Orthodontics deals with correcting irregularities of the teeth and jaws to improve appearance and function. It has its origins in ancient practices but was recognized as a specialty in the 19th century. The goal of orthodontic treatment is to achieve structural balance, aesthetic harmony and functional efficiency as described by Edward Angle, who is considered the father of modern orthodontics. Treatment may involve appliances like braces to align the teeth or surgery to correct severe malocclusions.

2. Orthodontics
Introduction and Brief History
Dr. Poorvi Harmani
MDS (ORTHO)

3. • “Heritages of the past are the seeds that bring forth the harvest
of the future.”
• “not to know what has been transacted in former times is to
continue always as a child. If no use is made of the labors of the
past ages, the world must remain in the infancy of Knowledge.”
Cicero, the great Roman

4. • Orthodontic: Greek derivative
– Ortho – Straight
– Dontic -- dentition

5. Definition
• -- A Branch/ specialty of Dental science that deals
with genetic variations, development and growth
of the facial form.
• -- It is also concerned with factors affecting
occlusion and function of associated organs.

6. Thus Orthodontic is concerned with
1.Treatment of Irregularities
2.Growth, development and function of the whole
Oro-facial complex

7. :. Aim is to have improved occlusal function
by correcting and better the dental health
and improved esthetics

8. Possible Types of harms DUE TO
ORTHO TX
1. Worsened dental arrangement
2. Worsened facial profile
3. Unsighty residual gaps resulting from
inappropriate extractions
4. Non-compliance of patient

9. Patient Non-Compliance
RESULTS IN:
1. Cavities damaging the teeth
2. Gingival damage resulting in periodontal
problems
3. Decalcification of enamel due to poor oral
hygiene

10. Role of the General
Dentist in Dental wellbeing
1. Monitoring and managing the developing
dentition
2. Knowing when to intervene for improved
arrangement
3. Knowing best time to refer for specialist opinion
or more complex treatment

11. Aims of Orthodontic
treatment
Jackson’s Triad
1. Structural balance
2. Aesthetic Harmony
3. Functional efficiency
Riedel
1. Beauty
2. Utility
3. Stability

12. Structural Balance
The oro-facial region consist of the dento-alveolar
system, skeletal tissue and soft tissue including
musculature.
Stable orthodontic treatment is best achieved by
maintaining balance between these three tissue
systems

13. Esthetic Harmony
By far the most common reason for seeking
orthodontic tx is to improve the appearance of the
teeth and face. Many malocclusion are
associated with unsightly appearance of teeth
and can thus affect the individual’s self image,
well being and success in society. Thus the
orthodontic treatment should aim at improving the
esthetics of an individual.

14. Functional Efficiency
Many malocclusion affect normal functioning of
the stomatognathic system. The orthodontic
treatment should thus aim at improving the
functioning of the orofacial apparatus.

16. Branches of orthodontics
PREVENTIVE
ORTHODONTICS
INTERCEPTIVE
ORTHODONTICS

17. CORRECTIVE
ORTHODONTICS SURGICAL ORTHODONTICS

19. History of orthodontics

20. 1600 BC – Desire for prefect smile
traced back to Egypt.
Archaeologists have discovered
mummies with teeth wrapped in
cords made of catgut or animal
intestines – similar to how modern
orthodontic wire is used.
 770 – 270 BC – Etruscans made
bridges out of gold and placed in
the mouths of the dead so they
would have straight teeth in their
after life.

21.  40 AD– Roman medical writer Celsus documented attempts at
straightening teeth using finger pressure at regular intervals
 1500 – Leonardo Da Vinci was first to recognize tooth form and
realize the relation of teeth with each other and opposing jaw.
 “those teeth farthest from the line of the temporomandibular
articulation are at a mechanical disadvantage compared to those
nearest.”
 1728 – Fauchard, made the first modern attempt at orthodontia
using a horseshoe shaped piece of precious metal and silk
threads to tie it to the teeth to straighten. Publishes Book with
special chapter on straightening teeth.

22.  1841 – the word Orthodontia is coined by Joachim La Foulon
to describe orthodontics
 Late 1800s – Norman Kingsley writes first book for
orthodontics and is one of the first to use extra-oral forces for
straightening teeth. Included extraction of teeth to straighten.
 1890s – Edward Angle –”father of Orthodontics” – developed
his postulate for ideal occlusion.
 Early 1900s – move towards treating malocclusion and
achieve Angle’s “ideal”. Also reduced extractions and extra-
oral forces for corrections

23.  1930s – reintroduction of extractions if it helped in
esthetics
 Post WWII – use of cephalometry helped
understand the skeletal and dental relationship.
Now possible to see that orthodontic treatment
could affect jaw development.
 In Europe there was a move towards using
“functional jaw orthopedics” and in America move
towards use of extra-oral forces.

24.  Early 21st century – changes in three important
ways
I. More emphasis on dental and facial
appearance
II. Patients now have more involvement in
treatment planning
III. More often offered as part of multidisciplinary
treatment plan.

26. What is Ideal Occlusion
 A hypothetical concept
 Very rarely exists in nature
 But gives a yardstick to compare against

27. Definition of ideal occlusion
Defined by Edward Angle
Also known as normal occlusion/ perfect
occlusion
Defined as when the mesiobuccal cusp
of maxillary first molar settles in the
buccal groove of the mandibular first
molar and when the teeth arrange into a
smooth curving line.
In this case the maxillary canine lands distal
to its mandibular counterpart

30. Angle’s Classification
Class I: Maxillary first molar
Mesiobuccal cusp lands in the
buccal groove of mandibular
first molar. Maxillary canine
may or may not fall distal to
mandibular counterpart;
crowding maybe present

31. • Class II Division 1: maxillary
MB cusp is mesical to the
mandibular buccal groove.
Maxillary canines are mesial to
the mandibular ones.

32. • Class II Division 2: maxillary
MB cusp is mesial to the
mandibular buccal groove.
The Maxillary Central
Incisors are lingually
inclined

33. • Class III: maxillary MB cusp is
distal to the mandibular buccal
groove. In this case the
maxillay canines maybe distal
to the Premolars.

34. Angle’s Classification of
occlusion

35. Malocclusion
1. Definition: any irregularity in occlusion outside the accepted
range of normal is known as Malocclusion
• It is Important to realize that treatment is not always
warranted if malocclusion is present
• Very important to realize that treatment is only done if it is
evident with certainty that the patient will benefit functionally
and esthetically

37. Prevalence of
malocclusion
• Malocclusion is more prevalent now than was earlier.
• Crowding and malocclusion was not the norm.
• Crowding and malocclusion less prevalent in groups
unaffected by modern development such as Australian
aborigines
• So indications towards modern changes in lifestyle

38. Causes of malocclusion
• Genetic – may inheret small mouth from mother and
larger tooth size from father. Lineage association and
discrepancies seen
• Tooth Loss – if tooth is lost by any means, remaining
teeth may shift toward empty space
• Bad Habits – such as thumbsucking can shift teeth or
cause them to erupt irregularly
• Malnutrition – nutritional deficits restrict jaw
development and growth thus leading to
malocclusions

39. Evolutionary changes
 Decrease in tooth size
 Decrease in tooth number
 Decrease in jaw size
 Changes in Jaw function

40. Need and demand
 Discrimination due to facial appearance
 Social handicap
 Oral function problems
 Mastication, swallowing and speech problems
 Dental trauma
 Fratured teeth, devitialized pulps
Increased awareness

43. Treatment Options
1. No treatment
2. Extraction only
3. Removable appliance therapy
4. Single arch fixed appliance
5. Full upper and lower arch fixed
6. Functional appliances/ Orthopedics
7. Orthognathic surgery

44. Timings for treatment
1. Deciduous dentition
2. Early mixed
3. Late mixed and early permanent
4. Late permanent

45. Other scopes of
orthodontics
1. Alignment of mal-positioned teeth before
prosthetic treatment – fixed or removable
2. Alignment of periodontically compromised teeth
prior to splinting
3. Alignment and planned positioning of teeth prior
to orthognathic surgery

46. Summary of scopes and
aims of Orthodontic
treatment
1. Improvement of facial and dental esthetics
2. Alignment of teeth to eliminate stagnation areas
3. Elimination of premature contacts
4. Elimination of traumatic irregularities
5. Reduce damage to prominant teeth by way of alignment
6. Assist in eruption and alignment of displaced teeth