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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 …

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.


Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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  • 1. DIAGNOSIS DEFINE THE PROBLEM DIAGNOSISDIAGNOSIS DEFINE THE PROBLEMDEFINE THE PROBLEM ORGANIZED THINKING THREE PLANES OF SPACE ANTERO-POSTERIOR VERTICAL TRANSVERSE INTRA-ARCH GROWTHwww.indiandentalacademy.com
  • 2. www.indiandentalacademy.com INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com
  • 3. PROBLEM LISTPROBLEM LISTPROBLEM 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 www.indiandentalacademy.com
  • 4. PROBLEM LISTPROBLEM LISTPROBLEM LIST VERTICAL OVERBITE/OPENBITE DOLICOFACIAL/BRACHYFACIAL TRANSVERSE MIDLINES FUNCTIONAL SHIFT/ASYMMETRY POSTERIOR CROSSBITE (SKELETAL/DENTAL) INTRA-ARCH: ARCH FORM; ASYMMETRY; CROWDING/SPACING www.indiandentalacademy.com
  • 5. from OBJECTIVES to TREATMENT PLAN fromfrom OBJECTIVESOBJECTIVES toto TREATMENT PLANTREATMENT PLAN SPECIFIC OBJECTIVES DENTAL = TOOTH MOVEMENTS SKELETAL CHANGES CEPHALOMETRICS MOLARS AND INCISORS THREE PLANES OF SPACEwww.indiandentalacademy.com
  • 6. What are the possibilities for tooth movements/skeletal changes in three planes of space? What are the possibilities for toothWhat are the possibilities for tooth movements/skeletal changes inmovements/skeletal changes in three planes of space?three planes of space? prioritizeprioritize www.indiandentalacademy.com
  • 7. OBJECTIVE: Expand the upper arch dentally and/or skeletally OBJECTIVE: Expand theOBJECTIVE: Expand the upper arch dentally and/orupper arch dentally and/or skeletallyskeletally PROBLEM posterior crossbite crowding-gain arch length APPLIANCE quadhelix Rapid palatal expander Hyrax expander Transpalatal bar E-arch or lip bumber archwire-outbend crossbite elasticswww.indiandentalacademy.com
  • 8. TRANSVERSE UNILATERAL POSTERIOR CROSSBITE BILATERAL POSTERIOR CROSSBITE www.indiandentalacademy.com
  • 9. MIDLINE DEVIATION TOOTH SHIFT ACROSS MIDLINE FUNCTIONAL (POSTURAL) SHIFT OF THE MANDIBLE COMBINATION www.indiandentalacademy.com
  • 10. MAXIMUM INTERCUSPATION INITIAL CONTACT POSITION TRANSVERSE DIMENSION RIGHT UNILATERAL POST. CROSSBITE FUNCTIONAL SHIFT www.indiandentalacademy.com
  • 11. DENTAL+?SKELETAL EXPANSION QUADHELIX EXPANDER FIXED BANDS AND REMOVABLE WIRE www.indiandentalacademy.com
  • 12. DENTAL+?SKELETAL EXPANSION REMOVABLE EXPANDER FULL COVERAGE ACRYLIC CLASPS MIDLINE EXPANSION SCREW EXPANSION KEY www.indiandentalacademy.com
  • 13. 5 MONTHS 2 TURNS/WEEK www.indiandentalacademy.com
  • 14. FIXED ACRYLIC EXPANDER www.indiandentalacademy.com
  • 15. PRE TREATMENT SKELETAL/DENTAL EXPANSION RAPID MAXILLARY EXPANDER TOOTH-BORNE (HYRAX) POST-EXPANSION MIDLINE DIASTEMA www.indiandentalacademy.com
  • 16. SKELETAL/DENTAL EXPANSION RME HYRAX FIXED TO FOUR BANDS www.indiandentalacademy.com
  • 17. SKELETAL EXPANSION RME TISSUE-BORNE (HAAS) FOUR BANDS BUCCAL + PALATAL WIRES PALATAL ACRYLIC MIDPALATAL SUTURE OPENINGwww.indiandentalacademy.com
  • 18. PRE TREATMENT BILATERAL POST. CROSSBITE NARROW UPPER ARCH POST TREATMENT SKELETAL EXPANSION SKELETAL EXPANSION RME BONDED EXPANDER www.indiandentalacademy.com
  • 19. SKELETAL EXPANSION BONDED RME POST EXPANSION STABILIZATION www.indiandentalacademy.com
  • 20. ONE TOOTH POSTERIOR CROSSBITE COINCIDENT MIDLINES CROSSBITE ELASTIC RECIPROCAL TOOTH MOVEMENT DENTAL EXPANSION www.indiandentalacademy.com
  • 21. PROBLEM: Crowding (create arch length); some A-P correction PROBLEM: Crowding (create archPROBLEM: Crowding (create arch length); some Alength); some A--P correctionP correction 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; bumperswww.indiandentalacademy.com
  • 22. CREATE SPACE HOLD/DISTALIZE LOWER MOLAR ADVANCE INCISORS TRANSVERSE EXPANSION (DENTAL) MANDIBULAR LIP BUMPER www.indiandentalacademy.com
  • 23. CREATE SPACE DISTALIZE UPPER MOLAR SPACE LOSS PENDULUM APPLIANCE UNILATERAL/BILATERAL POST TREATMENT NANCE HOLDING ARCH www.indiandentalacademy.com
  • 24. PENDULUM APPLIANCE-Unilateral www.indiandentalacademy.com
  • 25. TRANSPALATAL BAR- Unilateral REMOVABLE APPLIANCE- Sectional screw www.indiandentalacademy.com
  • 26. EXTRA-ORAL TRACTION CERVICAL HEADGEAR CLASS III ELASTICS LOWER ARCH COIL SPRING TANDEM MECHANICS CREATE SPACE DISTALIZE UPPER AND LOWER MOLARS MAINTAIN/ADVANCE LOWER INCISORS TRANSVERSE DENTAL EXPANSION www.indiandentalacademy.com
  • 27. EARLY PERMANENT DENTITION ANTERIOR CROWDING LEEWAY (E SPACE) MANDIBULAR LINGUAL HOLDING ARCH MAINTAIN SPACE LATE MIXED DENTITION www.indiandentalacademy.com
  • 28. STRATEGIES TO RESOLVESTRATEGIES TO RESOLVE CROWDINGCROWDING NONNON--EXTRACTION MECHANICSEXTRACTION MECHANICS INTERPROXIMAL ENAMELINTERPROXIMAL ENAMEL REDUCTION (STRIPPING)REDUCTION (STRIPPING) PREMOLAR EXTRACTIONSPREMOLAR EXTRACTIONS ONE LOWER INCISOR EXTRACTIONONE LOWER INCISOR EXTRACTION www.indiandentalacademy.com
  • 29. CROWDING MIXED DENTITION CRCRO NON-EXTRACTION: LEEWAY SPACE AND HOLDING ARCHES/FIXED APPLIANCES EXTRACTION: SERIAL EXTRACTION/ERUPTION GUIDANCE www.indiandentalacademy.com
  • 30. MAJOR DECISIONMA EXTRACTION • EXCESS SPACE • INCISOR POSITION • ANCHORAGE NON-EXTRACTION • ADVANCE INCISORS • DISTALIZE POSTERIORS • EXPAND ARCHES www.indiandentalacademy.com
  • 31. Extraction/Non-extraction decision is an important consideration BUT the specific objectives should lead to the decision to extract or not. Extraction/NonExtraction/Non--extractionextraction decision is an importantdecision is an important consideration BUTconsideration BUT thethe specific objectivesspecific objectives shouldshould lead to the decision to extractlead to the decision to extract or not.or not. www.indiandentalacademy.com
  • 32. PROBLEM: Crowding - close extraction spaces PROBLEM: CrowdingPROBLEM: Crowding -- closeclose extraction spacesextraction spaces OBJECTIVEOBJECTIVE Lower incisorsLower incisors maintain retract Lower molarsLower molars maintain protract MECHANOTHERAPYMECHANOTHERAPY AnchorageAnchorage maximum moderate minimal www.indiandentalacademy.com
  • 33. PROBLEM: Crowding - close extraction spaces PROBLEM: CrowdingPROBLEM: Crowding -- closeclose extraction spacesextraction spaces OBJECTIVEOBJECTIVE Upper incisorsUpper incisors maintain retract Upper molarsUpper molars maintain protract MECHANOTHERAPYMECHANOTHERAPY AnchorageAnchorage maximum moderate minimal www.indiandentalacademy.com
  • 34. MAXIMUM ANCHORAGE EXTRA-ORAL ANCHORAGE CERVICAL HEADGEAR RELATIVE ANCHORAGE VALUES OF THE TEETH EXTRACTION MECHANICS ANCHORAGE www.indiandentalacademy.com
  • 35. ANCHORAGE AUXILIARIES -MODERATE ANCHORAGE NANCE HOLDING ARCH TRANSPALATAL BAR (REMOVABLE) www.indiandentalacademy.com
  • 36. PROTRUSIVE LIPS STRAINED ON CLOSURE PRE TREATMENT CLASS I EXTRACTION CASE CROWDING DENTAL PROTRUSION www.indiandentalacademy.com
  • 37. CLASS I EXTRACTION CASE CROWDING DENTAL PROTRUSION PRETREATMENT CLASS I (CLASS II TENDENCY) INCREASED OVERJET INCREASED OVERBITE www.indiandentalacademy.com
  • 38. CLASS I EXTRACTION SLIGHT UPPER CROWDING MODERATE LOWER CROWDING www.indiandentalacademy.com
  • 39. EXTRACTION MECHANICS ELASTOMERICS (C CHAIN) PUSH COIL SPRING CLOSING LOOPS ELASTOMERICS www.indiandentalacademy.com
  • 40. CLASS I MIXED DENTITION SEVERE CROWDING SERIAL EXTRACTION PRETREATMENT ORTHOGNATHIC STRAIGHT/SLIGHTLY CONVEX LIPS RELAXED www.indiandentalacademy.com
  • 41. SERIAL EXTRACTION PRETREATMENT MIDDLE MIXED DENTITION CLASS I AVERAGE OVERJET+ ANTERIOR CROSSBITE AVERAGE OVERBITE POSTERIOR CROSS-BITE (RIGHT MOLARS) www.indiandentalacademy.com
  • 42. POSTERIOR MOLAR CROSSBITE (RIGHT SIDE) MIDLINES COINCIDE SEVERE CROWDING -MAXILLARY ARCH MOLAR ROTATION SERIAL EXTRACTION www.indiandentalacademy.com
  • 43. SERIAL EXTRACTION SEVERE CROWDING MANDIBULAR ARCH EXCESSIVE CURVE OF SPEE (DEEP OVERBITE) www.indiandentalacademy.com
  • 44. SERIAL EXTRACTION INTRA-ORAL (PERI-APICAL) RADIOGRAPHS CEPHALOMETRIC RADIOGRAPHwww.indiandentalacademy.com
  • 45. SERIAL EXTRACTION PROGRESS PRIMARY CANINES EXTRACTED AWAITING ERUPTION OF FIRST PREMOLARS www.indiandentalacademy.com
  • 46. SERIAL EXTRACTION FIRST PREMOLARS ERUPTING www.indiandentalacademy.com
  • 47. SERIAL EXTRACTION INTRA-ORAL RADIOGRAPHS PROGRESS www.indiandentalacademy.com
  • 48. SERIAL EXTRACTION EXTRACTION OF FIRST PREMOLARS AND ERUPTION OF CANINES LOWER LINGUAL HOLDING ARCH www.indiandentalacademy.com
  • 49. OBJECTIVE: Advance upper and/or lower incisors OBJECTIVE: Advance upper and/orOBJECTIVE: Advance upper and/or lower incisorslower 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 www.indiandentalacademy.com
  • 50. ADVANCE UPPER INCISORS ANTERIOR CROSSBITE MIXED DENTITION ANTERIOR CROSSBITE REMOVABLE APPLIANCE CLASPS; OCCLUSAL ACRYLIC FINGER SPRINGSwww.indiandentalacademy.com
  • 51. ANTERIOR CROSSBITE LIMITED FIXED APPLIANCE PRE-TREATMENT POST-TREATMENT www.indiandentalacademy.com
  • 52. ADVANDE INCISORS ANTERIOR CROSSBITE ANTERIOR CROSSBITE (ALSO BILATERAL POSTERIOR CROSSBITE) PARTIAL FIXED APPLIANCE www.indiandentalacademy.com
  • 53. www.indiandentalacademy.com
  • 54. QUADHELIX RETAINER www.indiandentalacademy.com
  • 55. ADVANCE INCISORS ANTERIOR CROSSBITE PSEUDO-CLASS III MAXIMUM INTERCUSPATION ANTERIOR CROSSBITE UPPER ARCH CROWDING UPPER MIDLINE RIGHT (CROWDING) INITIAL CONTACT POSITION FUNCTIONAL SHIFT (ANTERIOR+LATERALwww.indiandentalacademy.com
  • 56. OBJECTIVE: Level lower arch; increase compensating curve; extrude post. teeth / increase vertical OBJECTIVE: Level lower arch;OBJECTIVE: Level lower arch; increase compensating curve;increase compensating curve; extrude post. teeth / increase verticalextrude 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) www.indiandentalacademy.com
  • 57. EXTRUDE POSTERIOR TEETH (INCREASE THE VERTICAL DIMENSION) DEEP OVERBITE PRE-TREATMENT DEEP OVERBITE FIXED APPLIANCES ANTERIOR BITE PLATE www.indiandentalacademy.com
  • 58. EXTRUDE POSTERIOR TEETH (INCREASE THE VERTICAL DIMENSION) DEEP OVERBITE INITIAL INSERTION OF ANTERIOR BITE PLATE EFFECT OF ANTERIOR BITE PLATE + ARCH WIRES www.indiandentalacademy.com
  • 59. OBJECTIVE: Intrude upper and/or lower incisors OBJECTIVE: Intrude upper and/orOBJECTIVE: Intrude upper and/or lower incisorslower incisors PROBLEM deep overbite high lip line deep curve of Spee vertical pattern Class II-distally tip upper molars upright lower molars- avoid L1 advancement APPLIANCE 2 X 4 Incisor intrusion arches / utility arches www.indiandentalacademy.com
  • 60. INCISOR INTRUSION DEEP OVERBITE PRETREATMENT DEEP OVERBITE EFFECTS OF INTRUSION ARCH WIRES www.indiandentalacademy.com
  • 61. EXTRUDE UPPER INCISORS ANTERIOR OPEN BITE (THUMB/TONGUE HABIT) MIDDLE MIXED DENTITION ANTERIOR OPEN BITE THUMB/TONGUE CRIB www.indiandentalacademy.com
  • 62. EXTRUDE UPPER/LOWER INCISORS ANTERIOR OPEN BITE (THUMB/TONGUE HABIT) FOLLOWING TONGUE CRIB SPONTANEOUS INCISOR ERUPTION VERTICAL ELASTICS WITH FIXED APPLIANCES www.indiandentalacademy.com
  • 63. OBJECTIVE: Control/maintain vertical dimension-intrude upper/lower posterior teeth OBJECTIVE: Control/maintainOBJECTIVE: Control/maintain vertical dimensionvertical dimension--intrudeintrude upper/lower posterior teethupper/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) www.indiandentalacademy.com
  • 64. CONTROL VERTICAL DEVELOPMENT ANTERIOR OPEN-BITE VERTICAL SKELETAL PATTERN ANTERIOR OPEN BITE VERTICAL SKELETAL PATTERN www.indiandentalacademy.com
  • 65. CONTROL VERTICAL DEVELOPMENT ANTERIOR OPEN-BITE VERTICAL SKELETAL PATTERN HIGH-PULL HEADGEAR VERTICAL PULL CHIN-CUPwww.indiandentalacademy.com
  • 66. LOWER POSTERIOR BITE BLOCK (OCCLUSAL SPLINT) INTRUDE/HOLD POSTERIOR TEETH VERTICALLY www.indiandentalacademy.com
  • 67. OBJECTIVE: Growth modification (orthopedics)- Maxillary retraction/protraction Mandibular protraction/retraction OBJECTIVE: GrowthOBJECTIVE: Growth modification (orthopedics)modification (orthopedics)-- Maxillary retraction/protractionMaxillary retraction/protraction Mandibular protraction/retractionMandibular 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 www.indiandentalacademy.com
  • 68. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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