Orthodontics-Interceptive Orthodontics

2. INTERCEPTIVE ORTHODONTICS
Definitions:
Any procedure that eliminates or reduces the
severity of malocclusion in the developing
dentition.(Popovich and Thompson 1979, Hiles
1985.)
All simple measures that eliminate the developing
mal occlusion. (Ackerman and Proffit 1980)

3. INTERCEPTIVE ORTHODONTICS
 Unlike preventive orthodontic procedures, interceptive
orthodontics is undertaken at a time when the
malocclusion has already developed or is developing.
Thus interceptive orthodontics basically refers to
measures undertaken to prevent a potential
malocclusion from progressing into a more severe one.
 Some of the procedures carried out in preventive
orthodontics can also be carried out in interceptive
orthodontics but the timings are different.

4. Procedures undertaken in interceptive
orthodontics
Serial extraction.
Correction of developing crossbite.
Control of abnormal habits.
Space regaining.
Interception of skeletal malrelationship.
Removal of soft tissue or bony barrier to enable eruption of
teeth. Etc etc

5. SERIAL EXTRACTION:
Planned extraction of certain deciduous teeth and later
specific permanent teeth in an orderly sequence and pre-
determined pattern to guide the erupting permanent teeth
into a more favourable position…….when one can recognize
and anticipate potential irregularities in the dento-facial
complex.
History:-Kjellgren 1929 first used the term “serial
extraction”….Nance(USA) 1940’s popularized the technique

6. Indications:
Class I malocclusions showing harmony between skeletal and
muscular systems
Arch length deficiency.
Where growth is not enough to overcome the discrepancy
between tooth material and basal bone.

7. Contraindications:
Class II & III malocclusion with skeletal abnormalities
Spaced dentition
Anodontia/Oligodontia
Open bite and deep bite
Midline diastema
Class I malocclusion with minimal space deficiency
Unerupted malformed teeth. E.g.dilaceration
Extensive caries or heavily filled first permanent
molars
Mild disproportion between arch length and tooth
material that can be treated by proximal stripping.

8. INTERCEPTIVE ORTHODONTICS
SERIAL EXTRACTION………
Disadvantages:
1- Increasing the overbite.
2- Lingual tipping of lower incisors
3-Retarding future development in arches.
4-Lack of aesthetic fullness of the lips.
5-Rotated incisors do not align spontaneously.

9. INTERCEPTIVE ORTHODONTICS
SERIAL EXTRACTION
Method:
1-When the lateral are erupting in a crowded position,
all deciduous canines are removed.
2-When the roots of the first deciduous molars are half
resorbed. They are removed.
3-As soon as the first premolars erupt they are removed.

10. DEVELOPING ANTERIOR CROSSBITE:
Anterior cross bite is a condition characterized by
reverse overjet where one or more maxillary anterior
teeth are in lingual relation to the mandibular teeth.
Should be intercepted and treated at an early stage to
prevent a minor orthodontic problem from progressing
into a major dento-facial anomaly.
“The best time to treat a crossbite is the first time it is seen”
Or else it may grow into skeletal malocclusion

11. INTERCEPTIVE ORTHODONTIC TREATMENT

12. Anterior Crossbite

13. INTERCEPTION OF HABITS:
Habit’s refers to certain actions involving the teeth and
other oral or perioral structures which are repeated often
enough by some patients to have a profound and
deleterious effect on the positions of teeth and occlusion.
Some such habits are:
Thumb sucking
Tongue thrusting
Mouth breathing

14. Thumb sucking:
 Most frequently practiced by children.
 Causes damaging effect on dento-alveolar structures.
 It’s presence upto2-1/2 to 3 years age is considered normal.
 Persistence beyond 3-1/2 to 4 years have damaging effect.& should be
intercepted
 Intercepted by use of HABIT BREAKERS that could be removable or fixed.
Tongue thrusting:
 Condition in which tongue makes contact with any teeth anterior to the molars
during swallowing.
 Deleterious habit , can clinically present along with open bite and anterior
proclination.
 Intercepted using HABIT BREAKERS
Mouth breathing:
 Obstructive-nasal polyps ,tumors ,inflammations ,deviated septum
 Habitual –persistence of habit after removal of the obstruction.
 It affects the orofacial equilibrium due to lowered mandible & tongue posture.
And hence cause malocclusion.
 Intercepted by identifying and removing the cause.If persists , VESTIBULAR
SCREEN can be used.

15. Habit Breakers

16. SPACE REGAINING:
Early loss of primary molar and failure to use space maintainers
may lead to reduction in arch length by mesial movement of 1st
molars.
Space regained by distal movement of first molar. Which is
undertaken at an early age prior to eruption of second molar.

17. INTERCEPTION OF SKELETAL MALRELATIONS:
Interception of class II malocclusions:
Causes: Excess maxillary growth.
(Restricted by facebow with headgear)
Defficient mandibular growth.
(Myofunctional appliances)
Combination of both.
Interception of class III malocclusions:
Causes: Mandibular prognathism.(Chin cap with head gear)
Maxillary retrognathism ( Face mask therapy )
Combination of both

18. Chin cap,Face mask

19. REMOVAL OF SOFT TISSUE & BONY BARRIERS:
Failure of teeth to erupt in appropriate time should be
intercepted by surgically exposing the crown.
Over retained primary teeth,ankylosed primary teeth &
supernumerary teeth are possible causesof non-eruption of
succedaneous teeth . The soft tissue and any bone overlying
it are

20. INTERCEPTIVE ORTHODONTICS
Local factors: DELAYED ERUPTION OF UPPER
PERMANENT CENTRAL INCISOR.
Definition: 1 is considered to be delayed if the
contra-lateral tooth was fully erupted or if teeth
later in the usual eruption sequence were present.
Interceptive treatment: removal of
supernumerary with or without tooth exposure.
Treatment timing: as soon as the supernumerary
tooth is detected.

24. INTERCEPTIVE ORTHODONTICS
Local factors:RETAINED DECIDUOUS
TEETH.
Interceptive treatment: extraction.

25. INTERCEPTIVE ORTHODONTICS
Local factors: INFRAOCCLUSION
Definition: the tooth loses its vertical position
relative to the adjacent teeth and assumes a
position below the occlusal plane
Frequent site: lower 2nd
and 1st
primary molars.
Interceptive treatment: nothing unless the
permanent successor was absent or the
infraoccluded tooth is likely to disappear .

27. INTERCEPTIVE ORTHODONTICS
Local factors: UNILATERAL RETAINED
DECIDUOUS CANINE.
Definition: premature loss of one deciduous canine as
a result of early root resorption by a crowded lateral
incisor.
Interceptive treatment: extraction of the primary
canine on the opposite side of the arch to preserve the
midline.

28. INTERCEPTIVE ORTHODONTICS
Local factors: DOUBLE TEETH
Definitions:
Gemination: the attempt of a single tooth bud to form
two distinct morphological entities.
Fusion: the result of joining two adjacent tooth buds.

30. INTERCEPTIVE ORTHODONTICS
Local factors: ECTOPIC ERUPTION OF THE
PERMANENT FIRST MOLAR.
Definition: the molar erupts at an angle mesial to its
normal path of eruption.
Types : reversible and irreversible
Treatment: extraction of E or distalisation of
permanent molar

32. INTERCEPTIVE ORTHODONTICS
Local factors: Hypodontia
Definition: Absent teeth.
Common teeth: lower 2nd
premolar & upper lateral
incisor.
Treatment: space closure or space maintenance for
future prosthesis.

35. INTERCEPTIVE ORTHODONTICS
Local factors:DIASTEMA
Definition: space between the two upper central
incisors.
Treatment if indicated: removal of pathology
(supernumerary, frenum?….)

37. INTERCEPTIVE ORTHODONTICS
Local factors: ECTOPIC UPPER CANINE
Definition: the canine erupts out of its normal
eruption path.
Diagnosis: If the 3 was not palpable in the buccal
sulcus after the age of 10 years.
Treatment: Extraction of the deciduous canine.

41. INTERCEPTIVE ORTHODONTICS
Local factors: TRANSPOSITION
Definition: unusual type of ectopic eruption were
two permanent teeth have interchanged their
location in the dental arch.
Frequent sites: upper canine and first premolar
lower canine and lateral incisor.
Interceptive treatment: -extract transposed tooth.
-align before canine eruption
-accept the transposition
Treatment timing: before eruption of canine.

44. INTERCEPTIVE ORTHODONTICS
Crowding:
Treatment:
1-Space management.
2-Molar distalisation.
3-Serial extraction.
4-Extractions

45. Thank You