Orthodontic treatment modalities include preventive, interceptive, and corrective orthodontics as well as orthognathic surgery. Preventive orthodontics aims to preserve normal occlusion and includes procedures such as space maintainers. Interceptive orthodontics provides early treatment of developing malocclusions through methods like serial extraction. Corrective orthodontics utilizes fixed or removable appliances to fully treat malocclusions and can include orthognathic surgery to correct severe jaw discrepancies.

1. Orthodontic Treatment Modalities
Done by: Dr. Mohamad Ghazi Kassem

2. Orthodontic Treatment Modalities
Preventive orthodontics:
Interceptive orthodontics
Corrective orthodontics
• Removable appliances
• Fixed appliances
Orthognathic Surgery “Jaw Surgery”

3. Preventive orthodontics
Preventive Orthodontics is the action taken to preserve the integrity of what
appears to be normal at a specific time.
Any procedure that attempt to ward off untoward environmental attacks or
anything that would change the normal course of events, e.g.
1. Early connection of proximal caries that might change the arch length
2. Early recognition and elimination of oral habits that might interfere with
the normal development of the teeth and jaws
3. Placing of a space maintainer to maintain proper position of contiguous
teeth
It is defined as the action taken to preserve the integrity of
what appears to be a normal occlusion at a specific time.

4. 1960 : Kesling stated that “some case should be referred as early
as 3 or 4 years of age and all cases by the age of 8 or 9 years”
there by lying the foundation of preventive and interceptive
orthodontics.
1977: Begg stated that “proper time to begin the treatment is as
the beginning of the variation from the normal, in the process of
development of dental apparatus, as possible”
1980: Profit and Ackermann has defined it as a prevention of
potential interference with occlusal development.

5. Various Preventive procedures are :
1. Pre-dental procedures
2. Care of deciduous dentition
3. Patient and parents education programs
4. Supernumerary teeth
5. Early loss of deciduous teeth
6. Proximal caries
7. Oral habits
8. Space maintainers

6. 1. Pre-dental procedures:
• Proper nutrition of the child.
• Proper nursing care of the infant.
• Bottle feeding should be discouraged.

7. 2. Care of deciduous dentition:
3. Patient and parent’s education programs:
Need of maintaining good oral hygiene should be explained to the patient
and the parents.
Demonstration of brushing methods and diet counseling etc are also
important.

8. 4. Supernumerary teeth:
Supernumerary teeth and supplemental teeth can interfere with the eruption
of nearby teeth.
Presence of mesiodens prevents the two maxillary central incisors from
approximating each other. They should be removed at appropriate time.

9. 5.Oral habits:
Abnormal oral habits should be recognized and patient
should be helped by motivation or by fitting a suitable habit breaking
appliance.

10. digit sucking
Methods to prevent tongue thrusting
Mouth breathing

11. 6.Space maintainers:
Premature loss of deciduous teeth can cause drifting of the adjacent teeth
into the space. Space maintainers must be inserted in appropriate cases
after the loss of teeth, particularly after the loss of deciduous molars in
inadequate arches.
Fixed Space Maintainers
Removable space maintainers

12. Interceptive orthodontics
Richardson (1982)
defined interceptive orthodontics as the prompt treatment of unfavorable
features of a developing occlusion that may make the difference between
achieving a satisfactory result by simple mechanics later, thus reducing
overall treatment time and providing better stability and functional and
aesthetic results .
The percentage of children who would benefit from interceptive orthodontics
has been reported from 14% to 49% .

13. Interceptive orthodontics procedures will help to
correct or reduce the severity of malocclusion are:
1. Developing anterior cross bite.
2. Ectopically erupted teeth.
3. Anterior diastema and abnormal labial
fraenum.
4. Disking / slicing of teeth.
5. Space regainer.
6. Serial extraction.
7. Cleft lip and or palate.
8. Muscle exercise.
9. Removal of soft tissue or bony barrier to
eruption of teeth.

14. 1. Developing anterior cross bite.

15. 2.Ectopic eruption
Eruption is ectopic when a permanent tooth causes either:
Resorption of a primary tooth other than the one it is supposed to replace
OR resorption of an adjacent permanent tooth.

16. Ectopic eruption of Lateral incisors
remove the contralateral canine or maintain the position of the lateral incisor
on the side of the canine loss, using a lingual arch with a spur

17. Ectopic eruption of Maxillary First Molars
A simple fixed appliance can be fabricated to
move the molar distally
An Arkansas spring

18. 3. Anterior diastema and abnormal labial fraenum.

19. 4.The ugly duckling phase

20. 5.Serial extraction
Indications:
1.Straight profile
2.Class I malocclusion
3.Arch length discrepency in maxilla should be 11 mm while in
mandibular arch 10.5 mm
Contraindications:
1. Convex profile
2. Class II malocclusion
3. Low angle case
4. High angle case

21. Advantages of serial extraction
•
•
•
Reduces the severity of malocclusion
Reduces the extent of mechanotherapy
Reduces the duration of treatment
Disadvantages of serial extraction
•
•
•
Chances of increasing overbite
Canines may fail to migrate distally
Anterior teeth may tip lingually
Methods of serial extraction
•
•
Dewel’s method (cd4)
Tweed’s method (d4c)

22. Comprehensive Orthodontics
Comprehensive
procedures are those that involve growth modification for skeletal
correction and procedures that require banding more than 6 teeth per arch.
Treatment usually utilizes fixed orthodontic appliances and may include
functional and /or orthopedic appliances.
Adjunctive procedures, such as extractions, maxillofacial surgery,
myofunctional or speech therapy and restorative or periodontal care, may
be coordinated disciplines.
Optimal care requires long-term consideration of patient’s needs and
periodic reevaluation.
Treatment may incorporate several phases with specific objectives at
various stages of dentofacial development.

23. Comprehensive Orthodontics
fixed orthodontic appliances

24. Functional appliance
A removable or fixed appliance that alters the posture of the mandible and
transmits the forces created by the resulting stretch of the muscles and soft
tissues and by the change of the neuromuscular environment to the dental
and skeletal tissues to produce movement of teeth and modification of
growth.
They can bring about the following changes:
1.An increase or decrease in jaw size.
2.A change in spatial relationship of the jaws.
3.Change in direction of growth of the jaws.
4.Acceleration of desirable growth.

25. Classification of functional appliances

26. palatal expander
Bionator

27. Herbst Telescopic Appliance
Fränkl Appliance

28. Headgear

29. Forsus
Jasper Jumper

30. Orthognathic Surgery “Jaw Surgery”
Indication:
1. In severe malocclusion .
2. Unaesthetic appearance of a dentofacial
deformity resulting in undesirable psychological effects.
Orthognathic procedures are divided into
three categories:
a. Maxilla
b. Mandible
c. Bimaxillary

34. • Research & Reviews: A Journal of Dentistry
• Volume 2, Issue 1, April, 2011, Pages 6- 9 .
• A to Z ORTHODONTICS Volume: 09 Dr. Mohammad Khursheed
Alam BDS, PGT, PhD (Japan)
• http://www.gulatisclinic.com/orth_treat.php
• http://www.columbia.edu/itc/hs/dental/D5300/SCOPE%20OF%2
0PREDOCTORAL_BW.pdf