Expansion in orthodontics /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.


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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Expansion in orthodontics /certified fixed orthodontic courses by Indian dental academy

  1. 1. EXPANSIONEXPANSION INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. Topics :- Classification History Of Expansion Arch Width Changes (Physiologic) Anatomy Of Maxilla and Mandible Histology Of Suture and Symphysis Stresses generated during Transverse Expansionwww.indiandentalacademy.com
  3. 3. Expansion Transverse Antero-posterior Dental Skeletalwww.indiandentalacademy.com
  4. 4. ANATOMY AND HISTOLOGY www.indiandentalacademy.com
  5. 5. Symphysis joint (Grays Anatomy)www.indiandentalacademy.com
  6. 6. Symphysis joint Symphysis menti (Atlas Oral Anatomy Holland G R) www.indiandentalacademy.com
  7. 7. Symphysis joint (Grays Anatomy)www.indiandentalacademy.com
  8. 8. Bone Fibrocartilage Collagen Fibres www.indiandentalacademy.com
  9. 9. www.indiandentalacademy.com
  10. 10. Maxilla and its Articulations (Grays Anatomy) www.indiandentalacademy.com
  11. 11. American Journal Of Dentofacial Orthopedics 1987;91)www.indiandentalacademy.com
  12. 12. www.indiandentalacademy.com
  13. 13. www.indiandentalacademy.com
  14. 14. www.indiandentalacademy.com
  15. 15. www.indiandentalacademy.com
  16. 16. Midpalatal suture www.indiandentalacademy.com
  17. 17. Zone Of Intense Proliferation www.indiandentalacademy.com
  18. 18. A-P Direction Of Collagen Fibres www.indiandentalacademy.com
  19. 19. Transversely oriented collagen fibres www.indiandentalacademy.com
  20. 20. Network Of Collagen Fibres In centre Of Suture www.indiandentalacademy.com
  21. 21. www.indiandentalacademy.com
  22. 22. s www.indiandentalacademy.com
  23. 23. Sharpey fib www.indiandentalacademy.com
  24. 24. T B S TRANSITIONAL SPACE www.indiandentalacademy.com
  25. 25. SINUOUS AND IMBRICATING NATURE OF SUTURE www.indiandentalacademy.com
  26. 26. NARROWED ZONE OF CELLULAR PROLIFERATIONwww.indiandentalacademy.com
  27. 27. S www.indiandentalacademy.com
  28. 28. www.indiandentalacademy.com
  29. 29. LIGHT MICROSCOPIC VIEWwww.indiandentalacademy.com
  30. 30. ELECTRON MICROSCOPIC VIEW www.indiandentalacademy.com
  31. 31. HISTORY (The Angle Orthodontist1999;69) (Rapid Maxillary Expansion;Timms) www.indiandentalacademy.com
  32. 32. Sir Emerson C Angell www.indiandentalacademy.com
  33. 33. San Francisco Medical Press 1860 *14 year old girl patient with ectopic left upper lateral and premolar. *Importance of first permanent molars. Dental Cosmos www.indiandentalacademy.com
  34. 34. Expansion appliance:-Dr Angell Note Diastema www.indiandentalacademy.com
  35. 35. Appliance with contrarotating screw Gold www.indiandentalacademy.com
  36. 36. We must beg leave to differ with the author in the conclusion arrived at,that by the use of apparatus described he succeeded in separating the superior maxilla from each other.With no disposition to assert that such a thing is utterly impossible,yet,when taking into consideration the anatomical relations existing between the two halves of maxilla and other bones with which they articulatesuch a result appears exceedingly doubtful. (J.DeH.White) www.indiandentalacademy.com
  37. 37. As shown in Dental Cosmos www.indiandentalacademy.com
  38. 38. ARCH WIDTH CHANGES (American journal Of Dentofacial Orthopedics1997;111) (T.M.Graber;Orthodontics –Practise and Principles) www.indiandentalacademy.com
  39. 39. www.indiandentalacademy.com
  40. 40. www.indiandentalacademy.com
  41. 41. www.indiandentalacademy.com
  42. 42. www.indiandentalacademy.com
  43. 43. www.indiandentalacademy.com
  44. 44. Study Of Stress Distribution and Displacement Of Various Craniofacial Structures Following Application Of Transverse Orthopedic Forces:- FEM Study (The Angle Orthodontist2002;73) (American Journal Of Dentofacial Orthopedics 1987;91) www.indiandentalacademy.com
  45. 45. 1 www.indiandentalacademy.com
  46. 46. www.indiandentalacademy.com
  47. 47. www.indiandentalacademy.com
  48. 48. www.indiandentalacademy.com
  49. 49. www.indiandentalacademy.com
  50. 50. www.indiandentalacademy.com
  51. 51. www.indiandentalacademy.com
  52. 52. Conclusions:- •Maximum lateral displacement was 5.313mm at node 12911. •Pyramidal displacement of the maxilla was visible from the front view. •The width Of the nasal cavity increased markedly. The inferior parts of the pterygoid plates were markedly displaced or bent laterally,but minimal displacement was observed in the region close to cranial base. www.indiandentalacademy.com
  53. 53. www.indiandentalacademy.com
  54. 54. www.indiandentalacademy.com
  55. 55. •Maximum negative Y-displacement(backward displacement)was 1.1599 at node 2314 corresponding to the posterior rim of the frontalprocess of the zygomatic bone. •Maximum positive Y-displacement(forward displacement) was 1.077 at node6022,which represents the anteroinferior border of the nasal septum. www.indiandentalacademy.com
  56. 56. •Maximum negative Z displacement(downward displacement was 1.22 at node52,which represents the posterior most portion of the nasal septum. •Maximum positive Z displacement(upward displacement 1.758mm at node241 which represents body of the zygomatic bone. •Thus the nasomaxillary complex rotated such that the lateral structures had moved upwards and midline structures downwards. •The anterior part of maxillary bone(point A)were displaced downwards. www.indiandentalacademy.com
  57. 57. www.indiandentalacademy.com
  58. 58. www.indiandentalacademy.com
  59. 59. Topics: Rapid Palatal Expansion Slow Palatal Expansion www.indiandentalacademy.com
  60. 60. Expansion Skeletal Dental Transverse Anteroposterior Slow Semi rapid Rapid Ultra rapid www.indiandentalacademy.com
  61. 61. Indications Of Rapid Palatal Expansion:- Occlusion -Full cusp crossbite with skeletal component. -Some degree of dental as well as skeletal component. -No open bite tendency. -No preexisting dental expansion. Respiration -Poor nasal airway -Septal deformity -Recurrent nasal ,sinus infection -Asthama www.indiandentalacademy.com
  62. 62. Hazards Of RME:- Oral Hygiene Dislodgment and breakage Tissue damage Infection(Acute ulcerative gingivitis) Failure of suture to open www.indiandentalacademy.com
  63. 63.   (a) Derichsweiler type    Tags are welded and soldered to the palatal aspects  of the bands to provide attachments for the acrylic  which is also extended to the palatal aspects of all  non banded teeth except the insicors.‑ www.indiandentalacademy.com
  64. 64. (b) Haas type    A length of .045 in (1 .15 mm) stainless steel wire is  welded and soldered along the palatal aspects of the  bands The free ends are turned backand embedded  into the acrylic base.A proprietary srew is set in the  midline of the acrylic split. www.indiandentalacademy.com
  65. 65. Haaswww.indiandentalacademy.com
  66. 66. (c) lsaacson type    This  appliance  uses  a  special  spring  loaded  screw  called  a  Minne.  Expander  which  is  adapted  and  soldered  direct  to  the  bands  without  the  use  of  acrylic, The screw may be reduced in length to suit  narrow  arches  by  shortening  the  spring,  tube  and  rod. www.indiandentalacademy.com
  67. 67.   (d)Biedermann type    This appliance also required a special screw, either Hyrax  (Dentaurum  602 813).  Leone  620  or  Unitek‑ 440 160, These have extensions in heavy gauge wire‑ which  are  welded  and  soldered  to  the  palatal aspects of the bands   www.indiandentalacademy.com
  68. 68. Hyrax Screw www.indiandentalacademy.com
  69. 69. www.indiandentalacademy.com
  70. 70. Forestadent Screw www.indiandentalacademy.com
  71. 71. Activation:-180º rotation /day(Ziebe) Upto Age 15 years -90º both morning and evening. Age 15-20 years -45º turns 4 times a day Age over 20 years - Same as above or 45º in the morning and 90º at night www.indiandentalacademy.com
  72. 72. In general,bony spicules appear at the age of 15 and 19 years(0.9% fo suture length),but these bridges may be removed by osteoclast to suit physiologic requirements. A greater degree of obliteration occurs posteriorly than anteriorly. On average 5% of suture is closed by age 25. (By Persson et al 1977) www.indiandentalacademy.com
  73. 73. Age and prognosis: Age 7 to 15:Good Age 15 to 20:Good although recall every other day To check opening of suture. Age 20 to 30:Possible but daily recall necessary, Danger that the suture does not open and there is overloading of the posterior segment,ulceration of mucosa. www.indiandentalacademy.com
  74. 74. Treatment timing for rapid maxillary expansion (Angle orthodontist;2001) The group treated before the pubertal peak,in the long term,showed significantly greater maxillary skeletal Width,maxillary intermolar width,lateronasal width and Lateroorbital width The late treated group exhibited significant increase in Maxillary and mandibular intermolar width.(thus more Dentoalveolar than skeletal) www.indiandentalacademy.com
  75. 75. According to Mayoral and Aristeguinta www.indiandentalacademy.com
  76. 76. www.indiandentalacademy.com
  77. 77. www.indiandentalacademy.com
  78. 78. www.indiandentalacademy.com
  79. 79. www.indiandentalacademy.com
  80. 80. Slow Expansion Rapid Expansion www.indiandentalacademy.com
  81. 81. www.indiandentalacademy.com
  82. 82. www.indiandentalacademy.com
  83. 83. www.indiandentalacademy.com
  84. 84. www.indiandentalacademy.com
  85. 85. Maxillary Expansion by Hass(AJO;Vol 57,No8,1970) www.indiandentalacademy.com
  86. 86. Maxillary Expansion by Hass(AJO;Vol 57,No8,1970) www.indiandentalacademy.com
  87. 87. *Correction of mouth breathing. *Improvement of concentration. *Mouthbreathing not influenced. *Some improvement of nasal breathing www.indiandentalacademy.com
  88. 88. www.indiandentalacademy.com
  89. 89. www.indiandentalacademy.com
  90. 90. www.indiandentalacademy.com
  91. 91. www.indiandentalacademy.com
  92. 92. www.indiandentalacademy.com
  93. 93. www.indiandentalacademy.com
  94. 94. www.indiandentalacademy.com
  95. 95. www.indiandentalacademy.com
  96. 96. www.indiandentalacademy.com
  97. 97. Slow Expansion www.indiandentalacademy.com
  98. 98. Schwarz Appliance www.indiandentalacademy.com
  99. 99. www.indiandentalacademy.com
  100. 100. www.indiandentalacademy.com
  101. 101. Crozat Appliance www.indiandentalacademy.com
  102. 102. Fan Appliance www.indiandentalacademy.com
  103. 103. Wipla-type Forestadent screw www.indiandentalacademy.com
  104. 104. Bar type-Two way expansion screw www.indiandentalacademy.com
  105. 105. The Nardella eccentric expansion screw www.indiandentalacademy.com
  106. 106. Quad Helix Ricketts www.indiandentalacademy.com
  107. 107. www.indiandentalacademy.com
  108. 108. www.indiandentalacademy.com
  109. 109. www.indiandentalacademy.com
  110. 110. 3 D Multiaction palatal appliance www.indiandentalacademy.com
  111. 111. 3D Quad Helix palatal Appliance(Wilson) www.indiandentalacademy.com
  112. 112. www.indiandentalacademy.com
  113. 113. Sagittal I Appliance www.indiandentalacademy.com
  114. 114. www.indiandentalacademy.com
  115. 115. Sagittal II Appliance www.indiandentalacademy.com
  116. 116. Ultra-Rapid Expansion •By Chaure….3mm of expansion was achieved in one and half hour. •Three visits. •Anaesthesia is administered. •Used by E.N.T. surgeons then. www.indiandentalacademy.com
  117. 117. www.indiandentalacademy.com
  118. 118.   NiTi GROUP RPE GROUP Measure ment Mean Standard Deviation Mean Standard Deviation PWC(m m) 0.99 0.45 1.41 1.09 IMWC( mm) 6.26 1.65 4.76 1.55 PWC=palatal width change; IMWC=intermolar width change; PDC=palatal depth change; AT=alveolar tipping; MR=molar rotation; MT=molar tipping www.indiandentalacademy.com
  119. 119. RATIO PWC/IM WC 0.16 0.08 0.28 0.17 AT(degre es) 6.61 3.73 5.08 5.43 PDC(mm ) -0.04 0.70 -0.07 0.89 MR(degr ees) 26.61 16.29 1.58 2.74 www.indiandentalacademy.com
  120. 120. MR(degr ees) 26.61 16.29 1.58 2.74 MT(degr ees) 11.69 10.47 6.08 6.25 www.indiandentalacademy.com
  121. 121. The NiTi transpalatal loops has a transition temperature of 94o F. The martensitic transformation and superelastic properties of the NiTi wires helped the insertion of the expander into the lingual sheaths of prefitted maxillary molar bands. Expansion occurs after insertion when the appliance was warmed up to body temperature and the NiTi loops return to its original shape. Over expansion was built into the treatment to anticipate relapse (approximately 30%) due to uprighting of the maxillary molars after removal of appliance. www.indiandentalacademy.com
  122. 122. NiTi transpalatal loops were sprayed with tetrafluoroethane refrigerant prior to placement of the appliance. www.indiandentalacademy.com
  123. 123. www.indiandentalacademy.com
  124. 124. www.indiandentalacademy.com
  125. 125. www.indiandentalacademy.com
  126. 126. Original Pendulum design .032” TMA Nance Button Occlusal rests www.indiandentalacademy.com
  127. 127. Pendex www.indiandentalacademy.com
  128. 128. T-Rex Design Mesial wire www.indiandentalacademy.com
  129. 129. The PHD Appliance Pendulum Hygiene Design/devicewww.indiandentalacademy.com
  130. 130. www.indiandentalacademy.com
  131. 131. www.indiandentalacademy.com
  132. 132. www.indiandentalacademy.com Thank you For more details please visit www.indiandentalacademy.com

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