195-Interdisciplinary Treatment Integrating Orthodontics with Restorative Dentistry and Periodontics, - orthodontie pluridisciplinaire -Endodontics oussama sandid- olivier sandid..pptx

195-Interdisciplinary Treatment: Integrating
Orthodontics with Restorative Dentistry and
Periodontics, Endodontics.
O. SANDID- Orthodontist, D.C.D., D.U.O, C.E.S.B.B,
C.E.S.O.D.F ,
S.Q.O.D.F, Paris. France.

Plan
• Orthodontics and Restorative Dentistry
• 1 - Consequences of tooth loss
• 2- Space management of Microdontia, Management of 'peg laterals'or other diminutive teeth
• 3- Implant site preparation
• Orthodontics with Oral Surgery
• Orthodontics with Periodontics
• Exposure of Impacted Teeth for Orthodontics
• Gummy smile
• Wisdom teeth
• Freinectomy
• Extrusion
• Orthodontics with Pediatric dentistry
• Orthodontics with Endodontics
http://www.semortho.com/article/S1073-8746(97)80034-5/abstract
https://www.orthodontisteenligne.com/cas-traites-2/multidisciplinaire/
http://pocketdentistry.com/11-interdisciplinary-orthodontics/
http://www.slideshare.net/almuzian/orthodontics-and-
restorative-dentistry-by-almuzian-36418366

1-Consequences of tooth loss
• Mesial tipping and rotations of distal molars
http://pocketdentistry.com/18-special-considerations-in-treatment-for-adults/
Loss of a lower molar can lead to tipping and drifting of adjacent teeth,
poor interproximal contacts, poor gingival contour, reduced interradicular bone, and
supra-eruption of opposed teeth. Note the loss of alveolar bone in the area where a
mandibular first molar was extracted
M. ABOULNASER- O SANDID
Orthodontics and restorative dentistry

1a-Consequences of tooth loss
• Distal tipping and rotations of mesial teeth
http://www.columbia.edu/itc/hs/dental/D5300/Lecture%2012.DDS.Cl
ass2008.20050622.Principles%20of%20Molar%20Uprigh_BW.pdf

1b-Consequences of tooth loss
• Eruption of opposing tooth in edentulous
space
LE MAY J-https://www.orthodontisteenligne.com/en/ortho-101-en/adult-orthodontics-4/
Loss of posterior teeth in an adult. On one side (A), the loss of a lower
molar allowed the other molars to tip forward. On each side (A and B),
the upper molars migrate toward the space below (extrusion).

1c-Consequences of tooth loss
Gingival tissues become folded, and pockets form in the
area

1d-Consequences of tooth loss
This photo shows a lower ridge that has lost 60% of its width following an
extraction and normal healing. The black arrows indicate where bone is
located (compare the width to the adjacent molar). The red arrows
indicate the normal width that should be there.
http://www.pittsburghdentalimplants.com/dental-implants/effects-of-tooth-loss/

1e-Consequences of tooth loss
Occlusal Interferences and Temporomandibular Joint Disorders
http://www.dr-adrianbecker.com/page.php?pageId=281&nlid=50

1f-Consequences of tooth loss
Accumulation of plaque in pockets leads to periodontal damage, with loss of
gingival attachment and alveolar bone loss

1g-Loss of the mandibular first molar
Occlusal interferences- Overerupted 16- Gum pocket 47- Distalization 45-
Exaggerated curve of Spee - Exposed root

1h-Tooth loss and Impaction-space maintainer
Orthodontics and restorative dentistry M. ABOULNASER- O SANDID

1i-Uprighting the dental axes
http://pocketdentistry.com/18-special-considerations-in-treatment-for-adults/

Proffit & Fields
Controlled Orthodontic Mechanics – Distal crown tip vs. Mesial Root Tip with Intrusion

1k-Uprighting the dental axes – Miniscrews
https://www.researchgate.net/figure/26791749_fig7_Fig-7-Patient-2-schematic-illustration-of-biomechanics-for-molar-
uprighting-and /

1l-Intrusion of Overerupted Molars using Miniscrews
http://www.jcdr.net/article_fulltext.asp?id=6165

1m-Intrusion of Overerupted Molars using Miniscrews
http://www.jcdr.net/article_fulltext.asp?id=6165

1n-IMPLANT SITE PREPARATION
Dr LEMAY-@ortholemay.com
Molar Uprighting, with space creation

1p-Missing upper lateral incisors
Kazemi, https://www.facialart.com
IMPLANT SITE PREPARATION

1q-Missing upper lateral incisors
Closure space
http://www.scielo.br/pdf/jaos/v22n5/1678-7757-jaos-22-05-0465.pdf

1s- Managing the orthodontic-restorative patient
Early Tooth Loss and Space Maintenance Space regaining: Molar Uprighting and Distalization
Early tooth loss can be a result of traumatic avulsion or extraction of carious or infected teeth,
Premature loss of primary teeth can result in a loss of arch length and have a negative effect on
occlusion and alignment, often increasing the need for orthodontic treatment.

2-Multi-disciplinary approach for
space management of Microdontia
- A minimal reduction was needed for lateral incisors.
- Veneers cemented on lateral incisors.
- Definitive composite restorations after finishing and
polishing procedures.

2a-Anterior Space Management
https://www.researchgate.net/figure/235394688_fig1_Figure-2-
Occlusal-view-showing-spaces-between-maxillary-central-incisors-and-
between
Occlusal view showing spaces between maxillary central
incisors, and between lateral incisors and canines.
Management of 'peg laterals'or other diminutive teeth

2b-Anterior Space Management
https://www.researchgate.net/figure/235394688_fig1_Figure-2-Occlusal-
view-showing-spaces-between-maxillary-central-incisors-and-between

2c-Anterior Space Management
Additional orthodontic treatment is initiated to improve the dental midline and
evenly distribute the space around the microdontic lateral incisors

3-INTERDISCIPLINARY TREATMENT
Move the roots from implant site, To create space priorimplant placement, the
roots of the adjacent teeth should be upright and parallel
Dr Jebin

3b-INTERDISCIPLINARY TREATMENT-
Dr LEMAY-@ortholemay.com
Root parallelism

3c-INTERDISCIPLINARY TREATMENT-
Yvon Roberge, Sylvain Gagnon, Orthod Fr 2008;79:55–57
Implant site preparation : Open Space, Root proximity, Bone quality, implant types…

3d-INTERDISCIPLINARY TREATMENT

Benefits of orthodontics for a periodontal patient
- Create quality bone for implant placement
www.orthofree.com
Create quality bone for implant placement, Forced Eruption
improving the amount of bone available for implant placement.
Dr Jebin

Technique
Proffit & Fields
Team : Orthodontist
Restorative DDS
Endodontist
Periodontist

Extraction Space Closure
http://pocketdentistry.com/6-biomechanical-basis-of-extraction-space-closure/

http://www.scielo.br/pdf/dpjo/v21n2/2176-9451-dpjo-21-02-00115.pdf
Force system generated by a closed coil spring applying forces at the level of the
center of resistance by means of extension hooks (power arms). No moments
and vertical forces occur.

Clinical case with maxillary and mandibular first premolar
extractions. A) Initial phase; B) Beginning of space closure; C)
Headgear to provide greater anchorage on maxillary molars; D)
Frictionless mechanics on maxilla and friction mechanics associated
with miniscrew anchorage on the mandible; E) End of treatment.

Most common space closure loop designs used by
orthodontists: A) reverse vertical loop, B) open vertical loop,
C) closed vertical loop, D) bull loop, E) reverse vertical loop
with helix, F) open vertical loop with helix, G) closed vertical
loop with helix, H) tear drop loop, I) helical loop, J) T-loop

http://pocketdentistry.com/6-biomechanical-basis-of-extraction-space-closure/
A, A typical vertical loop. B, After horizontal activation
the two legs are at an angle to each other. This
angulation creates a moment opposite in direction to
that created by the moment due to a force (MF).

http://www.slideshare.net/indiandentalacademy/space-closure-31880784

-The screw used has the following features: 2.0mm screws, 8-12mm thread lengths, cruciform head
design, made of extra-hard stainless steel
-The time of treatment to achieve uprighting: about 9 months
Stefano Sivolella, Michela Roberto, Paolo Bressan, Eriberto Bressan,http://cdn.intechopen.com/pdfs-wm/31381.pdf
2.0 mm
8-12mm
Uprighting of the Impacted Second Mandibular Molar with Skeletal Anchorage
INTERDISCIPLINARY TREATMENT- DENTISTRY
O. SANDID

Oral Surgery and Orthodontics
M. ABOULNASER- Orthodontist, BAU, Connecticut, USA.
O. SANDID- Orthodontist, D.C.D., D.U.O, C.E.S.B.B, C.E.S.O.D.F ,
S.Q.O.D.F, Paris. France
Contact: dr.aboualnaser@hotmail.com

1-Orthodontics Exposure of Impacted Teeth for Orthodontics
2b-Gummy Smile
3c-Operculectomy /Excision of pericoronal gingiva
4a-Frenectomy Maxillary
5-Soft Tissue Grafting
6-Esthetic Crown Lengthening
7-Odontoma-associated tooth impaction
8-Repositioning - impaction lower second molar
9-Tooth impaction- Extraction
10-Gingivectomy

Exposure of Impacted Canine Gummy smile - recontouring Operculectomy
Repositioning Teeth Removal teeth impaction Odontoma
Frenectomy Soft tissue grafting Esthetic Crown Lengthening

1a-Exposure of Impacted Canine
Oral Surgery and Orthodontics M ABOULNASER- O SANDID
http://forum.dentalxp.com
http://www.drhungvu.com/impacted_canines
The orthodontic-surgical management of impacted canines requires accurate diagnosis and
precise location of the impacted canine and the surrounding structures.

1b-Exposure of Impacted mandibular 2nd Molar
http://www.fwperio.com/procedures.asp
Sometimes teeth do not erupt through the gum tissue on their own and they need to be exposed as part of
orthodontic treatment
Impacted tooth was exposed Orthodontic bracket placed 1 year later
Impacted mandibular 2nd molar

http://pocketdentistry.com/9-impacted-teeth-in-the-adult-patient/
1c-Exposure of Impacted Maxillary Central Incisor

2a-Gummy Smile
http://www.traceyortho.com/Treatment/LaserTreatment/tabid/190/Default.aspx
Before Laser Recontouring After
http://www.gummysmile.com/braces.html
M ABOULNASER- O SANDID
Gingival Sculpting - Reshaping Gum Tissue

3a-Operculectomy/Excision of pericoronal gingiva
Pericoronal gingiva that was removed with a combination of surgical
excision and laser.
Pericoronitis , Pain, Infection, discomfort.
Before After

3b-Laser recontouring
Laser Recontouring -Partially Impacted Canine
http://www.traceyortho.com/Treatment/LaserTreatment/tabid/190/Default.aspx
Before Laser Recontouring Braces in Place

4a-Frenectomy Maxillary -midline Diastemas
Lasers and Orthodontics
http://www.sarkissiandds.com/services/laser-frenectomy.html

5-Soft Tissue Grafting
Before After

6-Esthetic Crown Lengthening
http://pocketdentistry.com/esthetical-clinical-crown-lengthening-lip-repositioning-and-gingival-depigmentation/

7-Odontoma-associated tooth impaction and suprnumerary
teeth

8-Repositioning - impaction lower second molar

9-Considerations For Removal Of Wisdom Teeth

10-Gingivectomy

REFERENCES
https://www.google.com.lb/?ion=1&espv=2#q=ORAL+SURGERY+AND+ORTHODO
NTICS+RELATIONSHIP
https://www.perio.org/consumer/plastic-surgery-procedures
https://loveperio.com/2013/03/26/exposure-impacted-canine/
http://www.jcda.ca/article/a147
http://www.exodontia.info/Expose_and_Bonding_of_Teeth_Example.html
http://www.drcawhite.com/orthodontic-procedures/tooth-exposures/

Esthetic Crown Lengthening
Lip Repositioning
https://drnemeth.com/cosmetic-procedures/gummy-smile-treatment-michigan/

1a-of Impacted Teeth for Orthodontics
Oral and Maxillofacial Orthodontics M ABOULNASER- O SANDID

Considerations For Removal Of Wisdom
Teeth
M. ABOULNASER- Orthodontist, BAU, Connecticut, USA.
O. SANDID- Orthodontist, D.C.D., D.U.O, C.E.S.B.B, C.E.S.O.D.F ,
S.Q.O.D.F, Paris. France
Contact: dr.aboualnaser@hotmail.com

ikl
Considerations For Removal Of Wisdom Teeth
Impaction- Malpositions Risk of dental caries Prevent Orthodontic relapse Periodontal infection
Super- eruption Jaw facture Supernumerary Non-treatable pulpal
O. SANDID – M. ABOUALNASER
Prevent Resorption Cyst Pericoronal space + Bone Loss +

Considerations For Removal Of Wisdom Teeth
• 1-Impaction And malpositions- Anomalies of
tooth Formation and Eruption
• 2-Unrestorable caries- Increased risk of dental caries
• 3-Stabilization after orthodontic treatment- Prevent Orthodontic
relapse
• 4-Pain- Periodontal infection And malposition
• 5-Prevent Resorption of adjacent teeth
• 6-Wisdom teeth with pathology- Cyst…
• 7- Super- eruption
• 8-Extension of pericoronal space as revealed by radiology
• 9- Bone Loss Distal to the 2nd Molar
• 10-Prevention of jaw facture in the area of angle of mandible
• 11-Supernumerary 4th Molar
• 12- Non-treatable pulpal and/or periapical pathology
O SANDID - M ABOUALNASER

Indications pour l’extraction des dents de sagesse
Impaction And malpositions- Anomalies of tooth Formation and Eruption
Inclusion et malpositions –Anomalies de formation et d’eruption
J lemay - www.orthodontisteenligne.

https://dentistexpert.org/treatment/teeth-t/wisdom-t/symptoms-of-eruption.html
2-Unrestorable caries- Increased risk of dental caries
Caries intraitables – Augmentation du risque carieux

Stabilization after orthodontic treatment- Prevent Orthodontic relapse
Stabilisation du traitement orthodontique - Prevention des récidives
3-Indications for Wisdom Teeth Extraction

Pain- Periodontal infection And malposition
Douleur, Infection du parodonte, Malpositions
J lemay - www.orthodontisteenligne.

Prevent Resorption of adjacent teeth
Prevention des resorptions radiculaires des dents adjacentes
5-The Prophylactic Extraction of Third Molars

Wisdom teeth with pathology- Cyst…
Pathologie des dents de sagesse, Kyste…

Super- eruption
Extrusion
Consideration pour l’extraction des dents de sagesse

Extension of pericoronal space as revealed by radiology
Extension de l’espace pericoronaire

Bone Loss Distal to the 2nd Molar
Perte de l’os alveolaire distale a la seconde Molaire

Prevention of jaw facture in the area of angle of mandible
Prevention de la fracture de l’angle mandibulaire

Supernumerary
4th Molar
Dentigerous Cyst
Supernumerary 4th Molar
Dent de sagesse surnuméraire

Non-treatable pulpal and/or periapical pathology
Pulpe non traitable, Pathologie peri -apicale

13-Maxillofacial pain and/or tension
Treatment of pain of unexpalined origin

References
• Southard TE. Third molars and incisor crowding: when removal is unwarranted. J Am Dent Assoc.
1992;123: 75–79.
• DavisOrthodontics (Do wisdom teeth cause crowding of your front teeth?).
• Orthodontistes Lemay (Wisdom teeth – Myths and realities).
• Crédit pour l'image et l'animation (Dolphin imaging).
https://www.orthodontisteenligne.com/en/page/2/
• http://www.huffingtonpost.com/ruben-cohen-dds/wisdom-teeth-removal_b_972697.html
• http://www.slideshare.net/NaveedIqbal12/impacted-wisdom-teeth
• http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1963310/
• https://www.orthodontisteenligne.com/en/dentition-en/wisdom-teeth-myths-and-realities/
• https://www.quora.com/Why-are-wisdom-teeth-removed-What-is-the-procedure-like
• https://www.orthodontisteenligne.com/dentition-2/les-dents-de-sagesse/
• http://www.dentisteblackburn.com/services/dentisterie-generale/dents-de-sagesse
• http://www.slideshare.net/NaveedIqbal12/impacted-wisdom-teeth-management

Interdisciplinary Treatment: Integrating
Orthodontics with Periodontics

Benefits of orthodontics for a
periodontal patient
O.SANDID

Plan
A-Benefits of orthodontics for a periodontal patient-
-Gingival recession
-Implant site preparation
B-Periodontal Surgery for the Orthodontic Patient
• 1. Pericision-Circumferential Supracrestal Fiberotomy
• 2. Frenectomy
• 3. Mucogingival considerations
• 4. Gingival Grafting
• 5-Surgical Exposure of Impacted Tooth For Orthodontics
• 6-Extraction supernumerary teeth mesiodens
• 7- Mini-implant pose
• 8- Gummy smile
• 9- Wisdom tooth
C-Periodontal Problems during Orthodontic Treatment

Introduction
• Orthodontic treatment aims at providing an acceptable functional and aesthetic occlusion with appropriate
tooth movements. These movements are strongly related to interactions of teeth with their supportive
periodontal tissues.
• Aesthetic considerations, like uneven gingival margins or functional problems resulting from inflammatory
periodontal diseases should be considered in orthodontic treatment planning.
• The interrelationship between periodontics and orthodontics .
• Specific areas reviewed are how periodontal tissue reacts to orthodontic forces, influence of tooth movement on
the periodontium,
• effect of circumferential supracrestal fiberotomy in preventing orthodontic relapse,
• effect of orthodontic bands on the periodontium,
• specific microbiology associated with orthodontic bands,
• mucogingival considerations and time relationship between orthodontic and periodontal therapy In addition,
• the relationship between orthodontics and implant restorations (e.g., using dental implants as orthodontic
anchorage).
• the contribution of the orthodontist, the periodontist and the general dentist is essential for optimized treatment
outcomes.
Marianne M.A. Ong,Hom-Lay Wang, Periodontic and orthodontic treatment in adults, American Journal of Orthodontics and
Dentofacial Orthopedics, Volume 122, Issue 4, Pages 420–428, October 2002

- periodontics
www.orthofree
Máyra Reis Seixas1, Roberto Amarante Costa-Pinto, Telma Martins de Araújo, Dental Press J Orthod. 2012 Sept-Oct;17(5):190-201
Gingival recession and buccal positioning of tooth #32’s root (A, B);
Reduced recession after orthodontically moving root to correct position in alveolar bone (C, D).
www.orthofreee

Benefits of orthodontics for a periodontal
patient- periodontics
www.orthofree.com
idh.cdeworld.com
Teeth alignment improve bone loss and loss of gum tissue

-Implant site preparation
www.orthofree.com
Yvon Roberge, Sylvain Gagnon, Orthod Fr 2008;79:55–57
Implant site preparation : Open Space, Root proximity, Bone quality, implant types…

-implant site preparation
www.orthofree.com
Move the roots from implant site, To create space priorimplant placement, the
roots of the adjacent teeth should be upright and parallel
www.orthofree.com

www.orthofree.com
Create bone for implant placement,
Repositioning teeth

www.orthofree.com
http://www.orthodontisteenligne.com/wp-content/uploads/2009/05/Redressement-molaires-orthodontie-implants-2-083009-Lemay.jpg

Combined endodontic-orthodontic and prosthodontic
treatment of fractured teeth

Orthodontic Treatment in Periodontally Compromised
Patients
www.orthofree.com
Patient with advanced periodontitis and migration of the maxillary left central incisor,
Clinical view after the end of the orthodontic treatment the teeth are retained by means of a resin-bonded splints
Biomechanics used to intrude and move the central incisor into the defect
Stefanis Re, Giuseppe Corrente IJP and DR

Patients
www.orthofree.com
Radiographic view of the osseoous defect ,
Radiographic wiew at the end of the treatment with reduction of the defect
Stefanis Re, Giuseppe CorrenteIJP and DR

Patients
www.orthofree.com
Stefanis Re, Giuseppe CorrenteIJP and DR

Periodontal Surgery for the
Orthodontic Patient
O.SANDID

Periodontal Surgery for the
Orthodontic Patient
• 1. Pericision-Circumferential Supracrestal Fiberotomy
• 2. Frenectomy
• 3. Mucogingival considerations
• 4. Gingival Grafting
• 5-Surgical Exposure of Impacted Tooth For Orthodontics
• 6-Extraction supernumerary teeth mesiodens
• 7- Mini-implant pose
• 8- Gummy smile
• 9- Wisdom tooth

1-Periodontics- Pericision-Circumferential Supracrestal Fiberotomy
www.orthofree.com
Relapse of severely rotated teeth due to rebound of elastic ﬁbres in the
supracrestal tissues can be reduced by pericision.
Fiberotomy (CSF) Preventing Orthodontic Relapse
http://www.aso.org.au/members/NSW%20Brighter%20Futures/Brighter_Futures_002.pdf
www.orthofree.com

2-Periodontics- Frenectomy
www.orthofree.com
http://www.omahaperio.com/services/frenectomy.aspx

3-Periodontics- Mucogingival considerations
www.orthofree.com
Gingivae a. before and b. after crossbite correction.

4-Periodontics-Gingival recesion -Gingival Grafting
www.orthofree.com

5-Periodontics- Surgical Exposure of Impacted Tooth For
Orthodontics
www.orthofree.com
O.SANDID- O.Migault
Surgical Exposure of Impacted Tooth For Orthodontics

6-Extraction supernumerary teeth- mesiodens
www.orthofree.com
Dr O.SANDID

1k-Periodontics- Impacted Wisdom teeth
www.orthofree.com
Pericoronitis
Impacted Wisdom teeth
www.orthofree.com

Wisdom tooth extraction-Bone Loss Distal to the 2nd Molar
www.orthofree.com
www.orthofree.com

Repositioning - impaction lower second molar

6-Periodontics- Gummy smile
www.orthofree.com
http://www.gummysmile.com/
The problem: The combination of the overgrown gum tissue and the high lip line are working together to reduce the beauty of this
smile.
The solution: Following minimally-invasive surgery, where the patient had no post-surgical pain, we can now see the fullness of her
smile. Her high lip line is not a severe problem and is less of a concern.

Periodontics-Gingival esthetics
www.orthofree.com
A, B) Smile esthetics affected by disharmonious gingival contours although anterior teeth look well
aligned and leveled. C, D) Improved gingival contour after periodontal surgery and orthodontic
movement. Gingivectomies were performed on teeth #12 and 21, as well as intrusion of #11 with
subsequent restoration of its incisal edge. During orthodontic intrusion, tooth #11 moved apically,
carrying with it the entire periodontium, while maintaining biological distances.
Máyra Reis Seixas1, Roberto Amarante Costa-Pinto2, Telma Martins de Araújo3, Dental Press J Orthod. 2012 Sept-Oct;17(5):190-201

7-Periodontics- Mini-implant
www.orthofree.com
Anchorage control with mini-implant has become an important part of
the clinical management of the orthodontic patients.
L. Massif, L. Frapier, EMC
www.orthofree.com

1k-PeriodonticCorticotomy facilitated orthodontics
www.orthofree.com
http://parkell.cdeworld.com/

Periodontics-The Importance of Oral Hygiene in
Orthodontic Treatment
www.orthofree.com
idh.cdeworld.com
Tooth decay and enamal decalcification
After flossing, brush your teeth and braces thoroughly until they're clean and
shiny. ... Also, make sure to continue to see your dentist regularly every six
month

Periodontics- Black triangle
www.orthofree.com
http://www.oralhealthgroup.com/news/treating-the-dreaded-black-triangle/1002990029/?&er=NA
www.orthofree.com

Median dark space caused
Figure 6 - A) Median dark space caused by alveolar bone crest loss B) Interproximal stripping
performed with diamond steel disk at low rotation; C) polishing of the stripped surfaces with
flexible strips of sandpaper and whiting D) space created between incisors; E, F) bringing
teeth closer together with elastomeric chains, showing improvement in papillary esthetics.
Máyra Reis Seixas1, Roberto Amarante Costa-Pinto2, Telma Martins de Araújo3, Dental Press J Orthod. 2012 Sept-Oct;17(5):190-201

• the effects of a malocclusion on periodontal health
suggests that subjects with a malocclusion have worse
periodontal health than subjects without a malocclusion.
• we have no reliable evidence to recommend orthodontic
treatment to prevent periodontal disease.
• les effets d'une malocclusion sur la santé parodontale
suggère que les sujets ayant une malocclusion ont une
moins bonne santé parodontale que les sujets sans une
malocclusion .
• nous n'avons aucune preuve fiable de recommander un
traitement orthodontique pour prévenir les maladies
parodontales .
Anne-Marie Bollen, http://www.jdentaled.org/content/72/8/912.full

Periodontics Tmj dysfunctions
www.orthofree.com

The Timing of Orthodontic Treatment
Early Treatments in Orthodontics
O.SANDID
SQODF SPO- 2007

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

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

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)

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

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

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.

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/

Anterior Crossbite Why Early treatment ?
www.prorthoassist.com

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
•

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

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

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

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).

Why Early treatment ?
Anterior dental crossbite correction- improving gingival recession
www.orthofree.com
http://www.gaorthocare.com/
Gingival Recession Caused by Traumatic Occlusion
(Anterior crossbite).

Deficient anterior growth of maxilla, Maxilla stop growing, Early age cooperation is excellent.
Elie Callabe
Before After

Unaesthetic smile

- Enamel abrasion

4-Diagnois Anterior dental crossbite
Pseudo class III

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

Early detection and treatment of malocclusions- Treatment of 6-
and 9-Year
Anterior dental crossbite correction- improving gingival
recession and corretion hypomaxillie unilaterale…

5-CrossbiteTreatment
Initial intraoral views.
Final intraoral views
Removable appliance with finger spring used to correct anterior crossbite.

5-Anterior crossbite Treatment
Dr O SANDID

4-Anterior crossbite Treatment
Dr O SANDID

5crossbite Treatment
Dr O SANDID

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.

2- Posterior crossbite in primary and mixed dentition
etiology and management
143
http://www.slideshare.net/vjldmd/phase-i-
orthodontic-treatment
http://www.slideshare.net/search/slideshow?s
earchfrom=header&q=POSTERIOR+CROSSBITE

2-Early Treatments in Orthodontics
Posterior Crossbite
144
http://ejo.oxfordjournals.org/content/early/20
11/09/06/ejo.cjr095

Posterior Crossbite
145
http://www.scielo.br/scielo.php?script=sci_art
text&pid=S1678-77572012000200026
http://www.scielo.br/pdf/jaos/v20n2/a26v20n
2.pdf

Management of Posterior Crossbites
http://pocketdentistry.com/8-management-of-
posterior-crossbites/

Correction of Posterior Crossbites:
Diagnosis and Treatment
http://www.aapd.org/assets/1/25/Binder-26-
03.pdf

https://www.cda-adc.ca/jcda/vol-71/issue-
8/569.pdf

http://www.orthodonticproductsonline.com/2
012/07/correcting-true-unilateral-posterior-
crossbites-2012-07-02/

http://cyberdentist.blogspot.com/2006/02/po
sterior-crossbite.html

151
Posterior Crossbite

2-Early Treatments
in Orthodontics
Case1-B
www.orthofree.com
Juan M. Font Jaume
Comparison of intermolar width before treatment and after expansion with quadhelix.
Expansion with quadhelix

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

2-Early Treatments
in Orthodontics
Case1 -C
www.orthofree.com
Juan M. Font Jaume
11 years after the end of treatment.

Mouth breathing
www.orthofree.com

5-Anterior dental crossbite correction- improving Respiration
www.orthofree.com

5-Anterior dental crossbite correction- improving gingival
recession
www.orthofree.com

Anterior dental crossbite
www.orthofree.com
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

5-Anterior dental crossbite
www.orthofree.com
Removable acrylic appliance

Anterior dental crossbite
www.orthofree.com
Intraoral photograph after the treatment, after 6 months

Anterior dental crossbite correction- improving facial aesthetics
www.orthofree.com
Dr. Ramon Perera

5-Anterior crossbite Correction
www.orthofree.com
Daltro Enéas Ritter

Maxillary deficiency with crossbite

5-Anterior dental crossbite correction- improving gingival recession
www.orthofree.com

Pediatric Dentistry and
Orthodontics
O.SANDID
SQODF
2010

Frenum attachment
www.orthofree.com
Gingival recession is caused by frenal pull
Mandibular Labial Frenectomy

Pediatric Dentistry and Orthodontics
1-Space maintainers
2: Protrusion :Orthodontics & Dental Trauma Prevention

Early Tooth Loss and Space Maintainer

• 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/

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.

Anterior Tooth Loss
O. SANDID
Teeth replacement can be accomplished with cemented or removable space
maintainer

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

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

Posterior Tooth Loss
The lack of space prevents eruption of the permanent tooth into its proper
position.

Posterior Tooth Loss- Fixed space
maintainer
www.northsydneyorthodontics.com.au
www.pdgdental.com
lingual arch space maintainers. Nance Transpalatal arch
Fixed space maintainer

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.

Posterior Tooth Loss- Removable space
maintainer
www.northsydneyorthodontics.com.au
www.pdgdental.com
Removable space maintainer

Posterior Tooth Loss- Removable space
maintainer
Truitt Skip
Removable space maintainer

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.

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.

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

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.

Unilateral space maintainers
B.Ambriss

Early Tooth Loss and Space Maintenance

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…

• 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

Part 2: Protrusion - Orthodontics & Dental
Trauma
Prevention

Protrusion - Orthodontics & Dental Trauma Prevention
www.orthofree.com

Early Treatments
in Orthodontics
www.orthofree.com

1-Early Treatments
in Orthodontics
Anterior Crossbite
www.orthofree.com

3-Early Treatments
in Orthodontics
Crowding
198
www.orthofree.com

4-Early Treatments
in Orthodontics
Open bite
www.orthofree.com

6-Early Treatments
in Orthodontics
Ectopic Eruption
www.orthofree.com

7-Early Treatments
in Orthodontics
Class III malocclusion- Proglissement
www.orthofree.com

8-Early Treatments
in Orthodontics
Diastema- frenum
www.orthofree.com

9-Early Treatments
in Orthodontics
Oral habits - Thumb sucking
www.orthofree.com

9-Early Treatments
in Orthodontics
Lip sucking caused
open bite and tongue thrust
www.orthofree.com

9-Early Treatments
in Orthodontics
Finger sucking caused
open bite and tongue thrust
www.orthofree.com

9-Early Treatments
in Orthodontics
Thumb sucking
caused open bite
www.orthofree.com

9-Early Treatments
in Orthodontics
Open bite caused by lower tongue trust
www.orthofree.com

9-Early Treatments
in Orthodontics
Oral habits- Thumb sucking
www.orthofree.com

9-Early Treatments
in Orthodontics
Oral habits - Thumb sucking
Before trt After Trt
www.orthofree.com

9-Early Treatments
in Orthodontics
Oral habits- Tongue thrusting
www.orthofree.com

Class II, Division 2, malocclusion with
Deep Overbite
www.orthofree.com

Mandibular Growth of Children
with Temporomandibular Joint Abnormalities
www.orthofree.com

13-Early tooth loss may require a
space maintainer
Sandid.O - www.orthofree.com

space maintainer
www.orthofree.com

space maintainer
Sandid .O- www.orthofree.com

14-Early Treatment
Guidance of Eruption
selective extraction of deciduous teeth
www.orthofree.com

14-Early Treatment
Guidance of Eruption
www.orthofree.com

15-Prevention/interception
of impaction
Impacted Canines
www.orthofree.com
Before After
Dr O. SANDID
244

of impaction
Impacted Canines
www.orthofree.com
Dr O. SANDID
245

of impaction
www.orthofree.com
Dr O. SANDID
246
Odontoma – Root resorption

of impaction
Impacted Canines
www.orthofree.com
247

of impaction
Impacted Canines
www.orthofree.com
248
Dr O. SANDID

of impaction
Impacted Canines
www.orthofree.com
249
Dr O. SANDID

of impaction
Impacted Canines
www.orthofree.com
250
Dr O. SANDID

Prevention/interception of impaction
251

Early trt –Mesiodens
A. Patti
252

16- Early Treatments
in Orthodontics-
Serial Extraction
www.orthofree.com
O.SANDID

in Orthodontics-
Serial Extraction
www.orthofree.com
254
O.SANDID

in Orthodontics-
Serial Extraction
www.orthofree.com
255
DOLPHIN IMAGING
EXTRACTIONS 53-63-73-83

in Orthodontics-
Interceptive orthodontic correction of ectopically erupting permanent molar
www.orthofree.com
256

in Orthodontics-
www.orthofree.com
257

in Orthodontics-
www.orthofree.com
258

in Orthodontics-
www.orthofree.com
259

Early Treatments
in Orthodontics-
Ankylosis
www.orthofree.com

Early Treatments
in Orthodontics-
Premolar Impaction

13-Early Treatments
in Orthodontics
Space maintainers
www.orthofree.com
- Primary teeth as space maintainers
- Unilateral space maintainer

Early Treatments
in Orthodontics
Case 2: M.O. 4 years 2 months
www.orthofree.com
Unilateral crossbite
facial assymetry.

Early Treatments
in Orthodontics
www.orthofree.com
-Unilateral crossbite
-facial assymetry.
Composite build-ups on right deciduous molars,
selective grinding

Early Treatments
in Orthodontics
www.orthofree.com
-Follow -up

PREVENTIVE & INTERCEPTIVE ORTHODONTICS
www.orthofree.com
• Abnormal Labial Frenum

PREVENTIVE & INTERCEPTIVE ORTHODONTICS
www.orthofree.com
• Abnormal lingual Frenum

BIBLIOGRAPHIE
• Armstrong MM.(1971) : Controlling the magnitude, direction, and duration of extraoral
• force. Am J Orthod.,Vol.59, N°3, pp:217-43.
• Baccetti T,and al.(1998) : Skeletal effects of early treatment of Class III malocclusion with
• maxillary expansion and face-mask therapy. Am J Orthod Dentofacial Orthop.
• Vol.113, N°3, pp:333-43.
• Basciftci FA, Karaman AI.(2002) :Effects of a modified acrylic bonded rapid maxillary
• expansion appliance and vertical chin cap on dentofacial structures. Angle
• Orthod.Vol.72, N°1, p:61-71.
• Baumrind S, and al. (1983) :Superimpositional assessment of treatment-associated changes
• in the temporomandibular joint and the mandibular symphysis.Am J Orthod.
• Vol.84, N°6, pp:443-65.
• Behlfelt K, and al (1989) : Dentition in children with enlarged tonsils compared to control
• children. Eur J Orthod, Vol 11, N°4, pp:416-29.
• Clifford FO. (1971) : Cross-bite correction in the deciduous dentition : principles and
• procedures. Am J Ortthod.Vol.59 :343-9
• Cozza P and al. (2005) : Early orthodontic treatment of skeletal open-bite malocclusion: a
• systematic review.Angle Orthod.Vol.75, N°5, pp:707-13.
• Dale JG. (2000) Serial extraction ... nobody does that anymore. Am J Orthod Dentofacial
• Orthop.Vol.117, N°5, pp:564-6.
• Delaire J.(1971) Confection du masque ortopédique. Rev Stomat Paris Vol.72, pp: 579- 84
• Demisch A.(1972).: Effects of activator therapy on the craniofacial skeleton in classe II,
• division 1 malocclusion. Trans. Eur. Orthod. Soc., pp :295-310.
• Droschl H.(1973) : The effect of heavy orthopedic forces on the maxilla in the growing

BIBLIOGRAPHIE
• Egermark-Eriksson I, and al.(1990) :A longitudinal study on malocclusion in relation to signs
• and symptoms of cranio-mandibular disorders in children and adolescents. Eur J
• OrthodVol.12, N°4, pp:399-407.
• Freunthaller P.(1967) : Cephalometric observation in Class II, Division I malocclusions
• treated with the activator. Angle Orthod.Vol.37, N°1, pp:18-25.
• Gugino CF, Dus I. (1998) :Unlocking orthodontic malocclusions: an interplay between form
• and function.Semin Orthod. Vol.4, N°4, pp:246-55.
• Ghafari J, and al. (1998) : Headgear versus function regulator in the early treatment of Class
• II, division 1 malocclusion: a randomized clinical trial. Am J Orthod Dentofacial
• Orthop.Vol.114, N°2, pp:162-5.
• Gianelly AA, Arena SA, Bernstein L. (1984): A comparison of Class II treatment changes
• noted with the light wire, edgewise, and Fränkel appliances. Am. J.Orthod.Vol.86,
• N°4, pp:269-76.
• Graber TM. (1971) : Serial Extraction. AmJ Orthod Vol.60, pp:541-575.
• Graber TM., Profitt WR. (2007):Contemprary orthodontics. 4th St Louis,pp: 689- 707.
• Guyer EC, Ellis EE 3rd, Mc Namara JA Jr (1986): Components of class III malocclusion in
• juveniles and adolescents. Angle orthod.Vol.56, N°1, pp:7-30.
• Orthop.Vol.66, pp:599-617.

BIBLIOGRAPHIE
• McNamara JA Jr, Bookstein FL, Shaughnessy T.(1985) :Skeletal and dental changes
• following functional regulator therapy on class II patients. Am J Orthod.Vol.88, N°2,
• pp:91-110.
• McNamara JA Jr (1987) : An orthopedic approach to the treatment of Class III
malocclusion
• in young patients. J Clin Orthod.Vol.21, N°9, pp:598-608.
• McNamara JA Jr, Brudow WL.(1993): Orthdodontic and orthodpedic treatment in
the mixed
• dentition. Ann Arbor, Mich. : Needham Press.
• McNamara JA Jr. (2002) :Early intervention in the transverse dimension: is it worth
the
• effort? Am J Orthod Dentofacial OrthopVol.121, N°6, pp:572-4.
• Nartallo-Turley PE, Turley PK.(1998): Cephalometric effects of combined palatal
expansion
• and facemask therapy on Class III malocclusion. Am J Orthod. Vol.68, N°3, pp:217-
• 24.

http://www.quintpub.com/PDFs/book_previe
w/B5662.pdf

http://forum.dentalxp.com/case/details/impac
ted-upper-canine-treatment/4659#

5-Combined endodontic-orthodontic and prosthodontic
treatment of fractured teeth-extrusion
Treatment of fractured teeth-extrusion

6-Orthodontic Treatment in Periodontally Compromised
Patients- Intrusion
www.orthofree.com
Patient with advanced periodontitis and migration of the maxillary left central incisor,
Clinical view after the end of the orthodontic treatment the teeth are retained by means of a resin-bonded
splints
Biomechanics used to intrude and move the central incisor into the defect
Stefanis Re, Giuseppe Corrente IJP and DR

INTERDISCIPLINARY TREATMENT-
CREATE QUALITY BONE FOR IMPLANT PLACEMENT
Create quality bone for implant placement, Forced Eruption
improving the amount of bone available for implant placement
Dr Jebin
O.SANDID

http://orthodontievaudreuil.com/nos_sourires
_en.html
Front tooth (central incisor) trapped in gum
tissue – Surgical exposure: gum on top of the
impacted tooth lifted up to expose the hidden
tooth – Orthodontic repositioning with
“braces”

Intrusion of an overerupted molar using orthodontic miniscrew
implant: A preprosthodontic therapy
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4147828/

Traumatic loss of a maxillary incisor
https://www.researchgate.net/figure/255175102_fig2_Fig-2-A-Loss-of-maxillary-
incisor-in-a-10-year-old-girl-B-lack-of-space-and-agenesis

Traumatic of a maxillary incisor
http://www.jcda.ca/article/a147

http://www.dentaltraumaguide.org/

https://www.google.com.lb/url?sa=i&rct=j&q=
&esrc=s&source=images&cd=&ved=0ahUKEwj
xqOyhkcnOAhVBPBQKHZ23DF0QjB0IBg&url=ht
tp%3A%2F%2Fwww.jarjoura-
gagnon.ca%2Forthodontie%2Forthodontie-
pour-
enfants%2F&bvm=bv.129759880,d.ZGg&psig=
AFQjCNGuCi11QMdud4EOJ42edQOoeDcfBQ&
ust=1471546794335332

Odontoma impaction permanent teeth

Upper incisor trauma and the orthodontic patient—Principles of
management
http://www.sciencedirect.com/science/article/pii/S1073874614000723

https://www.orthodontisteenligne.com/en/blog/missin
g-lateral-incisors/

PEDO INTERDISCIPLINARY TREATMENT- DENTISTRY
Ectopic eruption of first permanent molars
Pre-operative radiograph
Placement of separator
Final
Eight years, maxillary first permanent molars had failed to erupt.
Treatment involved placement of an elastic orthodontic separator
O. SANDID
http://www.oralhealthgroup.com/features/diagnosis-and-treatment-
of-ectopic-eruption-of-permanent-molars/
6
6
6
V
V V

PEDO Space regaining: Molar
uprighting and distalization
http://pocketdentistry.com/10-molar-uprighting-and-space-regaining/
Stripping

PEDO Space regaining: Molar
uprighting and distalization
http://revodonto.bvsalud.org/scielo.php?script=sci_arttext&pid=S1519-44422012000100004&lng=es&nrm=iso

Space regaining: Molar uprighting and
distalization
http://revodonto.bvsalud.org/scielo.php?script=sci_arttext&pid=S1519-44422012000100004&lng=es&nrm=iso

EXTRACTION AND SPACE MAINTENER
http://www.dentistryiq.com/articles/2014/10/orthodontic-options-for-the-ectopic-eruption-of-a-maxillary-first-molar.html

Ectopic Eruption of Permanent Molars
http://www.oralhealthgroup.com/features/diagnosis-and-treatment-
of-ectopic-eruption-of-permanent-molars/
Preoperative radiograph
Post treatment radiograph
Placement of separator
Final

distalization
Pretreatment panoramic radiograph showing the ectopic
eruption of the upper permanent first molars.

distalization
-The lower arch of a patient with a mesially displaced lower right permanent first molar.
- Removable Shamy appliance was made to regain arch length.

distalization
Stefano Sivolella, Michela Roberto, Paolo Bressan, resorption-www.intechopen.com

ANKYLOSED PRIMARY TEETH WITH NO PERMANENT SUCCESSORS
http://www.dentistryiq.com/articles/2015/03/ankylosed-primary-teeth-with-no-permanent-successors-what-do-you-do-part-1.html
1-No treatment
2-Place an onlay to put it back into
occlusion, thus supporting the occlusal
plane.
3-Extraction of the ankylosed primary
tooth and space preservation is the most
frequently recommended treatment.
Preserve the alveolar bone both vertically
and horizontally ? .
Removal of the primary teeth now
obviously would produce a large alveolar
defect (atrophy like the edentulous ridge) ,
requiring bone grafting for an implant or
orthodontic closure, Conceivably, had the
teeth been removed during adolescence,
her vertical alveolar bone would have been
much better.
4- In the decoronation technique
O. SANDID

Ankylosed primary teeth with no permanent successors: What
do you do?
Extraction of the ankylosed primary tooth and space preservation is
the most frequently recommended treatment.
---------------------------------
would preserve the alveolar bone both vertically and horizontally as
they emerge into the arch.
or does it atrophy like the edentulous ridge of an adult?
removal of the primary teeth now obviously would produce a large
alveolar defect, requiring bone grafting for an implant or orthodontic
closure. Conceivably, had the teeth been removed during adolescence,
her vertical alveolar bone would have been much better, although not
at the same level as nonankylosed teeth would have.
Ostler (4) extracted the ankylosed teeth and followed them for a
seven-year period. He documented that alveolar width was reduced by
30%
but the edentulous ridge was documented to move occlusally as the
adjacent teeth erupted
In the decoronation technique, the crown of the tooth is removed to a
depth of 2 mm beneath the cervical bone margin. The surgical area is
left open and not sutured over. A new periosteum is formed and the
erupting teeth are linked with the periosteum, covering the top of the
alveolar socket, which induces bone formation during normal dental
eruption.

Ankylosed primary teeth with no permanent
successors: What do you do?

Ankylosed primary teeth with no permanent
successors: What do you do?
In the decoronation technique, the crown of the tooth is removed to a depth of 2
mm beneath the cervical bone margin. The surgical area is left open and not
sutured over. A new periosteum is formed and the erupting teeth are linked with
the periosteum, covering the top of the alveolar socket, which induces bone
formation during normal dental eruption.

INTERDISCIPLINARY TREATMENT-
GUMMY SMILE
Orthodontic Surgical Treatment of Gummy Smile

• +++http://pocketdentistry.com/18-special-
considerations-in-treatment-for-adults/
• https://www.orthodontisteenligne.com/en/or
tho-101-en/adult-orthodontics-4/

Multi-disciplinary approach for
space management of microdontia

A Multidisciplinary Approach to Implant Restoration
and Provisionalization in the Esthetic Zone
ttps://www.dentalaegis.com/id/2006/08/impl
ant-dentistry/a-multidisciplinary-approach-to-
implant-restoration-and-provisionalization-in-
the-esthetic-zone

The interdisciplinary management of
hypodontia: the relationship between an
interdisciplinary team and the general dental
practitioner
http://www.nature.com/bdj/journal/v194/n9/full/4810184a.html

multidisciplinary approach
ttps://www.dentalaegis.com/id/2009/12/how-a-multidiscinplinary-
approach-can-be-beneficial-in-a-complex-restorative-esthetic-case
https://orthonotes.wordpress.com/2014/10/12/the-essence-of-the-
multidisciplinary-approach-a-case-summary/
http://www.dentistryindia.net/article.php?id=2057
http://www.ijmdent.com/
The Link Between Orthodontics and
Prosthetics
Yves Samama, http://pocketdentistry.com/14-the-link-between-orthodontics-and-prosthetics/

Forced orthodontic extrusion
http://www.jcd.org.in/article.asp?issn=0972-
0707;year=2012;volume=15;issue=2;spage=191;epage=195;aulast=Kumar

Papillary regeneration: anatomical
aspects and treatment approaches
http://revodonto.bvsalud.org/pdf/rsbo/v9n4/a16v9n4.pdf
Diastema closing and papilla regeneration.
A: Teeth prior to the orthodontic treatment
showing
diastema. B: Orthodontic closure with papilla
formation
filling the space
Source: Sharma and Park [32]

Papillary regeneration: anatomical
aspects and treatment approaches
http://revodonto.bvsalud.org/pdf/rsbo/v9n4/a16v9n4.pdf
A: Divergent roots showing the black space. B:
Orthodontic bracket positioning to follow the long axis
of the teeth and correct the black space. C: Convergent
roots after the orthodontic treatment presenting the
filling of the space with the papilla
Source: Sharma and Park [32]

Treating the “Dreaded Black Triangle”
http://www.oralhealthgroup.com/features/treating-the-dreaded-
black-triangle/

Management of congenitally missing
maxillary lateral incisors
• Restoration of missing lateral incisor with implant
• Optimal implant space
• Implant site development

Aesthetics
• Excessive gingival display (‘gummy’ smile)
• Gingival architecture and teeth remodelling

Periodontally compromised patient
• Tooth position and periodontal condition
• Preliminary periodontal therapy
• Endodontic treatment
• Implants for anchorage and restoration
• Orthodontic treatment
• Pathologic tooth migration
• Restorative treatment

distalization
Stefano Sivolella, Michela Roberto, Paolo Bressan, resorption-www.intechopen.com
Example of screw positioning in retromolar area. Lateral view.
The screw used in the proposed case
has the following features: 2.0mm
screws, 8-
12mm thread lengths, made of 316L
extra-hard stainless steel for
maximum strength; selfdrilling,
self-tapping for one-step insertion;
groove under screw-head secures
wires or
elastics; cruciform head design; two
cross-holes with align cruciform head
slots; a 4-mm
capstan-style head to hold the wire
away from the mucosa (Synthes,
West Chester,
Pennsylvania).

Orthodontie Multidisciplinaire
• Le traitement Multi ou interdisciplinaire est la Combinaison de l’orthodontie avec d’autres disciplines.
• Dans certains cas, le traitement orthodontique fait appel à d’autres disciplines, le tout s’intègre dans un
plan de traitement global pour assurer une prise en charge optimale du patient ; Cela implique une
collaboration pluridisciplinaire de différents spécialistes à savoir :
• Orthodontie et parodontie :
• En cas de maladie parodontale, l’orthodontie permet de repositionner les dents avant de les maintenir
par un système de contention; Sinon elles risquent de continuer à bouger et à se déchausser.
• La collaboration entre le parodontiste et l’orthodontiste est capitale pour la prise en charge de patients
qui présentent des malocclusions associées à une maladie parodontale.
• Orthodontie et prothèse/ Implants
• L’orthodontie permet de redresser les dents pour recevoir une prothèse. Par exemple, en cas de fermeture
d’espace, après extraction de dents et déplacements des dents avoisinantes L’orthodontie permet, aussi,
d’aménager de l’espace pour recevoir un implant.
• Orthodontie et chirurgie :
• L’adulte est un patient qui a terminé sa croissance. Certaines anomalies squelettiques ne peuvent être
corrigées que par la chirurgie orthognathique. Pour cette raison, les traitements menés en collaboration
avec un chirurgien maxillo-facial sont assez fréquents chez l’adulte.
• Orthodontie et Occlusodontie :
• L’origine des problèmes de l’ATM (Articulation Temporo-mandibulaire) est généralement multifactorielle,
ce qui veut dire qu’il y a plus d’une cause contribuant au problème. Dans les cas où les dents et l’articulé
dentaire sont des facteurs contribuant dans le développement des problèmes de l’ATM, les soins
d’orthodontie peuvent jouer un rôle dans les thérapies de l’ATM..
• Orthodontie et ORL :
• La relation entre les mâchoires et les dents peut parfois engendrer des problèmes de respiration, du
ronflement et d’apnée du sommeil. Lorsque c’est le cas, des soins d’orthodontie peuvent aider dans le
traitement de ces problèmes.
http://www.ortho-casablanca.com/lorthodontie/multidisciplinaire/

http://www.worlddentalposters.com/
http://www.worlddentalposters.com/poster/760-management-of-
missing-maxilliary-lateralsorthodontic-restorative

Benign Lesions of the Jaw and Gum
Tissue

http://www.orthodonticexprts.com/new/146-
2

Odontoma-associated tooth impaction
http://www.jcdr.net/article_fulltext.asp?issn=0973-
709x&year=2013&month=October&volume=7&issue=10&page=2406&id=3540

Supernumerary Teeth and Impaction

Dental Ankylosis- eruption abnormalities

Dental Cyst - Impaction
http://www.storoe.com/wisdom-teeth/

Interdisciplinary Treatment: Integrating Orthodontics
with Restorative Dentistry
• Occasionally, patients require restorative treatment during or after orthodontic
therapy.
• Patients with worn or abraded teeth, peg-shaped lateral incisors, fractured teeth,
multiple edentulous spaces, or other restorative needs may require tooth
positioning that is slightly different from a nonrestored, nonabraded, completely
dentulous adolescent.
• Generally, orthodontists are not accustomed to dealing with patients who require
restorative intervention. Should the objectives of orthodontic treatment differ for
the restorative patient compared with the nonrestorative patient? How should the
teeth be positioned during orthodontic therapy to facilitate specific restorations?
Should teeth be restored before, during, or perhaps after orthodontics? The
answers to these and other important questions are vital to the successful
treatment of some orthodontic patients. This article will provide a series of eight
guidelines to help the interdisciplinary team manage treatment for the
orthodontic-restorative patient. (Semin Orthod 1997;3:3-20.) Copyright© 1997 by
W.B. Saunders Company
http://www.bbo.org.br/files/bibliografia/artigos/80_Guidelines
_for_managing-the_orthodontic_restorative_patient.pdf

https://books.google.com.lb/books?id=_XDkA
wAAQBAJ&pg=PA499&lpg=PA499&dq=Interdis
ciplinary+Treatment:+Integrating+Orthodontic
s+with+Restorative+Dentistry+and+Periodontic
s,+Endodontics&source=bl&ots=oSNRS1AeqS&
sig=voJjpoafJOJRATGdQP2pNcUQG2s&hl=en&s
a=X&ved=0ahUKEwjl0tXgrs7OAhWEtBQKHf60C
GkQ6AEIODAE#v=onepage&q=Interdisciplinary
%20Treatment%3A%20Integrating%20Orthodo
ntics%20with%20Restorative%20Dentistry%20
and%20Periodontics%2C%20Endodontics&f=fa
lse

ortho-endoprostho-relationship
• http://www.slideshare.net/indiandentalacademy
/endodontic-orthodontic-relationship-oral-
surgery-courses
• http://www.slideshare.net/indiandentalacademy
/ortho-endoprostho-relationship
• https://www.aso.org.au/sites/default/files/uploa
ded-
content/field_f_content_file/brighter_futures_-
_orthodontic_endodontic_considerations_part_1
.pdf

195-Interdisciplinary Treatment Integrating Orthodontics with Restorative Dentistry and Periodontics, - orthodontie pluridisciplinaire -Endodontics oussama sandid- olivier sandid..pptx

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