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193- Early treatment in orthodontics - traitement precoce en orthodontie- interception en orthodontie- oussam sandid- olivier sandid.pptx
1. 193-The Timing of Orthodontic Treatment
Early Treatments in Orthodontics
O.SANDID
SQODF SPO- 2007
2. 3-Do Deep Overbites require correction ?
M. ABOULNASER - O. SANDID
Overbites co-contributing factor in the aetiology of TMD, (abnormal TMJ
movements), locking mandibular growth
Australian Society of Orthodontists
3. Part I: Clinical and Biologic Principles of Early-Age
Orthodontic Treatment
• 1- Rationale for Early-Age Orthodontic Treatment
• 2- Development of the Dentition and Dental Occlusion
• 3-Examination, Early Detection, and Treatment Planning
4. Part II:Early-Age Orthodontic Treatment of Non skeletal
Problems
• 1-Management of Anterior Crossbite
• 2-Management of Transverse Problems (Posterior Crossbites)
• - Space Management in the Transitional Dentition
• -Management of Incisor Crowding
• 3 -Management of Deleterious Oral Habits
• 4- Orthodontic Management of Hypodontia
• 5- Orthodontic Management of Supernumerary Teeth
• 6 -Diagnosis and Management of Abnormal Frenum Attachments
• 7- Early Detection and Treatment of Eruption Problems
• 8-Management of Sagittal Problems (Class II and Class III Malocclusions)
• 10-Management of Vertical Problems (Open Bites and Deep Bites)
5. Early Treatments in Orthodontics
1-Anterior cross bite
2-Posterior Crosse bite
3-Crowding
4-Openbite
5-Protrusion
6-Ectopic eruption
7-Class III- proglissement
8-Disatema-freins
9-Oral habits- Thumb sucking Tongue thrusting Lips
10-Class II division 2-Blockc growth
11-Mouth breathing
12-Mandibular deviation growth midline
13-Space maintainer
15-guidage of eruption
6. Early Treatment
GENERAL CONSIDERATIONS
• First Phase of early orthodontic treatment frequently begins when
children are 7-10 years of age. At that time, only the front teeth and
back molars are adult teeth.
• Excellent patient cooperation at this age makes substantial
treatment changes possible in short periods of time.
• First Phase treatment results are usually obtained in 12 months.
• During this treatment time, it is customary to use a limited number
of braces on the front teeth and back permanent molars.
• Headgears, bionators and expanders are also used when necessary.
• The Second Phase of treatment is usually necessary when all the
permanent teeth have erupted.
• The time between First Phase treatment and Second Phase
treatment can vary from patient to patient. During this time,
retainers are worn and the patient is checked regularly
7. OTHER EARLY TREATMENT CONSIDERATIONS
• A Second Phase of orthodontic treatment is usually
necessary. All the permanent teeth are braced at this
time. This requires a separate fee.
• Two phases of treatment means more office visits are
necessary over the years.
• Treatment costs can be higher if two phases of
treatment are necessary. These costs are spread out
over a number of years.
• It's important for the parents to understand the
reasons for early treatment. Remember, it's easier to
fix a problem early before it has a chance to grow.
8. REASONS FOR EARLY TREATMENT IN ORTHODONTICS
• Early age cooperation is excellent.
• The function of the teeth is improved.
• Better tooth alignment makes brushing and flossing easier.
• Cosmetics are improved. Self-esteem and peer group criticism can be factors.
• Early alignment of protruding upper front teeth ("buck teeth") helps to prevent their fracture.
• Early treatment creates more space for the proper eruption of the permanent teeth. The need for
permanent tooth removal is less.
• Jaw problems are easier to correct at an early age because the younger patient finds it easier to
wear headgear and expanders. It's sometimes rough to get teenagers to help with this.
• Creating room for crowded, erupting teeth.
• Creating facial symmetry through influencing jaw growth.
• Reducing the risk of trauma to protruding front teeth.
• Reducing treatment time with braces.
• Easier speaking and phonetics.
• Improved chewing, mastication, and digestion.
• Correct harmful oral habits.
• Proper balance of lips & gums.
• Improves growth and development of facial structures.
http://www.mybraces.com/treatment-info/early-treatment.aspx
http://www.friendlysmilesortho.com/first-visit/life-with-braces/
10. PLAN
• POSTER
• 1-DEFINITION
• 2- ETIOLOGICAL FACTORS
• 3-Anterior Crossbite, Why Early treatment ?
• -Gingival recession
• - Deficient anterior growth of maxilla
• - Unaesthetic smile
• - Enamel abrasion
• 4- Diagnosis
• -Pseudo Class III
• -Class III malocclusion
• 5-Treatment, Case report
•
11. Anterior Crossbite, Why Early treatment ?
DEFICIENT ANTERIOR GROWTH OF MAXILLA // GINGIVAL RECESSION – UNAESTHETIC SMILE // ENAMEL ABRASION
NORMAL OCCLUSION ANTERIOR CROSSBITE UNILATERAL ANTERIOR CROSSBITE
O SANDID
12. 1-DEFINITION
Anterior Crossbite
An abnormal relationship of a tooth or teeth to the opposing teeth, in which normal buccolingual or
labiolingual relationships are reversed.
Incidence 2% - 4%.
www.orthofree.com, www.prorthoassist.com
13. 2-ETIOLOGICAL FACTORS
Anterior crossbite
1-Skeletal
Genetic predisposition
Embryological defective development
Class III malocclusion mandibular prognathia, Insuffecient maxillary
2-Dental
Lingual eruption path of maxillary anterior teeth
Trauma to deciduous dentition in which there is displacement of tooth buds
Retained deciduous causing lingual eruption of permanent teeth
Supernumerary teeth
3-Functional
a-Habits
Digital or pacifer sucking habits
Oral respiration
Low tongue position
Stomach sleeping posture
Tongue trusting
b-Pseudo Class III
Class I skeletal relationship
Insuffecient maxillary overjet and incisor interference
Multi-tooth anterior crossbite may result from a functional shift of the mandible in an effort to avoid
anterior interference in centric relation and to achieve maximun intercuspation
ETIOLOGICAL FACTORS
14. Initial
intraoral
views.
Final
intraoral
views
Roberta Nascimento ANDRADE, Flávia Ribeiro TÔRRES, RGO, Rev Gaúch Odontol, Porto Alegre, v.62, n.4, p. 411-416, out./dez., 2014
3-Anterior Crossbite, Why Early treatment ?
Anterior Dental Crossbite Correction - Gingival Recession Caused by Traumatic
Occlusion (Anterior crossbite).
17. 3-Anterior Crossbite, Why Early treatment ?
Deficient anterior growth of maxilla, Maxilla stop growing, Early age cooperation is excellent.
Elie Callabe
Before After
21. 4-Diagnois Anterior dental crossbite
Ayca Tuba Ulusoy, Ebru Hazar Bodrumlu, http://www.contempclindent.org/
Pre-treatment intraoral photograph
An 8 year old girl, with the chief complaint of an unaesthetic appearance of the maxillary central incisors, and
the patient did not have a family history of Class-III malocclusion.
Class-III malocclusion
22. Early detection and treatment of malocclusions- Treatment of 6-
and 9-Year
Anterior dental crossbite correction- improving gingival
recession and corretion hypomaxillie unilaterale…
30. Bibliography
• Bibliography
• 1. Arvystas MG. The rationale for early orthodontic treatment. Am J Orthod Dentofacial Orthop 1998:133:15-8.
• 2. Adams P. The design, construction and use of removable orthodontic appliances. 5th ed. Bristol; 1984. p.111-2.
• 3. Graber TM, Neuman B. Removable orthodontic appliances. 2nd ed. Saunders; 1984. p. 57-9.
• 4. Horosilkina FJ, Maligin JM. Osnovi konstruirovanija I tehnologija izgotovlenija ortodontoticeskih aparatur. Moskva:
Medicina; 1977. p. 168-9. Rus
• 5. Kalvelis DA. Aparatūras, kas darbojas pēc slīpās plāksnes principa. Ortodontija 1964:135-6;
• 6. Patti A, Perier G. Preface. In: Clinical success in early orthodontic treatment. Quintessence; 2005. p. 8.
• 7. Proffit WR. The timing of eraly treatment: An overview. Am J Orthod Dentofacial Orthop 2006;4:S48;
• 8. Sztele R. Herstellung Kieferorthop.disher apparate. Berlin; 1960. S. 53.
• 9. Taatz H. Kieferorthop.dische Prophylaxe und Frühbehandlung. I. Jirgensone et al. CLINICAL CASE
• München,Wien: Hanser; 1976. p. 238-9.
• 10. Vadiakas G, Viazis AD. Anterior crossbite correction in the early deciduous dention. Am J Orthod Dentofacial Orthop
• 1992;102:160-2.
• 11. Zachrisson B, Thilander B. Treatment of Dento-alveolar anomalies. In: Introduction to orthodontics. Stockholm; 1994.
• p. 146-182.
• 12. Tausche E, Luck O, Harzer W. Prevalence of malocclusions in the early mixed dentition and orthodontic treatment need.
• Eur J Orthod 2004;26:237-44.
• 13. Kiyak AH. Patients’ and parents’ expectations from early treatment. Am J Orthod Dentofacial Orthop 2006;129:S50-54.
• 14. Ngan P. Biomechanics of maxillary expansion and protraction in Class III patients. Am J Orthod Dentofacial Orthop
• 2002;121:58283.
• 15. Dugoni S, Aubert M, Baumrind S. Differential diagnosis and treatment planning for early mixed dentition malocclusions.
• Am J Orthod Dentofacial Orthop 2006; 129:S80-1.
31. 2- Posterior crossbite in primary and mixed dentition
etiology and management
31
http://www.slideshare.net/vjldmd/phase-i-
orthodontic-treatment
http://www.slideshare.net/search/slideshow?s
earchfrom=header&q=POSTERIOR+CROSSBITE
32. 2-Early Treatments in Orthodontics
Posterior Crossbite
32
http://ejo.oxfordjournals.org/content/early/20
11/09/06/ejo.cjr095
41. 2-Early Treatments
in Orthodontics
Case1 -a
www.orthofree.com
Lines indicate asymmetry between right and left condyles.
Juan M. Font Jaume
Posterior crossbite asymmetry
46. Anterior dental crossbite
www.orthofree.com
Ayca Tuba Ulusoy, Ebru Hazar Bodrumlu, http://www.contempclindent.org/
A panoramic radiograph showed no evidence of bone or dental pathology, a and lateral cephalometric radiographic view showed no
evidence of basal problem between mandibular and maxillary arche
59. • Early tooth loss in the anterior region can be a result of traumatic
avulsion or extraction of carious or infected teeth.
• Unlike tooth loss in the posterior region, anterior tooth loss does
not result in space loss if the primary cuspids are erupted.
• The lack of teeth does not interfere with the child’s ability to eat.
However it may interfere with speech if teeth loss occurs before
speech development is complete.
• The most valid reason to replace anterior teeth is for aesthetics
as lack of teeth may harm the patient’s self image.
Anterior Tooth Loss
http://www.dentalcare.com/
60. Anterior Tooth Loss
J.Anderssen -Dental Trauma Guide 2010
Early tooth loss in the anterior region can be a result of traumatic
avulsion or extraction of carious or infected teeth.
61. Anterior Tooth Loss
O. SANDID
Teeth replacement can be accomplished with cemented or removable space
maintainer
62. Anterior Tooth Loss
Teeth replacement can be accomplished with cemented or removable appliances. The “pedo partial” is a simple
yet effective replacement for extracted anterior teeth.
Orthodontic bands are fitted on the posterior molars. An impression is taken and
sent to the lab with the fitted bands. Primary denture teeth,
which are smaller and whiter than adult denture teeth are available
to fabricate a natural looking appliance
http://www.dentalcare.com
63. Posterior Tooth Loss
Premature loss of a posterior primary tooth results in
mesial tilting of the tooth distal to the extraction space
due to the mesial direction of eruption of the first
permanent molar.
The lack of space prevents eruption of the permanent
tooth into its proper position. To maintain the space
and allow normal eruption of the permanent tooth a
space maintainer is placed. Depending on the location
of the extraction site there are a variety of space
maintainers from which to choose. Space maintainers
are left in place until eruption of the permanent teeth
64. Posterior Tooth Loss
The lack of space prevents eruption of the permanent tooth into its proper
position.
65. Posterior Tooth Loss- Fixed space
maintainer
www.northsydneyorthodontics.com.au
www.pdgdental.com
lingual arch space maintainers. Nance Transpalatal arch
Fixed space maintainer
66. Posterior Tooth Loss- Fixed space
maintainer
BOUYAHYAOUI N., RAMDI H., BELHAISSI F.Z., AALLOULA E. Les mainteneurs d’espace : pour une prévention rationnelle des malocclusions Journal Dentaire Alger.
Tome 8 n°30-2002; pp 24-29HAJJY A.RAMDI H. El ALOUSSI M. CHHOUL H.
AMEZIANE R.Les mainteneurs d’espace d’utilisation courante en Odontologie Pédiatrique,Faculté de Médecine Dentaire de Rabat. Université Mohamed V Suissi.
67. Posterior Tooth Loss- Removable space
maintainer
www.northsydneyorthodontics.com.au
www.pdgdental.com
Removable space maintainer
68. Posterior Tooth Loss- Removable space
maintainer
Truitt Skip
Removable space maintainer
69. Bilateral space maintainer
• A bilateral space maintainer is indicated for
loss of more than one tooth in a quadrant or
loss of a second primary molar. Three
examples of bilateral space maintainers are
the Lingual Arch space maintainer, the Nance
appliance, and the Trans Palatal Arch space
maintainer.
70. Lingual Arch Space Maintainer
Indications for a lingual arch space maintainer are:
• Bilateral loss of the mandibular primary molars after eruption of the
permanent incisors
• Unilateral loss of more than one tooth in the mandibular arch
• Its design is of bilateral bands on molars that are connected by a heavy wire
that rests on the cingulums of the anterior incisors.
71. Nance Appliance
www.baileyorthoaz.com
The indications for a Nance appliance are bilateral loss of the maxillary primary
molars or unilateral loss of more than one tooth in the maxillary arch. Its
design is of bilateral bands on molars that are connected by a heavy wire
72. Transpalatal Arch Appliance
North Sydney Orthodontics
The indications for a Transpalatal Arch appliance is bilateral loss of the
maxillary primary molars or unilateral loss of more than one tooth in the
maxillary arch. Its design is of bilateral bands on molars that are connected by
a heavy wire that transverses the hard palate without touching soft tissue.
75. Benefits of using a space maintainer
-May reduce or eliminate the need for braces.
-Eat comfortably.
-Save space for proper eruption of adult teeth
-Improve aesthetics as lack of teeth may harm
the patient’s self image.
-Prevent Impacted Tooth…
76. • HAJJY A.RAMDI H. El ALOUSSI M. CHHOUL H. AMEZIANE R.Les mainteneurs d’espace d’utilisation courante en
Odontologie Pédiatrique,Faculté de Médecine Dentaire de Rabat. Université Mohamed V Suissi.
• PETER NGAN,RANDY G. ALKIRE, HENRY FIELDS JR., MANAGEMENT OF SPACE PROBLEMS IN THE PRIMARY AND
MIXED DENTITIONS,JADA, Vol. 130, September 1999
• Brock Rodeau ,Space Maintainers Laboratory ,The Schwarz Appliance
• Rick Balon ,Space Maintenance and Interceptive Orthodontics
• BOUYAHYAOUI N., RAMDI H., BELHAISSI F.Z., AALLOULA E.
Les mainteneurs d’espace : pour une prévention rationnelle des malocclusions.
Journal Dentaire Alger. Tome 8 n°30-2002; pp 24-29
• COZLIN A., JACQUELIN L-F., BERTHET A.
Extraction prématurée en denture temporaire et mixte : il faut maintenir l’espace.
Information Dentaire, n° 30 du 11 septembre 02 ; p 2131-2135.
Creighton university school Oral pathology service
• HAMZA M., EL ARABI S., BOUSFIHA B., MSEFER S.
Les mainteneurs d’espace fixe: un moyen pour prévenir la perte d’espace en denture temporaire. Espérance médicale.
Spécial Dentaire. Novembre 2004 ; tome 11 ; n°52 ; pp9-14.
• FORTIER Abrégé de Pédodontie Editions Masson- 1989.
The journal contemporary dental practice Vo 7 Number 2 May 2001
• Truitt Skip
References
www.orthofree.com
156. Early Treatments
in Orthodontics
Case 2: M.O. 4 years 2 months
www.orthofree.com
-Unilateral crossbite
-facial assymetry.
Composite build-ups on right deciduous molars,
selective grinding
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