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Recent advances in surgical orthodontics /certified fixed orthodontic courses by Indian dental academy
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Recent advances in surgical 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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  • 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. INDIA SHINES !! THE MOOD IS UPBEAT ECONOMY GROWS DISPOSABLE INCOMES ON THE RISE CONSUMERISM ON A HIGH BEAUTY IS BIG BUSINESS THE INDIAN FACE SELLS ALL !!! THE FEEL GOOD FACTOR +++++ www.indiandentalacademy.com
  • 3. THE GOOD NEWS •Increasing demand for orthodontics •A shift towards cosmetic dentistry •Mass Marketing ,consumer branding Strategies – Invisalign • 54 % OF INDIANS BELOW 25 YEARS OF AGE !! www.indiandentalacademy.com
  • 4. Indian Orthodontics: are we in a process of change ? A period of turbulent global change • Books journals ,information •A profusion of appliances,space age materials •New diagnostics and Treatment modalities, •Distraction,MIA, •Craniofacial orthodontics •Age,no longer a consideration !!! Have our dimensions,horizons changed ? Are we looking beyond our mechanical preoccupation? www.indiandentalacademy.com
  • 5. The Drivers for change in the 21st century Biology / technology / evidence Patient centered approach Efficient and effective orthodontics •Philosophies •Techniques •Comfort of status • quo/opinion www.indiandentalacademy.com •Convergence of technology •Materials •information
  • 6. SO WHY DO PEOPLE SEEK ORTHODONTIC TREATMENT ?? www.indiandentalacademy.com
  • 7. Orthodontics Justified spirit mind body “ If there is a defect on the soul, it cannot be corrected on the face, but if there is a defect on the face and one corrects it, it can correct a soul. “ - Jean Cocteau www.indiandentalacademy.com
  • 8. Esthetics primarily responsible for Orthodontics Appearance - The most important motivating factor for treatment. Physically attractive people achieve higher levels of success in life than unattractive people Breece & Nieberg JCO 1986 www.indiandentalacademy.com
  • 9. Reasons for seeking orthodontic treatment :  Malaligned teeth 84%  Advice of dentist 52%  Facial appearance 41% Self concept in class II malocclusion and early treatment Dan C et al Angle Orthod. 65(6) 411, 1995 Silver Platter Search www.indiandentalacademy.com ©
  • 10. Time Society driven by speed !! Service on Demand,Instant gratification + Information and Awareness Patient empowerment A right to participate in the decisions and entitled to results “Dentofacial Appearance is a significant predictor of orthodontic patients expectations of treatment” Am J Orthod Dentofacial Orthop 2003; 123-127 www.indiandentalacademy.com
  • 11. The Face “A singular structure that teems with subtleties An enchanted terrain,a zone of sensuality A playground of secrets,a glory of function” Daniel McNeill Facial Appearance :-The most important characteristic in relation to self image and self esteem People Dissatisfied with Facial appearance express more dissatisfaction with teeth than any other feature !! Hershon LE, Giddon DB. Determinants of facial profile self-perception. Am J Orthod 1980;78:279-95.   Berscheid E, Walster E, Bohrnstedt G. Body image. Psychol Today 1973;7:119-131v www.indiandentalacademy.com
  • 12. ADULT ORTHODONTICS- A NEW VISTA Growing segment in orthodontic Practice 95.3 % of orthodontists in US into Surgical orthodontics ! 30% 25% 20% 15% 10% 5% 70 75 80 85 90 www.indiandentalacademy.com 97 02 JCO 1997-02
  • 13. 1. Do traditional strategies and goals in orthodontics still hold good ? Is there a new paradigm in orthodontics ? Three dimensional treatment goals 4th Dimension TIME !! The 5th Dimension Function www.indiandentalacademy.com
  • 14. Success !! o Facial / Dental aesthetics decide successful outcome both may not correlate o Anterior Smile Aesthetics critical for the patient o Alteration of the skeletal bases needs to be harmonized with dentoalveolar modification o Orthodontics and surgeons – a synergism !! www.indiandentalacademy.com
  • 15. ORTHODONTIC LIMITATIONS Angle – Class 1 molar Relation ship 1925 – 1945 Tweed – Lower Incisor Position 1945 –1985 Surgical influence – Upper incisors/positioning anterior 6 teeth www.indiandentalacademy.com
  • 16. Cephalometrics – What Value ?  Measurements based on cranial base landmarks –inaccurate in defining clinical profile  Disconnect between hard & soft tissues!  No measurement is 100% accurate  Soft tissue thickness / axial inclination of incisors – the most important variables in inaccuracy Michels & Tourne Int J Adult orthod orthog Surg 1990 5 (1) 43-52 www.indiandentalacademy.com
  • 17. Face First – The Emerging Paradigm JCO Survey 99 – traditional Ceph Analysis used by 94% orthodontists Is it a Problem ? • Measure skeletal and dental relationships • Measure to cranial base • Soft tissue/ profile correlation ? •Did we forget to reintegrate soft and hard tissues ?? www.indiandentalacademy.com
  • 18. NO CORRELATION BETWEEN NORMSAND PROFILE BALANCE !! OCCLUSAL /DENTOALVEOLAR CORRECTION BASED ON NORMS – LESS THAN OPTIMAL FACIAL RESULTS www.indiandentalacademy.com
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  • 22. PRE-TREATMENT POST-TREATMENT www.indiandentalacademy.com
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  • 26. ORTHODONTIC LIMITATIONS Inheritance or mind set? Is Traditional Cephalometric and model diagnosis relevant towards a comprehensive treatment outcome ? Evidence :- Changes in facial profile during orthodontic treatment with extraction of first four premolars Am J Orthod Dentofac Orthop 95(3):220-30 Mar 89 Dobrocky and Smith found • 160 orthodontic patients treated to Class 1 models • 15% of lips excessively flat ! • 30.6 % nasolabial angles excessively obtuse !!( >120) www.indiandentalacademy.com
  • 27. A TIME FOR INTROSPECTION Did a good occlusion match a good face at the end of treatment ?? Was Anchorage ever a problem ?? Was a special effort required to finish and detail your cases ? www.indiandentalacademy.com
  • 28. 180° turn around in conceptual Orthodontic thought !!! AESTHETICS OCCLUSION Occlusion Static records Non extn Lower incisors 90’s paradigm www.indiandentalacademy.com Face First Soft tissue and smile dynamics Skeletal modification
  • 29. “The winds of change are blowing in the face of time” Scorpions www.indiandentalacademy.com
  • 30. Orthodontic Limitations The Perceived Ideal Position not possible orthodontically Adverse Facial Changes if attempt to compromise is made . A Surgical /Orthodontic solution is essential Compromised occlusions – a special challenge! An entire new dimension in Orthodontics !! www.indiandentalacademy.com
  • 31. Defining orthodontic limitations TVL 57 64 0 4 -5 TVL 0 4 57 64 -1 TVL 57 0 4 64 2 -12 -5 -11 Surgery -8 -6 -3 Orthodontics ++ www.indiandentalacademy.com normal
  • 32. TVL 57 64 0 3 -5 TVL 57 64 0 4 2 -12 -5 -11 -3 Repositioning teeth can help the profile only that much ! www.indiandentalacademy.com
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  • 37. TVL 0 57 64 TVL 0 4 57 4 7 64 2 1 -5 3 -3 www.indiandentalacademy.com Color codes used with the Arnett soft tissue cephalometric analysis Black Green Blue Red = = within 1 SD = within 2 SD = within 3 SD more than 3 SD
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  • 39. FACE FIRST – A Paradigm change Increasing focus on altering skeletal bases to achieve a positive outcome . Growth modification Compromise Orthodontics with malar augmentation, rhinoplasty ,genioplasty Osteotomies – mandibular / maxillary for skeletal excess Deficiencies ?? Grafts www.indiandentalacademy.com
  • 40. Right now my life is just one learning experience after another…… By the end of the week I should be a genius! Jeanette Osias www.indiandentalacademy.com
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  • 45. thank you www.indiandentalacademy.com