Orthodontic Consideration In Fixed partial denture.pptx

Orthodontic Consideration In Fixed partial denture.pptx

• 1.
  Presentation by Dr AbhidhaTripathi
• 2.
  Introduction Assessment Rationale for Orthodontic Treatment Useof Orthodontics as an adjunct to Overall therapy Indications and Contra Indications Conclusion Iatrogenic Factors Associated with Ortho treatment References 01 o6 02 07 03 08 05 04
• 3.
  • Primary Objectiveof periodontal therapy is to restore and maintain the health and integrity of the attachment apparatus of teeth. • Loss of teeth or periodontal support can result in pathologic tooth migration involving either a single tooth or a group of teeth. • This results in the development of a median diastema or general spacing of the teeth, rotation or tipping of premolars and molars with the collapse of the posterior occlusion and decreasing vertical dimension.
• 4.
  Malaligned teeth, suchas a mesially tipped molar, necessitate additional removal of tissue on the mesial aspect of the molar abutment to achieve compat?ible paths of placement for a planned fixed dental prosthesis. If the molar abutment is orthodontically uprighted before tooth preparation, crown preparation can be more conservative • Minor orthodontic tooth movement can significantly enhance the prognosis of subsequent restorative treatment. • Uprighting mal positioned abutment teeth can improve axial alignment, create more favorable pontic spaces, and improve embrasure form in the fixed prosthesis. • It can also direct occlusal forces along the long axes of the teeth and often leads to a substantial conservation of tooth structure
• 5.
  • The clinicalexamination should focus on tooth malpositioning both buccolingually and mesiodistally. • The need for orthodontic treatment is determined through a careful analysis of articulated diagnostic casts, whose usefulness can be enhanced with a dental surveyor. • One helpful procedure is to section a duplicate cast and reassemble it according to the proposed orthodontic modifications. This facilitates assessing the validity of any minor tooth movement (e.g., closing diastemas, uprightingmolars, aligning tilted teeth) and is especially valuable when explaining the treatment proposal to the patient.
• 6.
  • Diagnostic preparationsand waxing procedures made on these altered casts often clearly illustrate the benefits of minor tooth movement. • Many dentists are now using computer imaging technology to optimize esthetic treatment planning and improve patient communication. Use of diagnostic preparations (A) and a dental surveyor (B) in assessing the need for orthodontic treatment before
• 7.
  Diagnostic cast sectioning(A and B) for determination of desired orthodontic tooth movement Computer imaging technology can assist in treat?ment planning and communicating the envisioned esthetic changes to the patient. A, Before modification B, After simulated diastema closure.
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  1. REDUCING PLAQUERETENTION • Example: Crowded teeth (arch length deficiency), mesially tipped teeth, usually into an edentulous area creates plaque accumulation sites that are difficult to clean. • They open the distal contact creating an area of fooda impaction. • Crowding also creates enlarged contact surfaces and altered embrasure spaces that are displaced apically, thereby becoming less accessible to use floss and other plaque removing devices. • In these situations orthodontic treatment can improve the health of the tissues
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  2. IMPROVING GINGIVALAND OSSEOUS FORM • There is an interrelation between the position of the tooth, the shape of the gingiva and bone that surrounds it. • For example, lower first or second molar tilted into an edentulous mesial space. • In these cases there is a narrow space between its crown and the bone that easily becomes inflamed and in which case a pocket may develop. • Orthodontic treatment may improve the shape of the periodontium and reduces the indications for bone surgery
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  3. FACILITATING PROSTHETICREPLACEMENTS • The uprighting of tilted abutment teeth may be important for a better contoured crown and this will benefit the periodontal condition. 4. IMPROVING ESTHETICS • Correction of pathologic tooth migration and diastema between anterior teeth. • Correction of tongue-thrusting and other habits
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  1. Uprighting orrepositioning of teeth to improve parallelism of abutment teeth (e.g. tipped abutment teeth) 2. Improving future pontic spaces (e.g. inadequate spaces) 3. Correcting cross bites 4. Extruding teeth/Intruding teeth 5. Correcting crowding of teeth 6. Achieving adequate embrasure space and proper root positioning 7. Repositioning teeth for implant placement 8. Restoring lost vertical dimension 9. Increasing/decreasing overjet /overbite 10. Closure of diastema.
• 12.
  Orthodontic tooth movementas an adjunct to fixed prosthodontics. A to C, Minor tooth movement before correction of a diastema. D to G, A mesially tilted molar uprighted with a coil spring before the provision of a fixed dental prosthesis.
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  1. Crowded teeth 2.Closure of anterior diastema, 3. Mesial tilting of molars 4. Open contacts. 1. Persistence of active disease in spite of phase-I therapy procedures. 2. The superimposition of tooth movement on inflamed gingiva may exacerbate the periodontal problem. This can occur by shifting the position of plaque subgingivally, increasing the rate of periodontal attachment loss and altering the morphology of the bone
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  1. Orthodontic treatmentmay cause injuries to the teeth and periodontium but in most of the cases the changes are reversible and regeneration and repair of the tooth structures and periodontal tissues can occur. 2. Radiography should be performed at regular intervals in order to disclose any iatrogenic effects during the orthodontic treatment
• 15.
  • CONTEMPORARY FIXEDPROSTHODONTICS, ROSENSTEIL – 5 TH EDITION • FUNDAMENTALS OF FIXED PROSTHODONTICS, SHILLINBURG- 4 TH EDITION • TEXTBOOK OF PROSTHODONTICS – DEEPAK NALLASWAMY, 2ND EDITION
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  ThankYou!