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
This presentation is intended to give the GP dentists as well as specialists some essential information regarding " white spot lesions" ,which can be considered as one of the most common side effect of orthodontic treatment with fixed appliances.
This document discusses the definition, etiology, and management of anterior open bite. It defines anterior open bite as a malocclusion where the maxillary and mandibular incisors do not overlap vertically when the back teeth are in occlusion. Anterior open bite can be caused by skeletal factors like increased lower facial height, habits like digit sucking or tongue thrusting, soft tissue patterns, localized developmental failures, and mouth breathing. Management approaches include removing the underlying cause, using growth modification appliances in children, fixed appliance therapy, and in severe skeletal cases, surgical intervention like maxillary osteotomies.
The document discusses different types of anchorage used in orthodontics. It defines anchorage as the resistance used to overcome the reaction to an applied force. There are different factors that affect a tooth's resistance to force, as well as different types of anchorage including extra-oral anchorage like headgear and intra-oral anchorage that can be intra-maxillary or inter-maxillary. Examples of each type are provided. Temporary orthodontic micro anchorage systems are also discussed as a modern method to reinforce anchorage.
This document provides an overview of fixed orthodontic appliances. It begins by defining fixed appliances as those that cannot be removed by the patient and have attachments fixed directly to the tooth surface. It then covers the indications and contraindications for fixed appliances, the differences between fixed and removable appliances, and common types of fixed appliances like edgewise and Begg appliances. The document discusses components of fixed appliances like bands, brackets, wires and auxiliaries. It provides details on topics like orthodontic bends, placement and removal of appliances, and problems that can arise.
This document presents an overview of the activator appliance. It defines the activator, discusses its history and evolution. It outlines the indications and contraindications for activator use. The advantages and disadvantages are described. The components, mode of action, and modifications of different types of activators are explained. Case reports and references are also listed at the end. The document provides a comprehensive review of the activator appliance.
Index of Orthodontic Treatment Need (IOTN)Cing Sian Dal
The document describes the Index of Orthodontic Treatment Need (IOTN), which comprises two parts - the Dental Health Component (DHC) and Aesthetics Component (AC). The DHC records malocclusions based on their significance for dental health using a 5-grade scale, where grades 1-2 indicate no need for treatment, grade 3 indicates borderline need, and grades 4-5 indicate need for treatment. The AC records aesthetics impairment using a 10-photo scale where grades 1-4 indicate no need for treatment, grades 5-7 indicate borderline need, and grades 8-10 indicate need for treatment. Measurements for various malocclusions like overjet, reverse
Study models are essential records in orthodontics that provide a 3D representation of the teeth and occlusion. A study model has two parts - the anatomic portion showing the teeth and soft tissues, and the artistic portion which is the stone base. Models need to be trimmed accurately to reproduce the dental anatomy and occlusion. Various analyses like Carey's, Ashley Howe's and Bolton's can be done on study models to assess discrepancies and plan treatment. Mixed dentition analysis using Moyer's or Tanaka-Johnston method helps predict the size of unerupted teeth.
This presentation is intended to give the GP dentists as well as specialists some essential information regarding " white spot lesions" ,which can be considered as one of the most common side effect of orthodontic treatment with fixed appliances.
This document discusses the definition, etiology, and management of anterior open bite. It defines anterior open bite as a malocclusion where the maxillary and mandibular incisors do not overlap vertically when the back teeth are in occlusion. Anterior open bite can be caused by skeletal factors like increased lower facial height, habits like digit sucking or tongue thrusting, soft tissue patterns, localized developmental failures, and mouth breathing. Management approaches include removing the underlying cause, using growth modification appliances in children, fixed appliance therapy, and in severe skeletal cases, surgical intervention like maxillary osteotomies.
The document discusses different types of anchorage used in orthodontics. It defines anchorage as the resistance used to overcome the reaction to an applied force. There are different factors that affect a tooth's resistance to force, as well as different types of anchorage including extra-oral anchorage like headgear and intra-oral anchorage that can be intra-maxillary or inter-maxillary. Examples of each type are provided. Temporary orthodontic micro anchorage systems are also discussed as a modern method to reinforce anchorage.
This document provides an overview of fixed orthodontic appliances. It begins by defining fixed appliances as those that cannot be removed by the patient and have attachments fixed directly to the tooth surface. It then covers the indications and contraindications for fixed appliances, the differences between fixed and removable appliances, and common types of fixed appliances like edgewise and Begg appliances. The document discusses components of fixed appliances like bands, brackets, wires and auxiliaries. It provides details on topics like orthodontic bends, placement and removal of appliances, and problems that can arise.
This document presents an overview of the activator appliance. It defines the activator, discusses its history and evolution. It outlines the indications and contraindications for activator use. The advantages and disadvantages are described. The components, mode of action, and modifications of different types of activators are explained. Case reports and references are also listed at the end. The document provides a comprehensive review of the activator appliance.
Index of Orthodontic Treatment Need (IOTN)Cing Sian Dal
The document describes the Index of Orthodontic Treatment Need (IOTN), which comprises two parts - the Dental Health Component (DHC) and Aesthetics Component (AC). The DHC records malocclusions based on their significance for dental health using a 5-grade scale, where grades 1-2 indicate no need for treatment, grade 3 indicates borderline need, and grades 4-5 indicate need for treatment. The AC records aesthetics impairment using a 10-photo scale where grades 1-4 indicate no need for treatment, grades 5-7 indicate borderline need, and grades 8-10 indicate need for treatment. Measurements for various malocclusions like overjet, reverse
Study models are essential records in orthodontics that provide a 3D representation of the teeth and occlusion. A study model has two parts - the anatomic portion showing the teeth and soft tissues, and the artistic portion which is the stone base. Models need to be trimmed accurately to reproduce the dental anatomy and occlusion. Various analyses like Carey's, Ashley Howe's and Bolton's can be done on study models to assess discrepancies and plan treatment. Mixed dentition analysis using Moyer's or Tanaka-Johnston method helps predict the size of unerupted teeth.
The document discusses mixed dentition analysis, which involves estimating space requirements for permanent teeth based on measurements of primary teeth. It describes three main methods: arch length discrepancy, Moyer's predictability tables, and radiographic analysis. Arch length discrepancy involves measuring the space available between molars and comparing to the summed widths of teeth in between. Moyer's tables provide predicted widths of unerupted canines and premolars based on measured primary tooth widths. Radiographic analysis uses dental casts and x-rays to directly measure unerupted tooth sizes and correct for magnification.
This document discusses removable orthodontic appliances used for tooth movement. It defines key terminology like removable appliance and classifications active and passive appliances. It describes how removable appliances can be used to expand arches, reposition teeth, and intrude or extrude teeth. Specific active plate designs are outlined for anterior expansion, transverse expansion, and simultaneous anterior and posterior expansion. Removable appliances can also be used to position individual teeth using springs or screws. The document discusses various retentive components like Adams clasps and ways to improve retention. It concludes by noting other uses of removable appliances like as bite planes, to treat habits, as space maintainers, or to retain treatment results.
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.
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
This document discusses cephalometry, which involves analyzing standardized radiographs of the skull and facial bones. It describes the history and development of cephalometry from anthropological studies. The key types of cephalograms are lateral and frontal views. Cephalometry is used in orthodontic diagnosis and treatment planning to evaluate skeletal and dental relationships and abnormalities. The document outlines the equipment, positioning of patients, and evaluation of radiographs. It identifies important landmarks and reference planes used in cephalometric analysis. Several common cephalometric analyses are described, including measurements and norms. The document concludes with references on orthodontics and cephalometrics.
This document summarizes the construction of various types of removable orthodontic appliances including Hawley retainers, Begg retainers, and appliances used for tooth movement. It describes the components, construction steps, and principles of each appliance. Key steps in the construction include bending labial bows and Adams clasps, adding acrylic to make the base plate, and finishing and delivery. Removable appliances are useful for retention, minor tooth movement, and settling of the occlusion. Patient compliance is important for their effectiveness.
This document discusses the three orders of tooth movement that can be achieved through bending orthodontic archwires: first, second, and third order bends. First order bends move teeth inwards/outwards and can be used for derotation. Second order bends tip teeth vertically and are used for anchorage. Third order bends torque individual teeth by twisting the wire. Special pliers can help perform specific bends, like step pliers for first order bends and rose pliers for third order torque bends. Proper bending technique is important to avoid wire fractures.
white spot lesion - prevention and managementAshok Kumar
This document discusses white spot lesions (WSLs), which appear as white opacities on tooth enamel caused by demineralization. It covers the classification, prevalence, risk factors, detection methods, and prevention/treatment of WSLs. The key prevention strategies discussed are the use of topical fluorides like toothpaste, varnishes, and fluoride-releasing materials. Dietary modifications and antimicrobials are also reviewed as secondary prevention methods. Emerging treatments explored include casein phosphopeptide, lasers, and nanotechnology to enhance remineralization of enamel.
This document discusses anchorage, which refers to resistance to unwanted tooth movement. It is classified based on the manner of force application, jaws involved, site of anchorage, and number of anchorage units. Factors like tooth morphology, position, and mutual support affect anchorage. Sources include individual/multiple teeth, basal bone, and musculature. Anchorage planning depends on the number/type of teeth to be moved and treatment factors. Different anchorage techniques are described like intra/inter-maxillary, simple, stationary, and reciprocal anchorage. Anchorage loss and demand vary based on the case. Recent advancements have improved anchorage control.
This document discusses functional appliances used in orthodontic treatment. It describes the advantages and disadvantages of functional appliances, how they work to produce orthopedic, dentoalveolar and muscular changes, different types of functional appliances including activators and Frankel regulators, and guidelines for use and patient instruction.
The document discusses various methods for assessing skeletal maturity and growth, including hand-wrist radiographs. It describes the bones seen in hand-wrist radiographs and several methods for analyzing skeletal maturity based on stages of ossification, including the Greulich and Pyle atlas method, Bjork method, Fishman method, and Hagg and Taranger method. The document also discusses other indicators of skeletal maturity such as cervical vertebrae and their relationship to skeletal age assessment.
This document discusses different types of finish lines used in fixed prosthodontic restorations. It defines finish lines and describes their principles and configurations for both extracoronal and intracoronal restorations. For extracoronal restorations, finish line types for full veneer crowns, partial veneer crowns, and laminate veneers are explained. For intracoronal restorations, finish line designs and bevels for direct restorations using amalgam, composites, and direct gold are outlined. Guidelines for finish line placement and exposure techniques are also provided.
This document summarizes Tweed's analysis of cephalometric landmarks and angles used in orthodontic diagnosis and treatment planning. It describes Tweed's diagnostic facial triangle formed by the Frankfort horizontal plane, mandibular plane, and mandibular incisor plane. Norms for the angles FMA, FMIA, and IMPA are provided based on Tweed's studies. Shortcomings of the ANB angle in assessing jaw relationships are discussed. The Wits appraisal method is introduced as an alternative for measuring anteroposterior jaw disharmony. Related studies validating the Wits appraisal are summarized.
- The document discusses various orthodontic appliances, including removable appliances (e.g. tongue guard, expansion screw), fixed appliances (e.g. bands, brackets, lingual arch), and their components and functions. Removable appliances are smaller and more esthetic but require patient cooperation, while fixed appliances do not require cooperation but are more expensive. The document provides details on several specific appliances.
Chin cup for treatment of growing class III patientbilal falahi
Chin cups are a traditional orthopedic appliance used to treat Class III malocclusions. While some studies have found chin cups can temporarily retard mandibular growth and correct the malocclusion through backward rotation, the effects are not consistently maintained long-term. Meta-analyses found chin cups significantly reduced SNB angle and increased ANB and Wits appraisal in the short-term, but heterogeneity between studies was high. Chin cups also increased SN-ML angle and decreased gonial angle, indicating a tendency for increased vertical growth and posterior mandibular rotation. However, long-term stability and the effects of vertical chin cups require more research due to limited data.
The document summarizes the functional matrix theory of bone growth proposed by Melvin Moss. The theory states that bone growth occurs as a response to functional needs mediated by soft tissues, rather than bones growing independently. Growth involves periosteal matrices altering bone size in response to soft tissue demands, and capsular matrices passively translating bones during expansion. Experiments on rats supported the theory by showing bones altered in size and shape following muscle resection. Clinical implications include functional appliances altering bone growth by changing soft tissue pressures.
This document discusses various methods for gaining space in orthodontic treatment, including proximal stripping, arch expansion, extraction, distalization of molars, uprighting tilted molars, derotation of posterior teeth, and proclination/flaring of anterior teeth. It provides details on techniques such as rapid maxillary expansion using devices like Hyrax or bonded expanders, extraction of first premolars, and distalization of molars using appliances like pendulum or Jones Jig. The document also covers indications, advantages, and disadvantages of different space gaining methods.
This document discusses removable orthodontic appliances. It outlines the advantages as being less invasive than fixed appliances, allowing for oral hygiene, and having adjustments that are easier to make. Disadvantages include needing greater patient cooperation and limiting the types of tooth movements. The key components of removable appliances are retentive elements like clasps, and active elements like springs or screws. Common retentive components described include labial arches, ball clasps, and Adams clasps. Springs are an example of an active component, with different types like finger springs and Z-springs explained.
Diagnosis & treatment planing /certified fixed orthodontic courses by Indian ...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.
1) The document discusses smile esthetics in orthodontics, including the anatomy of the smile, ideal smile characteristics, smile classifications, and considerations for macroesthetics, miniesthetics, and microesthetics in treatment.
2) It describes the key components of the smile, including the lips, teeth, gingiva, and their proportions. Ideal smile characteristics include the smile arc, tooth width-height ratios, spacing, gingival levels, and lip fullness.
3) Smiles are classified based on the involved muscles and tooth display, including posed/social, unposed/enjoyment, and specific patterns involving the commissures or cuspids. Treatment must consider the patient's
Etiology of malocclusion /certified fixed orthodontic courses by Indian dent...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.
Etiological basis of malocclusion theories /certified fixed orthodontic cours...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.
The document discusses mixed dentition analysis, which involves estimating space requirements for permanent teeth based on measurements of primary teeth. It describes three main methods: arch length discrepancy, Moyer's predictability tables, and radiographic analysis. Arch length discrepancy involves measuring the space available between molars and comparing to the summed widths of teeth in between. Moyer's tables provide predicted widths of unerupted canines and premolars based on measured primary tooth widths. Radiographic analysis uses dental casts and x-rays to directly measure unerupted tooth sizes and correct for magnification.
This document discusses removable orthodontic appliances used for tooth movement. It defines key terminology like removable appliance and classifications active and passive appliances. It describes how removable appliances can be used to expand arches, reposition teeth, and intrude or extrude teeth. Specific active plate designs are outlined for anterior expansion, transverse expansion, and simultaneous anterior and posterior expansion. Removable appliances can also be used to position individual teeth using springs or screws. The document discusses various retentive components like Adams clasps and ways to improve retention. It concludes by noting other uses of removable appliances like as bite planes, to treat habits, as space maintainers, or to retain treatment results.
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.
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
This document discusses cephalometry, which involves analyzing standardized radiographs of the skull and facial bones. It describes the history and development of cephalometry from anthropological studies. The key types of cephalograms are lateral and frontal views. Cephalometry is used in orthodontic diagnosis and treatment planning to evaluate skeletal and dental relationships and abnormalities. The document outlines the equipment, positioning of patients, and evaluation of radiographs. It identifies important landmarks and reference planes used in cephalometric analysis. Several common cephalometric analyses are described, including measurements and norms. The document concludes with references on orthodontics and cephalometrics.
This document summarizes the construction of various types of removable orthodontic appliances including Hawley retainers, Begg retainers, and appliances used for tooth movement. It describes the components, construction steps, and principles of each appliance. Key steps in the construction include bending labial bows and Adams clasps, adding acrylic to make the base plate, and finishing and delivery. Removable appliances are useful for retention, minor tooth movement, and settling of the occlusion. Patient compliance is important for their effectiveness.
This document discusses the three orders of tooth movement that can be achieved through bending orthodontic archwires: first, second, and third order bends. First order bends move teeth inwards/outwards and can be used for derotation. Second order bends tip teeth vertically and are used for anchorage. Third order bends torque individual teeth by twisting the wire. Special pliers can help perform specific bends, like step pliers for first order bends and rose pliers for third order torque bends. Proper bending technique is important to avoid wire fractures.
white spot lesion - prevention and managementAshok Kumar
This document discusses white spot lesions (WSLs), which appear as white opacities on tooth enamel caused by demineralization. It covers the classification, prevalence, risk factors, detection methods, and prevention/treatment of WSLs. The key prevention strategies discussed are the use of topical fluorides like toothpaste, varnishes, and fluoride-releasing materials. Dietary modifications and antimicrobials are also reviewed as secondary prevention methods. Emerging treatments explored include casein phosphopeptide, lasers, and nanotechnology to enhance remineralization of enamel.
This document discusses anchorage, which refers to resistance to unwanted tooth movement. It is classified based on the manner of force application, jaws involved, site of anchorage, and number of anchorage units. Factors like tooth morphology, position, and mutual support affect anchorage. Sources include individual/multiple teeth, basal bone, and musculature. Anchorage planning depends on the number/type of teeth to be moved and treatment factors. Different anchorage techniques are described like intra/inter-maxillary, simple, stationary, and reciprocal anchorage. Anchorage loss and demand vary based on the case. Recent advancements have improved anchorage control.
This document discusses functional appliances used in orthodontic treatment. It describes the advantages and disadvantages of functional appliances, how they work to produce orthopedic, dentoalveolar and muscular changes, different types of functional appliances including activators and Frankel regulators, and guidelines for use and patient instruction.
The document discusses various methods for assessing skeletal maturity and growth, including hand-wrist radiographs. It describes the bones seen in hand-wrist radiographs and several methods for analyzing skeletal maturity based on stages of ossification, including the Greulich and Pyle atlas method, Bjork method, Fishman method, and Hagg and Taranger method. The document also discusses other indicators of skeletal maturity such as cervical vertebrae and their relationship to skeletal age assessment.
This document discusses different types of finish lines used in fixed prosthodontic restorations. It defines finish lines and describes their principles and configurations for both extracoronal and intracoronal restorations. For extracoronal restorations, finish line types for full veneer crowns, partial veneer crowns, and laminate veneers are explained. For intracoronal restorations, finish line designs and bevels for direct restorations using amalgam, composites, and direct gold are outlined. Guidelines for finish line placement and exposure techniques are also provided.
This document summarizes Tweed's analysis of cephalometric landmarks and angles used in orthodontic diagnosis and treatment planning. It describes Tweed's diagnostic facial triangle formed by the Frankfort horizontal plane, mandibular plane, and mandibular incisor plane. Norms for the angles FMA, FMIA, and IMPA are provided based on Tweed's studies. Shortcomings of the ANB angle in assessing jaw relationships are discussed. The Wits appraisal method is introduced as an alternative for measuring anteroposterior jaw disharmony. Related studies validating the Wits appraisal are summarized.
- The document discusses various orthodontic appliances, including removable appliances (e.g. tongue guard, expansion screw), fixed appliances (e.g. bands, brackets, lingual arch), and their components and functions. Removable appliances are smaller and more esthetic but require patient cooperation, while fixed appliances do not require cooperation but are more expensive. The document provides details on several specific appliances.
Chin cup for treatment of growing class III patientbilal falahi
Chin cups are a traditional orthopedic appliance used to treat Class III malocclusions. While some studies have found chin cups can temporarily retard mandibular growth and correct the malocclusion through backward rotation, the effects are not consistently maintained long-term. Meta-analyses found chin cups significantly reduced SNB angle and increased ANB and Wits appraisal in the short-term, but heterogeneity between studies was high. Chin cups also increased SN-ML angle and decreased gonial angle, indicating a tendency for increased vertical growth and posterior mandibular rotation. However, long-term stability and the effects of vertical chin cups require more research due to limited data.
The document summarizes the functional matrix theory of bone growth proposed by Melvin Moss. The theory states that bone growth occurs as a response to functional needs mediated by soft tissues, rather than bones growing independently. Growth involves periosteal matrices altering bone size in response to soft tissue demands, and capsular matrices passively translating bones during expansion. Experiments on rats supported the theory by showing bones altered in size and shape following muscle resection. Clinical implications include functional appliances altering bone growth by changing soft tissue pressures.
This document discusses various methods for gaining space in orthodontic treatment, including proximal stripping, arch expansion, extraction, distalization of molars, uprighting tilted molars, derotation of posterior teeth, and proclination/flaring of anterior teeth. It provides details on techniques such as rapid maxillary expansion using devices like Hyrax or bonded expanders, extraction of first premolars, and distalization of molars using appliances like pendulum or Jones Jig. The document also covers indications, advantages, and disadvantages of different space gaining methods.
This document discusses removable orthodontic appliances. It outlines the advantages as being less invasive than fixed appliances, allowing for oral hygiene, and having adjustments that are easier to make. Disadvantages include needing greater patient cooperation and limiting the types of tooth movements. The key components of removable appliances are retentive elements like clasps, and active elements like springs or screws. Common retentive components described include labial arches, ball clasps, and Adams clasps. Springs are an example of an active component, with different types like finger springs and Z-springs explained.
Diagnosis & treatment planing /certified fixed orthodontic courses by Indian ...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.
1) The document discusses smile esthetics in orthodontics, including the anatomy of the smile, ideal smile characteristics, smile classifications, and considerations for macroesthetics, miniesthetics, and microesthetics in treatment.
2) It describes the key components of the smile, including the lips, teeth, gingiva, and their proportions. Ideal smile characteristics include the smile arc, tooth width-height ratios, spacing, gingival levels, and lip fullness.
3) Smiles are classified based on the involved muscles and tooth display, including posed/social, unposed/enjoyment, and specific patterns involving the commissures or cuspids. Treatment must consider the patient's
Etiology of malocclusion /certified fixed orthodontic courses by Indian dent...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.
Etiological basis of malocclusion theories /certified fixed orthodontic cours...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.
Role of function /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
Etiology of malocclusion /certified fixed orthodontic courses by Indian denta...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.
Macrognathia refers to an abnormally large jaw, which can be caused by conditions like pituitary gigantism, Paget's disease of bone, or acromegaly in adults. Clinical features of macrognathia include mandibular protrusion, an enlarged mandible, a gummy smile showing excessive gums, a prominent chin button, and a less steep angle between the ramus and body of the mandible. Treatment may involve osteotomy to decrease the length of the mandible followed by orthodontic treatment.
The management of impacted canines is important in terms of esthetics and function. Clinicians must formulate treatment plans that are in the best interest of the patient and they must be knowledgeable about the variety of treatment options. When patients are evaluated and treated properly, clinicians can reduce the frequency of ectopic eruption and subsequent impaction of the maxillary canine. The simplest interceptive procedure that can be used to prevent impaction of permanent canines is the timely extraction of the primary canines. This procedure usually allows the permanent canines to become upright and erupt properly into the dental arch, provided sufficient space is available to accommodate them. In the present article, an overview of the incidence and sequelae, as well as the surgical, periodontal, and orthodontic considerations in the management of impacted canines is presented.
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
This document provides an overview of various methods for classifying malocclusion and summarizes key etiological factors. It describes Angle's classification system, the first and most widely used method based on molar relationships. It also discusses modifications by Dewey, Lischer, and others. Etiological classifications introduced include Moyer's system distinguishing osseous, muscular and dental origins, and Salzmann's prenatal and postnatal factors. The document aims to explain different approaches and highlight the importance of identifying causes to determine appropriate treatment.
The document discusses the Sharpe index model for portfolio management. [1] It presents an equation that divides a stock's expected return into two parts: return due to market movements and return independent of the market. [2] Beta indicates a stock's sensitivity to market changes and can be used to estimate systematic and unsystematic risk. [3] The variance of a portfolio is calculated based on the systematic risk and unsystematic risk of the stocks within it.
Intrinsic and extrinsic motivation of teachersbreeellen22
Teachers are primarily motivated intrinsically rather than extrinsically. Several studies found that teachers are most motivated by seeing their students learn and succeed, and derive satisfaction from helping students grow. While factors like salary, benefits, and job security provide some extrinsic motivation, intrinsic rewards like positive relationships with students and the joy of teaching were much stronger motivators. Some extrinsic factors like supportive administration and recognition can boost motivation as well, but intrinsic motivation from student success is the dominant factor that keeps teachers engaged in their work.
This document is Deepika Rajawat's project report submitted towards her Master's degree in Fashion Technology. It provides background on Deepika, her college (Dezyne E'Cole College in Ajmer, India), and her skills in areas important to the fashion industry like color, design principles, and working spaces like the library, labs, and material room. The report aims to demonstrate Deepika's qualifications and abilities gained through her education to potential employers in the fashion industry.
This document discusses intrinsic and extrinsic motivation and how intrinsic motivation comes from within an individual for fun or the greater good, while extrinsic motivation involves external factors like rewards. It also covers how autonomy, mastery, and purpose are related to intrinsic motivation and drive individuals. Finally, it states that intrinsic motivation is generally stronger than extrinsic and new teaching methods can improve performance in classrooms as motivation is an interesting topic.
The document discusses intrinsic and extrinsic motivation. It defines intrinsic motivation as engaging in an activity for its own sake rather than for external rewards. Extrinsic motivation involves doing something for external rewards like money or praise. The document also discusses factors that influence intrinsic motivation like developing relationships and building confidence. It explores the role of neurobiology in language learning and how the amygdala specifically impacts affect and appraisal of learning situations. Finally, it addresses issues with measuring affective factors through self-reports, including problems with validity and cultural bias.
This document discusses the etiology and classification of malocclusion. It begins with an introduction to malocclusion and normal occlusion. It then reviews several classifications of the etiology of malocclusion proposed by researchers, including Moyer's, White and Gardiner's, Proffit's, and Graber's classifications. Graber's classification divides etiologies into general factors, such as heredity, congenital defects, environment, and local factors like anomalies in tooth number or shape. The document provides examples to illustrate different etiologies, such as cleft lip and palate and how conditions like fetal pressure or thalidomide exposure can lead to malocclusion.
1. The document describes the morphological stages of tooth development from the dental lamina stage through the bell stage.
2. It explains the histological changes that occur in each stage, including the differentiation of cells in the enamel organ and dental papilla.
3. Root formation begins after enamel and dentin deposition reaches the cemento-enamel junction, guided by the epithelial root sheath of Hertwig.
Lecture 3 intrinsic and extrinsic factorsDavid mbwiga
1) Microbial growth in food is dependent on intrinsic factors like the food's physical and chemical properties as well as extrinsic factors like storage conditions.
2) Key intrinsic factors include pH, water activity, redox potential, nutrient content, and antimicrobial constituents. The pH, water activity, and available nutrients significantly impact which microorganisms can grow.
3) Important extrinsic factors are temperature, relative humidity, and gases in the storage environment. Temperature particularly influences what microbes can grow and their growth rates, with psychrotrophs growing at refrigeration temperatures posing challenges.
The document discusses student motivation for pursuing an MBA degree. It defines motivation and discusses intrinsic and extrinsic motivation. Several motivation theories are explained, including Maslow's hierarchy of needs. Surveys were conducted of MBA students across disciplines on intrinsic and extrinsic motivation levels. Results found most students highly intrinsically motivated regardless of gender or discipline. The conclusion is that students have a positive attitude towards the MBA course and are mainly intrinsically motivated to join. Suggestions include improving the learning environment and cultivating value awareness of other courses. Limitations include the abstract nature of motivation and respondents' understanding.
Local Factors_Etiology of Malocclusion - Dr. Nabil Al-ZubairNabil Al-Zubair
The document discusses various local factors that can contribute to malocclusion, including anomalies in tooth number, size and position. It covers conditions like hypodontia (missing teeth), supernumerary teeth, early loss of primary teeth, and retained primary teeth. These dental anomalies can impact the developing permanent dentition and cause issues like crowding, spacing, and displacement or rotation of teeth. The early loss of primary teeth in particular may have minimal effects if incisors are lost, but can cause space loss or centerline shifts if canines are prematurely lost.
Etiology of malocclusion/certified fixed orthodontic courses by Indian dental...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
Malocclusion general factors /certified fixed orthodontic courses by Indian...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.
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Malocclusion /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.
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Etiology of malocclusion 1/certified fixed orthodontic courses by Indian dent...Indian dental academy
This document discusses the etiology of malocclusion. It begins by defining etiology and malocclusion. Genetics and hereditary factors play an important role in malocclusion, with traits being passed down in autosomal dominant or recessive manners. Environmental factors like habits, trauma, diseases and nutrition can also influence malocclusion development. The document reviews several classification systems for categorizing etiological factors, including those proposed by White and Gardiner, Salzmann, Moyer and Graber. General factors discussed include heredity, congenital defects, environment, metabolism, habits, while local factors include tooth anomalies, eruption issues and dental caries.
This document discusses the classification of malocclusions. It begins with an introduction to orthodontics and the definition of normal occlusion versus malocclusion. It then discusses various ways malocclusions can be categorized, such as by etiology. The document focuses on Angle's classification system of Class I, Class II, and Class III malocclusions based on the molar relationship. It also discusses modifications to Angle's system proposed by others. The document provides an overview of several other classification systems and concludes with limitations of classification systems.
Malocclusion /certified fixed orthodontic courses by Indian dental academy Indian dental academy
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Concepts of occlusion /certified fixed orthodontic courses by Indian dental a...Indian dental academy
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classification of Malocclusion /certified fixed orthodontic courses by India...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
00919248678078
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
Classification of malocclusion1 /certified fixed orthodontic courses by India...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.
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This document provides an overview of the classification of malocclusions. It begins with definitions of key terms like occlusion, ideal occlusion, normal occlusion, and malocclusion. It then discusses the need for classifying malocclusions to aid in diagnosis and treatment planning. The major types of malocclusions covered are intra-arch, inter-arch, and skeletal malocclusions. Several classification systems are then described in detail, including Angle's classification, Dewey's modification, Lischer's modification, Bennett's classification, and the Ackerman-Profitt system. The classifications are based on factors like the molar relationship, sagittal, vertical and transverse discrepancies, dental arch alignment, and incisor relationships.
- The document summarizes the classification of malocclusion. It begins with defining malocclusion and explaining the need for classification.
- It describes different types of malocclusions including intra-arch and inter-arch malocclusions. Angle's classification is a commonly used system that categorizes malocclusions based on the molar relationship into Classes I, II, and III.
- Class I is considered normal occlusion. Class II is divided into Division 1 and 2 based on characteristics like overjet. Classifications help diagnose and plan treatment for different malocclusion patterns.
Primary etiologic sites:
1- Neuromuscular system:
The muscle group that serve most frequently as primary etiologic sites are:
== muscles of mastication
== muscles of facial expression
== tongue
The neuromuscular system plays its primary role in the etiology of dentofacial deformity by the effect of abnormal contraction of bony skeleton and the dentition. Both bones and teeth are affected by the many functional activities of orofacial region
2- Bone:
Since the bone pf maxilla and mandible serve as bases of dental arches, changes in dental arches growth may alter the occlusal and functional relationship.
3- Teeth;
The teeth may be primary sites in the etiology of dentofacial deformity in many ways
Gross variation in size and shape are encountered frequently and always are of concern
Decrease or increase in the regular number of teeth will give rise malocclusion
Etiologic factors:
A- Extrinsic factors:
1- Evolution:
With evolution, the jaws become smaller, reduction in number and size of teeth and diminution of jaw projections together with increased in vertical height of the face and there is a retrognathic tendency in mans as he ascends the evolutionary scale
2- Heredity:
Transmission of dentofacial characteristics through generations by genes. Most authors between 1900-- 1920 did not completely determine the role of inheritance in determination of the form, size and proportion of dentofacial skeleton, but they stress their work upon the effect of the environmental factors, and at this time they were hardly belief that the effect of local lack of function is more important.
Bennet statement: the size, form and density of bones such as maxilla and mandible varies according to the extent to which these structure are used during period of growth – (function stimulate growth)
Walk Joff statement: the form and degree of development of maxilla and mandible depends upon the magnitude of functional stimuli of muscles acting upon these structures.
Baker: his study was performed on animals by unilateral amputation of muscles of mastication, he found lack of growth on the affected side.
Brash: studied the facial form and the dental development in twins on genetic bases, he also emphasized the genetic facial pattern of some royal families in Europe where they had been inter-marriage, his studies gave the best evidence to support the role of inheritance
Axel Lundstorm:1925 showed that, the form and size of dental bases and the teeth are genetically determined, when the size of the teeth and their basal arches are not correlated, problems of crowding or spacing will be arising.
Broadbent and Hofrath 1931: developed standardized cephalometric x-ray technique which permit serial longitudinal studies of facial growth, by this studies the concept of inheritance growth pattern arises
There are three types of transmission of malocclusion from the standpoint of genetics:
a- Repetitive: the recurrence of single dentofacial deviation within the immediate famil
Malocclusion classification /certified fixed orthodontic courses by India...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
00919248678078
Description :
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
Similar to Extrinsic intrinsic factors /certified fixed orthodontic courses by Indian dental academy (20)
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Leader in continuing dental education
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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
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Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Indian dental academy
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Use of modified tooth forms in complete denture occlusion / dental implant...Indian dental academy
This document discusses dental occlusion concepts and philosophies for complete dentures. It introduces key terms like physiologic occlusion and defines different occlusion schemes like balanced articulation and monoplane articulation. The document discusses advantages and disadvantages of using anatomic versus non-anatomic teeth for complete dentures. It also outlines requirements for maintaining denture stability, such as balanced occlusal contacts and control of horizontal forces. The goal of occlusion for complete dentures is to re-establish the homeostasis of the masticatory system disrupted by edentulism.
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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This document discusses dental casting investment materials. It describes the three main types of investments - gypsum bonded, phosphate bonded, and ethyl silicate bonded investments. For gypsum bonded investments specifically, it details their classification, composition including the roles of gypsum, silica, and modifiers, setting time, normal and hygroscopic setting expansion, and thermal expansion. It provides information on how the properties of gypsum bonded investments are affected by their composition. The document serves as a comprehensive overview of dental casting investment materials.
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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
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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
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Receptor Discordance in Breast Carcinoma During the Course of Life
Definition:
Receptor discordance refers to changes in the status of hormone receptors (estrogen receptor ERα, progesterone receptor PgR, and HER2) in breast cancer tumors over time or between primary and metastatic sites.
Causes:
Tumor Evolution:
Genetic and epigenetic changes during tumor progression can lead to alterations in receptor status.
Treatment Effects:
Therapies, especially endocrine and targeted therapies, can selectively pressure tumor cells, causing shifts in receptor expression.
Heterogeneity:
Inherent heterogeneity within the tumor can result in subpopulations of cells with different receptor statuses.
Impact on Treatment:
Therapeutic Resistance:
Loss of ERα or PgR can lead to resistance to endocrine therapies.
HER2 discordance affects the efficacy of HER2-targeted treatments.
Treatment Adjustment:
Regular reassessment of receptor status may be necessary to adjust treatment strategies appropriately.
Clinical Implications:
Prognosis:
Receptor discordance is often associated with a poorer prognosis.
Biopsies:
Obtaining biopsies from metastatic sites is crucial for accurate receptor status assessment and effective treatment planning.
Monitoring:
Continuous monitoring of receptor status throughout the disease course can guide personalized therapy adjustments.
Understanding and managing receptor discordance is essential for optimizing treatment outcomes and improving the prognosis for breast cancer patients.
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
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Milan J. Anadkat, MD, and Dale V. Reisner discuss generalized pustular psoriasis in this CME activity titled "Supporting Patient-Centered Care in Generalized Pustular Psoriasis: Communications Strategies to Improve Shared Decision-Making." For the full presentation, please visit us at www.peervoice.com/HUM870.
Fexofenadine is sold under the brand name Allegra.
It is a selective peripheral H1 blocker. It is classified as a second-generation antihistamine because it is less able to pass the blood–brain barrier and causes lesser sedation, as compared to first-generation antihistamines.
It is on the World Health Organization's List of Essential Medicines. Fexofenadine has been manufactured in generic form since 2011.
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
CLASSIFICATION OF H1 ANTIHISTAMINICS-
FIRST GENERATION ANTIHISTAMINICS-
1)HIGHLY SEDATIVE-DIPHENHYDRAMINE,DIMENHYDRINATE,PROMETHAZINE,HYDROXYZINE 2)MODERATELY SEDATIVE- PHENARIMINE,CYPROHEPTADINE, MECLIZINE,CINNARIZINE
3)MILD SEDATIVE-CHLORPHENIRAMINE,DEXCHLORPHENIRAMINE
TRIPROLIDINE,CLEMASTINE
SECOND GENERATION ANTIHISTAMINICS-FEXOFENADINE,
LORATADINE,DESLORATADINE,CETIRIZINE,LEVOCETIRIZINE,
AZELASTINE,MIZOLASTINE,EBASTINE,RUPATADINE. Mechanism of action of 2nd generation antihistaminics-
These drugs competitively antagonize actions of
histamine at the H1 receptors.
Pharmacological actions-
Antagonism of histamine-The H1 antagonists effectively block histamine induced bronchoconstriction, contraction of intestinal and other smooth muscle and triple response especially wheal, flare and itch. Constriction of larger blood vessel by histamine is also antagonized.
2) Antiallergic actions-Many manifestations of immediate hypersensitivity (type I reactions)are suppressed. Urticaria, itching and angioedema are well controlled.3) CNS action-The older antihistamines produce variable degree of CNS depression.But in case of 2nd gen antihistaminics there is less CNS depressant property as these cross BBB to significantly lesser extent.
4) Anticholinergic action- many H1 blockers
in addition antagonize muscarinic actions of ACh. BUT IN 2ND gen histaminics there is Higher H1 selectivitiy : no anticholinergic side effects
The Children are very vulnerable to get affected with respiratory disease.
In our country, the respiratory Disease conditions are consider as major cause for mortality and Morbidity in Child.
Nutritional deficiency Disorder are problems in india.
It is very important to learn about Indian child's nutritional parameters as well the Disease related to alteration in their Nutrition.
PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
- Video recording of this lecture in English language: https://youtu.be/RvdYsTzgQq8
- Video recording of this lecture in Arabic language: https://youtu.be/ECILGWtgZko
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Storyboard on Acne-Innovative Learning-M. pharm. (2nd sem.) CosmeticsMuskanShingari
Acne is a common skin condition that occurs when hair follicles become clogged with oil and dead skin cells. It typically manifests as pimples, blackheads, or whiteheads, often on the face, chest, shoulders, or back. Acne can range from mild to severe and may cause emotional distress and scarring in some cases.
**Causes:**
1. **Excess Oil Production:** Hormonal changes during adolescence or certain times in adulthood can increase sebum (oil) production, leading to clogged pores.
2. **Clogged Pores:** When dead skin cells and oil block hair follicles, bacteria (usually Propionibacterium acnes) can thrive, causing inflammation and acne lesions.
3. **Hormonal Factors:** Fluctuations in hormone levels, such as during puberty, menstrual cycles, pregnancy, or certain medical conditions, can contribute to acne.
4. **Genetics:** A family history of acne can increase the likelihood of developing the condition.
**Types of Acne:**
- **Whiteheads:** Closed plugged pores.
- **Blackheads:** Open plugged pores with a dark surface.
- **Papules:** Small red, tender bumps.
- **Pustules:** Pimples with pus at their tips.
- **Nodules:** Large, solid, painful lumps beneath the surface.
- **Cysts:** Painful, pus-filled lumps beneath the surface that can cause scarring.
**Treatment:**
Treatment depends on the severity and type of acne but may include:
- **Topical Treatments:** Such as benzoyl peroxide, salicylic acid, or retinoids to reduce bacteria and unclog pores.
- **Oral Medications:** Antibiotics or oral contraceptives for hormonal acne.
- **Procedures:** Such as chemical peels, extraction of comedones, or light therapy for more severe cases.
**Prevention and Management:**
- **Cleanse:** Regularly wash skin with a gentle cleanser.
- **Moisturize:** Use non-comedogenic moisturizers to keep skin hydrated without clogging pores.
- **Avoid Irritants:** Such as harsh cosmetics or excessive scrubbing.
- **Sun Protection:** Use sunscreen to prevent exacerbation of acne scars and inflammation.
Acne treatment can take time, and consistency in skincare routines and treatments is crucial. Consulting a dermatologist can help tailor a treatment plan that suits individual needs and reduces the risk of scarring or long-term skin damage.
Storyboard on Acne-Innovative Learning-M. pharm. (2nd sem.) Cosmetics
Extrinsic intrinsic factors /certified fixed orthodontic courses by Indian dental academy
1. “ EXTRINSIC AND INTRINSIC
FACTORS IN THE ETIOLOGY OF
MALOCCLUSION & ITS ROLE IN
POST TREATMENT STABILITY ”
www.indiandentalacademy.com
INDIAN DENTAL ACADEMY
Leader in continuing dental education
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2. W. K. Bridgman in 1859 states “the proper antagonism of the
teeth is of very utmost importance, for if any of the cusps be
out of place they disturb equal distribution of forces in
biting & tend to produce mischief at the points holding
those cusps in their assumed positions”
Normal occlusion of teeth is supposed to be requisite for
normal facial balance which is influenced by soft tissue,
underlying bone, occlusion, axial inclination of teeth. The
position of the teeth within the jaw and the mode of
occlusion are determined by developmental processes that
interact with the teeth and associated structures during the
periods of formations, growth and postnatal modifications.
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3. NORMAL OCCLUSION
The word occlusion is derived from “clusion” i.e.
close & “oc” i.e. up.
Edward H. Angle in 1907 defined “occlusion as
being the normal relation of occlusal inclined
planes of teeth when the jaws are closed”
B.S.S.O in 1926 defined it as – “ that occlusion
which is within the standard deviation from the
ideal”
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4. CONCEPTS AND EVOLUTION OF OCCLUSION
Initially concept was given by E. H. Angle in 1899.
Matthew Cryer questioned Angle’s concept.
Dr P.R. Beggs gave his concept in 1924 of attritional
occlusion.
To understand the normal occlusion & to differentiate it from
malocclusion Lawrence F. Andrews in 1960 - 64 gave the
six keys of normal occlusion.
1. Molar relationship
2. Crown angulations – mesiodistal tip
3. Crown inclination – labiolingual or buccolingual
4. Rotations
5. Spaces
6. Plane of occlusion www.indiandentalacademy.com
5. WHAT IS MALOCCLUSION
It is a condition where there is departure from the normal relation of the
teeth to other teeth in the same arch and to the teeth in the opposing
arch.
Salzmann says “diagnosis of malocclusion is not to be based on
subjective, arbitrarily, established criteria or “standards”, but must
take into consideration the genetic endowment, ontogenetic growth &
postnatal development of the individual patient.”
Carabelli in mid of 19th
century was the first to describe abnormal
relation of upper & lower dental arches.
Angle defined “malocclusion of the teeth is but the perversion of their
normal relation.”
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6. INCIDENCE OF MALOCCLUSION
As per the various broad population studies done for the
prevalence of malocclusion
20 % of deciduous dentition had malocclusion
39 % of mixed dentition
58 % in permanent dentition
No difference noted according to sex.
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7. REVIEW
First direct attempt of classification give by Fox in 1803.
Marjolin in 1823 gave direction of dental arches; prominence, recession,
inversion.
J.C.F.Mary in 1828 gave the inclination of the teeth; inward, outward,
laterally.
C.F. Delabarra in 1829 was first to indicate 4 types of bite; overbite,
underbite, edge to edge, cross bite
Blandid in 1836 & J.M.A.Schange in 1841 gave the classification as per
the number, form, direction & position.
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8. M.S.Cartwright in 1864 gave irregularities of the teeth according to 3
forms of teeth, “heredity” “congenital” “mechanical”
Kingsley in 1872 classified the cause of irregularities first by
developmental & second as accidental
A.Ogston in 1974 classified congenital malformation of the lower jaw
- Non development of inferior maxilla.
- Excessive development
- Congenital smallness of the mandible either both halves / unilateral
- Congenital dislocation
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9. Most universally used classification was introduced by
Edward. H. Angle in 1899, the basis of Angle’s classification
was his hypothesis that the first molar is the key of
occlusion.
Simon with suggestion made by Bennet in 1912 categorized
malocclusion in 3 planes of space:
Horizontal,
Vertical &
Transverse.
Ackermann – Proffit recognizing the sagittal orientation &
limitations of the angles classification; gave a method of
diagrammatic & categorizing malocclusion using the Venn
Symbolic Logic Daigram, known as SET THEORYwww.indiandentalacademy.com
10. THE ORTHODONTIC EQUATION
CAUSE TIME TISSUES RESULT
some predisposing prenatal primary following of the three
Some existing postnatal secondary or combination.
-Heredity -continuous/intermittent -neuromuscular -malfunction
-Developmental cause -may act at different age -teeth - malocclusion
of unknown origin levels -bone and cartilage -osseous dysplasia
-Trauma -soft tissue other than
-physical agents muscles
-Habits
-Diseases
-Malnutrition
In an article by Dockrell in 1952 “classification of etiology of
malocclusion”
Act at on produce
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12. HEREDITY
Offspring inherits few attributes from his parents which are
modified by environmental factor, physical entities,
pressure, habits, malnutrition, etc.
Definite genetic determinant influence dentofacial
morphology, thus growth & development has a strong
hereditary component.
Certain racial & familial characteristics tends to recur. There is
a possibility of recapitulation of a hereditary trait from
either parent or combination of both parents to produce a
characteristic modification.’
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13. Heredity with racial influence: certain facial characteristics
show racial influence
Heredity with facial type: Hasen & Siversten pointed out
sex linked nature of facial width & dental arch shape.
Female demonstrates positive correlation wider the face
wider is the jaw.
Heredity influence on growth & development pattern:
Growth & development has a strong hereditary influence.
Environmental influence modify the hereditary determined
pattern.
Onset of puberty vary with different races & geographic
distribution.’ www.indiandentalacademy.com
14. Heredity & specific dentofacial morphology:
Lundstrum made an intensive analysis of these
characteristics in twin & concluded that heredity could be
considered significant in determining the following
characteristics:
Tooth size
- Width and length of arch
- Height of palate
- Crowding / spacing / rotation of teeth
- Tooth shape and number
- Overjet and overbite
- Inter arch variation in transverse/Sagittal/vertical plane
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15. - Frenum
- Position and confirmation of perioral
musculature to tongue size and shape.
- Soft tissue peculiarities
- Congenital deformity
- Facial asymmetry
- Micrognathia / macrognathia
- Cleft palate and lip
- Mandibular prognathism / retrusion
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16. Genetic aberrations make their appearance prenatally / may
not be seen until many years after birth. It can be
explained as follows as some primary etiological sites:
1. Neuromuscular system: the anomalies with inheriting
component are size, position, tonicity, contractility,
neuromuscular coordination pattern of facial, oral &
tongue musculature. It effects by reflex contraction on
bony skeleton & dentition leading to skeletal imbalance.
It is not possible to differentiate in the origin of certain habits.
There may be various reasons.’
Some malocclusion are associated with tongue size, lip length,
tonicity.
2. Soft tissue other than muscle:
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17. 3. Dentition:
- Size and shape of the teeth
- Number of the teeth
- Primary position of tooth germ and path of eruption.
- Shedding of deciduous teeth and sequence of eruption
- Mineralization of the tooth.
4. Skeletal structures:
Affected inherently as well as environmentally or acquired
congenital malformation.
Class III have strong familial tendency.
Any pathological condition affecting growth of the jaw affects
the dentition
Trauma
Infection during growing years can affect the jaw growthwww.indiandentalacademy.com
18. CONGENITAL
Can be identified as early as in 18 – 20 wks of pregnancy or
can be seen immediately after the birth. The aberrations are
both inherently & environmentally influenced.
The congenital abnormality that can cause malocclusion can
be classified as:
EXTRINSIC: abnormal state of mother during pregnancy
accidents during pregnancy or during birth
intra uterine pressure
accidental traumatization of the infant by external
forces
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19. INTRINSIC:
clefts of face and palate
macroglossia / microglossia
cleidocranial dysostosis
malnutrition & endocrinopathies
infectious diseases
metabolic & nutritional deficiency
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20. Cleft lip and palate:
- cicatricial bands restrict the horizontal maxillary anterior
segmental development
- Teeth on side of cleft are in lingual crossbites with
opposing lowers.
- Premaxilla displaced anteriorly or due to tight repaired lip
pushed posteriorly.
- Maxillary incisors badly malposed with bizarre axial
inclination and teeth frequently jumbled.
- Maxillary laterals are missing / twined / atypical in shape.
- Strong forces applied on teeth to correct the malocclusion
can lead to early loss of the teeth.
- Teeth are in good relation to basal bone but entire palatal &
alveolar structure is displaced medially.
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21. Cerebral palsy: paralysis/lack of muscular co-ordination attributes to
intracranial lesions, considered to be a birth injury.
The tissue are normal but lack in motor control with abnormal
function in muscle of mastication, deglutition, respiration, speech.
Aberrant action upset the muscle balance producing abnormal
pressure habits leading to malocclusion.
Tortocollis: foreshortening of sterno cleido mastoid muscle change the
bony morphology of cranium and face with bizarre facial
asymmetry with uncorrective dental malocclusion.
Micrognathism : seen with either of jaw mainly associated with
congenital heart disease.
Maxillary deficiency is due to premaxillary deficiency
Mandibular deficiency due to chin with steep mandibular angle.
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22. Cleido cranial dysostosis: its congenital and frequently
inheretent.
Features are: Absence of clavicle, delayed closure of sutures,
maxillary retrusion, mandibular protrusion, retarded
eruption of permanent teeth, retained deciduous teeth, roots
of permanent are short & thin, supernumerary present.
Syphillis: abnormal shaped teeth, malposed teeth like
hutchinson’s incisors, mulbery molars, enamel deficiency,
extensive dental decay, small maxilla, anterior cross bite.
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23. Oligodontia : it is commonly inheriting and congenital
III molars are commonly involved.
Anodontia: associated with hereditary ectodermal dysplasia
Some common reasons of congenital absent teeth are :
- Heredity
- Ectodermal dysplasia
- Localized inflammation / infection
- Systemic conditions
- Evolutionary changes in the dentition.
Rubella : infection to mother during pregnancy can lead to dental
hypoplasia, retarded eruption, extensive caries.
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24. ENDOCRINAL FACTOR
Prenatal influence show hypoplasia of tooth while postnatal can retard or
hasten the growth but do not distort the direction of the growth.
It affect the rate of ossification of bones, time of suture closure, time of
eruption of teeth, rate of resorption of roots.
Periodontal membrane and gingiva are extremely sensitive to endocrine
dysfunction thus affect teeth indirectly.
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25. Features of the endocrinal imbalance are:
1. Hypo thyroidism:
- Retarded growth with decreased vertical growth of face
- Anterior open bite tendency
- Delayed eruption of teeth
- Maxillary protrusion
- Spacing of the teeth
- Over retained deciduous
- Narrowing of dental arch
- Abnormal resorption pattern
- Gingival disturbances
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26. 2. Hyper thyroidism:
- Accelerated skeletal growth with irregular eruption of teeth
- Increased vertical facial height
- Open bite tendency
- Premature eruption of deciduous
3. Hypo pitutarism:
- Retarded growth with decrease linear facial measurement and cranial
base measures
- Open bite tendency
- Delayed tooth eruption
- Incomplete root formation with incomplete closure of apical foramen
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27. 4. Hyper pitutarism:
- Accelerated development seen in mandible
- Accelerated dental development and eruption
- Enlarged tongue
- Thick cortical plates
5. Parathyroidism :
- Accelerated skeletal growth with irregular eruption of teeth
- Increase vertical facial height
- Open bite tendency
- Premature eruption of deciduous
- Mobility due to loss of cortical bone
- Interruption of tooth development
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28. METABOIC DISEASE FACTOR
Febrile diseases not only affect health of
child but also the dentition and
surrounding hard and soft tissue.
They are able to show decrease growth and
delayed eruption of teeth.
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30. ENVIRONMENTAL
PRENATAL INFLUENCE:
Cause of malocclusion is due to
- Uterine fetal posture, Fibroids of the mother cause facial
asymmetries apparent during birth & disappear till 1st
year of life.
- Micro mandible / pierre robin syndrome / treacher collin syndrome
have tremendous increment of growth largely eliminate the original
malformation.
- Amniotic lesions
- Maternal diet and metabolism
- Drug induced deformity e.g. thalidomide
- Infections like germen measles
- Injury and trauma
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31. POSTNATAL INFLUENCE
- Cranial bone slide and mold more than the facial and dental
area
- High forceps delivery injure the infant with permanent
damage to TMJ due to Ankylosis patient show hypo plastic
mandible with retarded growth / vogelgesicht.
- Malocclusion associated with cerebral palsy attribute to
birth injury due to loss of muscle co-ordination
- Disabling accidents produce undue pressure on the
developing dentition.
- Falls lead to condylar fracture & facial asymmetry
- Extensive scar tissue restrict the mandibular growth.
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32. DEFICIENCY DISEASE /
MALNUTRITION / DIETARY PROBLEMS
- Malnutrition affect quality of tissue being formed, the rate of
calcification
- Good nutrition plays an imp role in growth & maintenance of good
bodily health and hygiene
- Vitamin deficiency lead to malocclusion by upsetting the dental
developmental time table
- This leads to premature loss of teeth, prolonged retention of teeth,
poor tissue health, abnormal eruption pathways
- Its mainly due to faulty utilization of ingested food, hormonal /
enzymatic imbalance, chronic alcoholism.
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33. Protein deficiency – delayed eruption
Vitamin A deficiency – retarded eruption
Vitamin B deficiency – retarded growth of the bones
Vitamin C deficiency – bleeding gums, loosening of the teeth
Vitamin D deficiency – retarded eruption and early loss of deciduous
Hyper vitaminosis, vitamin B 12 deficiency, folic acid deficiency – cleft
lip and palate
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34. INFECTION AND DISEASES
Malocclusion can be secondary to some neuropathies or neuromuscular
disorders or it may be a sequel of treatment problem like scoliosis.
1. Systemic: febrile diseases upset the dentitional development time
table during infancy and early childhood. It mainly affects the
quality rather than the quantity of the dentitional development.
2. Local:
a) Gingival & periodontal diseases
b) Tumors
c) caries
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35. d) Nasopharyngeal diseases and disturbed respiratory function:
There are 3 hypothesis to be considered:
- Adenoid enlargement leads to mouth breathing resulting in
particular type of facial form and dentition.
- Enlarged adenoids leads to mouth breathing but not influence facial
form and type of dentition.
- Enlarged adenoids in certain types of faces and dentition leads to
mouth breathing
The basic assumption is due to compression, tissue atrophy, altered
air pressure:
Enlarged adenoids obstruct the airway – mouth breathing – change in
tongue, lip and mandibular posture – upset the soft tissue balance –
lead to alter the craniofacial form & malocclusion – increase in the
anterior facial height – narrow & high palate – increased lower
facial height – anterior open bite, posterior cross bite tendency
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36. PHYSICAL AGENTS
Nature of food :
In the primitive fibrous food stimulates their muscle to work thus
increasing the load of function on the teeth. This type of food
produces less caries, great mean arch width, increased wear of
occlusal surfaces
Now highly refined, soft, pappy modern food plays a role I etiology of
malocclusion, as lack of adequate function results in contraction of
dental arches, insufficient occlusal wear, absence of occlusal
adjustments
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37. TRAUMA AND ACCIDEDNTS
1. Prenatal trauma / birth injury:
Hypoplasia of mandible is caused by intrauterine pressure /trauma
during delivery
Vegelgesicht: inhibited growth of mandible due to ankylosis in TMJ
2. Trauma at time of delivery : e.g. forcep delivery
3. Postnatal trauma :
Occur at any age and affect any region
Fracture of jaw and teeth, loss of vitality
Habits produce microtrauma if persists for a long time
Trauma to TMJ impair growth, function leads to asymmetry, TMJ
dysfunction
Frequent falls
Trauma leads to dilaceration, deformation, displacement, ankylosis.
Abnormal resorption pattern, deflect permanent tooth germ.www.indiandentalacademy.com
38. POSTURE
- poor posture accentuates existing malocclusion
- Those who hold their head straight & erect with head placed over the
spinal column will almost reflexly hold their chin forward in prefered
position
- Body posture is the summated expression of muscle reflexes & so
usually capable of change & correction
- E.g. abnormal tongue position usually cause open bite
a full fledged malocclusion seen in child resting his head on his
hands for long period each day, sleeping on his arm, or fist or
pillow.
a stoop shouldered child with head resting on his chest create his
own mandibular retrusion.
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39. HABITS
All habits are functional abrasion producing forces that are abnormal as
produced repeatedly over time thus bring about permanent
deformation in musculoskeletal unit.
This deformity depends on intensity, duration and frequency of habit.
The muscular element is capable of retrained but underlying skeletal
structure goes to abnormal proportion.
Thus it follows the functional matrix theory.
Abnormal pattern interferes with regular pattern of facial growth.
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40. Bone is a plaster tissue responsive to pressure that are continually acting
on it. Dynamic role of musculature is apparent.’
The dentist thinks muscles as a primary masticatory element. An average
person eats 3 meals per day, but swallows al the day long, breaths
constantly & talks a good part of time.
Premature occlusal contacts & compensatory muscle activity during
active function produces even greater departure from the normal,
which can even change the bony morphology thus accentuating the
malocclusion.
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41. 1.POSTURAL RESTING POSITION:
It is a sort of balance of extraoral & intraoral muscle forces with the
buccal & perioral musculature passively restraining the anterior
displacement of the teeth.
Lingual pressure are greater but hydraulic effect, tissue mass, cheek
elasticity & morphogenetic pattern contributes to a total balance.
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42. BUCCINATOR MECHANISM:
It runs posteriorly to pterygomandibular raphe, decussating the fibers of
deep constrictor muscles that carry on a round & anchor at pharyngeal
tubercle of occipital bone.
All facial muscles are intimately related to postvertebral, prevertebral, &
cervical musculature, so that a change in one muscle would influence
relationship with other muscle.
e.g. pattern in class II
pattern in class III
Thus the musculature dose not create skeletal malocclusion but
accentuates the existing deformity by virtue of its adaptive functional
activity.
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43. 2. FINGER SUCKING HABIT:
According to William James: an acquired habit from psychological
point of view is nothing but a new pathway of discharged formed in
brain, by which certain incoming current even after tent to escape.
Habits is relation to malocclusion are classified into:
- Useful
- Harmful
According to Dr. E A Barton apart from effect of constantly sucking the
foul thumb there is another side which demands consideration. The
thumb is a hard body frequently in mouth tends to pull the growing
premaxilla forward with upper incisors which projects labially beyond
upper lip giving “ Dents Des Anglais Appearance ”
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44. FINGER SUCKING FROM BIRTH TO 4 YEARS:
New born infant have a relatively well developed suckling mechanism
and receives not only nutriment but also a feeling of euphoria, we
being, sense of security, feeling of warmth, and being wanted.
Lips of infants are sensory organ & pathway to brain is relatively well
developed
PHILOSOPHY OF SUCKLING:
Gum pads are apart – tongue brought forward in plunger like fashion –
tongue & lower lip in constant contact – mandible move up & down
in rhythm & forward & backward by virtue of flat condylar path as
buccinator mechanism alternately contracts & relax.
Conventional nipple dose not duplicates the suckling and thus it becomes
sucking.
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45. Breast fed babies have less abnormal perioral muscle habit & less
retained infantile swallow.
Habit continued to 3 years show a temporary damage confined to
anterior segment.
The damaging features of the habit are similar to characteristics of
typical hereditary pattern of class II Div 1 malocclusion. The
sequence of total maxillary protrusion to sucking habit with increased
pressure from buccinator mechanism activating the pterigomandibular
raphe just behind the dentition forcing the teeth anteriorly, with severe
openbite, buccal crossbite, protruding maxillary anteriors, mandibular
incisor crowding, tongue thrust retained infantile suckle swallow
pattern.
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46. ACTIVE FINGER SUCKING HABIT AFTER THE AGE OF 4:
- Ineffectual badgering attempt to break the habit continues it.
- The finger sucking is associated with perioral musculature with
increased overjet & makes normal swallowing pattern difficult with a
class II tendency. As swallowing requires “closing off ”to create a
partial vacuum, the lip muscle aberration is assisted by compensatory
tongue thrust during swallowing thus retarding deglutition maturation.
- Finger sucking habit becomes innocuous (only at bed time) but tongue
thrust continues to adapt to the morphology. Tongue does not drops
back & spread out with abnormal mentalis muscle function while
lower lip activity flattens the anterior segment.
- Fore finger sucking is considered to cause more severe deformation
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47. Effects of digit sucking :-
Maxilla :
- Proclination of maxillary incisors
- Increased arch length
- Increased anterior placement of apical base of maxilla with / without
midline diastema
- Increased SNA angle
- Increased clinical crown length of upper incisors
- Increased counter clockwise rotation of occlusal plane
- Decreased width of palate
- Atypical root resorption of primary central incisors
- Trauma to anteriors due to their prominence
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48. Mandible:
- Proclination of mandibular incisors
- Increased mandibular intermolar width
- Mandible more distally placed than maxilla
- Mandibular incisors experience a lingual and apical force
Interarch relationship:
- Decreased interincisal angle
- Increased overjet & decreased overbite
- Posterior crossbite & anterior openbite
- Narrow nasal floor & high palatal vault
- Uni / bilateral class II occlusion
Other effects:
- Affect psychological health
- Risk of malpositioning of teeth &jaw
- lisping www.indiandentalacademy.com
49. “Digit sucking is not directly involved with production of malocclusion”
Freudian belief holds that an abrupt interference with such a basic
mechanism is likely to lead a substitution of such antisocial
tendencies.
Cook measured the forces of thumb sucking & found 3 distinctly
different pattern of force application during sucking utilizing force
sufficiently strong to displace the teeth & deform the growing bone.
Melson found digit sucking & pacifiers to increase the tendency towards
abnormal swallowing.
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50. MUSCLE FACTOR:-
Teeth erupt in an environment of functional activity governed by the
muscle of mastication, tongue, face. The muscles of tongue, lip,
cheeks are important in guiding teeth into their final position,
variation in muscle for and function affect the position and occlusion
of the teeth.
All muscle exert their influence by virtue of their origin and insertion.
The muscles have their main origin on basal part of the jaw, so
position of jaw affect position and action of muscles which functions
on the teeth.
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51. 3. LIPS :
1. Vertical form of the lip: determine the amount of lip pressure on teeth
-ideal lip form
-lip competency
2. Sagittal form of the lip: determine the position of lip pressure on teeth
It is equally possible for the lip activity to produce class II / class III
relationships by altering the inclination of the incisor teeth during
eruption or to produce class I occlusion on class II / class III skeletal
relationship if the skeletal discrepancy is not severe.
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52. Function of the lips:-
- Modify erupting tooth position
- Govern the position of incisor teeth
- Lower lips lead to retroclination of incisors in normal function of
swallow, speech, smiling activities
- The ultimate position of teeth before and after the orthodontic
treatment is very much dependent on the lips
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53. In finger sucking the muscle activity accentuates the deformity.
Increase in overjet leads to lip incompetence & difficulty in creating
negative pressure for normal swallow.
Lower lip drops behind the upper incisors & thrust against it with
abnormal mentalis muscle activity to affect the closure.
Upper lip remains hypotonic, functionless, retracted, and short called as
“incompetent resting lip posture ”.
To create an anterior lip seal orbicularis oris mentalis muscle complex
contracts.
Thus the tongue thrust forward to aids in lower lip closing during
swallowing
Upper lip no longer serve as an effective restraining force, the lower lip
teaming with tongue exert a powerful upward & forward vector of
force against premaxilla thus enhancing the severity of malocclusion.
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54. This leads to protrusion of maxillary incisors & anterior openbite
This cycle repeats during each swallow.
Spontaneous drop of finger sucking habit leads to tongue thrust habit.
LIP SUCKING:
It results due to excessive overjet & difficulty in closing the lips
properly during deglutition.
It leads to flattening & crowding of lower anteriors with retraction while
maxillary incisors forced up & forward.
Vermillion border hypotonic & red with flaccid lip & accentuated
mentolabial sulcus.
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55. 4. TONGUE
In conjugation with lips and cheeks it is the other major guiding force for
the erupting teeth. The muscles of the tongue are attached to the
inner aspect of the mandible, hyoid bone, palate, styloid process and
affect the teeth by virtue of size, resting posture and function.
Resting position of the tongue:- is completely with in the dental arches
filling the space enclosed by teeth, some times it takes up the
adaptive postural position protruded between the teeth to touch the
lower lip in order to seal the front of the mouth
The essential features of normal swallowing are:
- Closure of the lips
- Teeth in light occlusal contact
- Tongue elevated to the palate
- Momentary clenching of teeth as food passes into the pharynx
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56. Adaptive swallowing involves tongue between teeth carried out with
buccal teeth apart or together.
1. Tooth apart adaptive swallow : tongue positioned between the
teeth so does not fill the upper arch – both muscle & air pressure in
upper arch reduced –narrowing of arch & buccal cross bite –full
vertical development of anterior dento alveolar segment prevented
by tongue – incomplete overbite.
2. Tooth together adaptive swallow : involves forward positioning of
teeth between incisors during swallowing – anterior open bite.s
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57. Tongue thrust is a retention of infantile suckling swallow, with eruption
of deciduous the tongue does not drops back & continue to thrust
Etiology of tongue thrust is :
- genetically inherent
- Learned behavior due to improper bottle feeding, tenderness of gums,
tonsilitis, upper respiratory tract infection
- Macroglossia
Malocclusion caused by tongue thrust are:
- Openbite (anterior / posterior)
- Proclination of upper anterior segment with spacing in canines &
incisors.
- Posterior cross bite due to narrow & constricted maxillary arch.
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58. Mechanism of action of malocclusion caused by tongue:
Tongue thrust forward continuously – increase in overjet and overbite –
peripheral position no longer lie on the lingual cusps of buccal
segment – posterior teeth erupt and gradually eliminate the inter
occlusal clearance – the postural resting vertical dimension and
occlusal vertical dimension becomes the same with posterior teeth in
contact all the time – leads to bruxism, bilateral narrowing of
maxillary arch, as the tongue drops down lower in the mouth –
providing less support to the maxillary arch – cross bites
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59. MOUTH BREATHING:
Caused in nasal passage obstruction / inadequacy.
Nasal obstruction:
- Enlarged turbinates : infection leads to hypertrophy of the mucosa
causing obstruction
- Adenoid hypertrophy : blocks the posterior nares leads to mouth
breathing. In enlarged tonsils soft palate rest on their upper poles
instead of dorsum of tongue thus displace tongue downward &
forward causing an open bite posture.
- Intranasl defect deviate the septum
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60. Altered respiratory pattern – mouth breathing – alter the posture of head,
jaw, tongue – alter the equilibrium of pressure of jaw teeth and growth
– lowers the mandible & tongue extends the face thus face height
increases – posterior teeth supra erupt – mandible rotate down and
back – increase in overjet and anterior open bite – narrow the
maxillary arch – adenoid face appearance – incompetent lips – short
upper lip – proclination and spacing in upper anterior teeth – lower lip
heavy and everted – mandible in distal rotation to maxilla – lower
anteriors elongate and touch the palatal tissue.
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62. ANOMALIES IN NUMBER OF TOOTH:
Heredity plays a strong part & some believe extra tooth as a left over
from the primitives.
High frequency of extra / missing tooth is associated with congenital
deformity e.g. clefts.
General pathosis also affect the number of teeth.
SUPERNUMERARY TOOTH :
- they vary in size, shape and location
- There is no definite time for its development may form prior to birth /
as late as at 10 – 12 years called as third set of teeth
- Commonly seen in maxilla in between central incisor
- Many a time they are well formed & so become difficult to identify
called as “supplementary teeth” in premolar region of near lateral
incisor www.indiandentalacademy.com
63. - Frequency seen is the mesiodens in midline palatal to maxillary
incisors, conical in shape with short root & crown, occasionally fused
with right / left central incisors
- Unerupted becomes generally cystic
- Some remain out of occlusion so have no deleterious effects & must
be left alone.
EFFECTS:
- Lead to deflection / noneruption of permanent central incisor or if
they erupt it is in malposed
- Permanent teeth fail to erupt due to presence of supernumerary teeth,
congenital absence, any mucosal barrier
- Delay the eruption of adjacent teeth
- Increase the arch perimeter (increase the overjet in maxillary arch &
decrease the overjet in mandibular arch )
- Crowding in dental arch
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64. MISSING TEETH:
- Called as partial anodontia / hypodontia
- Congenitally missing more commonly found than supernumerary.
- Order of frequently missing tooth
Maxillary & mandibular III molars
Maxillary lateral incisors
Mandibular II premolar
Mandibular incisors
Maxillary II premolar
- In congenitally missing tooth size tooth shape deformity is quite
frequent
- Congenitally missing are many a times bilateral e.g. mandibular II
premolar
- Partial / complete anodontia is rare.
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65. - Heredity plays a significant role
- Congenital absence seen commonly in permanent than deciduous
- When permanent missing roots of deciduous do not sorb
- In missing maxillary lateral incisor, permanent canine erupt mesial to
deciduous canine in space of missing teeth.
- Teeth are even lost in accidents
EFFECTS:
- Spacing
- Aberrant swallowing pattern
- Abnormal tilting & axial inclination
- The location of adjacent teeth
- Absence of permanent lead to over retained deciduous teethssssss
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66. ANOMALIES IN TOOTH SISE:
- In order to have normal occlusion there must be harmony in tooth size
& arch length
- Called as micro / macrodontia. True microdontia is rarely seen.
- Largely determined by heredity
- Microdontia seen with pitutary drawfism while macrodontia with
gygantism
- Greatly vary from individual to individual also within same individual
- Crowding is major characteristic
- The width is greater in male than in female, mainly seen in permanent
than in deciduous
- Canine show greater difference than lateral incisors e.g. peg laterals
- Frequently seen in mandibular premolar region
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67. - Developmental aberration are anomalous in shape / fused with
neighboring tooth
- Increase in tooth size lead to crowding
- decrease in tooth size leads to spacing.
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68. ANOMALIES IN TOOTH SHAPE:
- Most commonly seen is the peg lateral, small size leads to spacing in
anterior segment.
- Laterals also deform in the congenital clefts
- Japanese show pronounced cingulum, sharp marginal ridges, well
defined boundary to lingual fossa, this all together force the involved
tooth labially & prevent normal overbite & overjet
- Mandibular II premolar show maximum variation with extra lingual
cusp thus increasing mesiodistal dimension which reduces the space
that the loss of II deciduous teeth provide.
- Other anomalies are gemination, fusion, concresence, talon cusp,
dilaceration, amelogenesis imperfecta, hypoplasia, dens in dente,
odontomas, mulberry molars, hutchinson’s inciors.
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69. ABNORMAL LABIAL FRENUM
- labial frenum & midline diastema is a topic of controversy due to
incomplete understanding of role of heredity, tooth size, local habits,
process of growth & development
- Spacing in maxillary centrals & thick frenum is a chicken or egg
controversy.
- In the past frenum was needlessly clipped.’ thus in lack of
recognization of habit problems, tooth size discrepancy, congenitally
missing teeth, midline supernumerary tooth, clipping of frenum did a
little job.
- Now what exactly is normal?
- Faustin Waber noted some etiological factors like:
- Microdontia, macrognathia, supernumerary tooth, peg laterals,
missing laterals, heavy occlusal force against the lingual surface of
the maxillary incisors, habits, midline cyst.
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70. - According to Taylor interincisal spacing close without any
interference
- Existence of heavy fibrous frenum dose mot always mean spacing,
during ortho treatment frenum get atrophy.
- Frenum migrates superiorly enough at the age of 10 – 12 years
- Heredity plays an important role.
Age Incedence
of daistema
6 97%
6 – 7 88%
10 – 11 48 %
12 – 18 7 %
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71. PREMATURE LOSS OF PRIMARY TOOTH
- The primary are considered as space saver for permanent. If primary
tooth lost before crown formation completion & root formation begin
of permanent, bone reform atop it thus delay the eruption – adjacent
teeth drift in space.
- Caries play an important role in decreasing the arch length by
decreasing the mesiodistal dimension.
- Rate of loss of space is related to extraction age in maxilla but not in
mandible e.g. loss of first primary molars in maxilla block out
permanent cuspids while loss of maxillary II primary molar tends to
impact the II premolar.
- Molar & canine occlusal relationship is significantly affected by
premature loss of primary molars in either archeswww.indiandentalacademy.com
72. - Loss of PRIMARY INCISORS is of less concern but its loss before
permanent erupt – drifting of most distal teeth – malocclusion.
- Loss of PRIMARY CUSPIDS matter of great concern – as permanent
canine erupt late in maxilla & if lost before permanent central &
lateral erupt – permanent spacing seen in anterior segment with
labioversion of canine erupting due to no space.
- In mandible early loss – lingual tipping of anteriors with abnormal
mentalis muscle activity.
- Loss of FIRST PRIMARY MOLAR – permanent canine & I
permanent molar move mesially – I premolar not displaced as it is
narrow mesiodistally.
- In mandible – II primary molar shift forward at the time permanent
molar is erupting
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73. - Loss of SECOND PRIAMRY MOLAR – first permanent molar drift
forward & rotates mesiolingually – II premolar, canine shift distally
as it is wider mesiodistally the space get occupied with permanent
canines – incisors alter midline – canine erupt with no space to
occupy.
- In mandible – II premolar is last to erupt – block out the teeth – loss
of tooth substance is more important than the whole teeth as it
establish occlusal relationship & in maintenance of arch perimeter
- Loss of ONE OR MORE PRIMARY TOOTH – drifting with loss of
posterior support when mandible held in position to provide some sort
of adaptive occlusal function – result in crossbite – affects TMJ,
musculature, growth of facial bone, final position of permanent teeth
- Loss of PERMANENT TOOTH – upset physiological functioning –
break mesiodistal contact – shift
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74. According to Dewey after loss of primary molars the drifting of
permanent molar the factors related were
1. Leeway space – more drift occurred in arches with less leeway space.
2. Cusp height – high cusp height prevent drifting
3. Age when the primary teeth were lost – great loss occur when primary
molars lost before eruption of the permanent
Abnormal order lead to shift & loss of space
This will shorten the arch length, crowding, tip the contagious teeth,
over erupt the opposing teeth, cause further periodontal problem
Periapical pathology of primary teeth hasten the eruption of successors
due to loss of bone & increased vascularity
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75. PROLONGED RETENTION & ABNORMAL
ERUPTION OF DECIDUOUS TEETH
ETIOLOGY :
- Absence of underlying permanent successor
- Hypothyroidism
- Ankylosed deciduous tooth that fail to resorb
- Non vital deciduous
EFFECTS:
- Deflection in path of eruption
- Cross bite due to palatal eruption
- Impaction of permanent as its last tooth to erupt, space occupied by
deciduous canine is less, premolar migrate mesially leaving limited
space for canine, longest path of eruption its the only tooth to erupt
after root completion.
- Prolong retention lead to break in contact, rotationswww.indiandentalacademy.com
76. Any mechanical interference deflect an erupting permanent tooth
If the roots of deciduous not resorbed, permanent successor withheld
from eruption & defect into malocclusion
Some children are precocious & loss teeth early while other very
slow, both the patterns are normal
Gonadotropis hormone accelerates the dental development
Early maturation lead to crowding
Medicines like cortisone, steroids, metabolic, climatic, endocrinal
balance alter the pattern.
Many a times fragments of root remain n alveolar process that do not
resorb but deflect the permanent tooth.
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77. DELAYED ERUPTION OF PERMANENT TOOTH
- heredity plays an important role
- Hpothyroidism leads to absence of permanent, presence of
supernumerary, deciduous root pieces “road blockers”, mucosal
barrier, eruption force not vigorous, bony crypt, premature loss of
deciduous,
- early loss of deciduous lead to flaring & spacing which decrease the
space available for the permanent
- Odontomas, cyst, fibroma, tumor delay or malpose the teeth
- Ankylosed deciduous teeth
- Congenitally missing succedenous teeth
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78. ANKYLOSIS
- Called as partial anodontia, with union of roots and bone, occur at the
age of 10 – 12 years
- Due to injury to periodontal membrane, or if it get perforated, any
bony bridge forms joining lamina dura & cementum.
- Occur at buccal or lingual aspect.
- If left can cover the mucosa deflect / block the tooth.
- Accidents, trauma, endocrinal conditions, congenital diseases,
cleidocranial dysostosis , certain infections, in case of apisectomy.
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79. ABNORMAL ERUPTIVE PATHWAY
- Each tooth travel a distinct path till it erupts. But it can deviate due to
- Tooth bud displaced from its ideal location
- Presence of supernumerary odomtomas, cyst, tumors
- Unresorbed / retained deciduous tooth or root fragment
- True arch length discrepancy or excess tooth material
- Heredity cause crowding due to less space.
- A blow, mechanical interference by ortho treatment, early class II
treatment restrict the maxilla posteriorly so II molar erupt into
crossbite or impacted.
- Ectopic eruption mainly due to arch length deficiency e.g. maxillary
II deciduous molar
- Most commonly maxillary canine is in abnormal position.’
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80. DENTAL CARIES:
Premature loss of deciduous or permanent – drifting of adjacent teeth –
abnormal axial inclination – over eruption – bone loss – loss of arch
length – crowding – tilting of teeth, supra eruption.
IMPROPER DENTAL RESTORATION:
Improper proximal restoration – gingival inflammation, loss of
periodontal membrane attachment, mobility in tooth
Tight contacts lead to elongation of teeth, tilting.
Cross bite occur due to poorly placed restorations
Mechanical separation, large restorations, unnecessarily increases the
arch length
Under contoured proximal restoration decreases arch length while over
contoured occupy the space left out by deciduous
Premature contact – functional shift of mandiblewww.indiandentalacademy.com
81. BRUXISM / CLENCHING:
It was described by Marie in 1907. Called as psychogenic or idiopathic
functional aberration
Contraction of masticatory muscle, rhythmic side to side grinding,
gnashing of teeth during sleep cause malocclusion
EFFECTS
- Deep bite
- Malposed dental unit, Tooth mobility
- Non functional pattern of occlusal wear
- Pulp exposure
- Fracture of crown & root
- Muscular facial pain, tired ness, hypertrophy, incordination
- Locking of jaw, deviation
- TMJ pain and dysfunction
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82. ETIOLOGY:
GENERAL
- Psychogenic
- Environmental, heredity
- Nervous tension
- High strung person, excited children, athletes
- Nutritional deficiency, hyperthyroidism,
- Infections, GIT disturbances, enzymatic imbalance,
- Pubertal growth spurt
- Nocturnal : due to increased negative pressure in tympanic cavity from allergic
edema of Eustachian tube mucosa
- LOCAL
- Faulty restoration
- Traumatic occlusal relationship
- Functionally incorrect occlusion
- Cyst , faulty eruption of teeth
- “ Bruxism cause malocclusion or malocclusion cause bruxism is a chicken or egg
controversy ”
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83. CLASSIFICATION OF ETIOLOGY OF
MALOCCLUSION
The proposed classifications are:-
1. Bennet’s classification
2. The Graber's classification.
3. The Moyer's classification
4. The White & Gardener’s classification
5. The Salzmann's classification
6. The McCoy and Shepard’s classification.
7. The Strang’s classification
8. Some other classification.
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84. BENNETS’S CLASIFICATION
Sir Normal Bennet introduced a classification of abnormality of
occlusion based on their etiology;
Class I: abnormal position of one or more teeth due to local causes.
Class II: abnormal formation of a part of whole or either arch due to
developmental defects of bone.
Class III: abnormal relationship between upper and lower arches,
between either arch or facial contour and correlated abnormal
formation of the arch.
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85. Graber's Classification
General
-Heredity
-Congenital
-Environmental
Prenatal
Postnatal
-Predisposing metabolic
climate & disease
Endocrine imbalance
Metabolic disturbances
Infectious disease
-Dietary problems
-Abnormal pressure habits
& functional
-Posture
-Trauma &accident.
Local
-Anomalies of no.
Supernumerary teeth
Missing teeth
-Anomalies of tooth size.
-Anomalies of tooth shape
-Abnormal labial frenum: mucosal barriers
-Premature loss of deciduous teeth
-Prolonged retention
-Delayed eruption of permanent teeth
-Abnormal eruptive path
-Ankylosis
-Dental caries
-Improper dental restorations
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86. General factors will always be present producing ideal occlusion or same
occlusal variation & usually the major factors are interrelated.
The muscles are attached to the jaws & variation in jaw position
produces variation in muscle action. Variation in muscle activity alter
the relevance of variation in the size of dentition.
The local factors are present in isolation or in combination or may
superimpose on the adverse effect of one or more of the general factor
adding further complication to the occlusion of the teeth.
Final form of occlusion & position of teeth exhibit a wide range of
variation.
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87. Moyer’s Classification (1972):- (causes and clinical entity)
1. Hereditary :
a) neuromuscular system
b) bone
c) teeth
d) soft part (other than nerve And muscle)
2. Developmental defects of unknown origin
3. Trauma :
a) prenatal / birth injuries- hypoplasia of mandible, position of fetus
b) postnatal – fracture of jaw, teeth, habits
4. Physical agents:
a) premature extraction of primary teeth
b) nature of food
5. Habits
6. Diseases :-
a) systemic
b) endocrinal
c) local
7. malnutrition
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88. WHITE AND GARDINER’S CLASSIFICATION
A. Dental base abnormality: -AP malrelations
- Vertical / lateral malrelations
- Disproportion of size between teeth and basal bone
- Congenital abnormalities
B. Pre eruption abnormalities: -Abnormality in position of developing tooth germ
- Missing teeth
- Supernumerary teeth or teeth with abnormal form
- Prolonged retention of deciduous teeth
- Large labial frenum
- Traumatic injury
C. Post eruptive abnormalities: - premature loss of deciduous
- Extraction of permanent
- Active muscle force
- Resting position of musculature
- Suckling habits
- Abnormalities in path of closure
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89. Salzmann’s diagrammatic representation:-
ETIOLOGICAL FACTOR OF MALOCCLUSION
PRENATAL AND POSTNATAL
GENETIC ENVIRONMENTAL
DEVELOPMENTAL
CONGENITAL FUNCTIONAL
DIFFRENTIATIVEDIFFRENTIATIVE
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90. Genetic- transmitted by gene may / may not be present since birth.
Differentiative- engrafted on the body during the pre functional
embryonic developmental stage. May affect the whole body / only
teeth & jaw.
Congenital- may be hereditary / acquired, present since birth
Environmental-
General : diseases / radiation
Local : eruption anomalies
premature loss/ prolonged retention of deciduous
loss of permanent tooth
periodontal diseases & trauma, infections
harmful dentofacial pressure habits, TMJ disturbances
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91. Developmental:
General-
abnormality in relative growth rate in dentofacial region
hypo / hyper tonicity of muscles
childhood diseases, nutritional, endocrine & metabolic
disturbances
radiation /radiotherapy to mother or fetus
Local-
birth injuries
macro or micrognathia
micro or macro glossia
abnormal labial frenum
facial hemi atrophy
anomaly of tooth development & eruption
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92. Functional :
General:
hypo / hyper tonicity of muscles
neutrotropic disturbances
postual defects of tongue and jaw
masticatory disturbances
Local :
premature loss/ prolonged retention of deciduous
loss of proximal contacts
periodontal diseases & trauma, infections
harmful dentofacial pressure habits, TMJ disturbances
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93. According to McCoy & Shepard (1956)
- Indirect / predisposing causes:-
hereditary
congenital defect
prenatal abnormalities
acute or chronic infections
deficiency disease
metabolic and endocrinal disturbances
- Direct / determining causes :-
missing tooth
supernumerary tooth
transposed teeth
malformed teeth
abnormal labial frenum
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94. intrauterine pressure
sleeping habit
posture / pressure
abnormal muscular habit
malfunctioning muscles
premature shedding of deciduous teeth
tardy eruption of permanent teeth
prolonged retention of deciduous teeth
improper dental restoration
loss of permanent teeth
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95. STRANG’S CLASSIFICATION
Heredity
Prenatal influence bearing upon malocclusion.
1. Condition of the mother
a. Faulty diet.
b. Diseases of serious character.
c. Traumatism
2. Conditions in Embryo
a. Faulty position in utero producing localized
Pressure & tissue displacement.
b. Injury during development.
c. Hare lip & Cleft lip.
d. Injury at time of delivery.
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96. Postnatal causes of malocclusion.
Intrinsic
Premature loss of deciduous
The loss of permanent teeth.
Prolonged retention of the deciduous teeth.
Missing &supernumerary teeth
Environmental.
Systemic.
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97. One classification refers to:-
- Inherited or congenital:-
inherited from parents,
problems of tooth number and size,
congenital deformities,
condition affecting the mother during pregnancy,
fetal environment.
- Acquired :-
premature loss and prolonged retention of deciduous teeth,
habit
abnormal function
diet
trauma
metabolic and endocrinal disturbances
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99. ETIOLOGY OF CROWDING
1. Disproportion in arch size and tooth size or arch length discrepancy.
2. Prolonged retention of deciduous teeth.
3. Altered path of eruption.
4. Premature loss of deciduous teeth.
5. Delayed eruption of permanent teeth.
6. Presence of supernumerary teeth.
7. Trauma
8. Localized abnormal size and shape of the teeth e.g. fusion
9. Late horizontal growth of mandible
10. Mesial migration of buccal segment
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100. CAUSES OF SPACING
GENERALISED:
relative microdotia
oligodontia / partial anadontia
Large tongue
Suckling habits
LOCALISED:
Missing tooth
Undue retention of primary teeth
Deleterious sucking habit
Premature loss of permanent teeth
Localized soft tissue abnormalities
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104. CAUSES OF ANTERIOR OPEN BITE
1. Occur during normal closure of development of dentition
2. Disturbances in eruption of teeth and alveolar process (Ankylosis)
3. Mechanical interference with eruption and alveolar growth (finger /
thumb sucking / lip sucking habit)
4. Gross osseous dysplasia (micrognathia, mandibular hypertrophy)
5. Soft tissue factor (tongue thrust)
6. Dental factor (failure of alveolar development)
7. Skeletal factor (increased lower facial height, decreased ramal
height, increased maxillo mandibular lane angle)
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106. CAUSES OF DEEP BITE
1. Skeletal factor:
- Decreased lower facial height
- Increased ramal height
- Low maxillo mandibular plane angle
2. Dental factor:
- Increased interincisal angle
- Supra eruption of anterior teeth
- Under eruption of posteriors
3. Soft tissue factor:
- Lateral spreading and low tongue posture interferes with nsormal
eruption of the posterior teeth
- High lip line
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107. ETIOLOGY OF MALOCCLUSION
1. Class II Div 1:
- Hereditary
- Habits
2. Class II Div 2:
- Low tongue posture
- High lip line
3. Class III:
- True class III – hereditery
- Pseudo class III – occlusal prematurities
early loss of upper deciduous teeth
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108. BIMAXILLARY PROTRUSION
its a skeletal problem in which both maxilla and mandible have a
relationship more forward than normal with respect to cranial base,
with large SNA and SNB angle .
In true bimaxillary protrusion axial inclination of teeth are normal.
While in bimaxillary dental protrusion there is procumbancy of both
upper and lower teeth on the basal bone.
It is genetically predetermined.
Arise from mesial drifting of teeth in both the arches.
Commonly seen in negroids, Keralites.
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109. UNFAVORABLE SEQUELAE OF
MALOCCLUSION
Depending upon the severity of malocclusion and psychological frame of
the patient’s mind the sequelae can range from mild malocclusion to
severe psychological problems:
- Poor appearance of the patient
- Predisposition to periodontal disease, dental caries trauma
- Abnormal muscle function
- Abnormal oral function resulting from malocclusion
- Interference to normal growth and development
- TMJ problems
- Impacted / unerupted teeth
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110. Thank you
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