INTERCEPTIVE ORTHODONTICS- DR SONU

2. • Refers to measures undertaken to prevent a potential
malocclusion from progressing into a more severe one.
• When the maloccl has already developed or is developing
• Preventive orthodontics – when dentition and occl are prefectly
normal
• Interceptive orthodontics – when signs and symptoms of
maloccl already developed.

3. • Phase of the science and art of orthodontics employed to
recognize and eliminate potential irregularities and
malpositions of the developing dentofacial complex.

4. • Serial extraction
• Correction of developing crossbite
• Control of abnormal habits
• Space regaining
• Muscle exercises
• Interception of skeletal malrelation
• Removal of soft tissue or barrier to enable eruption of teeth

5. • Early mixed dentition
• Planned extraction of certain deciduous teeth in an orderly
sequence and predetermined pattern to guide the erupting
permanent teeth into a more favourable position.
• Kjellgren 1929 used the term first
• Nance 1940 popularised this technique in USA and termed it ‘
planned and progressive extraction’
• Hotz 1970 – ‘active supervision of teeth by extraction’

6. Principles
Arch length - tooth material discrepancy
Physiologic tooth movement – natural force, move to extraction
space

7. Indication
• Class I maloccl with nrml skeletal pattern
• Arch length deficiency
• Absence of physiologic spaces
• Premature loss
• Crowding
• Localized gingival recession in lower antrs
• Ectopic eruption
• Mesial migration of buccal segment
• Abnrml eruption pattern
• Lower antr flaring
• Ankylosis
• Where growth is not enuf to overcome discrepancy
• Straight profile

8. Contraindication
• Class II & III maloccl with skeletal abnrmlty
• Spaced dentition
• Anodontia / oligodontia
• Openbite and deepbite
• midline diastema
• Class I maloccl with minimal space defi
• Unerupted malformed teeth – dilaceration
• Extensive caries or heavily filled first permanent molar
• Mild disproportion between arch length and tooth matrl that
can be treated with proximal stripping.

9. Advantages
• Physiologic movement
• Physiological trauma can be avoided
• Reduce duration of fixed treatment
• Btr oral hygiene
• Healthy periodontium
• Lesser retention period
• More Stable result

10. Disadvantage
• Proper clinical judgement needed
• Treatment time prolonged (2-3 yrs)
• Pt cooperation needed
• Develop tongue thrusting
• Deepening of bite
• Mesial migration of buccal teeth
• Ditching between canine and premolar
• Fixed appl needed to correct axial inclination

11. Diagnosis
• Arch length deficiency of not less than 5-7 mm should exist
• Careys and arch perimeter analysis
• Mixed dentition analysis
• OPG to evaluate eruption status
• Ceph to assess skeletal relation
• Soft tissue assessment by clinical examination and ceph

12. Procedures
• Dewel’s method
• Tweed’s method
• Nance method

13. Dewel’s method
CD4

14. Tweeds method
D4C

15. Nance method
Similar to tweed
D(4C)

16. • Characterized by reverse overjet where in one or more
maxillary anterior teeth are in lingual relation to the mandibular
teeth
• To prevent a minor orthodontic problem from progressing into
a major dentofacial anomaly

17. Classification
1) Dento alveolar anterior crossbite – due to retained deci tooth
Single tooth usually
Tongue blade
Catalans appliance
Double cantilever spring with PBP
2) functional anterior crossbite
Pseudo class III malocclusion
Occlusal prematurity
Eliminate occlussal prematurity

18. 3) Skeletal anterior crossbite
Due to skeletal discrepancy
Growth modification

19. • Thumb sucking (2-3 yrs normal)
• Tongue thrusting
• Mouth breathing – obstructive and habitual

20. • Space loss by mesialization of molar after early loss of primary
molar
• Correction by distalization of molar
Appliances
• Gerber space regainer
• Space regainer using jack screw
• Space regaining using cantilever spring

21. • Improves aberrant muscle function
Exercise for the masseter muscle
• Clenching of teeth while counting 10
• Repeat for some duration of time

22. Exercise for lips
• Stretching of upper lip to maintain lip seal – hold a piece of
paper
• Stretch upper lip in a downward direction
• Holding and pumbing of water back and forth behind the lips
• Massaging of lips
• Button pull exercise : 1 ½ inch diameter button is taken and a
thread passed through the button hole. Asked to place the
button behind the lips and pull the thread while restricting it
from being pulled out by using lip pressure
• Tug of war exercise – two buttons. One placed behind the lips
while the other button is held by another person to pull the
thread.

23. Exercise of tongue
• One elastic swallow – to correct tongue position. 5/16 inch intra oral
elastic placed on the tip of the tongue,Pt is asked to raise the tongue
and hold the elastic against the rugae and swallow
• Tongue hold exercise – 5/16 inch elastic is positioned over the
tongue for a period of time with lip closed.pt is asked to swallow
with elastic in place and lips apart.
• Two elastic swallow – two 5/16 inch elastics placed one in midline
and other on tip
• Hold pull exercise – tip of the tongue and the midpoint are made to
contact the palate and the mandible is gradually opened. Stretches
the lingual frenum

24. • To reduce the severity
• To normalize the skeletal relationship
Interception of class II skeletal maloccl
• Facebow with headgear
• Myofunctional appliances
Interception of class III skeletal maloccl
• Chincup with headgear
• FR III
• Facemask therapy

25. • Surgical exposure of impacted canine
• Ankylosis, supernumerary, retained decidous tooth