
Diagnosis define the problem /certified fixed orthodontic courses by Indian dental academy
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Diagnosis define the problem /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

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Diagnosis define the problem /certified fixed orthodontic courses by Indian dental academy

  1. 1. ORTHODONTIC DIAGNOSIS – DEFINE THE PROBLEM INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com
  2. 2. DIAGNOSIS DEFINE THE PROBLEM ORGANIZED THINKING THREE PLANES OF SPACE ANTERO-POSTERIOR VERTICAL TRANSVERSE INTRA-ARCH GROWTH
  3. 3. PROBLEM LIST GENERAL: CARIES; PERIODONTAL; IMPACTIONS; CONGENITAL ABSENCE; PEG LATERALS ETC. FACE : PROFILE + LIPS + SMILE ANTERO-POSTERIOR MOLAR + CANINE CLASS II /III OVERJET/ANTERIOR CROSSBITE DENTAL PROTRUSION
  4. 4. PROBLEM LIST VERTICAL OVERBITE/OPENBITE DOLICOFACIAL/BRACHYFACIAL TRANSVERSE MIDLINES FUNCTIONAL SHIFT/ASYMMETRY POSTERIOR CROSSBITE (SKELETAL/DENTAL) INTRA-ARCH: ARCH FORM; ASYMMETRY; CROWDING/SPACING
  5. 5. from OBJECTIVES to TREATMENT PLAN SPECIFIC OBJECTIVES DENTAL = TOOTH MOVEMENTS SKELETAL CHANGES CEPHALOMETRICS MOLARS AND INCISORS THREE PLANES OF SPACE
  6. 6. What are the possibilities for tooth movements/skeletal changes in three planes of space? prioritize
  7. 7. OBJECTIVE: Expand the upper arch dentally and/or skeletally PROBLEM posterior crossbite crowding-gain arch length APPLIANCE quadhelix Rapid palatal expander Hyrax expander Transpalatal bar E-arch or lip bumber archwire-outbend crossbite elastics
  8. 8. TRANSVERSE  UNILATERAL POSTERIOR CROSSBITE  BILATERAL POSTERIOR CROSSBITE
  9. 9. MIDLINE DEVIATION  TOOTH SHIFT ACROSS MIDLINE  FUNCTIONAL (POSTURAL) SHIFT OF THE MANDIBLE  COMBINATION
  10. 10. TRANSVERSE DIMENSION INITIAL CONTACT POSITION RIGHT UNILATERAL POST. CROSSBITE FUNCTIONAL SHIFT MAXIMUM INTERCUSPATION
  11. 11. DENTAL+?SKELETAL EXPANSION QUADHELIX EXPANDER FIXED BANDS AND REMOVABLE WIRE
  12. 12. DENTAL+?SKELETAL EXPANSION REMOVABLE EXPANDER FULL COVERAGE ACRYLIC CLASPS MIDLINE EXPANSION SCREW EXPANSION KEY
  13. 13. 5 MONTHS 2 TURNS/WEEK
  14. 14. FIXED ACRYLIC EXPANDER
  15. 15. SKELETAL/DENTAL EXPANSION RAPID MAXILLARY EXPANDER TOOTH-BORNE (HYRAX) PRE TREATMENT POST-EXPANSION MIDLINE DIASTEMA
  16. 16. SKELETAL/DENTAL EXPANSION RME HYRAX FIXED TO FOUR BANDS
  17. 17. SKELETAL EXPANSION RME TISSUE-BORNE (HAAS) FOUR BANDS BUCCAL + PALATAL WIRES PALATAL ACRYLIC MIDPALATAL SUTURE OPENING
  18. 18. SKELETAL EXPANSION RME BONDED EXPANDER PRE TREATMENT BILATERAL POST. CROSSBITE NARROW UPPER ARCH POST TREATMENT SKELETAL EXPANSION
  19. 19. SKELETAL EXPANSION BONDED RME POST EXPANSION STABILIZATION
  20. 20. DENTAL EXPANSION ONE TOOTH POSTERIOR CROSSBITE COINCIDENT MIDLINES CROSSBITE ELASTIC RECIPROCAL TOOTH MOVEMENT
  21. 21. PROBLEM: Crowding (create arch length); some A-P correction A-P OBJECTIVE Derotate U molars Hold/distalize U molar Maintain L incisor antero-posteriorly Hold/distalize L molar Expand premolars and molars APPLIANCE TP bar; quadhelix; archwires;bumper Headgear; bumper; pendulum appl. Class III elastics; tandem mechs.; lip bumper archwires; quadhelix; bumpers
  22. 22. CREATE SPACE HOLD/DISTALIZE LOWER MOLAR ADVANCE INCISORS TRANSVERSE EXPANSION (DENTAL) MANDIBULAR LIP BUMPER
  23. 23. CREATE SPACE DISTALIZE UPPER MOLAR SPACE LOSS PENDULUM APPLIANCE UNILATERAL/BILATERAL POST TREATMENT NANCE HOLDING ARCH
  24. 24. PENDULUM APPLIANCE-Unilateral
  25. 25. TRANSPALATAL BAR- Unilateral REMOVABLE APPLIANCESectional screw
  26. 26. CREATE SPACE DISTALIZE UPPER AND LOWER MOLARS MAINTAIN/ADVANCE LOWER INCISORS TRANSVERSE DENTAL EXPANSION TANDEM MECHANICS CLASS III ELASTICS EXTRA-ORAL TRACTION LOWER ARCH CERVICAL HEADGEAR COIL SPRING
  27. 27. MAINTAIN SPACE LATE MIXED DENTITION EARLY PERMANENT DENTITION ANTERIOR CROWDING MANDIBULAR LEEWAY (E SPACE) LINGUAL HOLDING ARCH
  28. 28. STRATEGIES TO RESOLVE CROWDING NON-EXTRACTION MECHANICS INTERPROXIMAL ENAMEL REDUCTION (STRIPPING) PREMOLAR EXTRACTIONS ONE LOWER INCISOR EXTRACTION
  29. 29. CROWDING MIXED DENTITION CRCRO  NON-EXTRACTION: LEEWAY SPACE AND HOLDING ARCHES/FIXED APPLIANCES  EXTRACTION: SERIAL EXTRACTION/ERUPTION GUIDANCE
  30. 30. MAJOR DECISIONMA EXTRACTION • EXCESS SPACE • INCISOR POSITION • ANCHORAGE NON-EXTRACTION • ADVANCE INCISORS • DISTALIZE POSTERIORS • EXPAND ARCHES
  31. 31. Extraction/Non-extraction Extraction/Non-extraction decision is an important consideration BUT the specific objectives should lead to the decision to extract or not.
  32. 32. PROBLEM: Crowding - close extraction spaces OBJECTIVE Lower incisors maintain retract Lower molars maintain protract MECHANOTHERAPY Anchorage maximum moderate minimal
  33. 33. PROBLEM: Crowding - close extraction spaces OBJECTIVE Upper incisors maintain retract Upper molars maintain protract MECHANOTHERAPY Anchorage maximum moderate minimal
  34. 34. EXTRACTION MECHANICS ANCHORAGE RELATIVE ANCHORAGE VALUES OF THE TEETH MAXIMUM ANCHORAGE EXTRA-ORAL ANCHORAGE CERVICAL HEADGEAR
  35. 35. ANCHORAGE AUXILIARIES -MODERATE ANCHORAGE NANCE HOLDING ARCH TRANSPALATAL BAR (REMOVABLE)
  36. 36. CLASS I EXTRACTION CASE CROWDING DENTAL PROTRUSION PRE TREATMENT PROTRUSIVE LIPS STRAINED ON CLOSURE
  37. 37. CLASS I EXTRACTION CASE CROWDING DENTAL PROTRUSION PRETREATMENT INCREASED OVERBITE CLASS I (CLASS II TENDENCY) INCREASED OVERJET
  38. 38. CLASS I EXTRACTION SLIGHT UPPER CROWDING MODERATE LOWER CROWDING
  39. 39. EXTRACTION MECHANICS ELASTOMERICS (C CHAIN) PUSH COIL SPRING CLOSING LOOPS ELASTOMERICS
  40. 40. CLASS I MIXED DENTITION SEVERE CROWDING SERIAL EXTRACTION PRETREATMENT ORTHOGNATHIC STRAIGHT/SLIGHTLY CONVEX LIPS RELAXED
  41. 41. SERIAL EXTRACTION PRETREATMENT MIDDLE MIXED DENTITION CLASS I AVERAGE OVERJET+ ANTERIOR CROSSBITE AVERAGE OVERBITE POSTERIOR CROSS-BITE (RIGHT MOLARS)
  42. 42. SERIAL EXTRACTION POSTERIOR MOLAR CROSSBITE (RIGHT SIDE) MIDLINES COINCIDE SEVERE CROWDING -MAXILLARY ARCH MOLAR ROTATION
  43. 43. SERIAL EXTRACTION SEVERE CROWDING MANDIBULAR ARCH EXCESSIVE CURVE OF SPEE (DEEP OVERBITE)
  44. 44. SERIAL EXTRACTION INTRA-ORAL (PERI-APICAL) RADIOGRAPHS CEPHALOMETRIC RADIOGRAPH
  45. 45. SERIAL EXTRACTION PROGRESS PRIMARY CANINES EXTRACTED AWAITING ERUPTION OF FIRST PREMOLARS
  46. 46. SERIAL EXTRACTION FIRST PREMOLARS ERUPTING
  47. 47. SERIAL EXTRACTION PROGRESS INTRA-ORAL RADIOGRAPHS
  48. 48. SERIAL EXTRACTION EXTRACTION OF FIRST PREMOLARS AND ERUPTION OF CANINES LOWER LINGUAL HOLDING ARCH
  49. 49. OBJECTIVE: Advance upper and/or lower incisors PROBLEM anterior crossbite crowding - gain arch length Class II- mandibular dental retrusion APPLIANCE archwires-utility advancement; levelling wire Class III elastics Class II elastics high lip bumper tandem mechanics
  50. 50. ADVANCE UPPER INCISORS ANTERIOR CROSSBITE MIXED DENTITION ANTERIOR CROSSBITE REMOVABLE APPLIANCE CLASPS; OCCLUSAL ACRYLIC FINGER SPRINGS
  51. 51. ANTERIOR CROSSBITE LIMITED FIXED APPLIANCE PRE-TREATMENT POST-TREATMENT
  52. 52. ADVANDE INCISORS ANTERIOR CROSSBITE ANTERIOR CROSSBITE (ALSO BILATERAL POSTERIOR CROSSBITE) PARTIAL FIXED APPLIANCE
  53. 53. QUADHELIX RETAINER
  54. 54. ADVANCE INCISORS ANTERIOR CROSSBITE PSEUDO-CLASS III MAXIMUM INTERCUSPATION ANTERIOR CROSSBITE UPPER ARCH CROWDING UPPER MIDLINE RIGHT (CROWDING) INITIAL CONTACT POSITION FUNCTIONAL SHIFT (ANTERIOR+LATERAL
  55. 55. OBJECTIVE: Level lower arch; increase compensating curve; extrude post. teeth / increase vertical PROBLEM overbite deep curve of Spee deep bite pattern (brachyfacial) good lip line APPLIANCE full-arch mechanics anterior bite plate functional appliances cervical headgear inter-arch elastics (Class II or Class III; vertical)
  56. 56. EXTRUDE POSTERIOR TEETH (INCREASE THE VERTICAL DIMENSION) DEEP OVERBITE PRE-TREATMENT DEEP OVERBITE FIXED APPLIANCES ANTERIOR BITE PLATE
  57. 57. EXTRUDE POSTERIOR TEETH (INCREASE THE VERTICAL DIMENSION) DEEP OVERBITE INITIAL INSERTION OF ANTERIOR BITE PLATE EFFECT OF ANTERIOR BITE PLATE + ARCH WIRES
  58. 58. OBJECTIVE: Intrude upper and/or lower incisors PROBLEM deep overbite high lip line deep curve of Spee vertical pattern Class II-distally tip upper molars upright lower molarsavoid L1 advancement APPLIANCE 2 X 4 Incisor intrusion arches / utility arches
  59. 59. INCISOR INTRUSION DEEP OVERBITE PRETREATMENT DEEP OVERBITE EFFECTS OF INTRUSION ARCH WIRES
  60. 60. EXTRUDE UPPER INCISORS ANTERIOR OPEN BITE (THUMB/TONGUE HABIT) THUMB/TONGUE CRIB MIDDLE MIXED DENTITION ANTERIOR OPEN BITE
  61. 61. EXTRUDE UPPER/LOWER INCISORS ANTERIOR OPEN BITE (THUMB/TONGUE HABIT) FOLLOWING TONGUE CRIB SPONTANEOUS INCISOR ERUPTION VERTICAL ELASTICS WITH FIXED APPLIANCES
  62. 62. OBJECTIVE: Control/maintain vertical dimension-intrude dimension-intrude upper/lower posterior teeth PROBLEM open bite vertical pattern dolicofacial APPLIANCE high-pull headgear lower lingual arch occlusal splint vertical pull chin-cup “Kim” mechanics (MEAW)
  63. 63. CONTROL VERTICAL DEVELOPMENT ANTERIOR OPEN-BITE VERTICAL SKELETAL PATTERN ANTERIOR OPEN BITE VERTICAL SKELETAL PATTERN
  64. 64. CONTROL VERTICAL DEVELOPMENT ANTERIOR OPEN-BITE VERTICAL SKELETAL PATTERN HIGH-PULL HEADGEAR VERTICAL PULL CHIN-CUP
  65. 65. INTRUDE/HOLD POSTERIOR TEETH VERTICALLY LOWER POSTERIOR BITE BLOCK (OCCLUSAL SPLINT)
  66. 66. OBJECTIVE: Growth modification (orthopedics)(orthopedics)Maxillary retraction/protraction Mandibular protraction/retraction PROBLEM Class II div. 1 max. protrusion mand. retrusion Class III max. deficiency mand. prognathism APPLIANCE Headgear Functional appliances Class II elastics Face mask Class III elastics Functional appliances Chin cup
  67. 67. www.indiandentalacademy.com Leader in continuing dental education

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