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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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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
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.for more details please visit
www.indiandentalacademy.com
Ricketts analysis /certified fixed orthodontic courses by Indian dental academy Indian dental academy
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
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
Mc namara analysis. /certified fixed orthodontic courses by Indian dental aca...Indian dental academy
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
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.for more details please visit
www.indiandentalacademy.com
This slide gives an full view of the important bio mechanics of temporary anchorage devices (TADS) this slide includes :
# Bio-mechanical principles of miniscrews in orthodontics
# Force Systems
#Biomechanical Considerations : Miniscrews
#Biomechanics For Anterior Retraction
#Biomechanics For Molar Intrusion
#Biomechanics For Molar Distalization
#Biomechanics For Molar Uprighting
#Biomechanics For Molar Protraction
American journal /certified fixed orthodontic courses by Indian dental academy Indian dental academy
Welcome to Indian Dental Academy
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 has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
Mc namara analysis. /certified fixed orthodontic courses by Indian dental aca...Indian dental academy
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
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.for more details please visit
www.indiandentalacademy.com
This slide gives an full view of the important bio mechanics of temporary anchorage devices (TADS) this slide includes :
# Bio-mechanical principles of miniscrews in orthodontics
# Force Systems
#Biomechanical Considerations : Miniscrews
#Biomechanics For Anterior Retraction
#Biomechanics For Molar Intrusion
#Biomechanics For Molar Distalization
#Biomechanics For Molar Uprighting
#Biomechanics For Molar Protraction
American journal /certified fixed orthodontic courses by Indian dental academy Indian dental academy
Welcome to Indian Dental Academy
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 has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
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.for more details please visit
www.indiandentalacademy.com
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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
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.for more details please visit
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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
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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.
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.for more details please visit
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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.
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.for more details please visit
www.indiandentalacademy.com
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.
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
Opportunity for Dentists (BDS/MDS )to relocate to United kingdom -Register as a DENTAL HYGIENIST/ DENTAL THERAPIST without Board exams and after approval you can register in GDC as a DH/DT and start working as a DH/DT Immediately and get paid.
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Eligibility / requirements-
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at the appropriate level.(Within 2 yrs of application date )
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3: A recent pass in a language test for registration with a regulatory authority in a country where the first language is English.
If you are interested Please contact us for more details.
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Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals
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Dear Doctor,
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--
Indian Dental Academy
Leader in continuing dental education
www.indiandentalacademy.com
skype:indiandentalacademy
+919248678078
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
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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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
Andreas Schleicher presents at the OECD webinar ‘Digital devices in schools: detrimental distraction or secret to success?’ on 27 May 2024. The presentation was based on findings from PISA 2022 results and the webinar helped launch the PISA in Focus ‘Managing screen time: How to protect and equip students against distraction’ https://www.oecd-ilibrary.org/education/managing-screen-time_7c225af4-en and the OECD Education Policy Perspective ‘Students, digital devices and success’ can be found here - https://oe.cd/il/5yV
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
2. CONTENTS
• Introduction
• Development of vertical problem
• Classification of growth patterns
• Bjorks seven signs – mandibular growth prediction
• Diagnosis of low angle cases
a.Clinical examination
B.Cephalometric evaluation
• Different treament modalities in low angle cases
• Conclusion
• References
3. Introdoction
• The most important prerequisite for facial balance is a normal
vertical dimension of the lower face.
• Before initiation of orthodontic therapy ,it is vital for the
clinician to clearly define the treatment goals related to the
vertical dimension of face .
4. Development of vertical problem
• Facial growth in relation to the cranial base proceeds along a
vector with variable amounts of horizontal and vertical
growth.
• Vertical growth increments at the facial sutures and the
maxillary and mandibular alveolar process exceeds the
condylar growth ,the mandible would rotate backwards
• Growth at the condyle exceeds the total vertical growth at the
facial sutures and alveolar processes the mandible would
rotate forward
8. BJORK SOLOW AND
HOUSTON
PROFFIT
Rotation of
mandibular core
relative to cranial
base
Total
rotation
True rotation
Internal
rotation
Mandibular plane
relative to cranial
base
Matrix
rotation
Apparent
rotation
Total
rotation
Mandibular plane
relative to the core
of the mandible Intra matrix
rotation
Angular
remodeling of
lower border
External
rotation
9. Growth rotations
• According to the type of rotation and the centre of rotation the
growth of the mandible can be divided into
– Forward rotation
• Type I
• Type II
• Type III
– Backward rotation (less common)
• Type I
• Type II
10. CORCOR FACIAL HEIGHTFACIAL HEIGHT CAUSECAUSE
AnteriorAnterior PosteriorPosterior
Type IType I JointJoint DecreaseDecrease
AFH lowAFH low
angleangle
-- Occlusal imbalance dueOcclusal imbalance due
to loss of teeth /to loss of teeth /
powerful musculature.powerful musculature.
Type IIType II Inciscal edge ofInciscal edge of
the lowerthe lower
anterior teethanterior teeth
Normal AFHNormal AFH MarkedMarked
increasedincreased
PFHPFH
(i). Lowering at middle(i). Lowering at middle
cranial fossa, loweringcranial fossa, lowering
the condylar fossathe condylar fossa
(ii). Vertical growth at(ii). Vertical growth at
the mandibular condylethe mandibular condyle
Type IIIType III At the level ofAt the level of
premolarspremolars
DecreaseDecrease
AFH lowAFH low
angleangle
IncreaseIncrease
PFHPFH
In anamolous occlusionIn anamolous occlusion
of anterior e.g.of anterior e.g.
Increased overjet.Increased overjet.
FORWARD ROTATIONS
11. CORCOR CAUSECAUSE FACIALFACIAL
Type IType I TMJTMJ 1. Raising of bite by1. Raising of bite by
orthodontic meansorthodontic means
Increased AFHIncreased AFH
2. Flattening of cranial2. Flattening of cranial
basebase
3. Oxycephaly3. Oxycephaly
Decreased PFHDecreased PFH
Increased AFHIncreased AFH
Type IIType II Most distalMost distal
occluding molarsoccluding molars
Growth in the saggitalGrowth in the saggital
direction at thedirection at the
mandibular condyulesmandibular condyules
Basal open biteBasal open bite
BACKWARD ROTATIONS
Less frequent than forward rotations
12. 2. FACIAL PATTERNS :
SHORT FACE PATTERN
Excessive forward rotation of mandible during growth.
Short Anterior LFH
Horizontal palatal
plane
Square jaw
(Mandible)
Square gonial
angle
Low MPAlow angle and
crowding
13. Excessive forward rotation may be due to
• (i) Increase in internal mandibular rotation
• (ii) Decrease in external rotation
14. MUTUAL RELATIONSHIP BETWEEN ROTATING JAW
BASES
• Rotation of mandible decides the vertical proportions of the
face.
• Horizontal growers have a
– Short lower anterior facial height.
– Predisposed to having a deep bite
15. • According to Lavergne and Gasson the mutual rotation of
the upper and lower jaw can be of following 4 types
1. Convergent rotation.
Severe low angle.
Difficult to treat with a functional therapy.
1. Divergent jaw bases.
Severe open bite.
In severe cases orthognathic surgery is required.
16. 3. Cranial rotation of both the bases.
Horizontal growth pattern.
Maxillary cranial rotation compensates for the
mandibular rotation.
Normal overbite.
3. Caudal rotation of both bases.
Vertical growth pattern.
Maxillary caudal rotation compensates for the
mandibular rotation.
Normal overbite.
28. Short, square face and an edentulous
appearance.
Maxillary incisors are hidden behind the upper
lip.
The upper lip curves downward and the corners
of mouth are below the occlusal line
Distinct skin folds are seen lateral to the oral
commissure.
VIKEN SASSOUNI:A CLASSIFICATION OF SKELETAL FACIAL TYPES:
AJO 1969 FEB VOLUME 55 NO.2 :109-23
Extra oral examination
29. The posterior part of face appears wide because of prominent
mandibular angles.
Large masseter muscles are attached to the laterally flared
gonial processes.
the incisal edges of the maxillary anterior teeth are positioned
above the inferior margin of upper lip
distinct chin button, which is made more apparent by a deep
mentolabial fold
small gonial angles add to square appearance of the patients
face
VIKEN SASSOUNI:A CLASSIFICATION OF SKELETAL FACIAL TYPES:
AJO 1969 FEB VOLUME 55 NO.2 :109-23
31. B) Intraoral examination
• Absolute transverse maxillary excess.
• Mandibular overclosure
• Shorter dentoalveolar heights
• Deep overbite
• The maxillary arch is broad and the palatal vault is typically
flat.
• Maxillary buccal crossbites are commonly associated with
interdental spacing.
• Gingival recession with maxillary and / or mandibular incisors
is seen.
VIKEN SASSOUNI:A CLASSIFICATION OF SKELETAL FACIAL TYPES:
AJO 1969 FEB VOLUME 55 NO.2 :109-23
33. Study models show excessive overbite.
Lower arch shows exaggerated curve of spee.
Typically reverse curve or compensatory curve of maxillary
occlusal plane in cases of class II division 2 malocclusion.
Palatal vault appears to be flat.
Molars are in infraocclusion in true low angle cases.
Incisors are supraerupted in pseudo low angle cases.
Maxillary arch is wider.
Sometimes teeth are in buccal cross bite.
36. FRONTAL VIEW
• In normal individual upper, middle and lower third of face are
proportional to each other but in low angle cases, the lower
third of face height is decreased.
• A study of the middle third of face shows broad nasal alar
bases and large nostrils.
• Full-face examination typically discloses that the patient has a
short, square shaped face and an edentulous appearance.
• The posterior part of face appears wide because of prominent
mandibular angle.
37. • The smile view shows maxillary incisors hidden behind the
upper lip.
• Frontal view shows curled or redundant lips.
• The upper lip curves downward and the corners of mouth are
below the occlusal line.
• Upper tooth to upper lip relationship is a vertical measurement
made in midline from the incisal edges of maxillary central
incisor to the most inferior portion of the upper lip. Usually
this distance is 2-5 mm. If the upper teeth are buried under the
upper lip, it indicates skeletal low angle.
38. • Interlabial distance is the vertical distance between the most
inferior portion of the upper and lower lip when the lips are
relaxed and the teeth are in centric relation. In normal
individual it is approximately 2mm.Decreased interlabial
distance or redundancy of the lips indicates low angle.
39. PROFILE VIEW
• 1. The lower third of face height is decreased.
• 2. Analysis of lower third of face reveals that nasolabial
angle is essentially normal or obtuse.
• 3. There is distinct chin button, which is made more
apparent by a deep mentolabial fold.
• 4. Lips are curled or redundant.
49. • Patients with upward and forward growth of the mandibular
condyle often have reduced anterior face height; if they
develop a malocclusion, it is nearly always characterized by a
deep bite.
50. Classification
A) Developmental deep bite
1) Skeletal deep bite
--- horizontal growth pattern
2) Dento alveolar deep bite
--- supra occluded incisors
--- > inter occlusal clearance
(functionally a pseudo deep over bite)
51. B) Acquired Deep Bite
1) Lateral Tongue Thrust
Infra Occluded Posterior Teeth
Deep bite e.g. class II div 2
2) Early loss of Deciduous Teeth
Tipped Contiguous Teeth
Acquired Secondary Deep Over Bite
3) Wearing of Occlusal Surface
or Tooth abrasion
Acquired secondary over biteAcquired secondary over bite
52. MORPHOLOGY OF DEEP BITE
DEEP BITE
DENTO ALVEOLAR SKELETAL
(GROWTH PATTERN AVG TO VERTICAL) ( GROWTH PATTERN HORIZONTAL)
INFRA OCCLUDED MOLAR SUPRA ERUPTED INCISORS 1) ANT FACE HT
1- MOLARS PARTIALLY 1- INCISORS BEYOND 2) POST FACE HT
ERUPTED FUNCTIONAL OCC PLANE 3) INTER OCC CLR
2- INTER OCCLUSAL SPACE 2- FULLY ERUPTED MOLARS 4) II HORIZONTAL
3- LATERAL TONGUE THRUST 3- CURVE OF SPEE CEPH PLANES
4- DISTANCE B/W MAX,MAND 4- INTER OCC SPACE &
53. Characteristic findings of Deepbite:
Dentoalveolar Deep Overbite:
The growth pattern usually is average or tends toward the
vertical. The deep overbite caused by the infraocclusion
of molars has the following symptoms:
1. The molars are partially erupted.
2. The interocclusal space is large.
3. A lateral tongue posture and thrust are present.
4. The distances between the maxillary and mandibular
basal planes and occlusal plane are short.
54. The deep overbite caused by over eruption of the
incisors has the following characteristics:
1. The incisal margins of the incisors extend beyond
the functional occlusal plane.
2. The molars are fully erupted.
3. The curve of Spee (compensating curve) is
excessive.
4. The interocclusal space is small.
55. Skeletal Deep Overbite
• Horizontal type of growth pattern.
• The AFH is short, particularly the lower facial third,
whereas the posterior facial height is long.
• Ratio of U/L anterior facial height is reduced in the
skeletal deep overbite to a ratio of 2:2.5 or 2:2.8
(normal- 2:3).
• The horizontal cephalometric planes (sella-nasion,
palatal, occlusal, and mandibular) are approximately
parallel to each other.
56. • The interocclusal clearance is usually small.
• An extreme horizontal growth pattern can be at least
partially compensated by an up and forward inclination
of the maxillary base (anteinclination).
• On the other hand, the combination of a horizontal
growth pattern with a down and forward inclination
(retroclination) of the maxillary base results in a more
severe skeletal deep overbite.
58. Treatment planning in primary dentition
• An excessive overbite is seen in the primary
dentition, it is likely to have a skeletal basis with the
presence of developing class ii malocclusions.
• Activator type appliance may he used to direct
differential alveolar growth, reduce the interocclusal
distance, and improve skeletal morphology
59. Treatment planning for mixed dentition
• If the skeletal bases are class I with normal incisor angulation,
it is better to wait and watch till the eruption of the posterior
teeth which results in resolution of deep bite.
• In non skeletal deep bites a utility arch that incorporates molar
and incisor teeth can be used during the mixed dentition to
intrude, tip, or reposition both molars and incisors.
60. • Early childhood is the best time to treat complex deep bite.
• Functional jaw orthopedic appliances can then guide the
eruption of the permanent dentition upper molars.
• Deepbites with anterior vertical maxillary excess showing
gummy smiles can be intercepted by high pull headgears.
62. 62
• Functional appliances used for correction
of deepbite include
1.Activator
2.Bionator
3.Frankel appliance
4.Twin block
63. Activator
• Two movements are seen with
activator therapy
1. Extrusion
2. Intrusion
• Activator provides limited
intrusion
• Extrusion of molars can be
facilitated by loading the
lingual surfaces of these teeth
above the area of greatest
convexity in the maxilla or
below this area in the
mandible 63
64. When the deep overbite is due to infraocclussion of the
posterior teeth, the interocclusal clearance is large
and hence the construction bite is made high or
moderate accroding to thee size of the freeway
space.
64
65. Bionator
• Developed by Balters
• Method of trimming is
similar to activator except
1. To allow extrusion of the
posterior teeth some
acrylic is always left
interdentally at the level
of the occlusal plane
forming the so called
tooth bed
65
66. 2. The acrylic projections
between the teeth are
left untouched or
replaced with self cure
acrylic- they exert a
distalising influence on
the permanent first
molars
3. The occlusal surfaces
of the bionator are
trimmed to facilitate
transverse movement
66
68. Frankel appliance
• Used for correction of class II div 2 is FR II
• Abnormal perioral muscle function has an ability to exert a
deforming action that prevents optimal growth and
development.
• Frankel appliance has buccal sheilds and lip pads that the
prevent the deforming muscle action in the dentoalveolar
region both during deglutation and at rest.
• Frankel is indicated in the mixed dentition with short lower
anterior facial height ,deep overbite and abnormal
activity,leading to bite opening and facial esthetics.
68
70. Cervical pull head gear
• It is the most common headgear used in patients
with decreased vertical dimension
• The force is exerted below the occlusal plane
producing both extrusive and distalising effects
• This type of traction is used when molar extrusion
is a desirable treatment outcome
• When used in conjunction with intrusive arch it
generates a moment opposite of the moment
generated by the intrusion arch and prevents
mesial movement of the roots of the molar
70
72. Treatment planning for early permanent
dentition
• In class II div I growing patients intrusion or prevention of
excessive eruption of the lower incisors is achieved by
leveling out an excessive curve of Spee with the continuous
arch wire mechanics from molar to incisors.
• In the absence of growth, absolute intrusion is required and
segmented arch mechanics must be used to achieve this .
Eruption of the first molars can be aided by the use of a flat
maxillary bite plane or a monobloc and the incisors depressed
with utility archwire.
73. • METHODS OF DEEP BITE CORRECTION
• Deep overbite can be corrected by following
methods.
• Intrusion of anterior teeth
• Extrusion of posterior teeth
• Combination of both.
• Proclination of incisors.
74. EXTRUSION OF POSTERIOR TEETH
• Extrusion of posterior teeth is commonly indicated in patients
with decreased lower anterior face height.
• It is also indicated in true deep bite cases.
• If the incisal edges of the maxillary anterior teeth are
positioned above the inferior margin of upper lip, in these
cases extrusion of posterior teeth is indicated.
• Extrusion of molars of an average of 1mm results in 2 to 2.5
mm of bite opening.
75. • This is probably the most common and easiest, although not
always the best method to correct the deep overbites.
• Extrusion of posteriors can be done by myofunctional
appliances, removable appliances and fixed appliance therapy.
• Extrusion of posterior teeth in growing patients is stable but in
adults, it may result in relapse.
76. METHODS OF POSTERIOR EXTRUSION
• The posterior teeth can usually be leveled about several
centers of rotation, depending on the amount of required arch
length..
• 1. Tip-back mechanism.
• 2. Base arch mechanism.
• 3. 0.016-inch distal extension.
• 4. Parallel eruption of the buccal segment
77. Tip - Back Mechanism
1. In growing patients with a forward growth rotation.
2. For a deep curve of Spee in the lower arch.
3. For a deep overbite.
4. For slight arch length inadequacy (1 to 2 mm per
side).
5. For a steepened natural plane of occlusion.
INDICATIONS:
78. The tip-back mechanism consists of
1. 0.036-inch lingual arch.
2. 0.018 x 0.025 inch anterior segment, which
can sometimes be left long, distal to the cuspids.
3. Buccal stabilizing segments (BSS) of 0.018
x 0.025 inch from (ideally) 7-4,
4. 0.018x0.025 inch tip back spring
79. With the correct use of this tip-back mechanism, one will
notice that
1. The C Rot
is placed distally, somewhere around the
distal root of the second molar.
2. There is eruption and rotation of the buccal segments.
3. There is increased arch length distal to the canines (1 to
2 mm).
4. The second molar is often buried.
5. With the hook placed distal to the CRes
of the anterior
segment, the roots of the lower anterior segment often come
forward, which is good, if one is flattening the plane of
occlusion.
6. There is no flaring of the anterior teeth, because the
hook is made to slide freely along the anterior segment wire.
80.
81. The force values used are calculated on the basis that between 3,500 and 4,000
g-mm is required to erupt and rotate the buccal segments optimally. This is a
moment of a force; the force can be calculated by knowing the distance from
the CRes
of the lower buccal segment (mesial to the lower first molar root for a
four -tooth segment ) to the point of attachment on the anterior segment:
3,500
____ = F
L
where L = the distance from the CRes
of the buccal segment to the point of
attachment on the anterior segment. The force can be adjusted using the
Dontrix tension gauge.
82. Base Arch Mechanism
The main difference between this applicance and the previous tip-
back mechanism is in the location of the center of rotations.
The force system is nearly identical to that of the tip-back spring, except for the
fact that there is no anterior hook free to slide anteroposteriorly; with the base
arch tied back securely as , the CRot
is moved mesially to somewhere close to
the mesial root of the first molar.
83. 1. Eruption and a negative rotation of the buccal segment
(flattening of the plane of occlusion).
2. No increase in arch length.
3. That the roots of the buccal segment move forward.
4. That second molars sometimes appear to be buried
(remember the negative moment
84. 0.016-inch Distal Extension
1. In order to use this appliance, there should be
Good growth increments remaining, since
the appliance is eruptive.
2. A significant second-order discrepancy
between the canines and the incisors;i.e., the
incisors should be higher than the canines.
3. Minimal arch length required (2 to 3 mm per
side).
4. A deep curve of Spee.
5. Extraction of teeth, usually the first premolars
85. •The appliance itself consists of 0.018 x 0.025 inch base
arch.0.016-inch distal extension.
•Immediately mesial to the canine bracket a vertical loop is
placed and immediately distal to the canine bracket a helix is
placed.
• The distal extension can be adjusted to lie over the tie-wings
of the second premolar bracket, or can be hooked over the
buccal segment wire.
•.0.036-inch lingual arch.
86.
87. Parallel Eruption of the Buccal Segment
• Parallel eruption of the buccal segment is used in the
upper jaw only.
• Using a cervical headgear with its long outer bow bent
high (about 60 degrees), a negative moment is provided by
bringing the outer bow down to the line of action of the
headgear straps .
• Once engaged, the line of action of the force times the
perpendicular distance away from the CRes
of the upper jaw
produces a positive moment.
• Both moments tend to cancel each other out, and one is
left with a purely extrusive force to the buccal segments .
88.
89. Removable appliances
• Maxillary acrylic bite plate or anterior bite plane:
• With this appliance in the mouth during the
mandibular closing movement, the mandibular
• incisors come in contact with the acrylic platform,
• which causes a disocclusion of the posterior teeth.
92. • The ability of an orthodontist to predict future mandibular
growth would greatly aid in the diagnosis and treatment
planning.
• Better therapeutic decisions could be made regarding timing
and length of the treatment, appliance selection, extraction
pattern and possible need for surgery.
• And with it’s knowledge therapy could be truly tailored to the
individual with the possibility of obtaining optimal results in
shorter period of time.
94. • Essentials of facial growth – D.H. Enlow.
• Contemporary orthodontics – W.R. Proffit.
• Handbook of orthodontics – R.E. Moyers.
• Textbook of clinical orthodontics: ASHOK KARAD
• Dentofacial orthopaedics with functional appliances -Thomas
M.Graber, Thomas Rakosi, Alexandrer G.Petrovic
• The Rotation Of The Mandible Resulting From Growth: Its
Implications In Orthodontic Treatment - F. F. SchSome effects
of mandibular growth on the dental occlusion and profile –
R.J. Isaacson et.al., AO, April 1977, pg. 97-106.
95. • Prediction of mandibular growth rotation – A. Bjork, AJO, June
1969, pg. 585-599.
• The puzzle of growth rotation – J.M.H. Dibbets, AJO, June 1985,
pg. 473-480.
• Prediction of mandibular growth rotation evaluated from a
longitudinal implant sample – Bjork, Skieller and Hansen, AJO,
Nov 1984, pg. 359-370
• The puzzle of growth rotation. J.M.H.Dibbets –AJO-DO June 1985
,87,6;473-480.
• Patterns of vertical growth in the face:(AM J ORTHOD
DENTOFAC ORTHOP 1988;93:103-16.)
96. • Mandibular rotation and enlargement. J.M.H.Dibbets.AJO-
DO July 1990,29-32.
• Diagnosis of the Vertical Dimension:(Semin Orthod 2002;8:
120-129,)
• The vertical dimension,the low angle patient: WJO Volume 6:
number 2:2005
Editor's Notes
Forward or backward inclination of the condylar head is characteristic sign
In forward growing mandible condyle is upright compared to a backward growing mandible in which it is inclined backward
Is difficult to identify on the lateral cephalogram.
MANDIBULAR CANAL
The mandibular canal curvature remains the same throughout the life.
In vertical growing mandible the curvature of the canal is more than that of the mandibular contour. Where as in case of horizontal growers the canal may be flat or may even be curved in opposite direction
Shape of the lower border of mandible.
In vertical growers there is an increased deposition below the symphysis, anterior part of the mandible becomes thick along with this there is resorption at the angle producing a characteristic concavity.
In horizontal growers the anterior rounding is absent so the concavity of the lower border is absent.
INCLINATION OF THE SYMPHYSIS
In horizontal growers chin swings forward to become prominent.
In vertical growers symphysis is swung backward causing a receding chin.
INTERINCISAL ANGLE:
Interincisal angle is almost constant showing that the lower incisors is related functionally to the upper incisors
In vertical growers angle in less
In horizontal growers there is an increased interincisal angle.
INTERMOLAR ANGLE
In case of forward rotation the molars get more upright increasing the intermolar and interpremolar angle
while in case of backward rotation the molars become mesially tipped hence decreasing the intermolar and interpremolar angle
LOWER FACE HEIGHT
It is increased in case of vertical growth pattern while is less in case of a horizontal growth pattern
The extra-oral examination shows following features in low angle cases
Studying the angle formed between lower border of mandible and Frankfort horizontal plane can assess low angle relationship. Normally the two planes intersect at the occipital region. If the two planes meet beyond occipital region, it indicates a low angle case.
In general intraoral examination of low angle shows
Evaluation of facial vertical proportions & mandibular plane angle. Vertical proportions can be observed
during the full face examination but sometimes can be seen more carefully in profile. A well proportioned face can be divided into vertical thirds.
The clinical examination, the inclination of the mandibular plane to the true horizontal should be noted.
This is important because a steep mandibualr plane angle correlates with long anterior facial vertical dimensions and
anterior open bite malocclusion, while flat mandibular plane angle correlates with short anterior facial height and low angle malocclusion.
The photographs should be taken with the head in the natural position.
In the low angle patients following features are seen in frontal view.
Shows forward or backward rotation of mandible.
Negative value shows excess vertical development of the face, where as deficient vertical development of the face is indicated by positive values.
Mean 0±3.50
To evaluate the lower facial height, posterior facial height and horizontal or vertical growth pattern
Mean 22±40
To evaluate the lower facial height, posterior facial height and horizontal or vertical growth pattern
Formed by tangent to lower border of mandible and posterior border of ramus
A large angle indicates tendency for posterior rotation of the mandible Activator treatment is Contraindicated.
Small gonial angle
(lower Go angle of Jarabak)on the other hand indicates anterior rotation with horizontal growth of the mandible
>65% greater posterior face height and horizontal growth.
<62% shorter posterior face height and vertical growth
Determine the rotation of the mandible.
If the angle is large, (vertical growth type).
If it is small, the mandible is rotated forwards (horizontal growth type).
Anterior deep bites in the primary dentition are fairly common but are rarely treated.
Indications
for treatment in the primary dentition include
impingement on the palatal mucosa, excessive
grinding, clenching, and headaches if they are
believed to be secondary to the deep bite
Functional jaw orthopedic appliances
can then guide the eruption of the permanent
dentition upper molars, while eruption can be
manipulated with and help control vertical skeletal
growth