This is my E-Portfolio

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Grace Joy Uriarte-Mendoza DDM
WORK as an Orthodontist
NickName: Dra. Grace Joy
Profession: Orthodontist/ general
Dentist
School Graduated: Our Lady Of Fatima
University
Affiliations: PDA & AIO

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Introduction
 Hello! Im Dra. Grace Joy and im here to discuss to you what is
IO (Interceptive Orthodontics) and to show different cases of
orthodontics that can help you understand the treatment and
importance of a aesthetically pleasing teeth and its normal
function.
 IO is performed to eliminate or reduce the severity of a
developing malocclusion with early treatment in order to
simplify treatment.
 IO is performed in the mix dentition and is associated with full
correction and improvement in treated cases but often forms
the basis of a comprehensive treatment plan.

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Interceptive Orthodontics
Definition
Any procedure that eliminates or reduces
the severity of malocclusion in the
developing dentition.(Popovich and
Thompson 1979, Hiles, 1985.)
All simple measures that eliminate the
developing mal occlusion. (Ackerman and
Proffit 1980)

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IO in mixed dentition phase starts at 5-6 y/o and ends with the exfoliation of
the last primary tooth.
IO in 8-10 y/o should focus on recognising unusual dental development. The
decision wether to treat depends on the child cooperation, behavior, family
support, social interaction, cost and commitment.
IO overriding aims are the maintenance of midline, the prevention of class II
molars, reduction of crowding, reduction of incidence of trauma and
psychosocial factors associated with malocclusion. Important to assess the
ff: aesthetics, attitude to dental health and psychological well being on
potentially lengthy treatment before it may leave them feeling burnt-out.

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When to start IO
 Start early at age 9 and 11 y/o has been suggested by Al Nimri
& Richardson.
 Deciduous Dentition do not require treatment but it is important
to monitor the eruption sequence to predict future crowding and
malocclusion of teeth.

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What requires treatment
 Important to distinguish the following:
A. Dental development
B. Facial development
C. Aberrant development attributable to syndromes:
- Cleft lip and palate
- Teacher collins
- Hemifacial macrosomia and so on.

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Discrepancies in Facial
Development
 Class II malocclusion:
a. Division 1
b. Division 2
 Class III malocclusion
 Facial Asymmetries

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Descrepancies in Dental
Development
 Anterior Crossbites -
 Posterior Crossbites
 Impacted Upper Central Incisors
 Ectopic Maxillary Permanent Canines
 Poor Quality First permanent Molars
 Infra Occlusion of Primary Molars
 Non Nutritive Sucking Habits
 Unilateral Loss of primary teeth
 Increased Overjet and Trauma Risk

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Anterior Crossbite
Crossbite is a condition that
describes a malposed labiolingual
relationship between one or more
axillary and mandibular teeth.

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Anterior Crossbite
 Anterior cross bite is a condition characterized by
reverse overjet wherein one or more maxillary
anterior teeth are in lingual relation to the mandibular
teeth.
 Should be intercepted and treated at an early stage
to prevent a minor orthodontic problem from
progressing into a major dento-facial anomaly.as an
old maxim states
“The best time to treat a crossbite is the first
time it is seen”
 Or else it may grow into skeletal malocclusion

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Posterior Crossbite

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Impacted Upper Central Incisors

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Ectopic Maxillary Permanent
Canines

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Ectopic Maxillary Permanent
Canines
Definition: the canine erupts out of its
normal eruption path.
Diagnosis: If the 3 was not palpable in the
buccal sulcus after the age of 10 years.
Treatment: Extraction of the deciduous
canine.

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Poor Quality First permanent Molars

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First Molar Extraction
 Indications:
-At least one permanent first molar have poor
prognosis.
-Crowding in the relevant quadrant.
-The development of second molar roots did not
reach more than half way.
-No other missing teeth in the same quadrant.
-Normal arch relationship.
-The overbite is not deep.
-The second premolar is contained within the E roots

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First Molar Extraction
Advantages:
 – No need for future prosthesis
 – Reduce incisor crowding
 – Eliminate buccal segment crowding
 – Less chance for third molar impaction
Disadvantages:
 – The uncertainty of the final contact point between
the second molar and second premolar

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Infra Occlusion of Primary Molars

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Non Nutritive Sucking Habits

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Unilateral Loss of primary teeth

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Increased Overjet and Trauma Risk

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Thumb Sucking
Treatment
Adult Approach
Deterrent Appliance

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Space Management
Crowding: SPACE MANAGEMENT.
Definition: utilization of Lee Way space to
relieve anterior crowding.
Indications:1- Cl I molar relationship
2- E,s are still present in the. crowded
side(s).
3- Mild crowding

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Space Management
Crowding: SPACE MANAGEMENT
Methods:
1-Space maintainer extract E,s Or
2- Slice the mesial surface of the deciduous
canine and molars before the eruption of
permanent canine and premolars.

27. 1. Procedures that eliminate or reduce the severity of malocclusion in
the developing dentition.
2. One of the etiology of malocclusion could be eating
3. The interceptive Treatment for Retained Deciduous Teeth is via
extraction
4. Intraocclusion is when the tooth loses its vertical position relative to
the adjacent teeth and assumes a position below the occlusal plane
5. Unilateral retained deciduous canine can be interceptively treated via
extraction of malformed tooth
6. Double teeth in the permanent dentition is treated by mask, split and
extract
7. Absent teeth can be treated by space closure
8. Extraction of the deciduous canine is the interceptive treatment for
ectopic upper canine
9. The unusual type of ectopic eruption were two permanent teeth
which have interchanged their location in the dental arch, this can be
treated after eruption of canine
10. Crowding can be treated by space management

28. 1. Procedures that eliminate or reduce the severity of malocclusion in
the developing dentition.
2. One of the etiology of malocclusion could be eating
3. The interceptive Treatment for Retained Deciduous Teeth is via
extraction
4. Intraocclusion is when the tooth loses its vertical position relative to
the adjacent teeth and assumes a position below the occlusal plane
5. Unilateral retained deciduous canine can be interceptively treated via
extraction of malformed tooth
6. Double teeth in the permanent dentition is treated by mask, split and
extract
7. Absent teeth can be treated by space closure
8. Extraction of the deciduous canine is the interceptive treatment for
ectopic upper canine
9. The unusual type of ectopic eruption were two permanent teeth
which have interchanged their location in the dental arch, this can be
treated after eruption of canine
10. Crowding can be treated by space management
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31. This 9.5 year old patient presented severe Class III
and extreme AP discrepancy. Her family knew her
bite was not right and was concerned about how it
would progress. Since they did not want her to go
through surgery (as her previous dentist
recommended), they sought a second and third
opinion.
In her third opinion, Dr. Christopher Lee considered
surgery but ultimately recommended to use Jane’s
growth early in two phases to fix her severe
maxillo-mandibular Class III relationship.

32. 1. What do you think Dr. Christopher Lee
did?
2. If you were the dentist, what
interceptive treatment will you conduct
and how will be the procedure?

33. The first phase of mixed dentition treatment
included daily use of reverse headgear for 6
months and a nickel-titanium open coil to make
space for her erupting upper lateral incisors.
Pink filling composites were also used to disclude
Jane’s bite. 016N and 18x25 heat activated niti
wires were also used to help with tooth alignment.
Phase I treatment, before the eruption of
secondary teeth, was used to fix her malocclusion
and AP relationship during 9 months within an
important stage of her growth.

35. The bite was corrected from a Class III functional
anterior crossbite to having good overbite and
overjet. With a dramatic improvement of her
overjet, her jaws and muscles adjusted to the
correct occlusal placement. When she experiences
more craniofacial growth during adolescence, her
bite has a greater chance to stay in its proper
occlusion. Full braces were not used during this
Phase I stage.
In a few years after her permanent teeth are all in,
Jane will go into full braces in the second phase of
treatment to straighten her teeth and evaluate for
possible surgery if facial esthetics are
unacceptable.

36. Further Clarifications?

37.  https://www.scribd.com/presentation/215908612/interceptiveo
rthodontics-111013083234-phpapp02
 https://www.scribd.com/doc/26598391/Paediatrics-A-Clinical-
Guide-for-Nurse-Practitioners

38. Grace Joy U. Mendoza, D.M.D
Presenter