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

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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  • 1. ORTHODONTIC DIAGNOSIS – DEFINE THE PROBLEM INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com
  • 2. DIAGNOSIS DEFINE THE PROBLEM ORGANIZED THINKING THREE PLANES OF SPACE ANTERO-POSTERIOR VERTICAL TRANSVERSE INTRA-ARCH GROWTH
  • 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. PROBLEM LIST VERTICAL OVERBITE/OPENBITE DOLICOFACIAL/BRACHYFACIAL TRANSVERSE MIDLINES FUNCTIONAL SHIFT/ASYMMETRY POSTERIOR CROSSBITE (SKELETAL/DENTAL) INTRA-ARCH: ARCH FORM; ASYMMETRY; CROWDING/SPACING
  • 5. from OBJECTIVES to TREATMENT PLAN SPECIFIC OBJECTIVES DENTAL = TOOTH MOVEMENTS SKELETAL CHANGES CEPHALOMETRICS MOLARS AND INCISORS THREE PLANES OF SPACE
  • 6. What are the possibilities for tooth movements/skeletal changes in three planes of space? prioritize
  • 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. TRANSVERSE  UNILATERAL POSTERIOR CROSSBITE  BILATERAL POSTERIOR CROSSBITE
  • 9. MIDLINE DEVIATION  TOOTH SHIFT ACROSS MIDLINE  FUNCTIONAL (POSTURAL) SHIFT OF THE MANDIBLE  COMBINATION
  • 10. TRANSVERSE DIMENSION INITIAL CONTACT POSITION RIGHT UNILATERAL POST. CROSSBITE FUNCTIONAL SHIFT MAXIMUM INTERCUSPATION
  • 11. DENTAL+?SKELETAL EXPANSION QUADHELIX EXPANDER FIXED BANDS AND REMOVABLE WIRE
  • 12. DENTAL+?SKELETAL EXPANSION REMOVABLE EXPANDER FULL COVERAGE ACRYLIC CLASPS MIDLINE EXPANSION SCREW EXPANSION KEY
  • 13. 5 MONTHS 2 TURNS/WEEK
  • 14. FIXED ACRYLIC EXPANDER
  • 15. SKELETAL/DENTAL EXPANSION RAPID MAXILLARY EXPANDER TOOTH-BORNE (HYRAX) PRE TREATMENT POST-EXPANSION MIDLINE DIASTEMA
  • 16. SKELETAL/DENTAL EXPANSION RME HYRAX FIXED TO FOUR BANDS
  • 17. SKELETAL EXPANSION RME TISSUE-BORNE (HAAS) FOUR BANDS BUCCAL + PALATAL WIRES PALATAL ACRYLIC MIDPALATAL SUTURE OPENING
  • 18. SKELETAL EXPANSION RME BONDED EXPANDER PRE TREATMENT BILATERAL POST. CROSSBITE NARROW UPPER ARCH POST TREATMENT SKELETAL EXPANSION
  • 19. SKELETAL EXPANSION BONDED RME POST EXPANSION STABILIZATION
  • 20. DENTAL EXPANSION ONE TOOTH POSTERIOR CROSSBITE COINCIDENT MIDLINES CROSSBITE ELASTIC RECIPROCAL TOOTH MOVEMENT
  • 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. CREATE SPACE HOLD/DISTALIZE LOWER MOLAR ADVANCE INCISORS TRANSVERSE EXPANSION (DENTAL) MANDIBULAR LIP BUMPER
  • 23. CREATE SPACE DISTALIZE UPPER MOLAR SPACE LOSS PENDULUM APPLIANCE UNILATERAL/BILATERAL POST TREATMENT NANCE HOLDING ARCH
  • 24. PENDULUM APPLIANCE-Unilateral
  • 25. TRANSPALATAL BAR- Unilateral REMOVABLE APPLIANCESectional screw
  • 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. MAINTAIN SPACE LATE MIXED DENTITION EARLY PERMANENT DENTITION ANTERIOR CROWDING MANDIBULAR LEEWAY (E SPACE) LINGUAL HOLDING ARCH
  • 28. STRATEGIES TO RESOLVE CROWDING NON-EXTRACTION MECHANICS INTERPROXIMAL ENAMEL REDUCTION (STRIPPING) PREMOLAR EXTRACTIONS ONE LOWER INCISOR EXTRACTION
  • 29. CROWDING MIXED DENTITION CRCRO  NON-EXTRACTION: LEEWAY SPACE AND HOLDING ARCHES/FIXED APPLIANCES  EXTRACTION: SERIAL EXTRACTION/ERUPTION GUIDANCE
  • 30. MAJOR DECISIONMA EXTRACTION • EXCESS SPACE • INCISOR POSITION • ANCHORAGE NON-EXTRACTION • ADVANCE INCISORS • DISTALIZE POSTERIORS • EXPAND ARCHES
  • 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. PROBLEM: Crowding - close extraction spaces OBJECTIVE Lower incisors maintain retract Lower molars maintain protract MECHANOTHERAPY Anchorage maximum moderate minimal
  • 33. PROBLEM: Crowding - close extraction spaces OBJECTIVE Upper incisors maintain retract Upper molars maintain protract MECHANOTHERAPY Anchorage maximum moderate minimal
  • 34. EXTRACTION MECHANICS ANCHORAGE RELATIVE ANCHORAGE VALUES OF THE TEETH MAXIMUM ANCHORAGE EXTRA-ORAL ANCHORAGE CERVICAL HEADGEAR
  • 35. ANCHORAGE AUXILIARIES -MODERATE ANCHORAGE NANCE HOLDING ARCH TRANSPALATAL BAR (REMOVABLE)
  • 36. CLASS I EXTRACTION CASE CROWDING DENTAL PROTRUSION PRE TREATMENT PROTRUSIVE LIPS STRAINED ON CLOSURE
  • 37. CLASS I EXTRACTION CASE CROWDING DENTAL PROTRUSION PRETREATMENT INCREASED OVERBITE CLASS I (CLASS II TENDENCY) INCREASED OVERJET
  • 38. CLASS I EXTRACTION SLIGHT UPPER CROWDING MODERATE LOWER CROWDING
  • 39. EXTRACTION MECHANICS ELASTOMERICS (C CHAIN) PUSH COIL SPRING CLOSING LOOPS ELASTOMERICS
  • 40. CLASS I MIXED DENTITION SEVERE CROWDING SERIAL EXTRACTION PRETREATMENT ORTHOGNATHIC STRAIGHT/SLIGHTLY CONVEX LIPS RELAXED
  • 41. SERIAL EXTRACTION PRETREATMENT MIDDLE MIXED DENTITION CLASS I AVERAGE OVERJET+ ANTERIOR CROSSBITE AVERAGE OVERBITE POSTERIOR CROSS-BITE (RIGHT MOLARS)
  • 42. SERIAL EXTRACTION POSTERIOR MOLAR CROSSBITE (RIGHT SIDE) MIDLINES COINCIDE SEVERE CROWDING -MAXILLARY ARCH MOLAR ROTATION
  • 43. SERIAL EXTRACTION SEVERE CROWDING MANDIBULAR ARCH EXCESSIVE CURVE OF SPEE (DEEP OVERBITE)
  • 44. SERIAL EXTRACTION INTRA-ORAL (PERI-APICAL) RADIOGRAPHS CEPHALOMETRIC RADIOGRAPH
  • 45. SERIAL EXTRACTION PROGRESS PRIMARY CANINES EXTRACTED AWAITING ERUPTION OF FIRST PREMOLARS
  • 46. SERIAL EXTRACTION FIRST PREMOLARS ERUPTING
  • 47. SERIAL EXTRACTION PROGRESS INTRA-ORAL RADIOGRAPHS
  • 48. SERIAL EXTRACTION EXTRACTION OF FIRST PREMOLARS AND ERUPTION OF CANINES LOWER LINGUAL HOLDING ARCH
  • 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. ADVANCE UPPER INCISORS ANTERIOR CROSSBITE MIXED DENTITION ANTERIOR CROSSBITE REMOVABLE APPLIANCE CLASPS; OCCLUSAL ACRYLIC FINGER SPRINGS
  • 51. ANTERIOR CROSSBITE LIMITED FIXED APPLIANCE PRE-TREATMENT POST-TREATMENT
  • 52. ADVANDE INCISORS ANTERIOR CROSSBITE ANTERIOR CROSSBITE (ALSO BILATERAL POSTERIOR CROSSBITE) PARTIAL FIXED APPLIANCE
  • 53. QUADHELIX RETAINER
  • 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. 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. EXTRUDE POSTERIOR TEETH (INCREASE THE VERTICAL DIMENSION) DEEP OVERBITE PRE-TREATMENT DEEP OVERBITE FIXED APPLIANCES ANTERIOR BITE PLATE
  • 57. EXTRUDE POSTERIOR TEETH (INCREASE THE VERTICAL DIMENSION) DEEP OVERBITE INITIAL INSERTION OF ANTERIOR BITE PLATE EFFECT OF ANTERIOR BITE PLATE + ARCH WIRES
  • 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. INCISOR INTRUSION DEEP OVERBITE PRETREATMENT DEEP OVERBITE EFFECTS OF INTRUSION ARCH WIRES
  • 60. EXTRUDE UPPER INCISORS ANTERIOR OPEN BITE (THUMB/TONGUE HABIT) THUMB/TONGUE CRIB MIDDLE MIXED DENTITION ANTERIOR OPEN BITE
  • 61. EXTRUDE UPPER/LOWER INCISORS ANTERIOR OPEN BITE (THUMB/TONGUE HABIT) FOLLOWING TONGUE CRIB SPONTANEOUS INCISOR ERUPTION VERTICAL ELASTICS WITH FIXED APPLIANCES
  • 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. CONTROL VERTICAL DEVELOPMENT ANTERIOR OPEN-BITE VERTICAL SKELETAL PATTERN ANTERIOR OPEN BITE VERTICAL SKELETAL PATTERN
  • 64. CONTROL VERTICAL DEVELOPMENT ANTERIOR OPEN-BITE VERTICAL SKELETAL PATTERN HIGH-PULL HEADGEAR VERTICAL PULL CHIN-CUP
  • 65. INTRUDE/HOLD POSTERIOR TEETH VERTICALLY LOWER POSTERIOR BITE BLOCK (OCCLUSAL SPLINT)
  • 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. www.indiandentalacademy.com Leader in continuing dental education

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