class1 malocclusion ppt


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  • The diagnosis and treatment of this presentation make it too simple:
    how about the balance of the face ??? Steep mandibular angular--- still Class I ?????
    If all it concerns is about alleviating the crowding , then the clinician of this treatment is ' a teeth alignment specialist '
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class1 malocclusion ppt

  1. 1. RUBAB HAIDER D-606
  2. 2. <ul><li>>>Angle’s class I malocclusion is also known as neutrocclusion where the molars are in normal class I relationship ( Mesiobuccal cusp of the upper first permanent molar lies in the mid buccal groove of the lower first permanent molar) </li></ul><ul><li>leaving the other teeth in malocclusion. </li></ul><ul><li>>>Harmonious relationship of the underlying skeletal structures and malocclusion component is restricted to the dental malrelations only.. </li></ul>
  3. 4. <ul><li>1) Class I malocclusion. </li></ul><ul><li>2) Bimaxillary protrusion </li></ul>
  4. 6. <ul><li>SKELETAL FEATURES: </li></ul><ul><li>Prognathic jaws </li></ul><ul><li>Increased ANB angle </li></ul><ul><li>Convex profile </li></ul><ul><li>Everted lips </li></ul><ul><li>Smaller upper and posterior facial height with divergent facial planes </li></ul>
  5. 8. <ul><li>Bimaxillary proclination </li></ul><ul><li>Increased incisal angle </li></ul><ul><li>Spacing between teeth </li></ul><ul><li>Normal molar and canine relationship </li></ul><ul><li>Steep mandibular plane angles </li></ul>
  6. 11. <ul><li>SKELETAL FEATURES: </li></ul><ul><li>Harmonious face </li></ul><ul><li>Straight to convex profile </li></ul><ul><li>Nothing really abnormal </li></ul>
  7. 13. <ul><li>Class I molar relationship </li></ul><ul><li>Individual tooth malocclusion with varying degree of severity </li></ul><ul><li>Malocclusion may be in vertical and transverse planes. </li></ul><ul><li>Lip competence is dependant on degree of anterior proclination </li></ul>
  8. 17. <ul><ul><li>Spacing </li></ul></ul><ul><ul><li>Crowding </li></ul></ul><ul><ul><li>Crossbite </li></ul></ul><ul><ul><li>Openbite (anterior) </li></ul></ul><ul><ul><li>Rotations </li></ul></ul><ul><ul><li>Deepbite (anterior) </li></ul></ul><ul><ul><li>Bimaxillary protrusion </li></ul></ul>
  9. 18. <ul><li>History </li></ul><ul><li>Clinical examination </li></ul><ul><li>Study models </li></ul><ul><li>Radiography </li></ul><ul><li>OPG </li></ul><ul><li>Periapical </li></ul><ul><li>Lateral ceph </li></ul>
  10. 20. <ul><li>Generalized: </li></ul><ul><ul><li>Eliminate cause </li></ul></ul><ul><li>Microdontia </li></ul><ul><ul><li>Eliminate spaces between anteriors,leaving a space between canine and 1 st premolar </li></ul></ul><ul><ul><li>Prosthesis </li></ul></ul><ul><li>Spacing with proclination: </li></ul><ul><ul><li>Labial bow </li></ul></ul><ul><ul><li>Elastics with fixed or removable appliance </li></ul></ul>
  11. 21. <ul><li>Labial bow with finger spring </li></ul>
  12. 22. <ul><ul><li>Eliminate cause i.e. high labial frenum attachment </li></ul></ul><ul><ul><li>Removable appliances : </li></ul></ul><ul><ul><ul><li>Finger spring </li></ul></ul></ul><ul><ul><ul><li>Finger spring with labial bow </li></ul></ul></ul><ul><ul><ul><li>Split labial bow </li></ul></ul></ul><ul><ul><li>Fixed appliances: </li></ul></ul><ul><ul><ul><li>Pin and tube appliance . </li></ul></ul></ul>
  13. 24. <ul><li>Analyze space discrepancy using model analysis. </li></ul><ul><li>Treatment is planned on the amount of space required. </li></ul><ul><li>Mild Crowding: </li></ul><ul><li>If the space discrepancy is up to 4mm: </li></ul><ul><ul><li>usually resolves without extraction. </li></ul></ul><ul><ul><li>Proximal stripping </li></ul></ul><ul><ul><li>Alignment of teeth by labial bow, finger spring. </li></ul></ul>
  14. 25. <ul><li>Moderate crowding: </li></ul><ul><li>If space discrepancy is in the range of 5-9mm, treated without extractions by : </li></ul><ul><ul><li>Arch expansion </li></ul></ul><ul><ul><li>Molar anchorage or </li></ul></ul><ul><ul><li>Enamel reduction. </li></ul></ul>
  15. 26. <ul><li>Severe crowding : </li></ul><ul><li>Patients with space discrepancy of 10 mm or more: </li></ul><ul><ul><li>Extract all 1 st premolars </li></ul></ul><ul><ul><li>Retract canine by canine retractor </li></ul></ul><ul><ul><li>Align anteriors by labial bow </li></ul></ul><ul><ul><li>Retention by Hawley’s retainer. </li></ul></ul>
  16. 29. <ul><li>ANTERIOR </li></ul><ul><ul><ul><li>Z-spring with posterior bite plane </li></ul></ul></ul><ul><ul><ul><li>Expansion screw with posterior bite plane </li></ul></ul></ul>
  17. 30. <ul><li>POSTERIOR </li></ul><ul><ul><li>Single tooth: </li></ul></ul><ul><ul><ul><li>Cross-elastics </li></ul></ul></ul><ul><ul><li>Unilateral: </li></ul></ul><ul><ul><ul><li>Unilateral expansion screw </li></ul></ul></ul><ul><ul><ul><li>Functional appliance </li></ul></ul></ul><ul><ul><li>Bilateral: </li></ul></ul><ul><ul><li>Maxillary expansion is done to relieve cross bite by: </li></ul></ul><ul><ul><ul><li>Coffin spring </li></ul></ul></ul>
  18. 31. <ul><ul><li>Quad Helix Appliance </li></ul></ul>
  19. 32. <ul><li>Hyrax screw for rapid maxillary expansion </li></ul>
  20. 34. <ul><li>ANTERIOR: </li></ul><ul><ul><li>Eliminate habit </li></ul></ul><ul><ul><ul><li>Thumb sucking </li></ul></ul></ul><ul><ul><ul><li>Tongue thrust </li></ul></ul></ul><ul><ul><ul><li>Mouth breathing </li></ul></ul></ul><ul><ul><li>Skeletal openbite </li></ul></ul><ul><ul><li>during mixed dentition: </li></ul></ul><ul><ul><ul><li>Frankel IV or chin cap with high pull headgear </li></ul></ul></ul><ul><ul><li>In permanent dentition,before puberty </li></ul></ul><ul><ul><ul><li>Fixed appliance with box elastics </li></ul></ul></ul><ul><ul><li>In permanent dentition after puberty: </li></ul></ul><ul><ul><ul><li>Surgery </li></ul></ul></ul><ul><ul><li>If due to supra-erupted posteriors: </li></ul></ul><ul><ul><ul><li>Posterior segmental osteotomy </li></ul></ul></ul>
  21. 36. <ul><li>Single Tooth: </li></ul><ul><ul><li>Removable Appliance: </li></ul></ul><ul><ul><ul><li>Couple force by flapper spring/ double cantilever spring and labial bow </li></ul></ul></ul><ul><ul><li>Semi-fixed Appliance: </li></ul></ul><ul><ul><ul><li>Whip spring </li></ul></ul></ul><ul><ul><ul><li>High labial bow with soldered ‘T’ spring </li></ul></ul></ul><ul><li>Multiple rotations: </li></ul><ul><ul><li>Treated by fixed appliance </li></ul></ul><ul><ul><li>Overcorrection is done and retention is given for atleast 1 year…. </li></ul></ul>
  22. 37. <ul><li>High Labial bow </li></ul><ul><li>T spring </li></ul>
  23. 39. <ul><li>Growing age: </li></ul><ul><ul><li>With less low facial height : </li></ul></ul><ul><ul><ul><li>Anterior bite planes </li></ul></ul></ul>
  24. 40. <ul><ul><li>Anterior bite planes are contraindicated if patient already has more lower facial height. </li></ul></ul><ul><ul><ul><li>Intrude anteriors by: </li></ul></ul></ul><ul><ul><ul><li>Fixed appliance </li></ul></ul></ul><ul><ul><ul><li>J hooks of vertical pull headgear </li></ul></ul></ul>
  25. 42. <ul><li>Extract all 1 st premolars, or 1 st molars. </li></ul><ul><li>Treatment depends on angulation of canine: </li></ul><ul><ul><li>Distally inclined canine : </li></ul></ul><ul><ul><ul><li>Retract canine and align incisors using retainers </li></ul></ul></ul><ul><ul><li>Mesially inclined canine: </li></ul></ul><ul><ul><ul><li>Fixed appliance </li></ul></ul></ul>
  26. 43. <ul><li>Use of anterior subapical osteotomy in conjunction with extraction of a tooth in each quadrant, usually the 1 st premolars . </li></ul><ul><li>Bone apical to upper 6 anteriors is cut, and the whole segment is pushed back, in conjunction with surgical splints and rigid osteosynthesis (plating). </li></ul><ul><li>Box and vertical elastics and retainers are used postsurgically to prevent relapse of teeth. </li></ul>
  27. 45. YOU !!
  28. 46. <ul><li>Lecture notes </li></ul><ul><li>Contemporary orthodontics by William R Proffit </li></ul><ul><li> </li></ul><ul><li> </li></ul>