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Leader in continuing dental education
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“LOWER INCISOR CROWDING IN THE
EARLY MIXED DENTITION”
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SPECIFIC OBJECTIVES:
1. Know how to approach the problem of lingually
erupting lower incisors.
2. Know when to assess a ch...
SPECIFIC OBJECTIVES (cont):
4. Explain leeway space control and the role of the
mandibular lingual arch in assisting lower...
REQUIRED READING:
(In manual)
Article: Early Mixed Dentition Developmental Module
Article:

Management of lower incisor cr...
1.

Primate space

2.

General spacing

3.

Preservation of “leeway space”

4.

Sequences of eruption

5.

Tooth size and ...
Crowding and protrustion of the incisors
must be considered two aspects of the same
thing:

how crowded and irregular the
...
 Identify WHY incisor guidance is needed.
 List WHAT is to be considered.
 Indicate WHEN incisor guidance is appropriat...
 To help prevent orthodontic relapse.
 Prevent unnecessary periodontic problems.

www.indiandentalacademy.com
 Interdental spacing.
 Intercanine distance.
 Increase of the arch perimeter.
 Size ratio between the primary and perm...
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1° - 4 YEARS
CROWDING
NO SPACE
0-3 MM SPACE
3-6 MM SPACE
> 6 MM SPACE

PERMANENT
-

10/10
7/10
5/10
2/10
0/10

B. C. LEIGH...
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 Continue to observe the case.
 Disc primary teeth.
 Extract primary teeth.
 Refer to an orthodontist.

www.indiandent...
Those < 2mm. crowding may
resolve into good alignment. (Profitt)

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www.indiandentalacademy.com
www.indiandentalacademy.com
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Those with 3 – 4 mm. arch crowding.

The goal is to transfer the anterior crowding
posteriorly into the leeway space.

www...
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When arch crowding is 4 to 9 mm.

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The goal is improve incisor alignment
(unraveling), perhaps preventing periodontal
problems and improving post-orthodontic...
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
Most class I cases having more than 10 mm.
crowding should be referred to an
orthodontic
specialist by general dentists an...
7 years old

9 years old

14 years old

Changes in the axial inclination due to the eruption of the maxillary anterior
tee...
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www.indiandentalacademy.com
 Avoid unnecessary periodontal problems.
 Enhance the long term stability of orthodontic

treatments.
 Involve more cli...
ECTOPIC ERUPTION AND SPACE
REGAINING
2004-2005
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GENERAL OBJECTIVE:
To discuss the problem of ectopic eruption
generally.
To discus the problem of ectopic eruption the
can...
SPECIFIC OBJECTIVES:
1. Define ectopic eruption.
2. Know the frequency of ectopically
eruption first permanent molars.
3. ...
SPECIFIC OBJECTIVES (continued):
5. Know methods for correcting ectopic
molar eruption.
6. Explain why long term follow-up...
REQUIRED READING (continued)
Article:

Weinberger, S., “Correction of bilateral
ectopic eruption of first permanent molars...
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Authors

Year of
study

Country

Number Of

Children With

Ectopic Eruption

CHILDREN

NUMBER

PERCENT

Cheyne & Wessels

...
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A ligature wire is passed through beneath the
contact and then twisted tightly.
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
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GENERAL OBJECTIVE:
Diagnose and regain the space loss.
www.indiandentalacademy.com
SPECIFIC OBJECTIVES:
1. Explain how space loss occurs in the
posterior region.
2. Describe indications for space regaining...
SPECIFIC OBJECTIVES (continued):
5. List the diagnostic aids required prior to
initiating space regaining.
6. Present the ...
SPECIFIC OBJECTIVES (continued):
7. (b)

removable appliance with jackscrew

(c)

fixed appliance with coil spring

(d)

l...
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Thank you
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Leader in continuing dental education

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Incisor guidance and ectopic eruption /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.


Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078

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  • Mn Incisors tend to show relapsse more
  • Arch perimeter - Upper jaw about 6mm lower jaw 4mm gained between 2 and 8 (85% of boys finished, 100% of girls by this time)
  • Most of growth when central incisors erupting, then again when canines erupting
  • **EXAM QUES: Which spacing is shown here… General spacing
  • Primary &amp; Freeway spacing? Leeway?
  • Canine is a little outside and distal… helps create 1-2mm for incisors
  • Primate(ry) spacing
  • Canine spacing… if its almost 28mm, can almost guarantee that there’ll be no probs with crowding….&lt;26mm , very questionable about whether there’ll be crowding
  • Central incisors in nice pos’n
  • 15%... Normal… two row teeth  mouth pos’n of teeth - check if mobile… if so, then pretty much normal. If not, extract… two row teeth cannot be tolerated - called ‘guiding eruption’
  • Primary spacing at 4 years, gives the likelihood of permanent crowding
  • First arch preserv… is good restorative work
  • Disc if around 4mm
    Extract primary canine if needed… do NOT do serial extractions!!!
  • Wedge to protect
  • ***EXAM: Where do you use varnish? Discing, often get into dentin, have to use varnish
  • 3. If maxilla distal to cranial base …congenital probs
    And couple other reasons
  • no two row teeth, as soon as diagnosed, extract
  • Two row teeth, not ectopic eruption
    1st perm M not supposed to resorb any tooth
  • Lateral incisor being resorbed slightly, not ectopic, somewhat normal
  • 70% of ectopically erupting teeth can self correct
  • Lateral is blocked, not resorbing anything
  • Canine erupting ectopically commonly in a mesial direction towards lateral and central…(up to 70% will self-correct) 99(?)% of time will erupt normally
    94% of extraction of primary canine will help… whenever you see a primary canine, extract… around 10-11
    Can also put on a removable appliance to help guide 2&amp;3 is lateral… etc..
  • Ectopic molar
  • Normal molar
  • ectopic
  • Self correction of previously ectopically erupting molar
  • Must monitor about 3months to give it a chance, then appliances if not erupting normally
  • SSC
  • Ligature wire
  • Tooth separators
  • Was only slightly ectopically erupting, but ended up becoming quite extensive by time film C was taken
  • Child came on time, but you screwed up, so it needs to be extracted
  • Removable appliances
    Kids often play and break them
  • Incisor guidance and ectopic eruption /certified fixed orthodontic courses by Indian dental academy

    1. 1. www.indiandentalacademy.com
    2. 2. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
    3. 3. “LOWER INCISOR CROWDING IN THE EARLY MIXED DENTITION” www.indiandentalacademy.com
    4. 4. SPECIFIC OBJECTIVES: 1. Know how to approach the problem of lingually erupting lower incisors. 2. Know when to assess a child patient’s tooth sizearch length relationship. 3. Identify when discing of lower cuspids is required. www.indiandentalacademy.com
    5. 5. SPECIFIC OBJECTIVES (cont): 4. Explain leeway space control and the role of the mandibular lingual arch in assisting lower incisor alignment. 5. Be able to design an appliance to improve lower incisor alignment. _____________________________________ REQUIRED READING: Preceding material in this Syllabus. www.indiandentalacademy.com
    6. 6. REQUIRED READING: (In manual) Article: Early Mixed Dentition Developmental Module Article: Management of lower incisor crowding in the early mixed dentition. T. Foley, G. Wright, S. Weinberger, Journal of Dentistry for Children, May-June, 1996, pp 169-174. www.indiandentalacademy.com
    7. 7. 1. Primate space 2. General spacing 3. Preservation of “leeway space” 4. Sequences of eruption 5. Tooth size and jaw in harmony www.indiandentalacademy.com
    8. 8. Crowding and protrustion of the incisors must be considered two aspects of the same thing: how crowded and irregular the incisors are reflects both how much room is available and where the incisors are positioned relative to the supporting bone. www.indiandentalacademy.com
    9. 9.  Identify WHY incisor guidance is needed.  List WHAT is to be considered.  Indicate WHEN incisor guidance is appropriate.  Suggest HOW incisor guidance is performed. www.indiandentalacademy.com
    10. 10.  To help prevent orthodontic relapse.  Prevent unnecessary periodontic problems. www.indiandentalacademy.com
    11. 11.  Interdental spacing.  Intercanine distance.  Increase of the arch perimeter.  Size ratio between the primary and permanent teeth. www.indiandentalacademy.com
    12. 12. www.indiandentalacademy.com
    13. 13. www.indiandentalacademy.com
    14. 14. www.indiandentalacademy.com
    15. 15. www.indiandentalacademy.com
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    18. 18. www.indiandentalacademy.com
    19. 19. www.indiandentalacademy.com
    20. 20. www.indiandentalacademy.com
    21. 21. 1° - 4 YEARS CROWDING NO SPACE 0-3 MM SPACE 3-6 MM SPACE > 6 MM SPACE PERMANENT - 10/10 7/10 5/10 2/10 0/10 B. C. LEIGHTON www.indiandentalacademy.com
    22. 22. www.indiandentalacademy.com
    23. 23. www.indiandentalacademy.com
    24. 24.  Continue to observe the case.  Disc primary teeth.  Extract primary teeth.  Refer to an orthodontist. www.indiandentalacademy.com
    25. 25. Those < 2mm. crowding may resolve into good alignment. (Profitt) www.indiandentalacademy.com
    26. 26. www.indiandentalacademy.com
    27. 27. www.indiandentalacademy.com
    28. 28. www.indiandentalacademy.com
    29. 29. Those with 3 – 4 mm. arch crowding. The goal is to transfer the anterior crowding posteriorly into the leeway space. www.indiandentalacademy.com
    30. 30. www.indiandentalacademy.com
    31. 31. www.indiandentalacademy.com
    32. 32. www.indiandentalacademy.com
    33. 33. www.indiandentalacademy.com
    34. 34. When arch crowding is 4 to 9 mm. www.indiandentalacademy.com
    35. 35. The goal is improve incisor alignment (unraveling), perhaps preventing periodontal problems and improving post-orthodontic stabliity. www.indiandentalacademy.com
    36. 36. www.indiandentalacademy.com
    37. 37. www.indiandentalacademy.com
    38. 38. www.indiandentalacademy.com
    39. 39. www.indiandentalacademy.com
    40. 40. Most class I cases having more than 10 mm. crowding should be referred to an orthodontic specialist by general dentists and (perhaps paediatric dentists). www.indiandentalacademy.com
    41. 41. 7 years old 9 years old 14 years old Changes in the axial inclination due to the eruption of the maxillary anterior teeth (Broadbent, 1957). www.indiandentalacademy.com
    42. 42. www.indiandentalacademy.com
    43. 43. www.indiandentalacademy.com
    44. 44.  Avoid unnecessary periodontal problems.  Enhance the long term stability of orthodontic treatments.  Involve more clinicians in guiding the developing dentition. www.indiandentalacademy.com
    45. 45. ECTOPIC ERUPTION AND SPACE REGAINING 2004-2005 www.indiandentalacademy.com
    46. 46. www.indiandentalacademy.com
    47. 47. GENERAL OBJECTIVE: To discuss the problem of ectopic eruption generally. To discus the problem of ectopic eruption the canine and first permanent molar and its management. www.indiandentalacademy.com
    48. 48. SPECIFIC OBJECTIVES: 1. Define ectopic eruption. 2. Know the frequency of ectopically eruption first permanent molars. 3. Explain the reasons for ectopic eruption occurring with first permanent molars. 4. Distinguish between a reversible and non-reversible ectopic eruption. www.indiandentalacademy.com
    49. 49. SPECIFIC OBJECTIVES (continued): 5. Know methods for correcting ectopic molar eruption. 6. Explain why long term follow-up is needed for corrected ectopic eruption cases. REQUIRED READING Article: Weinberger, S., Wright, G., “The Unpredictability of primary molar resorption following ectopic eruption of permanent molars”, Journal of Dentistry for Children, Nov-Dec, 1987. www.indiandentalacademy.com
    50. 50. REQUIRED READING (continued) Article: Weinberger, S., “Correction of bilateral ectopic eruption of first permanent molars using a fixed appliance”, Pediatric Dentistry, Nov-Dec, 1992, Vol 14, No. 6 www.indiandentalacademy.com
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    67. 67. Authors Year of study Country Number Of Children With Ectopic Eruption CHILDREN NUMBER PERCENT Cheyne & Wessels 1947 USA 500 9 2 Young 1957 USA 1,619 52 2 O'Meara 1962 USA 315 6 2 Pulver 1968 USA 831 26 3.1 Bjerklin & Kurol 1981 Sweden 2,903 126 4.3 Mackerle-Heporauto 1981 Switzerland 543 32 6 Kimmel et al 1982 USA 5,277 250 3.8 Kurol-1986
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    83. 83. A ligature wire is passed through beneath the contact and then twisted tightly. www.indiandentalacademy.com
    84. 84. www.indiandentalacademy.com
    85. 85. www.indiandentalacademy.com
    86. 86. www.indiandentalacademy.com
    87. 87. www.indiandentalacademy.com
    88. 88. GENERAL OBJECTIVE: Diagnose and regain the space loss. www.indiandentalacademy.com
    89. 89. SPECIFIC OBJECTIVES: 1. Explain how space loss occurs in the posterior region. 2. Describe indications for space regaining in regards to the magnitude of space loss. 3. Describe the differences between maxillary and mandibular arch space regaining. 4. Describe indications for tipping and bodily tooth movement to regain the space. www.indiandentalacademy.com
    90. 90. SPECIFIC OBJECTIVES (continued): 5. List the diagnostic aids required prior to initiating space regaining. 6. Present the maximum amount of space that can likely be regained with removable appliances and the time for the treatment. 7. Describe the most commonly used appliances for space regaining, such as: (a) removable applicant with finger spring www.indiandentalacademy.com
    91. 91. SPECIFIC OBJECTIVES (continued): 7. (b) removable appliance with jackscrew (c) fixed appliance with coil spring (d) lip bumper REFERENCE: Proffit, Contemporary Orthodontics, 2nd ed., 1993, Chapter 13, pp. 382-387 www.indiandentalacademy.com
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    139. 139. Thank you www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com

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