Vertical malocclusions /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
0091-9248678078

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Vertical malocclusions /certified fixed orthodontic courses by Indian dental academy

  1. 1. VERTICAL MALOCCLUSIONS: etiology, development, diagnosis and some aspects of treatment INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2.         INTRODUCTION DEVOLOPMENT OF MALOCCLUSIONS MADIBULAR GROWTH & VERTICAL MALOCCLUSIONS GROWTH ROTATIONS & MALOCCLUSIONS GROWTH PREDICTION TREATMENT ASPECTS SUMMARY CROSS-REFRENCES CONTENTS www.indiandentalacademy.com
  3. 3.  Vertical malocclusions result from interplay of many etiological factors during growth. ◦ Growth of maxilla and mandible ◦ Function of lips ◦ Tongue & dentoalveolar development ◦ Eruption of teeth INTRODUCTION www.indiandentalacademy.com
  4. 4.  Important factor in development of deep bite and open bite is the pattern of growth of the mandible.  In this article, we discuss  The role of facial growth as an etiological factor in the development of vertical malocclusions,  possible association between functional factors and malocclusions,  diagnostic considerations and treatment aspects. www.indiandentalacademy.com
  5. 5. VERTICAL MALOCCLUSIONS DENTOALVEOLAR  SKELETAL Based on growth patterns of the jaws. www.indiandentalacademy.com
  6. 6.  In studies using metallic implant technique, by Bjork an Bjork & Skieler, direction of growth of lower jaw varies greatly in normal population.  Most common direction of condyle is vertical, with some anterior component.  Posterior growth is less frequently observed. MANDIBULAR GROWTH www.indiandentalacademy.com
  7. 7. Patients with upward and anterior growth of mandibular condyle often have reduced anterior facial height.  They develop mostly deep bite.   In extreme upward and forward movement of condyle, a Class II div 2 malocclusion in combination with skeletal deep bite is common. www.indiandentalacademy.com
  8. 8. Subject with skeletal deep bite. Pronounced anterior rotation of both maxilla and mandible www.indiandentalacademy.com
  9. 9.  In this cases, mesial migration of max.& mand. teeth with some degree of proclination of mand. Incisors occurs. In patients with pronounced increase in lower facial height, have a more posteriorly directed growth pattern of mandibular condyle.  Termed as long-face syndrome.  www.indiandentalacademy.com
  10. 10.  Malocclusion seen in these patients is mostly anterior open bite often in combination with Class I or Class II.  The dental eruption pattern of posterior teeth is mostly vertical. Anterior teeth may be more retroclined.  Crowding is seen lately. www.indiandentalacademy.com
  11. 11. Vertical growth pattern mandible rotated posteriorly during growth www.indiandentalacademy.com
  12. 12.  Differences in height development lead to positional changes of the mandible. AFH-eruption of maxillary mandibular teeth.  PFH-lowering of temporomandibular fossae and condylar growth.   Risk of development deep bite is more during active growth. GROWTH ROTATIONS www.indiandentalacademy.com
  13. 13. Development of deepbite depends on relationship of max.&mand. Incisors.  Acc. To Bjork, fulcruming point for forward mandibular growth rotation is located at incisors.  If incisal contact is lacking due to: Lip dysfunction Finger sucking deepbite Skeletal discrepancy •Treated early.  www.indiandentalacademy.com
  14. 14.  Posterior condylar growth-similar AFH & PFH  If AFH > PFH post. Condylar growth openbite  If treatment is done, Increased risk of extrusion.  www.indiandentalacademy.com
  15. 15. Fulcrum at incisors- stable occlusion overbite remains unchanged during growth www.indiandentalacademy.com
  16. 16. lack of ant. occlusal contact – fulcrum shifted to occlusal plane bite deepens during growth www.indiandentalacademy.com
  17. 17. Vertical growth – fulcrum at condyles www.indiandentalacademy.com
  18. 18. In a study by Isaacson et al, 3 groups  Low angle  Average  High angle  In high angle cases, 1. posterior dental development is greater Moller & Ingervall-due to weaker musculature. 2. lower facial height is more. 3. Openbite- less biting force.  FACIAL MORPHOLOGY www.indiandentalacademy.com
  19. 19. 8yrs1mon patient with increased AFH convex profile & incompetant lips. Facial growth downwards & forwards www.indiandentalacademy.com
  20. 20.  Treatment consisted of 2 bands on maxillary central incisors, & spurs to prevent fingersucking & tongue dysfunction.  She was instructed to chew sugerless gum for 2hrs daily.  In mandible, lingual arch was placed to maintain archlength during transition of dentition. www.indiandentalacademy.com
  21. 21. Patient at 14yrs 6mon. Maxilla rotated posterior. Mandible rotated in anterior direction. www.indiandentalacademy.com
  22. 22. 2nd phase: extraction of 1st PM.  Use of high pull headgear in combination with transpalatal arch.  After2yrs of retention, occlusion is good with harmonious soft tissue profile.  www.indiandentalacademy.com
  23. 23. 11yrs 3mons patient with class II div2 malocclusion,deepbite & concave profile www.indiandentalacademy.com
  24. 24. Begg appliance was tried for 1yr with little success.  Mandible was advanced surgically & rotated vertically to increase AFH.   Post-treatment, occlusion was class I, with straighter profile. www.indiandentalacademy.com
  25. 25. Increase in lower facial height. Corrected sagittal jaw discrepancy www.indiandentalacademy.com
  26. 26. EXTREME VARIATIONS IN VERTICAL FACIAL GROWTH & VARIATION IN SKELETAL AND DENTAL RELATIONS JOHN R. ISAACSON,DDS.,MSD ROBERT J. ISAACSON,DDS.,PhD T. MICHAEL SPEIDEL,DDS.,MSD FRANK W. WORMS,DDS.,MSD Angle orthodondist vol41,no:3 July 1971 Cross references www.indiandentalacademy.com
  27. 27.  3groups of 20 each, randomly selected cases of MP-SN, Low MP-SN(260) – 13.34yrs Average MP-SN(320) – 13.26yrs High MP-SN(380) – 14.20yrs  Cephalometric tracings were studied. www.indiandentalacademy.com
  28. 28. www.indiandentalacademy.com
  29. 29. Overbite became deeper when MP-SN angle decreased.  In high angle group, there was openbite, (mean= -0.65mm)  Avg. angle mean=3.38  Low group mean=5.25   Actual values ranged from 9.5mm–4mm. www.indiandentalacademy.com
  30. 30. PATTERNS OF VERTICAL GROWTH IN THE FACE SURENDER K.NANDA DMD,MS AJODO 1988 FEB 103-116 www.indiandentalacademy.com
  31. 31.  Longitudinal data based on lateral cephalometric radiographs of 16 male and 16 female subjects, ages 3 to 18 years, were used.  Curves of absolute and incremental growth for total anterior face height, upper anterior face height, lower anterior face height, posterior face height, and ramal length were analyzed statistically and graphically. www.indiandentalacademy.com
  32. 32. Deep-bite subjects are characterized by increased upper anterior face heights, while increased lower anterior face heights are observed in open-bite persons. 2. Posterior face height and ramal height do not significantly differ. 3. The pattern of development is established before the eruption of the first permanent molars and long before the adolescent growth spurt. 1. www.indiandentalacademy.com
  33. 33. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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