Cervical headgear is used to restrain maxillary growth in class II malocclusions involving maxillary excess compared to the mandible. The headgear applies distalizing forces to the maxillary molars through a facebow attached to maxillary first molar bands. This redirects maxillary growth downward and backward, allowing the mandible to grow forward into a class I relationship. The headgear is worn 12-14 hours per day to achieve correction over 12 months, followed by fixed appliance therapy. Potential side effects include unwanted tooth movement if compliance is poor.
The document discusses the long-term effects of early headgear treatment for class II malocclusions. It found that headgear treatment significantly reduced the need for extraction treatment compared to controls. The headgear inhibits maxillary growth and results in wider and longer dental arches that are maintained long-term. The main effect is on the orientation of the maxillary plane. Arch expansion during headgear treatment leads to corresponding expansion of the lower arch as an adaptation.
Class II division 1 malocclusion is characterized by maxillary excess and mandibular retrusion and can be intercepted during mixed dentition using cervical headgear to restrain maxillary growth and distalize the upper dentition. A Kloehn facebow applies orthopaedic forces to the maxilla via a rigid outer bow connected to cervical traction to guide alveolar growth and correct the class II malocclusion. Long-term outcomes of early headgear treatment show reduced need for extraction treatment and maintenance of arch expansion.
Class II division 1 malocclusion is characterized by maxillary excess and mandibular retrusion and can be intercepted during mixed dentition using cervical headgear to restrain maxillary growth and distalize the upper dentition. A Kloehn facebow applies orthopaedic forces to the maxilla via a rigid outer bow connected to cervical traction to guide alveolar growth and correct the class II malocclusion. Long-term outcomes of early headgear treatment show reduced need for extraction treatment and maintained arch expansion.
Class II malocclusion is characterized by a distal relationship between the maxillary and mandibular teeth. Early intervention during mixed dentition using cervical headgear can address maxillary excess by restraining maxillary growth and distalizing the upper dentition. This results in improvement of the molar and overjet relationships while allowing normal mandibular growth. Potential side effects include unwanted tooth movement if not worn properly.
Class II malocclusion is characterized by a distal relationship between the maxillary and mandibular teeth. During mixed dentition, interceptive treatment using a Kloehn facebow can guide maxillary growth in cases of maxillary excess. By applying orthopedic forces from a cervical headgear to an outer facebow, the maxilla's forward growth can be restrained, allowing the mandible to reach a normal relationship. This treatment modality reduces maxillary protrusion while improving the sagittal position of the mandible.
This document discusses class II malocclusion and early intervention for growing maxillary excess. It defines class II malocclusion and outlines its prevalence, clinical features, and cephalometric findings. It emphasizes the importance of maintaining a healthy primary dentition to allow proper eruption of permanent molars. For growing maxillary excess, it recommends using a Kloehn cervical facebow headgear during the mixed dentition stage to restrain maxillary growth and distalize the upper dentition into a class I relationship.
This document discusses class II malocclusion features and early intervention. Key points include: class II is characterized by a prognathic maxilla, retrognathic mandible, or combination; early features include a distal molar relationship and narrow maxilla; cervical headgear can be used in mixed dentition to guide maxillary growth and distalize molars for correction. The Kloehn facebow is described for application of orthopedic forces to restrain maxillary growth.
The document discusses the long-term effects of early headgear treatment for class II malocclusions. It found that headgear treatment significantly reduced the need for extraction treatment compared to controls. The headgear inhibits maxillary growth and results in wider and longer dental arches that are maintained long-term. The main effect is on the orientation of the maxillary plane. Arch expansion during headgear treatment leads to corresponding expansion of the lower arch as an adaptation.
Class II division 1 malocclusion is characterized by maxillary excess and mandibular retrusion and can be intercepted during mixed dentition using cervical headgear to restrain maxillary growth and distalize the upper dentition. A Kloehn facebow applies orthopaedic forces to the maxilla via a rigid outer bow connected to cervical traction to guide alveolar growth and correct the class II malocclusion. Long-term outcomes of early headgear treatment show reduced need for extraction treatment and maintenance of arch expansion.
Class II division 1 malocclusion is characterized by maxillary excess and mandibular retrusion and can be intercepted during mixed dentition using cervical headgear to restrain maxillary growth and distalize the upper dentition. A Kloehn facebow applies orthopaedic forces to the maxilla via a rigid outer bow connected to cervical traction to guide alveolar growth and correct the class II malocclusion. Long-term outcomes of early headgear treatment show reduced need for extraction treatment and maintained arch expansion.
Class II malocclusion is characterized by a distal relationship between the maxillary and mandibular teeth. Early intervention during mixed dentition using cervical headgear can address maxillary excess by restraining maxillary growth and distalizing the upper dentition. This results in improvement of the molar and overjet relationships while allowing normal mandibular growth. Potential side effects include unwanted tooth movement if not worn properly.
Class II malocclusion is characterized by a distal relationship between the maxillary and mandibular teeth. During mixed dentition, interceptive treatment using a Kloehn facebow can guide maxillary growth in cases of maxillary excess. By applying orthopedic forces from a cervical headgear to an outer facebow, the maxilla's forward growth can be restrained, allowing the mandible to reach a normal relationship. This treatment modality reduces maxillary protrusion while improving the sagittal position of the mandible.
This document discusses class II malocclusion and early intervention for growing maxillary excess. It defines class II malocclusion and outlines its prevalence, clinical features, and cephalometric findings. It emphasizes the importance of maintaining a healthy primary dentition to allow proper eruption of permanent molars. For growing maxillary excess, it recommends using a Kloehn cervical facebow headgear during the mixed dentition stage to restrain maxillary growth and distalize the upper dentition into a class I relationship.
This document discusses class II malocclusion features and early intervention. Key points include: class II is characterized by a prognathic maxilla, retrognathic mandible, or combination; early features include a distal molar relationship and narrow maxilla; cervical headgear can be used in mixed dentition to guide maxillary growth and distalize molars for correction. The Kloehn facebow is described for application of orthopedic forces to restrain maxillary growth.
This document discusses class II malocclusion and early intervention. It defines class II malocclusion and outlines its prevalence, clinical features, and cephalometric findings. It describes maintaining the primary dentition, using cervical headgear to guide maxillary growth in mixed dentition cases involving maxillary excess, and addressing habits. Headgear with a facebow can distalize the maxilla to achieve class I molar and canine relationships. Treatment is most effective in late mixed/early permanent dentition when compliance is possible.
The document discusses class II malocclusion, including its prevalence, clinical and cephalometric findings, and interceptive treatment during the mixed dentition stage. In particular, it describes using a Kloehn facebow cervical headgear to apply orthopedic forces in cases involving maxillary excess compared to the mandible in order to guide alveolar growth and correct the class II malocclusion. The facebow is intended to restrain maxillary growth and distalize the upper dentition during the period of active clinical crown height.
The document discusses class II malocclusion features and intercepting growing maxillary excess through the use of cervical headgear with a facebow, which applies orthopedic forces to restrain maxillary growth and distalize the upper dentition during the mixed dentition stage in order to achieve class I molar and canine relationships. Cephalometric and clinical findings of class II malocclusions are also presented, along with potential adverse effects and long-term outcomes of early headgear treatment.
Class II malocclusion is characterized by a maxillary excess or mandibular deficiency. Early intervention during mixed dentition with a Kloehn facebow can help guide maxillary growth. By applying distal forces to the maxillary molars, the facebow can restrain maxillary protrusion and distalize the upper dentition to achieve a Class I relationship. Long-term outcomes show maintenance of the correction and reduced need for future extractions.
Kloehn facebow is an orthodontic appliance that can be used in the mixed dentition stage to intercept developing Class II malocclusions caused by maxillary excess, by applying orthopedic forces from a cervical headgear to restrain maxillary growth and distalize the upper dentition. The facebow is fitted to maxillary first molar bands and uses traction from an outer bow extending to the ear to guide alveolar growth. Long-term effects show reduced need for extraction treatment and maintained arch expansion.
1. Class 2 malocclusion is characterized by a distal positioning of the mandible or protrusion of the maxilla.
2. Early signs in the deciduous and mixed dentition include a distal step relationship of the second deciduous molars and transverse discrepancy between the maxillary and mandibular arches.
3. For cases involving maxillary excess, a Kloehn cervical facebow is used to restrain maxillary growth and distalize the upper dentition into a Class I relationship.
This document discusses class II malocclusion, specifically those involving maxillary excess. It describes the prevalence, clinical findings, and cephalometric characteristics of class II malocclusions during mixed and permanent dentition. Early intervention options are presented, including maintaining healthy primary dentition, addressing habits, and using cervical headgear with a facebow to restrain maxillary growth in cases involving maxillary excess compared to the mandible. The headgear is intended to be worn for 12-14 hours per day to distalize the maxillary dentition over 12 months and guide alveolar growth into a class I relationship.
This document discusses early intervention for class II malocclusions caused by maxillary excess. It describes using a Kloehn cervical facebow appliance during the mixed dentition stage to restrain maxillary growth and guide the mandible forward into a class I relationship. The facebow applies distalizing forces to the maxillary molars via headgear worn for 12-14 hours per day. This treatment modality was effective at correcting class II malocclusions but required good patient compliance.
The document discusses class II malocclusion, including its prevalence, clinical and cephalometric features, and interceptive treatment during mixed dentition. Class II malocclusion is characterized by a distal relationship between the maxillary and mandibular teeth. During mixed dentition, the maxilla grows forward more than normal while the mandible grows less, worsening the malocclusion. Interceptive treatment aims to restrain maxillary growth using appliances like the Kloehn facebow to allow the mandible to catch up during its growth. Early treatment can help reduce the need for future extraction treatment.
The document discusses class II malocclusion, including its prevalence, clinical findings, and cephalometric characteristics. It also describes intercepting the developing class II malocclusion through early orthodontic intervention such as maintaining primary dentition, restoring caries, and using cervical headgear in mixed dentition cases involving maxillary excess to guide alveolar growth. Headgear application for 12-18 months can distalize maxillary molars, reduce maxillary protrusion, and allow normal mandibular growth.
The document discusses using a cervical headgear with facebow (Kloehn facebow) to treat Class II malocclusion caused by maxillary excess. The headgear applies orthopedic forces to restrain maxillary growth and distalize the upper dentition. It is most effective when started in late mixed or early permanent dentition. Long-term effects include reduced need for extraction treatment and maintained arch expansion. However, the treatment requires patient compliance and can have adverse effects if not worn correctly.
The document discusses class II malocclusion and early intervention during the mixed dentition stage. It describes using a Kloehn cervical facebow to apply orthopaedic forces in cases where maxillary excess is the primary issue. The facebow is fitted to the maxillary first molars to restrain maxillary growth and distalize the upper dentition into a class I relationship. Proper age of treatment, components of the facebow, and effects on the craniofacial structures are outlined. Potential adverse effects and importance of long-term compliance are also noted.
The document discusses early intervention for class II malocclusion focusing on cases involving maxillary excess compared to the mandible, outlining that a Kloehn facebow with cervical traction can be used starting in the mixed dentition stage to restrain maxillary growth and distalize the upper dentition. The facebow applies orthopaedic forces to guide alveolar growth and inhibit the forward growth of the maxilla, aiming to correct class II malocclusion during the active growth period.
Class II malocclusion is characterized by a distal relationship between the maxillary and mandibular teeth. It has a prevalence that varies across populations. Clinical features include a distal step in the deciduous molars, overjet, and a retruded mandible. Cephalometric findings show a prognathic maxilla, retrognathic mandible, or combination of the two. Early intervention utilizes cervical headgear to restrain maxillary growth and distalize the upper dentition, achieving Class I molar and overjet correction.
This document discusses intercepting growing class II malocclusions through the use of cervical headgear. It describes how a Kloehn facebow can be used in the mixed dentition stage to restrain maxillary growth and distalize the upper dentition when there is maxillary excess. The facebow is fitted to bands on the maxillary first molars and extends to an outer bow at the ear. Wearing it 12-14 hours per day can help achieve a class I molar relationship in about 12 months. Long-term follow up shows maintenance of arch expansion and reduced need for extraction treatment.
The document discusses intercepting growing class II malocclusions through the use of cervical headgear with a facebow during mixed dentition. Specifically, it describes how a Kloehn facebow can guide maxillary growth in class II division 1 cases by restraining the maxilla and distalizing the upper dentition. The facebow is fitted to maxillary first molar bands and uses cervical traction to correct maxillary excess compared to the mandible. Proper use of the appliance requires compliance and can effectively treat class II malocclusions if worn as directed.
- Class 2 malocclusion is characterized by maxillary excess relative to the mandible.
- Early intervention during mixed dentition can guide maxillary growth using cervical headgear with a facebow. This restrains maxillary growth and distalizes the upper dentition.
- A Kloehn facebow consists of an inner and outer bow connected to maxillary first molar bands. It is effective but requires patient compliance as it is worn for 12-18 months.
1. The forward growing maxilla can be intercepted during mixed dentition using orthopaedic forces applied with a Kloehn facebow appliance.
2. The Kloehn facebow applies cervical traction to restrain maxillary growth and distalize the upper dentition into a Class I relationship.
3. When used for 12-14 hours per day, the Kloehn facebow is an effective but patient compliance-dependent way to intercept Class II malocclusions caused by maxillary excess.
1) The forward growing maxilla can be intercepted during mixed dentition using orthopaedic forces applied with a Kloehn facebow in the correct direction and amount.
2) The Kloehn facebow appliance is effective at redirecting maxillary growth but requires patient compliance to wear the headgear for 12-14 hours per day.
3) Long term effects of early headgear treatment show significant reduction in need for extraction treatment compared to controls and inhibition of maxillary growth, resulting in wider arches that are maintained long term.
- Class II malocclusion is characterized by a distal position of the lower molars or mandible, or protrusion of the maxilla and maxillary teeth.
- A key finding is excessive labial proclination and forward positioning of the maxillary anterior teeth. The maxillary first molar is often mesially positioned as well.
- Early intervention using a cervical headgear with facebow can help restrain maxillary growth and distalize the upper dentition to achieve a Class I relationship. The facebow is fitted to the maxillary first molar bands.
This document discusses behaviour management techniques for treating children in a dental setting. It defines behaviour shaping and modification, and outlines the objectives of behaviour management. It describes several classifications of children's behaviour put forth by Frankel, Lampshire and Wright. Non-pharmacological behaviour management methods are outlined, including communication, behaviour shaping techniques like desensitization and modelling, and contingency management. Additional techniques discussed are audio analgesia, biofeedback, voice control, humour, coping strategies, relaxation, hypnosis, implosion therapy and aversive conditioning.
This document discusses behavioural dentistry and guidelines for conscious sedation and general anesthesia. It defines behaviour as any observable change in an organism's functioning. Conscious sedation requires practitioners to be trained and continuously monitor patients' vital signs. General anesthesia may be used for uncooperative patients or those with medical compromises. Proper pre-operative, peri-operative, and post-operative procedures and patient instructions are important for safety.
This document discusses class II malocclusion and early intervention. It defines class II malocclusion and outlines its prevalence, clinical features, and cephalometric findings. It describes maintaining the primary dentition, using cervical headgear to guide maxillary growth in mixed dentition cases involving maxillary excess, and addressing habits. Headgear with a facebow can distalize the maxilla to achieve class I molar and canine relationships. Treatment is most effective in late mixed/early permanent dentition when compliance is possible.
The document discusses class II malocclusion, including its prevalence, clinical and cephalometric findings, and interceptive treatment during the mixed dentition stage. In particular, it describes using a Kloehn facebow cervical headgear to apply orthopedic forces in cases involving maxillary excess compared to the mandible in order to guide alveolar growth and correct the class II malocclusion. The facebow is intended to restrain maxillary growth and distalize the upper dentition during the period of active clinical crown height.
The document discusses class II malocclusion features and intercepting growing maxillary excess through the use of cervical headgear with a facebow, which applies orthopedic forces to restrain maxillary growth and distalize the upper dentition during the mixed dentition stage in order to achieve class I molar and canine relationships. Cephalometric and clinical findings of class II malocclusions are also presented, along with potential adverse effects and long-term outcomes of early headgear treatment.
Class II malocclusion is characterized by a maxillary excess or mandibular deficiency. Early intervention during mixed dentition with a Kloehn facebow can help guide maxillary growth. By applying distal forces to the maxillary molars, the facebow can restrain maxillary protrusion and distalize the upper dentition to achieve a Class I relationship. Long-term outcomes show maintenance of the correction and reduced need for future extractions.
Kloehn facebow is an orthodontic appliance that can be used in the mixed dentition stage to intercept developing Class II malocclusions caused by maxillary excess, by applying orthopedic forces from a cervical headgear to restrain maxillary growth and distalize the upper dentition. The facebow is fitted to maxillary first molar bands and uses traction from an outer bow extending to the ear to guide alveolar growth. Long-term effects show reduced need for extraction treatment and maintained arch expansion.
1. Class 2 malocclusion is characterized by a distal positioning of the mandible or protrusion of the maxilla.
2. Early signs in the deciduous and mixed dentition include a distal step relationship of the second deciduous molars and transverse discrepancy between the maxillary and mandibular arches.
3. For cases involving maxillary excess, a Kloehn cervical facebow is used to restrain maxillary growth and distalize the upper dentition into a Class I relationship.
This document discusses class II malocclusion, specifically those involving maxillary excess. It describes the prevalence, clinical findings, and cephalometric characteristics of class II malocclusions during mixed and permanent dentition. Early intervention options are presented, including maintaining healthy primary dentition, addressing habits, and using cervical headgear with a facebow to restrain maxillary growth in cases involving maxillary excess compared to the mandible. The headgear is intended to be worn for 12-14 hours per day to distalize the maxillary dentition over 12 months and guide alveolar growth into a class I relationship.
This document discusses early intervention for class II malocclusions caused by maxillary excess. It describes using a Kloehn cervical facebow appliance during the mixed dentition stage to restrain maxillary growth and guide the mandible forward into a class I relationship. The facebow applies distalizing forces to the maxillary molars via headgear worn for 12-14 hours per day. This treatment modality was effective at correcting class II malocclusions but required good patient compliance.
The document discusses class II malocclusion, including its prevalence, clinical and cephalometric features, and interceptive treatment during mixed dentition. Class II malocclusion is characterized by a distal relationship between the maxillary and mandibular teeth. During mixed dentition, the maxilla grows forward more than normal while the mandible grows less, worsening the malocclusion. Interceptive treatment aims to restrain maxillary growth using appliances like the Kloehn facebow to allow the mandible to catch up during its growth. Early treatment can help reduce the need for future extraction treatment.
The document discusses class II malocclusion, including its prevalence, clinical findings, and cephalometric characteristics. It also describes intercepting the developing class II malocclusion through early orthodontic intervention such as maintaining primary dentition, restoring caries, and using cervical headgear in mixed dentition cases involving maxillary excess to guide alveolar growth. Headgear application for 12-18 months can distalize maxillary molars, reduce maxillary protrusion, and allow normal mandibular growth.
The document discusses using a cervical headgear with facebow (Kloehn facebow) to treat Class II malocclusion caused by maxillary excess. The headgear applies orthopedic forces to restrain maxillary growth and distalize the upper dentition. It is most effective when started in late mixed or early permanent dentition. Long-term effects include reduced need for extraction treatment and maintained arch expansion. However, the treatment requires patient compliance and can have adverse effects if not worn correctly.
The document discusses class II malocclusion and early intervention during the mixed dentition stage. It describes using a Kloehn cervical facebow to apply orthopaedic forces in cases where maxillary excess is the primary issue. The facebow is fitted to the maxillary first molars to restrain maxillary growth and distalize the upper dentition into a class I relationship. Proper age of treatment, components of the facebow, and effects on the craniofacial structures are outlined. Potential adverse effects and importance of long-term compliance are also noted.
The document discusses early intervention for class II malocclusion focusing on cases involving maxillary excess compared to the mandible, outlining that a Kloehn facebow with cervical traction can be used starting in the mixed dentition stage to restrain maxillary growth and distalize the upper dentition. The facebow applies orthopaedic forces to guide alveolar growth and inhibit the forward growth of the maxilla, aiming to correct class II malocclusion during the active growth period.
Class II malocclusion is characterized by a distal relationship between the maxillary and mandibular teeth. It has a prevalence that varies across populations. Clinical features include a distal step in the deciduous molars, overjet, and a retruded mandible. Cephalometric findings show a prognathic maxilla, retrognathic mandible, or combination of the two. Early intervention utilizes cervical headgear to restrain maxillary growth and distalize the upper dentition, achieving Class I molar and overjet correction.
This document discusses intercepting growing class II malocclusions through the use of cervical headgear. It describes how a Kloehn facebow can be used in the mixed dentition stage to restrain maxillary growth and distalize the upper dentition when there is maxillary excess. The facebow is fitted to bands on the maxillary first molars and extends to an outer bow at the ear. Wearing it 12-14 hours per day can help achieve a class I molar relationship in about 12 months. Long-term follow up shows maintenance of arch expansion and reduced need for extraction treatment.
The document discusses intercepting growing class II malocclusions through the use of cervical headgear with a facebow during mixed dentition. Specifically, it describes how a Kloehn facebow can guide maxillary growth in class II division 1 cases by restraining the maxilla and distalizing the upper dentition. The facebow is fitted to maxillary first molar bands and uses cervical traction to correct maxillary excess compared to the mandible. Proper use of the appliance requires compliance and can effectively treat class II malocclusions if worn as directed.
- Class 2 malocclusion is characterized by maxillary excess relative to the mandible.
- Early intervention during mixed dentition can guide maxillary growth using cervical headgear with a facebow. This restrains maxillary growth and distalizes the upper dentition.
- A Kloehn facebow consists of an inner and outer bow connected to maxillary first molar bands. It is effective but requires patient compliance as it is worn for 12-18 months.
1. The forward growing maxilla can be intercepted during mixed dentition using orthopaedic forces applied with a Kloehn facebow appliance.
2. The Kloehn facebow applies cervical traction to restrain maxillary growth and distalize the upper dentition into a Class I relationship.
3. When used for 12-14 hours per day, the Kloehn facebow is an effective but patient compliance-dependent way to intercept Class II malocclusions caused by maxillary excess.
1) The forward growing maxilla can be intercepted during mixed dentition using orthopaedic forces applied with a Kloehn facebow in the correct direction and amount.
2) The Kloehn facebow appliance is effective at redirecting maxillary growth but requires patient compliance to wear the headgear for 12-14 hours per day.
3) Long term effects of early headgear treatment show significant reduction in need for extraction treatment compared to controls and inhibition of maxillary growth, resulting in wider arches that are maintained long term.
- Class II malocclusion is characterized by a distal position of the lower molars or mandible, or protrusion of the maxilla and maxillary teeth.
- A key finding is excessive labial proclination and forward positioning of the maxillary anterior teeth. The maxillary first molar is often mesially positioned as well.
- Early intervention using a cervical headgear with facebow can help restrain maxillary growth and distalize the upper dentition to achieve a Class I relationship. The facebow is fitted to the maxillary first molar bands.
This document discusses behaviour management techniques for treating children in a dental setting. It defines behaviour shaping and modification, and outlines the objectives of behaviour management. It describes several classifications of children's behaviour put forth by Frankel, Lampshire and Wright. Non-pharmacological behaviour management methods are outlined, including communication, behaviour shaping techniques like desensitization and modelling, and contingency management. Additional techniques discussed are audio analgesia, biofeedback, voice control, humour, coping strategies, relaxation, hypnosis, implosion therapy and aversive conditioning.
This document discusses behavioural dentistry and guidelines for conscious sedation and general anesthesia. It defines behaviour as any observable change in an organism's functioning. Conscious sedation requires practitioners to be trained and continuously monitor patients' vital signs. General anesthesia may be used for uncooperative patients or those with medical compromises. Proper pre-operative, peri-operative, and post-operative procedures and patient instructions are important for safety.
The document discusses various behavior management techniques used for treating uncooperative pediatric dental patients. It describes techniques like voice control, hand-over-mouth exercise, physical restraint, aversive conditioning, implosion therapy, and retraining. It provides details on how each technique is performed and guidelines on their appropriate usage. The overall aim of these techniques is to modify undesired behaviors and facilitate quality dental treatment for children.
Class 2 malocclusion is characterized by a distal relationship of the lower teeth to the upper teeth. Early intervention during the mixed dentition stage can address a developing Class 2 malocclusion caused by maxillary excess. A Kloehn facebow with cervical headgear can be used to restrain maxillary growth and distalize the upper molars, helping to correct the Class 2 relationship and overjet. The facebow is most effective when worn for 12-14 hours per day during the period of rapid maxillary growth.
1. Class II malocclusion is characterized by a distal relationship of the maxillary teeth to the mandibular teeth and is one of the most common types of malocclusion.
2. Early signs in the deciduous and mixed dentition include a distal step relationship of the deciduous molars, large overjet, and narrow maxillary arch width.
3. Interceptive treatment during the mixed dentition aims to correct the sagittal jaw relationship and involves appliances like the Kloehn facebow to restrain maxillary growth.
1) Various behavior management techniques are described including desensitization, modeling, contingency management, and aversive conditioning.
2) Aversive conditioning techniques include voice control, the hand-over-mouth exercise, and physical restraint to redirect a child's attention and reduce avoidance behavior.
3) Behavior modification aims to facilitate cooperation through techniques like preparing the child beforehand, using positive reinforcement, and exposing the child to anxiety-provoking stimuli in a gradual, controlled way until their negative response extinguishes.
1) The document discusses various behavior management techniques used in pediatric dentistry including desensitization, modeling, contingency management, voice control, hand-over-mouth exercise, physical restraint, implosion therapy, and retraining.
2) Desensitization involves exposing children to stimuli related to dental treatment in a gradual, repeated manner to reduce anxiety while modeling and contingency management use reinforcement to encourage positive behaviors.
3) Aversive techniques like voice control, hand-over-mouth exercises, and physical restraint aim to redirect disruptive behavior but require strict guidelines around appropriate use.
This document discusses various behavior management techniques used for treating uncooperative pediatric dental patients. It describes techniques like voice control, hand-over-mouth exercise, and physical restraint that aim to redirect a child's attention and modify their behavior. It also explains behavior modification methods like desensitization, modeling, and contingency management that use reinforcement to encourage positive behaviors. The document provides details on how to implement these aversive and non-aversive approaches and notes appropriate and contraindicated uses of different restraint techniques.
The document discusses various behavior management techniques used for treating uncooperative pediatric dental patients. It describes precautions that must be taken when using stabilization techniques. It then explains in detail various behavior modification techniques like desensitization, modeling, and contingency management. It also discusses aversive conditioning techniques like voice control, hand-over-mouth exercise, and physical restraint. Other topics covered include coping mechanisms, relaxation training, implosion therapy, and retraining approaches.
The document discusses various behavior management techniques used for pediatric dental patients, including desensitization, modeling, and contingency management. It describes in detail aversive conditioning techniques like voice control, hand-over-mouth exercise, and physical restraint. Precautions for patient safety and indications and contraindications for different techniques are provided. The goal is to modify uncooperative behavior and facilitate quality dental treatment.
The document discusses various behavior management techniques used for treating uncooperative pediatric dental patients. It describes precautions that must be taken when using stabilization techniques. It then explains in detail techniques like desensitization, modeling, contingency management, preappointment preparation, coping strategies, relaxation, aversive conditioning including voice control, hand-over-mouth exercise and physical restraint, implosion therapy, and retraining. The goal is to modify undesired behaviors and facilitate quality dental treatment for children.
Behaviour modification techniques aim to reduce dental anxiety in children. Dessensitization involves gradually exposing children to stimuli related to dental treatment, from telling to showing to doing. Modelling allows children to observe appropriate behaviours. Contingency management uses reinforcement to modify behaviour by presenting or withdrawing rewards. Aversive conditioning techniques like voice control, hand-over-mouth exercises, and physical restraint are used as a last resort to manage disruptive behaviour and allow treatment.
This document discusses various behavior management techniques used for pediatric dental patients. It begins by describing behavior modification techniques like desensitization, modeling, and contingency management. It then discusses preappointment preparation, audioanalgesia, hypnosis, coping mechanisms, relaxation, and aversive conditioning techniques like voice control, hand-over-mouth exercises, and physical restraint. Finally, it briefly mentions implosion therapy and retraining approaches. The overall document provides an overview of both non-pharmacological and pharmacological behavior management strategies used in pediatric dentistry.
This document discusses various behavior modification techniques used in dentistry, including desensitization, modeling, and contingency management. Desensitization involves gradually exposing patients to anxiety-provoking stimuli. Modeling allows patients to observe appropriate behaviors. Contingency management modifies behavior through reinforcement. Other techniques covered include pre-appointment preparation, audioanalgesia, hypnosis, coping mechanisms, relaxation, aversive conditioning using voice control or restraints, implosion therapy, and retraining.
This document discusses various behavior modification techniques used in dentistry, including desensitization, modeling, and contingency management. Desensitization involves gradually exposing patients to anxiety-provoking stimuli. Modeling allows patients to observe appropriate behaviors. Contingency management modifies behavior through reinforcement. Other techniques covered include pre-appointment preparation, audioanalgesia, hypnosis, coping mechanisms, relaxation, aversive conditioning using voice control or hand-over-mouth exercises, physical restraint, implosion therapy, and retraining.
This document discusses various behavior modification techniques used in pediatric dentistry. It describes communication approaches like using a child's name and euphemisms. Behavior modification is defined as altering behavior according to learning theory. Techniques include desensitization by gradually exposing children to dental stimuli, modeling by demonstrating appropriate behaviors, and contingency management using reinforcers. Other approaches covered are preappointment preparation, audioanalgesia, hypnosis, coping mechanisms, relaxation, aversive conditioning techniques like voice control and hand-over-mouth exercises, as well as physical restraint and implosion therapy.
This document discusses various non-pharmacological behavior management techniques used in pediatric dentistry. It covers communication techniques, behavior modification including desensitization, modeling and contingency management. It also discusses pre-appointment preparation and techniques like voice control, hand-over-mouth exercise, physical restraint, implosion therapy, and retraining that aim to modify disruptive behaviors in children undergoing dental treatment.
This document discusses various non-pharmacological behaviour management techniques used for managing child patients in dentistry. It describes communication, behaviour modification techniques like desensitization, modelling and contingency management. It also discusses pre-appointment behaviour modification, aversive conditioning techniques like voice control, hand-over-mouth exercise and physical restraint. Other techniques mentioned include implosion therapy, relaxation and retraining. The document emphasizes establishing strong communication and using reinforcement to modify undesirable behaviours and help children cope with dental treatment.
This document discusses various non-pharmacological behavior management techniques used for pediatric dental patients. It covers communication strategies, behavior modification techniques like desensitization and modeling, and contingency management using reinforcement. It also discusses aversive conditioning techniques like voice control, the hand-over-mouth exercise, and physical restraint. The goal of these techniques is to establish rapport, modify undesired behaviors, and facilitate dental treatment for children.
This document discusses Class II malocclusion, specifically Class II division 1 malocclusion which involves maxillary excess. It provides an overview of the features of Class II malocclusion including the prevalence, etiology, clinical findings during mixed and permanent dentition stages, and cephalometric characteristics. Early intervention for growing maxillary excess is also discussed, including the use of Kloehn cervical headgear with a facebow to restrain maxillary growth and distalize the upper dentition into a Class I relationship.
Event Report - SAP Sapphire 2024 Orlando - lots of innovation and old challengesHolger Mueller
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Building Your Employer Brand with Social MediaLuanWise
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1. Effect o f cervical headgear on dental/
craniofacial structures in sagittal, vertical and
transverse dimensions..
Following 12-18 months of treatment, there is a reduction
in maxillary protrusion, while mandible continues to
Grow normally. The distalizing effect on maxillary molars
causes them to erupt backward and downward, thus inhibit
loweringof the posterior region of the maxilla, while
anterior region continues to move downward.
.
2. Transverse width of the maxilla improves from the
expanded inner bow, and allows an anterior displacement of
mandible and hence, improvement in the facial convexity.
The maxillary protrusion is reduced while sagittal position
of the mandible improves, which is measured as a reduction
in angleANB. The improvement in craniofacial skeletal and
dental profile is sustained during the period of fixed
appliance therapy and post retention period.
3.
4. Supervisor . Dr Maher
Fouda
Prepared by Hawwa
Shoaib
Class II division 1 malocclusion:
features and early intervention of
growing maxillary excess
5. Prevalence of malocclusion of class 2
malocclusion.
Cephalometric finding.
Clinical findings.
Interception of growing class2 division 1
malocclusion.
OVERVIEW
6. Class 2 malocclusion comprises agroup of specific
skeletal. Dental and facial features. It is second in
frequency. Distribution and prevalence amongAngle’s
malocclusion classes .
It is the most frequently encountered and treated
malocclusion in orthodontic practice
7. Class 2 malocclusion is a synonym with distal position of
the lower molar or mandible or protrusion of the maxilla
and maxillary teeth or a variable combination
8. Prevalence
The prevalence of Angle’s class 2 malocclusion varies
among population groups.. It is high among caucasians
and lowest among the primitive races..
Class 2 malocclusions are observed in a wide – spectrum
of presentation and severity …
10. Clinical findings
Presentation during deciduous and early mixed
dentition..
• Adistal step relationship 2nd deciduous molars is an
indication of a devoloping class 2 malocclusion during
the mixed dentition ..
Mixed dentition Permanent dentition
11. Occlusal and craniofacial characteristics from
deciduous to mixed dentition
• Distal terminal plane of second deciduous molars . Large
over jet and overbite .
• Narrow maxillary basal bone
• Poor or no spacing in the deciduous dentition
• Transverse discrepancy ( TD) between maxillary and
mandibular deciduous intermolar withs (2.8-1.1) mm
compared to nil among normal occlusal groups .
• Retruded mandible and shorter mandibular length ( Co-Pg)
on cephalometric examination
• The maxilla can also displaced forward in class || subjects
with or without difference in the mandible ..
12. Occlusal and craniofacial characteristics from
deciduous to mixed dentition
• It has been stated by Bishara et al that a distal step deciduous
molar relationship is never self - correcting in growing
children.
• Children with straight terminal plane may develop into a class |
molar or class || molar relationship influenced by the
mandibular growth pattern and adjustment of occlusion during
the late mixed dentition .that would in clinical sense .
• Infer that when we encounter a class|| distal molar relation
early in the mixed or permanent dentition.
• Some sort of interceptive measures may have to be undertaken
or planned because nature would not take care
13. • During transition from deciduous to mixed dentition ,the
craniofacial skeletal patteren shows an abnormal and
variable patteren of growth in class || children compared
to the control group of normal occlusion .
• The upper jaw becomes more prominent due to larger
increments of maxillary protrusion relative to stable basal
cranial structures .
• The mandible grows at a lesser pace than children with
normal occlusion.
• A more backward and downward inclination of the
mandibular body leading to a lesser decrease in the facial
angle is seen .
14. • All this is coupled with a narrow maxillary base in the
development of class || malocclusion .
• Other variations in class || subjects consist of contraction
of the maxilla at both the skeletal and dentoalveolar levels
and narrowing of the base of the nose.
• In general , the occlusal and skeletal features of class ||
malocclusion may remain stable or worsen to the stage of
mixed dentition . There are certainly no favourable
changes into a class | occlusion ..
15. Occlusal and craniofacial findings of class II
malocclusion during late mixed/permanent dentition stage
• A child with class II malocclusion presents with a
protrusive mid-face and/or a retrusive chin. They often
report with complaints of superior protrusion, front teeth
jutting out or showing too much.
.
Mid – face protrusive
Retrusive chin
16. This is often accompanied by a large overjet,
deep bite (open bite can be seen in some) and a
class II (distal) molar, premolar and canine
relationship.
.
Large over jet
Deep bite
17. These children have an aberrant pattern of
muscle activity of the facial musculature such as
a flaccid upper lip hyperactive mentalis and
lower lip trap under the procumbent upper
incisors.
Lower lip trap
under the
procumbent
upper incisors
18. The etiology may be attributed to mouth
breathing/prolonged thumb sucking which can be
elicited on carefully recording the history of the
patient….
THUMP SUCKING
MOUTH BREATHING
19. The underlying craniofacial pattern of class II children has
been extensively investigated. Most of the studies have
concentrated on angular, sagittal and vertical
measurements on lateral cephalograms. A few studies are
also available ontransverse dimensions using PA
cephalograms.
Cephalometric findings
PA. CEPHALOGRAM
LA
T. CEPHALOGRAM
20. Aclass II skeletal pattern may be associated with:
prognathic maxilla retrognathic mandible or combination
of these in varying severity…
Prognathic maxilla
Rertognathic mandible
21. McNamara5 observed two types of skeletal
combinationsin class II children. He found
mandibular retrusion thesingle most
characteristic feature which was attributed
toenvironmental factors such as :
abnormal muscle
function which
altered occlusal
interdigitations.
22. The skeletal maxillary protrusion was not the major finding.
But was rather neutral.
The 2nd was a combination of maxillary and mandibular
skeletal retrusion, often in association with altered mode of
respiration, i.e. mouth breathing.
These children with maxillary and mandibular retrusion
showed :
Greater vertical
development of the
face
23. An excessive labial
proclination and forward
position of the maxillary
anterior teeth is a
common finding in class
IIdivision 1
malocclusion.
The maxillary first
molar is more mesially
positioned ..
Class 2 division 1 , division 2 : the upper first molar mesially
positioned.
24. The anterior segment of maxilla is more
protrusive and superiorly positioned. Excessive
anterior cranial base length and enlarged frontal
and maxillary sinus may be a contributing factor in
the development of class IIdiv. 1 malocclusion.
The mandible and dentition were identical to those
of the controls in size, form and position..
25. Moyers et al6 (1980) have identified six
horizontal types of class II pattern which they
designated: A, B,C, D, E and F.They identified
five (1, 2, 3, 4, 5) vertical class II types ..
26. In brief, each case of class II malocclusion cannot
be placed in a single category or type, and it may
have a combination of sagittal, vertical and
transverse deviations of varying severity. Hence,
the treatment options may have to be considered
accordingly and should be chosen as a function of
disease entity. For type B and E, extraoral traction
to maxilla is suggested while for C, D and F
functional jaw orthopaedics is proposed….
27.
28.
29.
30.
31. Interception of developing class II malocclusion
Orthodontic interventions in class II
malocclusion during deciduous dentition :
Only limited orthodontic interventions are possible during
the deciduous dentition stage for the interception of
developing class II malocclusion…..
32. Maintenance of healthy primary dentition.
All efforts are directed
towards maintenance of the
healthy primary dentition
and thus integrity of arch
length. This is achieved
through education and
home care by all the
measures that minimize
occurrence of dental caries.
.
33. Restoration of carious teeth to their correct antero posterior
dimensions is absolutely essential especially proximal
carious lesions on deciduous molars.
The sole purpose is that permanent first molars should
occupy the space distal to 2nd deciduous molars and
should not prematurely migrate forward.
6
E
34. Habits. Non-nutritive sucking habits such as prolonged
thumb and finger sucking are taken care of with appropriate
counselling and interceptive habit breaking appliance.A
child with recurrent throat infection, nasal blockages or
allergies should have ENT consultation to prevent mouth
breathing.
Mouth breathing ENT consultation
35. Orthodontic interventions in class II
malocclusion during mixed dentition..
1- Cases involving essentially maxillary excess compared
to the mandible.
2 - Cases involving essentially mandibular retrusion .
36. Cases involving essentially maxillary excess compared to
the mandible. Involve guiding alveolar growth in class II
division 1 using headgear orthopaedic force.
Used in class 2 with open bite
cases to intrude molars
Used in class 2 with deep bite
cases to extrude molars
37. Kloehn (1953) was the earliest advocate of the use of
orthopaedic forces to change positions of teeth and so
influence the changes of the alveolar process in the maxilla.
During normal craniofacial and alveolar growth, alveolus
and teeth move forward and this can be intercepted. Thus
if the maxilla is restrained in class II patients, mandible will
follow its normal growth and reach to a normal relation with
the maxilla.
38. Acervical headgear with
a face bow is used to
restrain maxillary growth
and distalize the upper
dentition to
class I dentition.
39. Components of a face bow
Kloehn cervical facebow consists of an inner bow of 0.045"
diameter and an outer bow of 0.071" diameter. The inner
bow fits in the round headgear tube on the first molar
bands. Conventionally, a double buccal tube is welded and
soldered on to the maxillary first molar bands..
The inner face bow fits in the headgear tube on
first molar bands
Inner and outer facebow
40. the roundtube is housed as much gingival as permissible by
the15° (10°-20°) to the inner bow to prevent distal tipping
of the first molar crowns and prevent their extrusion
The inner bow is expanded, 8 to 10 mm larger than distance
between first molar tubes, and made parallel to the occlusal
plane.
The ends of inner bows are bent inwards to prevent the
rotation of the first molars in their position.
41. Aforce 350 gm is used from cervical gear to the outer bow.
The cervical headgear is recommended to be worn 12-14
hrs/day, in the evening and at night
It usually takes about 12 months to achieve class I molar
relation.
improvement in over jet. This phase of orthopaedic
correction is followed by full bonded fixed mechanotherapy
42.
43.
44. Age of treatment
Kloehn facebow can be used in suitable cases where
maxillary prognathism exists or mesial molar movement has
occurred. The facebow is indicated in early mixed dentition
when permanent maxillary first molars have erupted and can
be banded.
45. Filho et al8 recommended the onset of treatment
in the late mixed dentition or beginning of the permanent
dentition based on the belief that it often coincides with the
facial growth spurt. It may also have the advantage of
continuing the treatment with full-banded fixed appliance,
following completion of 12 months of the first phase.
46. cervical traction is continued during/or till the end of
activeclinical crown height. The purpose is to place it close
to centre of resistance of the first molar which is near the
trifurcation of the roots. The inner bow has stops against
molar tubes and are so adjusted that a space of 4-6 mm is
kept between the bow and incisors. The stops can be either
soldered or bent..
47. The outer face bow is extended to the tragus of the ear.
The rigid outer bow is maintained at an elevation of about
treatment to prevent relapse and enhance anchorage for
maxillary anterior retraction/overjet correction
48.
49. There is a downward tipping
of palatal plane at the anterior nasal spine (ANS).
causes rotation of the palatal plane and slight increase in
SN-PP angle. The inferior descent or extrusion of upper
molars is essentially prevented by the forces of occlusion
from the masticatory muscles.
50. Adverse effects
Unwanted side effects of Kloehn headgear can result from
the use of this method of treatment in high angle cases,
where molar extrusion and distal tipping may be significant.
This coupled with unfavourable growth of mandible and
clockwise rotation may bring about an undesirable outcome.
The success of the treatment is fully compliance dependent.
The appliance, if not worn correctly or in case of loose
molar band, breakage or welding failure of buccal tube(s),
may cause injury of various kinds and severity.
51. Long-term effects
The long-term effects of early headgear treatment on 8-year
follow-up have shown that headgear treatment shows a
significant reduction in number of extraction treatment as
compared to controls. The appliance inhibits the growth of
the maxilla and results in wider and longer arches. Its main
effect on maxilla is on the orientation of the maxillary plane.
The maxillary arch expansion achieved during early headgear
treatment results in a corresponding wide lower arch as an
adaptation to maxillary arch..
The arch expansion has been found to be maintained during
long-term follow-up
52.
53. Summary
The forward growing maxilla can be intercepted during
mixed dentition utilising orthopaedic forces in right
direction and amount with Kloehn face bow
This modality of treatment was once very popular
especially in USA. The appliance is effective however
requires patient compliance..