Dentistry methods of gaining spaces

3. CONTENTS
INTRODUCTION
PROXIMAL
STRIPPING
PERIODONTAL
CONSIDERATION
EXTRACTION AS
A METHOD OF
GAINING SPACE
DEROTATION
AND
PROCLINATION
CONCLUSION

4. The correction of
many malocclusions
requires space in
order to move teeth
into molar ideal
solutions.
Space is required for correction of
crowding , retraction of proclined
teeth, levelling a steep curve of
spee , derotation of anterior teeth
and for correction of unstable molar
relation.

5. SOME OF THE METHODS OF GAINING SPACE INCLUDE:
Proximal
stripping
Expansion
and
Extraction
Distalization
Up righting of
Molars
Derotation of
Posterior
Teeth
Proclination
of Anteriors

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PROXIMAL STRIPPING
 Proximal stripping is a method
by which the proximal surfaces
of the teeth are sliced in order to
reduced the mesio-distal width
of the teeth to create space.
Also called

8. DIAGNOSTIC AIDS FOR
PROXIMAL STIPPING
1.ARCH
PERIMETER
ANALYSIS
2.BOLTON,S ANALYSIS
3.INTRA – ORAL PERIAPICAL
RADIOGRAPHS
AMOUNT OF PROXIMAL STRIPPING
ADANTAGE OF PROXIMAL STRIPPING
DISADVANTAGE OF PROXIMAL STRIPPING

9. :
 Carey’s analysis showing a TTM excess of 0-2.5mm
 Bolton’s analysis showing mild tooth material excess
 For correction of minimal inter arch tooth material discrepancy
 In lower anteriors to aid retention
 In cases where individual tooth size prevents class I molar relation
 To obtain favourable overjet or overbite
:
o Young patients
o Patients with high caries index
o Patients with enamel hypoplasia

10. Minimizes potential consequences
of extraction such as:
⚫Difficulty incompleting space
closure
⚫Need forgreater
anchorage
⚫Possibilityof space re- opening
⚫Difficulty in paralleling roots
next toextraction sites
Drawbacks include:
⚫Roughened proximal surfaces
thatatrract plaque
⚫Increased caries
susceptibility
⚫Sensitivityof teeth
ADVANTAGE DISADVANTAGE

14. PERIODONTAL CONSIDERATION
OF PROXIMAL STRIPPING
PROCEDURE OF PROXIMAL
STRIPPING
1.USE OF METALLIC ABRASIVE
STRIPS
2.SAFE SIDED CARBORUNDUM
OF DIAMOND DISCS
3.LONG THIN TAPERED FISSURE
BURS.
FLUORIDE APPLICATION

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⚫Non-invasive method of space
gaining
⚫Undertaken in patients having
constricted arch
⚫Crossbite
⚫Crowding
⚫Skeletal class III malocclusion
⚫surgical orthodontics

19. EXTRACTION AS A METHOD OF
GAINING SPACE

20. • eg: peg shaped
laterals, mesodens
, macrodontia
Need for
extractio
n:
1.Arch
length
2.Correction
of inter arch
relation
3.Abnormal
size and
shape of
teeth

22. INDICATIONS FOR DISTALIZATION
CONTRAINDICATION FOR DISTALIZATION
1.EXTRA-ORAL METHODS
2. INTRA-ORAL METHODS
SAGITTAL APPLIANCE
PENDULUM APPLIANCE
1>HIGHER PENDEX
2>T-REX APPLIANCE
3>THE HIGHER PhD APPLIANCE

23. ⚫First tried by Kingsley using headgear
⚫Aimed at moving the molarsdistally togain spoace
⚫Ideal timing mixed dentition period priortoeruption of second
permanent molars
Indications
⚫Straightprofile
⚫Functional :
 Normal, healthy temporomandibular joint
 Correct maxillo-mandibularrelationship

24. ⚫INDICATIONS
⚫Skeletal
 class I skeletal relationship
 skeletalclosed bite
 brachycephalicgrowthpattern
⚫Dental
 Class II orend on relationship
 Discrepancyof 2 to 3 mm
Contraindications :
Class I or III malocclusion
Open bite
Posteriorcrowding

25. Extra oral: (Using headgears)
 Components:
o Force delivering unit : face bow/ J hook
o Forcegenerating unit :elasticstrap
o Anchoring unit: head cap/ neck strap

26. It brings about
bodily movement
or distal tipping of
the molars in a
posterior direction
Tipping
movement is
recommended in
case of
horizontal
growth pattern
and deep bites.
In such cases it
helps in opening
the bite and also
increases lower
anterior facial
height.
Headgears allow
bilateral as well
as unilateral
distalization.
Also, amount of
distalization can
be controlled
individually

27. DISTALIZATION USING INTRA-ORAL MAGNETS
USE OF OPEN COIL SPRINGS TO DISTALIZE MOLAR
JONES JIG
THE DISTAL JET
AECO APPLIANCE
THE FAST BOOK APPLIANCCE
TRANSPALATAL ARCH FOR DISTALIZTION
USE OF FIXED FUNCTIONAL

28. INTRA ORAL:
Sagittal
appliance
• Removable appliance
incorporating jackscrews
• Consists of a split acrylic
plate joined by jackscres
• Acrylic plate is sectioned in
such a way that the tooth to
be distalised is isolated and
the rest of the arch is used
for anchorage
• Retained using adams
clasps
• Jackscrews are parallel to
surface of molars
• Used for individual tooth
distalization

29. Pendulum appliance
Intra-oral distalization appliance
introduced by Hilgers
Incorporates a modified Nance
button for anchorage and a
stainless steel wire
The wire has a helix the distal end of which
is inserted into a sleeve at the palatal
aspect of the molar to be distalised
Activated by opening the helices and
engaging the distal ends into the
sleeves
Types Heliger’s pendex
Heliger’PhDappliance
T-rex appliance

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Jones jig
Open coil spring
Placed on buccal aspect;
generates required force when
compressed
Anchorage by Nance’s palatal button and
Ni-Ti wire to bring about distal movement
The assembly is ligated onto d
first molar to prevent rolling

34. Distal jet appliance:
• Lingual distalization appliance
• Active components are placed palatally
which provide more bodily movements
• Consists of bilateral piston and tube
arrangement
• Tube is embedded in modified acrylic
• Anchorage by Nance palatal button that
are bonded to bands attached to 1 or 2
premolars
• A Ni-Ti spring and activation collar are
placed near each tube
• Activation collar is retracted distally,
causing compression and thereby
activation
• Advantage: less distal tipping
DISTAL JET
ACCO

35. THE FAST BACK
APPLIANCE
TRANSPALATAL
ARCH

36. UPRIGHT OF MOLARS

37. Premature loss of
teeth may result in
tipping of the
adjacent teeth
Itcan beachieved by
space regainer
• A tipped teeth
occupies more
space.
• Therefore upright
of teeth allows
for
recoveryof some
space

38. • Rotated teeth occupy
more space
• De-rotation provides
some amountof
space
• Can be brought
about by space
regainers and springs

39. PROCLINATION OFANTERIOR TEETH