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1. Interceptive
orthodontics
Dr.Zana Hussein Aziz
BDS MSc Orthodontics
Email: zana.aziz@spu.edu.iq

2. • Definitions
• Steps in interceptive orthodontics
• Serial extraction
• Muscle exercises
• Removal of soft / hard tissue barriers
• Management of ectopic eruption
• Management of missing permanent teeth
• Resolution of crowding
CONTENTS

3. CONTENTS
• Correction of midline diastema
• Correction of developing crossbite
• Functional appliances
• Orthopedic appliances
• Maxillary intrusive splint
• Pre orthodontic trainer
• Bent wire system
• Invisalign
• Conclusion
• References.

4. DEFINITION- AAO (1969)
• That phase of the science & art of orthodontics
employed to recognize & eliminate potential
irregularities & malpositions in the developing
dentofacial complex.

5.  “Interceptive orthodontics” basically refers to
measures undertaken to prevent a potential
malocclusion from progressing into a more severe
One.
 Is undertaken at a time when the malocclusion has
already developed or still developing.
 Procedures, are aimed at elimination of factors,
that may lead to malocclusion.

6. Serial extraction
Dev. Cross bite
Abnormal habits
Space regaining
Muscle exercises
Removal of barrier-
eruption
Interceptive
Orthodontics
Interception of
skeletal
malrelation

7. SERIAL EXTRACTION
Historical review-
Kjellgren (1929) : Serial extraction
Hotz (1970) : Guidance of eruption
Palsson & Bunon: (1743) first ref to the extraction
of deci teeth (Publication- Diseases of Teeth)
Nance (1940) : popularized the technique
Father of serial extraction

8. SERIAL EXTRACTION
• DEFINITION:
– Dewel (1967) : orderly removal of selected primary
& permanent teeth in predetermined sequence
-Tweed : planned & sequential removal of primary
& permanent teeth to intercept & reduce dental
crowding problems

9. I: On the basis of hereditary determined tooth
size arch length discrepancy:
Midline line shift of
mandibular Incisor…
premature exfoliation
of pri C
INDICATIONS

10. 2. Gingival recession on a
labially displaced
incisor.
3. Crowded maxillary or
mandibular teeth that
are excessively
inclined labially.

11. 4. Labially but unerupted
permanent canine that are
extremely prominent.
5. Splayed out perm Max /
Mandi Incisor due to crowded
position of unerupted canines

12. 6. Unusual shape, size and no of teeth.
7. Ectopic eruption of maxillary 1st molar
8. Premature loss of primary canine
9. Abnormal / pathological root resorption of primary canine.
10. Crowded anteriors

13. 1. Unusual resorption
pattern of certain
primary teeth.
2. Aberrant eruption
pattern of perm teeth
II : Indications due to loss of arch
length :

14. 3. Prolonged
retention of
primary teeth /
ankylosis
4. Transposition

15. 5. Rotation of teeth
6. Suppression of primary
teeth

16. CONTRAINDICATIONS
1. Skeletal Class II and Class III malformation.
2. Spaced dentitions
3. Anodontia / oligodontia
4. Open bite & deep bite
5. Midline diastema
6. Class I malocclusions with minimal space def.
7. Unerupted malformed teeth Eg: dilacerations
8. Mild disproportions b /w arch length & tooth material
that can be treated by proximal stripping.

17. DIAGNOSTIC RECORDS
Intra oral radiographs:
Panoramic radiograph
Cephalometric radiographs:
Facial Photographs:
Study models
Model analysis

18. IOPA radiographs:
Detection of congenital absences of teeth.
 Detection of supernumerary teeth
Calculations of total space analysis.
Determine the root resorption before & after treatment.
Determine size, shape, relative position of perm teeth.
Detection of pathologic conditions in the early stages
Eruptive patterns of the unerupted teeth

19. Cephalometric radiographs:
 Evaluation of craniofacial relationship before treatment
 Assessment of soft tissue matrix.
 Classification of facial patterns.
 Calculation of tooth –size / jaw- size discrepancies.
 Prediction of growth & development
 Detection pathologic conditions before, during and after treatment.
 Determination of mandibular rest positions

20. Facial photographs
 Evaluation of craniofacial (&dental) relationships& proportions
before treatment.
 Assessment of soft tissue profile.
 Proportional facial analysis & Total space analysis
 Monitoring treatment progress.
 Study relationships before, immediately following & several years
treatment.
 Detecting & recording facial asymmetry.
 Identifying patients
Intra oral photographs

21. 1. Total space analysis.
2. Dental anatomy.
3. The intercuspation.
4. Arch form.
5. Curves of occlusion
6. Measure progress during
treatment
7. Evaluate occlusion
ABO specifications:
Study models:

22. Space analysis:
Conventional method
• Space required-four mandibular incisors were measured at MD crown
diameter by means of boley gauge.
• The values for unerupted canine and premolars were obtained by
measuring their MD on the image on the periapical radiograph.
• To reduce the radiographic enlargement the formula recommended
by Huckaba is.
(y)(x')
• X= y’
• X-is the estimated size of the permanent tooth.
• X’ –the radiographic size of the permanent teeth.
• Y-is the size of the primary second molar on the cast.
• Y’-is the radiographic size of the primary molar.

23. • Space required –MD width of mandibular incisors on
the cast and canine and premolar on the radiograph
were added.
• Space available-obtained by extending brass wire
from the mesiobuccal of the first permanent molar
on one side to mesiobuccal of the molar on the
opposite side.
• The difference in the value obtained for space
required and space available was the amount of the
discrepancy.

24. ADVANTAGES OF SERIAL
EXTRACTION
 Removal of deciduous canines….
 Extraction of deciduous 1st
molar….
 Extraction of first premolar before crowding allows…
 It lessens the period of future appliance therapy and
cost of treatment.

25. ADVERSE EFFECTS
First (Dewel-1967), tendency of developing
anterior deep bite following loss of posterior teeth.
Second side effect is failure of premolars to reach their normal
occlusal level.
Third : Effect of Serial Extraction has on facial esthetics.
The over emphasis on straight profile…..
Lip fullness is not a reliable criterion
The straight profile must be viewed with greater concern
because early removal of premolars…

26. Fourth : Nasal development is another unpredictable hazard
Unrestrained extraction will accentuate nose prominence
by reducing skeletal development in dental area.
Moreover growth of chin is unpredictable. If growth in nose
and chin exceeds normal range a concave profile is
obtained.

27. Most common & accepted
sequences:-
1. Tweed’s method
2. Dewel’s methd
3. Nance’s method
4. Grewe’s method

28. Dewel’s Method: 1978 (CD4)
– There are 3 stages in Serial Extraction Therapy:
• Removal of deciduous canines:
• Removal of first deciduous molars:
• Removal of erupting premolars:

29. REMOVAL OF DECIDUOUS
CANINES
 Extraction 8-9 yrs.

30. Removal of primary 1st
molars

31. REMOVAL OF ERUPTING
PREMOLARS

32. TWEED’S SEQUENCE OF
EXTRACTION (1966)
• Sequence is :DC4
– At approx 8 years all deci 1st molars are extracted.
– Deciduous canines maintained to retard eruption of
permanent canines.
– 1st premolar –in advanced eruptive stage- crown above alv
bone.
– Deciduous canines along with first premolar are extracted

33. Treatment procedure in class I
malocclusion
 Group A - Anterior discrepancy : crowding
 Group B - Anterior discrepancy : Alveolodental protrusion
 Group C - Middle discrepancy : impacted canine
 Group D - Enucleation in mandible
 Group E - Enucleation in mandible & maxilla
 Group F - Alternative to enucleation
 Group G - Interproximal stripping
 Group H- congenital absence

34.  Closure of Residual Xn spaces
 Improvement in axial inclination
 Correction of rotation
 Correction of Midline discrepancy
 Correction of residual overbite and overjet
 Correction of cross bites
 Improvement in arch form
Advantages of mechanotherapy

35. MUSCLE EXERCISES
 The dental tissues are blanketed from all directions
by the muscles
 Normal occlusal development depends on normal
oro-facial muscle function.
 Muscle exercises helps in improving aberrant muscle
function.

36. 1. Exercise for the masseter muscle:
2. Exercise for the lips:
 Stretching of upper lip to maintain lip seal for
short hypotonic lips
 Holding a piece of paper between lips
 Holding and pumping of water back and forth
behind the lips.
 Massaging of lips
 Scotch tape
 Button pull exercise:

37. 3. Exercise for the pterygoid muscles:
4. Exercise for the tongue: (5/16 inch intra oral elastic)
One elastic swallow:
Tongue hold exercise:
Two elastic swallow:
The hold pull exercise: tongue tie exercise

38. Limitation of muscle exercises
• Does not drastically alter any growth pattern
• Are not substitute for corrective orthodontic
treatment
• Pt compliance is extremely important

39. • Retained deciduous teeth
• Supernumerary teeth
• Fibrous/ Bony obstruction of the erupting
tooth bud
• Impacted teeth
REMOVAL OF SOFT /HARD TISSUE BARRIERS IN
THE PATHWAY OF ERUPTION

40. ECTOPIC ERUPTION
Lateral incisors… crowding..aberrant tooth positioning
Lingual arch with spur to….
Already midline shift…. BALANCED EXTRACTION
• Prevalence 2-3%
• Maxi
• Boys
• 2/3rd
of….

41. ECTOPIC ERUPTION OF 1ST
PERM
MOLAR
waitful watching
3-6 month
pulpo..SS crown on 2nd
molar
supplemented with band material
extending subgingivally
Difficult to do
Orthodontic elastic separators Replacement at 1-2wks..2mnths
Brass ligature wire Periodic tightening 3-5 day interval
Safety pin spring Gentle forc exrted, distally helps..
Humphrey appliance-S shaped loop
-helical springs
Continual forc, easy reactivation,
bonded composite to engage..
Halterman appliance Elastomeric chain, changed
monthly
Removal of 2nd
primary molar extensive resorption..distal shoe;
regain space

42. Management: arch length, adjacent tooth morphology and
colour,incisor position and esthetics
MISSING PERMANENT TEETH
Congenitally missing LATERAL
INCISOR
Canine erupts normally
resin bonded bridge,
conventional bridge or implant
Canine erupts in lat incisor position moved back…bridge or implant
Substitution of canine with lateral
incisor
recontouring to improve
esthetics
Congenitally missing LI transplanted posterior
teeth..premolars…reshaping
Congenitally missing PREMOLAR
substitute primary molar
ankylosis and root resorption…
exn
primary molar removed space closed ortho…
resin bonded bridge,
conventional bridge or implant

43. Resolution of crowding
Anterior segment- incisal liability
Posterior segment- leeway space of nance
Management:
1. Observation
2. Disking of primary teeth-hand held strip, tapered bur in a high
speed handpiece
3. Extractions and serialextraction
4. Corrective orthodontic referral

44. MAXILLARY MIDLINE DIASTEMAS
Frenum Attachments Diastema should be closed first..
Scarred tissue….
Supernumerary teeth Removal without causing injury to
perm teeth..
Early removal..erupt normally..space
closes spontaneously
Faciolingual positioning Active labial bow.. Acrylic removed
from palatal side.. 2mm/mnth
Very protrusive Fixed orthodontic
appliances..rectangular arch wires
Faulty mesiodistal positioning (tipping)Finger spring appliance..
2mm/mnth
Shud not take more than 2 mnths.
(bodily) bonded brackets with
elastomeric chain

45. Correction of developing Anterior
and Posterior Cross Bites
• Eliminates functional shifts and wear on the erupted permanent teeth
• Dentoalveolar asymmetry
• Increases circumference and provides more room for permanent teeth

47. ANTERIOR CROSSBITES
tongue blade therapy/ popsicle
stick therapy
20 times before each meal,pt
counting to 5 each time..shud b done
several times, at certain periods of d
day
Anterior inclined plane 45degree to the long axis of lower
inci
1/4th
inch post.. bite jumping wthn 1
week.. results wthn 2 wks
Doubl helical spring- activated 2 mm to provide 1 mm of
tooth movmnt per month
Mild rotation..
POSTERIOR CROSSBITES
Cross arch elastics Isolated molars in 4-8 weeks
Fixed palatal wire designs
W arch
Quad helix
Slow expansion
4-5 mm of buccal expansion in 4-6
wks..left behind for 3 months
Fixed jackscrew expanders
HYRAX, RPE
1-2 turns per day for 4 weeks(1
turn=0.25mm)

48. INTERCEPTION OF SKELETAL
MALOCCLUSION
Skeletal class II mal due to max
prognathism
Restricted max growth using
headgears
Skeletal class II mal due to mand
retrognathism
Myofunctional appliance to promote
mand growth
Skeletal class II due to mand
retrognathism & max prognathism
Myofunctional appliances to promote
mand growth & headgear to restrict
max growth
Sk class III due to mand prognathism Chincup therapy to restrict mand
growth
Sk class III due to max retrognathism Myofunctional appliance to promote
max growth & face mask therapy
Sk class III due to max retrognathism
& mand prognathism
Face mask therapy & chin cup to
restrict max growth

49. FUNCTIONAL APPLIANCES
• Myofunctional appliances - harness the muscle
pressure
• Functional appliances- elicit certain natural
functions of the orofacial region

50. • Functional appliances are conceptually based
on Moss’ functional matrix theory
Form follows function
BACKGROUND

51.  These appliances either transmit, eliminate or
guide the natural forces of the masculature.
 Are used for growth modification procedures that
are aimed at intercepting and treating jaw
discrepancies
They bring about following changes:
An increase or decrease in jaw size.
A change in spatial relationship of the jaws
Change in direction of growth of the jaws
Acceleration of desirable growth

52. classifications
I) Tom Graber, when functionals were removable:
Group A- teeth supported appliances eg.
Catalans, inclined planes, etc.
Group b- teeth/tissues supported appliances.
Eg. Activator, bionator, etc.
Group c- vestibular positioned appliances.
With isolated support from tooth / tissue eg. Oral
Screens, frankel, lip bumpers.

53. classification
II) With the advent of fixed functionals another classification
evolved:
A)Removable functionals eg. Activator, Frankel etc.
B)semi fixed functionals eg. Den holtz, Bass appliances.
C)fixed functionals eg. Herbst, Jasper jumper, MARA, etc.

54. classification
III) With the awareness & acceptance of the concept of
hybridism by Peter Vig, functionals could be further
classified as
A)classic functional appliances like
Activator, Catalans, Frankel etc.
B)hybrid appliances like Propulsor, Double Oral
screen, Hybrid bionators, bass appliance.

55. classification
IV)
1) Tooth borne passive appliances- myotonic appliances
Eg. Andresen/Haupl activator, Herren activator, Woodside activator
Balters bionator etc.
2) Tooth borne active appliances- myodynamic appliances
Eg. Elastic open activator (EOA), Bimler appliances, Modified bionator,
Stockfish appliances, Kinetor,etc.
3) Tissue borne passive appliances.
Eg. Oral screens, Lip plumpers
4) Tissue borne active appliances
Eg. Frankel’s appliances
5) Functional orthopedic magnetic appliances (FOMA)

56. ORAL SCREEN (NEWELL 1912)
MODE OF ACTION
 both the principles of force application n elimination

57. Indications :
 Interception of habits like –
 Correction of mild disto-occlusion
 Muscle exercises for correction of hypotonic lip & cheek
muscles.
 Correction of mild anterior proclination.
Fabrication :
 Impression
 Sealing of cast in occlusion
 Covering of labial surfaces of teeth & alveolar process with
wax of 2-3mm thickness.
 Fabrication of appliance with self cure or heat cure resin.
Patient is asked to wear the appliance in the night & 2-3 hrs
during the day time.
Seen about once every 3 weeks or a month

58. Modification of vestibular screen
1. Hotz modification- metal ring- muscle
exercises
2. Double oral screen- tongue thrust
3. With holes- mouth breathers

59. LIP BUMPER
• Combined removable fixed appliance
• Muscular force application or force elimination
• Both maxilla and mandible
• USES:
o Lip sucking
o Hyperactive mentalis- crowding of lower ant
o Distalization of first molars
Maxillary arch- Denholtz appliance

60. Appliance design

61. ACTIVATOR
Kingsley 1879 : Vulcanite palatal plate.
Hotz : Vorbissplate
Perrie Robin- Monoblock
Viggo Andreasen 1908 :Biomechanical working retainer
Along with Karl Haulp - Norwegian appliance
It was named activator because of its ability to activate
muscle forces.

62. MODE OF ACTION
1. Myotactic reflex- Introduces a new pattern of mandibular
closure
2. Condylar adaptation- Backward & upward growth
3. Force generated while swallowing & sleep
INDICATIONS:
Class II, div 1 malocclusion.
Class II, div 2
Class III malocclusion
Class I, open bite
Class I, deep bite
Post treatment retention.
Children with decreased lower facial height.

63. Fabrication of appliance
• Impression
• Bite registration
• Articulation of the model
• Preparation of wire element- labial bow-0.8 or
0.9mm wire
• Fabrication of acrylic portion
o Maxillary part
o Mandibular part
o Interocclusal part

64. CONSTRUCTION BITE
• Mandible is advanced by 4-5 mm and bite opened by
2-3 mm
• General considerations-

65. Trimming of the activator
• For vertical control
 Intrusion of teeth-
 Extrusion of teeth-

66. • For sagittal control
Class II correction
Protrusion & retrusion of incisors

67. • For transverse control - Jack screw is incorporated
Management:
• 1st
week: 2-3 hrs during day
• 2nd
week: full night + 1-3 hr each day
• 3rd
week: appliance is checked to evaluate the trimming
• Every 6 weeek: check up appointment

68. MODIFICATIONS
• Bow activator of Schwarz
• Wunderer’s modification
• Propulsor
• Reduced activator or cybernator of Schmuth
• Cutout or palate free activator
• Karwetzky modification
• Herren’s modification

69. BIONATOR (BALTER 1950)

70. Philosophy of bionator
• Does not activate the muscle

71. ACTIONS OF THE BIONATOR
 Causes sagittal repositioning of mandible thereby increasing
the oro functional space.
 Causes anterior positioning of the tongue
 prevents the external unfavorable muscle forces by means of
vestibular arch and its buccal extension.
 Intrusion and extrusion of teeth

72. Types of bionator
• Standard appliance
• Open- bit appliance
• Class III or reverse bionator

73. OPEN BITE APPLIANCE
• The interocclusal bite blocks prevent the extrusion of
posterior teeth.
• prevents thrusting of tongue

74. CL III OR REVERSED BIONATOR

75. FUNCTIONAL REGULATOR
FRANKEL’S PHILOSOPHY AND MODE OF ACTION
1. VESTIBULAR ARENA OF OPERATION
Dentition is influenced by peri-oral muscle function.
Abnormal peri-oral muscle function creates a barrier for
the optimal growth of the dento-alveolar complex.

76. FRANKEL’S PHILOSOPHY
2) Sagittal correction via tooth borne anchorage
3) Differential eruption guidance
4) Periosteal pull by buccal shields & lip pads
5) Minimal maxillary basal effect

77. • Frankel-Ia
– class I malocclusion, minor to moderate crowding & deep
bite cases.
• Frankel-Ib
– class II, division 1 malocclusion
– overjet < 7mm.
Types of Frankel appliances

78. • Frankel-Ic
– Cl - II division 1 malocclusion
– overjet >7mm.
• Frankel-II
– CL-II and division 1 & 2
– Is modified by adding a stainless
steel protrusion bow behind the
maxillary incisors.
Types of Frankel appliances

79. Frankel-III - CL-III malocclusion.
 lip pads are situated in the maxillary vestibular labial sulcus.
 Labial bow rests against the mandibular teeth
 There is a protrusive bow similar to that of Frankel-II
Types of Frankel appliances

80. FRANKEL-IV
 correction of open bite & to a lesser extent in
bimaxillary protrusion.
 redirect the mandibular growth from a downward &
backward growth rotation to a upper and forward
rotation.
Frankle V
• Used along with headgears

81. TWIN BLOCK APPLIANCE
• Occlusal inclined plane is the fundamental functional
mechanism of the natural dentition.
Class I Class II

82. MODE OF ACTION OF TWIN BLOCK
 The unfavourable cuspal contacts of the distal occlusion are
replaced by favourable proprioceptive contact on the inclined
plane of Twin block
 Due to the inclined plane effect a mesial component of force
is created

83. Case Selection
• Angles class II div I with good arch form
• Arches that uncrowded or decrowded
• overjet10-12mm & a deep overbite
• VTO positive
• Actively growing individual
Angulation of inclined plane
• 70 degree- more horizontal
component of force- encourage
fwd mand growth

84. Stages of treatment
• Active phase – 6-9 months
• Support phase- 3-6 months
• Retention phase- 9 months
• avg- 18 months
• 8-10 hours a day
• 2-3 months

85.  Emil Herbst (1900s).
 Pancherz 1982 & McNamara 1990 - both skeletal and dental
adaptations
 This was previously used in the mixed dentition period but
now primarily used as an appliance in permanent dentition.
HERBST APPLIANCE

86. holds lower jaw in a forward position
while pushing the upper jaw backward.
INDICATIONS
 In class II due to retrognathic mandible
 As an anterior repositioning splint in pt
having TMJ disorders
 Uncooperative pts
 Post adolescent …

87. TREATMENT EFFECTS
 Class II to class I molar relation
 Increase in mand growth
 Distal driving of max molars
 Overjet reduction
 An inhibitory influence on sagittal max growth

88. JASPER JUMPER
 J.J Jasper 1980
 MOA -Similar to that of Herbst
appliance.
 A coil spring is used instead of rigid
telescopic unit as in case of Herbst
appliance .
INDICATIONS:
 Skeletal class II malocclusion with
maxillary excess & mandibular def.

89. Acc Sassouni et al- 1972
• Orthodontic therapy- aimed at correction of
dentoalveolar malocclusion
• Orthopedic therapy- correction skeletal imbalance
with correction of any dentoalveolar malocclusion
being of less importance
• Orthopedic forces are heavier (400gm) when
compared to orthodontic forces( 50-100gm)
ORTHOPEDIC APPLIANCES

90. Basis for orthopedic appliances
• Makes use of teeth as a “handle” to transmit forces
to the underlying skeletal structures.
1. Amount of force -400-600gm/side
2. Duration of force- 12-14hrs /day
3. Direction of force- posteriorly &superiorly through
the centre of resistance of the maxilla.
4. Age of the patient-
5. Timing of force application-

91. Orthopedic appliances
• Headgear
• Facemask
• Chin cup

92. HEAD GEARS
Distalize the maxillary dentition or maxilla it self.
 350 -450 gms on each side for 12-14 hrs / day.
COMPONENTS :
 Force delivering unit- Face bow, J hook
 Force generating unit ( elastic / springs )
 Anchorage unit ( head strap/ cervical strap )

93. Types
1. Cervical headgear-
2. Occipital headgear
3. High pull(parietal )
4. Combination pull

94. CHIN CUP THERAPY
Objective - to provide growth inhibition or redirection
& posterior positioning of mandible.

95.  A force is usually directed through the condyle or
below the condyle.
 Most studies recommend an orthopaedic force of 300 to 600
g per side (AJO 1987).
 Patients are instructed to wear the appliance 12-14 hrs/day.

96. Ideal patient for chin cup-
Acc to T M Graber
• A mild skeletal problem with the ability to bring incisors
edge to edge or nearly so
• Short vertical facial height
• normally positioned or protrusive , but not retrusive lower
incisors
Types of chin cup
1. Occipital pull chin cup-
Classs III with mild to moderate prognathism
pt with short facial height also benefits from yhis type
2. Vetical pull chin cup- high angle cases or long face patients

97. PROTRACTION FACE MASK
 Hickham 1972.. Reverse head gear
 Mainly used to pull the max ahead simultaneously pushing
the mandible distally.
 250gm per side for 13 months
 12-24 hrs/day.

98. MAXILLARY INTRUSIVE SPLINT
• Indication –severe “gummy” class II div 1
malocclusion
• It reduces the visibility & vulnerability of the
maxillary incisors by
 Achieving intrusion of max teeth
 Restraining the max growth
 Forward mandibular rotation

99. MAXILLARY INTRUSIVE SPLINT
FABRICATION-

100. PRE ORTHODONTIC TRAINER

101. Technical Features
1.Tooth channels
2. Labial bows
3.Tongue tag
4.Tongue guard
5. Lip bumpers
6. Jaw repositioning
Tooth guidance
system
Myofunctional
Training
Jaw positioning /
Functional appliance
116

102. Phase 1
 Soft : maximum compliance & flexibility
 Adapts to severe dental alignment
 made of Silicone
Recommended use :
Every day for 1 hr plus overnight while
the child sleeps
Duration : 6 – 8 months
117

103. Phase 2
Duration : 6 – 12 months
 much stiffer
 same principle as orthodontic arch wire
 Made of polyurethane
118

104. The TRAINER System™
T4K™ - The Pre-orthodontic TRAINER™.Improves
facial & dental development in the growing child
(mixed dentition).
T4A™ - Aligns and retains anterior teeth in the per
manent dentition.
INFANT TRAINER™ - For habit correction.To assist
development of teeth & jaws in the growing child.
119

105. The TRAINER System™ cont’.,
T4B™ - The TRAINER for Braces.Shields the soft
tissue from brackets.
T4CII™ - The TRAINER for Class II Correction.
Jaw alignment in combination with fixed
orthodontics.
LINGUA™ - Train the Tongue Day & Night.tongue
retraining.
120

106. The FARRELL BENT WIRE System
The BWS™ allows arch development and anterior dental alignment to be
combined without encroaching on the natural position of the tongue.
Therefore the force of the…….. allowing the BWS™ to use very light forces.
Fabrication:

107. Uses:
Dental arch alignment
Along with trainer for treatment of habits
Advantages:
Eliminate speech and functional problems
Fixed; no patient compliance
Stability..along with trainer
No lab work…..
Cost effective
Management:
Follow Up Visits Every 2 - 3 Weeks
Activation at the loops should be no more than one
millimeter initially then subsequently 1–2mm every three to four
weeks.
Open the loops bilaterally with Adams pliers at the base of the loop
and place a compensating bend……

108. THE MYOBRACE SYSTEM
Features 2 main elements-
• A soft flexible outer , &
• Dynamicore- a hard
inner core- produces
positive arch
development & tooth
alignment
• Used in late mixed &
early permanent
dentition

110. Interceptive series- i-3
1: A Frankel cage for maxillary development, with an offset
Class I/II incisor preset.
2: High extended “reflex” sides to discourage anterior
mandibular posture.
3: Positive tongue position elevator to raise tongue position in
conjunction with the tongue tag used in the Pre-Orthodontic
TRAINER™ (T4K™)..

111. • custom-made series of
aligners .
• These aligner trays are made
of smooth, comfortable and
virtually invisible plastic .
• Wearing the aligners will
gradually and gently….
• You just pop in a new set of
aligners approximately every
two weeks, until your
treatment is complete.
INVISALIGN

112. SOME OF THE INTERCEPTIVE
CASES OF OUR DEPARTMENT

113. Correction of anterior crossbite
Prarthana 7/F.. Tongue blade theray
Chitra 9/F.. Hawley’s with expansion screw

114. Kavana 8/F.. Anterior inclined plane

115. Management of Class I malocclusion with crowding using Trainer
Usha 12F
Pre op
Post op

116. Arch expansion using Bent Wire System for management of crowding
Brunda 11/F

117. CONCLUSION
“The earlier treatment begins, the more the
face will adapt to your standards, the later
treatment begins the more your standards will
have to adapt to the face.”
C.Gugino

118. REFERENCES
 Orthodontics current principles: 4th
edition- T.M.Graber
 Hand book of orthodontics : 4th
edition - Moyers
 Contemporary orthodontics : 4th
edition - Proffit
 Dentistry for child and adolescent : 9th
edition - R.J.
McDonald
 Textbook of orthodontics:2nd
edition- Gurkeerat singh
 Orthodontics : 3rd
edition - SI.Balajhi
 Functional appliances in orthodontic treatment- An atlas
of clinical prescription & lab construction. Harry S Orton

119. Clinical Pedodontics: 4th
edition –Finn
Textbook of pedodontics:2nd
edition- Tandon
Occlusal guidance in pediatric dentistry – Nakata
Pediatric dentistry .infancy through adolescence: 4th
edition –
Pinkham
Google search
Myobrace.com
REFERENCES

120. THANK
YOU