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Expansion on Deciduous Teeth

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How use Rapid Palatal Expansion on deciduous teeth without touching the permanent molars!

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Expansion on Deciduous Teeth

  1. 1. Studio Odontoiatrico Iancu-Marchione L’AQUILA – ITALY Dott. Maciej Iancu Potrubacz Dott.ssa Laura Marchione PALATAL EXPANSION: CLASSIC REP VS REP ON 5
  2. 2. MAXILLAR HYPOPLASIA Rapid maxillary expansion (REP) is able to eliminate a transverse discrepancy between the dental arches due to maxillary constriction Treatment-induced widening of the maxilla leads to the correction of posterior crossbites, coordination of the maxillary and mandibular dental arches prior to orthopedic or functional treatment of Class II and Class III malocclusions
  3. 3. BIBLIOGRAFIA <ul><li>Deciduous dentition-anchored rapid maxillary expansion in crossbite and non-crossbite mixed dentition patients: reaction of the permanent first molar. Prog. Orthod. 4, 2003; 15–22 Cozzani M, Rosa M, Cozzani P, Siciliani G: </li></ul><ul><li>Marco Rosa: Relazione presentata durante l’Incontro di Primavera, Reggia di Caserta, 2-4 marzo 2006 Ortognatodonzia Italiana, Vol 13,1-2006 </li></ul><ul><li>Carlo Merlini: Strategie terapeutiche della terza classe scheletrica nell’adolescenza; Martina Edizioni Volume 4 Collana di Ortodonzia ( citazione dal Proffit) </li></ul><ul><li>F.Fiorile, A.Marino, M.Righi: Il molaggio selettivo in dentatura decidua; Ortognatodonzia Italiana, Vol.15, 3-2008 </li></ul>
  4. 4. WHEN ??? HOW??? WHAT WE CAN DO…? INTERCEPTIVE ORTHODONTICS
  5. 5. WHEN ??? <ul><li>Posterior Cross Bite mono o bi lateral for lateral expansion of the maxilla </li></ul>
  6. 6. WHEN ??? <ul><li>Crowding in the frontal sector of the upper arch where with the possibility for the lateral incisors to move spontaneous in its correct position </li></ul>
  7. 7. PRINCIPAL TYPES OF RAPID PALATAL EXPANSORS (REP): <ul><li>ON 4 BANDS </li></ul><ul><li>ON 2 BANDS </li></ul><ul><li>ON BANDS AND ACRILIC </li></ul><ul><li>ACRILIC ( MC NAMARA) </li></ul><ul><li>REP ON 5 ( ON PRIMARY THEET) </li></ul>
  8. 8. REP ON 4 AND 2 BANDS
  9. 9. Giulia 8 aa
  10. 10. Giulia: REP 6-ti Left Cross-bite
  11. 11. April 2004 October 2004
  12. 12. APRIL 2004 MAY 2008
  13. 13. January 2009 CTRL
  14. 15. April 2004 January 2009
  15. 16. RAPID PALATAL EXPANSION (REP) ON DECIDUOUS THEET Prog. Orthod. 4, 2003; 15–22 Cozzani M, Rosa M, Cozzani P, Siciliani G: Deciduous dentition-anchored rapid maxillary expansion in crossbite and non-crossbite mixed dentition patients: reaction of the permanent first molar Marco Rosa: Relazione presentata durante l’Incontro di Primavera, Reggia di Caserta, 2-4 marzo 2006 Ortognatodonzia Italiana, Vol 13,1-2006
  16. 17. <ul><li>Movement of the permanent molars is 60% of the screws expansion and of the deciduous teeth! </li></ul><ul><li>Don’t need contention ! </li></ul><ul><li>In the long term, the spontaneous permanent molar cross-bite correction was stable! </li></ul>RAPID PALATAL EXPANSION (REP) ON DECIDUOUS THEET
  17. 18. “ Spontaneous permanent molar occlusion “ <ul><li>deciduous teeth could be utilized as anchor units for very heavy forces like those produced during a rapid maxillary expansion; </li></ul><ul><li>In case of the posterior cross-bite, molars have a spontaneous expansione with a normal growth in the occlusion ! </li></ul>
  18. 19. REP ON DECIDUOUS WITH RESIN, HASS MODEL Expansion without touch the permanenth theet
  19. 20. ” REP ON DECIDUOUS BONDED ON C” Expansion without touch the permanenth theet
  20. 21. PALATAL EXPANSION: CLASSIC REP VS REP ON 5 CASE REPORTS
  21. 22. DAVIDE 8,5 yr
  22. 23. DAVIDE: APRILE 2006
  23. 24. July 2006 Second Expansion with screw 7 mm
  24. 26. Gennaio 2007 MULTI P MISURA 65 HIGH
  25. 27. APRILE 2006 – FEBRUARY 2007 10 MONTH
  26. 28. APRILE 2006 – FEBRUARY 2007 10 MONTH
  27. 29. APRIL 2006 – NOVEMBER 2007
  28. 30. 2. in the non-crossbite group the permanent intermolar distance decreased during the retention phase to reach a correct cusp–fossa relationship “ Spontaneous permanent molar occlusion “
  29. 31. ANDREA A. 8,9 yr
  30. 32. ANDREA A. 8,9 yr
  31. 33. Anterior crowding without posterior cross bite!
  32. 34. Anterior crowding in the lower arch, also!
  33. 35. <ul><li>October 2008 </li></ul><ul><li>REP on 5 </li></ul><ul><li>1 activ/ day </li></ul>
  34. 36. <ul><li>February 2009 </li></ul><ul><li>REP on 5 / stop expansion </li></ul><ul><li>Slicing D Right </li></ul>
  35. 37. <ul><li>April 2009 </li></ul><ul><li>REP on 5 </li></ul><ul><li>1.2 Ok </li></ul>
  36. 38. October 2008 April 2009
  37. 39. <ul><li>January 2010 </li></ul><ul><li>No REP </li></ul><ul><li>Lingual Arch </li></ul>
  38. 40. October 2008 February 2010
  39. 41. GLORIA P. 8,5 yr
  40. 42. GLORIA P. 8,5 yr
  41. 43. Ottobre 2008 REP Decidui Attivazione 1 giro al giorno
  42. 45. October 2008 January 2009 <ul><li>Resolution of the anterior crowding </li></ul><ul><li>CTRL of the anterior open bite and of the vertical dimension </li></ul>
  43. 46. October 2008 January 2009
  44. 47. October 2008 November 2009
  45. 48. October 2008 November 2009 <ul><li>Resolution of the anterior crowding </li></ul><ul><li>CTRL of the anterior open bite and of the vertical dimension </li></ul>
  46. 49. SUSANNA 6 AA
  47. 50. SUSANNA: FEBRUARY 2006
  48. 51. 5 months !!!
  49. 52. Marzo 2007 CTRL NiteGuide Only Night Need correct Cross-2.6 ERP on deciduous – Lower crowding
  50. 53. Settembre 2007 CTRL REP - REP until change 1.2 e 2.2 Activation of REP – Contraction. 2.6 – Inferior Slicing
  51. 55. May 2008 OG misura 5 Slicing Inf.
  52. 57. September 2008 OG misura 5
  53. 58. September 2008 February 2006
  54. 59. February 2006 December 2009
  55. 60. FABIO 8,5 AA
  56. 61. FABIO: OCTOBER 2007
  57. 62. REP ON DECIDUOUS: WHERE ??? ?
  58. 63. WHAT CAN I DO???
  59. 64. <ul><li>OCTOBER 2007 </li></ul><ul><li>REP ON DECIDUOUS BONDED ON INCOLATO 5.4 & 6.5 – 1 ACTIV/28 DAYS </li></ul>
  60. 65. <ul><li>December 2007 </li></ul><ul><li>REP ON DECIDUOUS BONDED ON INCOLATO 5.4 & 6.5 – 1 ACTIV/28 DAYS </li></ul>
  61. 67. <ul><li>January 2008 </li></ul><ul><li>CTRL </li></ul><ul><li>Lower Slicing </li></ul>
  62. 68. December 2008 Upper Contention Lingual Arch
  63. 70. October 2007 February 2010
  64. 71. CONCLUSIONS ◗ poserior crossbite (mono or bilateral); ◗ corwding in the upper anterior teeth (incisive); ◗ correction of the postural mandibular asymetry ◗ Light autoexpansion of the lower anterior teeth (max 2-3mm) Remember : The expansion cannot change an extractive case in one non-extractive
  65. 72. THIS IS OUR JOB, EVERYDAY!!

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