This document discusses interceptive orthodontics, which aims to recognize and eliminate potential irregularities in a developing dentofacial complex. It defines interceptive orthodontics and describes common procedures like serial extraction and correction of cross-bites. Serial extraction involves the planned extraction of certain teeth to guide the eruption of permanent teeth. Developing cross-bites should be intercepted early to prevent minor issues from becoming more severe malocclusions. The document provides details on the rationale, indications, contraindications, advantages and disadvantages of serial extraction procedures. It also discusses diagnostic assessments and popular methods like Dewel's method.

1. Good MorningGood Morning
Good Morning
www.indiandentalacademy.co
m

2. Interceptive OrthodonticsInterceptive Orthodontics
Dept. Of Orthodontics & Dento-facial OrthopedicsDept. Of Orthodontics & Dento-facial Orthopedics
www.indiandentalacademy.co
m

3. DefinitionDefinition
• Interceptive orthodontics has been defined
as that phase of science and art of
orthodontics employed to recognize and
eliminate potential irregularities and
malpositions of the developing dento-facial
complex
www.indiandentalacademy.co
m

4. ProceduresProcedures
• Serial extraction
• Corrections of developing cross-bite
• Control of abnormal habits
• Space regaining
• Muscle exercises
• Interception of skeletal malocclusion
• Removal of soft tissue of bony
barrier to enable eruption
www.indiandentalacademy.co
m

5. Serial ExtractionSerial Extraction
www.indiandentalacademy.co
m

6. Serial Extraction
Interceptive procedures initiated in early
mixed dentition
Recognize and anticipate potential
irregularities in dento-facial complex
Planned & Progressive extraction of
certain tooth
Guide the eruption of permanent teeth
www.indiandentalacademy.co
m

7. HistoryHistory
• Kjellgren (1929)- Gave the term
“Serial extraction”
• Nance (1940’s)- Popularized this
technique in US & termed as
“Planned & Progressive extraction”
• Hotz (1970)- Called this procedure
as “active supervision of teeth by
extraction”
www.indiandentalacademy.co
m

8. RationaleRationale
• 2 Basic principles:
– Arch length-tooth material discrepancy
– Physiological tooth movement
www.indiandentalacademy.co
m

9. Arch length-tooth materialArch length-tooth material
discrepancydiscrepancy
• Excess of tooth material as
compared to arch length
• Advisable to reduce the tooth
material in order to achieve stable
results
• Tooth material is reduced by
selective extraction the teeth, so
that rest of the teeth can be
guided to normal occlusion
www.indiandentalacademy.co
m

10. Physiological tooth movementPhysiological tooth movement
• Human dentition shows physiological
tendency to move towards the
extraction space
• Hence by selective removal of some
teeth, will guide rest of the teeth
which are in process of eruption into
the extraction space by natural
forces
www.indiandentalacademy.co
m

11. IndicationsIndications
• Class I malocclusion showing harmony
between skeletal and muscular system
• Arch length deficiency
•Absence of physiological spacing
•Unilateral and bilateral loss of
deciduous canines with midline shift
•Malpositioned or impacted lateral
incisors that erupt palatally out of
arch
•Crowded upper and lower anteriors
•Localised gingival recession in lower
anterior region (feature of arch length
deficiency)www.indiandentalacademy.co
m

12. •Mesial migration of buccal
segments
•Lower anterior flaring
•Abnormal eruption pattern and
sequence
•Ankylosis of one or more teeth
• Growth is not enough to over come the
discrepancy between the tooth material
and basal bone
• Patients with straight and pleasing
profile
www.indiandentalacademy.co
m

13. Contraindications of SerialContraindications of Serial
extractionextraction
• Class II, Class III skeletal
• Spaced dentition
• Anodontia / Oligodontia
• Open-bite/ deep-bite
• Midline diastema
• Class I malocclusion with minimal space
deficiency
• Unerupted malformed teeth E.g.
Dilacerations
www.indiandentalacademy.co
m

14. • Extensive caries or heavily filled Ist
permanent molars
• Mild disproportion between arch length
and tooth material that can be treated
by proximal stripping
www.indiandentalacademy.co
m

15. www.indiandentalacademy.co
m

16. Advantages of SerialAdvantages of Serial
extractionextraction
• Is more physiological Involves the
guidance of teeth to normal position, uses
physiological forces
• Physiological trauma associated with
malocclusion can be avoided by early age
treatment
• Eliminates or reduces duration of multi-
banded fixed therapy
• Better oral hygiene is possible  thereby
reducing risk of caries
www.indiandentalacademy.co
m

17. • Health of investing tissue is
preserved
• Lesser retention period is indicated
at the end of treatment
• More stable & harmonious results are
achieved between the tooth material
and arch length
www.indiandentalacademy.co
m

18. Disadvantages of SerialDisadvantages of Serial
extractionextraction
• Requires clinical judgment, no single
approach that can be universally applied
to all patients  Each patient has to
assessed and a suitable extraction
timetable has to planned
• Treatment time is long as treatment is
carried out in stages over 2-3 years
• Requires patient cooperation and regular
visits
• Extraction spaces are created 
Tendency of developing tongue thrustwww.indiandentalacademy.co
m

19. • Extraction of buccal teeth can result
in deepening of bites
• If procedures are not carried out
properly, risk of reducing arch length
by mesial migration
• Ditching or space exists between
canine and 2nd premolar
• Axial inclination of teeth may require
correction  Short term fixed
therapy
www.indiandentalacademy.co
m

20. Diagnostic proceduresDiagnostic procedures
Comprehensive assessment of dental, skeletal
& soft tissues
• Study model analysis determine arch
length discrepancy
– Lower  carey’s analysis
– Upper  Arch perimeter analysis.
– Mixed dentition analysis in determining
space for erupting
• OPG
– Evaluation of eruption status of dentition
www.indiandentalacademy.co
m

21. ProcedureProcedure
www.indiandentalacademy.co
m

22. ProcedureProcedure
Three of popular methodsThree of popular methods
Dewel’s method
Tweed’s method
Nance method
www.indiandentalacademy.co
m

23. Initial diagnosis made
when severe space
deficiency is documented
& there is marked incisal
crowding
The primary canines
are extracted to
provide space for
alignment of incisors
www.indiandentalacademy.co
m

24. Primary Ist molar are
extracted when ½ to 2/3 of
the first premolar root is
formed to speed the eruption
of Ist premolars
When the first premolar have
erupted they are extracted &
the canines erupt into the
extraction space. Residual
space is closed by
drifting/tipping of posteriorwww.indiandentalacademy.co
m

25. Dewel’s methodDewel’s method
• Three step method serial extraction
procedure
• Deciduous canines extracted – For alignment
of Incisors (8-9 yrs)
• A year later deciduous molars are extracted
-- Eruption of Ist premolars is accelerated
• Followed by extraction of erupting Ist
premolars – to permit permanent canines to
erupt in their place
www.indiandentalacademy.co
m

26. Modified Dewel’s technique- the first
premolars are enucleated at the time of
extraction of Ist deciduous molars
• Tweed’s method
– Around 8 yrs
– DC4
• Nance method
– D4C
• Grewes method
www.indiandentalacademy.co
m

27. Developing Cross-biteDeveloping Cross-bite
www.indiandentalacademy.co
m

28. Development of anterior cross-biteDevelopment of anterior cross-bite
• Anterior cross-bite is a condition
characterized by reverse over-jet where in
one or more maxillary anterior teeth are in
lingual relation to mandibular teeth
• Anterior cross-bite should be intercepted &
treated at early age – to prevent minor
orthodontic problem from progressing into
major dento-facial anomaly
• An old orthodontic maxim states “the best
time to treat cross-bite is the first it is
seen”
www.indiandentalacademy.co
m

29. Anterior cross-bite should be intercepted &Anterior cross-bite should be intercepted &
treated at early age because of followingtreated at early age because of following
reasonsreasons 
• This type of malocclusion is self
perpetuating  If present in deciduous
mar manifest in mixed & permanent
dentition as well
Simple anterior cross-bite that are not
treated early  have the potential of
growing into skeletal malocclusion
www.indiandentalacademy.co
m

30. Anterior cross-bite
Dento-alveolar Skeletal Functional
Reverse over-jet
Lingual relation
Usually Single tooth
Due to over-retained deciduous
Deflects permanent teeth palatally
Rx
Tongue blades
Catalans appliance
Double cantilever springs
with posterior bite plate
Pseudo Class III- Mandible is compelled to close
in a position forward of its true centric relation
As a result of occlusal pre maturities
Rx
Eliminating occlusal
pre-maturities
www.indiandentalacademy.co
m

31. Not the endNot the end
• Habits
• Space regainers
• And more
Coming up
www.indiandentalacademy.co
m

32. www.indiandentalacademy.co
m

33. Introduction, History & definition
Gum pads, Development of dentition
Mixed dentition & Permanent dentition
Functional development
Normal occlusion
Malocclusion, Classification
Etiology of malocclusion-Local & general
factors
Growth & development-Basic concepts &
theories
Pre & Post-natal development
Growth of maxilla & mandible
Clinical implications of growth &
development
Preventive & interceptive orthodontics
www.indiandentalacademy.co
m

34. www.indiandentalacademy.co
m