Preventive orthodontics aims to prevent malocclusion through educating parents, monitoring growth, and early treatment if needed. Its key aspects include parent counseling from prenatal stages, caries control, space maintenance when primary teeth are lost, and treating issues like abnormal frenal attachments. Space maintainers are used to prevent arch length loss and guide permanent teeth into position. They can be removable or fixed, with or without bands, and include types like lingual arches. Maintaining oral hygiene and preventing early tooth loss are important for proper alignment.
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.
Stainless steel crowns in pediatric dentistry pptdrvinodini
This document provides an overview of stainless steel crowns (SSCs), including their history, composition, indications, contraindications, placement procedure, and modifications. SSCs were first described in 1950 as a semi-permanent restoration option for primary and young permanent teeth. They are made of stainless steel or nickel-chromium alloys. SSCs are indicated for restoring teeth with extensive decay, fractures, pulpotomies, or as a space maintainer. Placement involves tooth preparation, selection and fitting of the crown, contouring, crimping, cementation, and finishing. Modifications include altering crown size or adding material to accommodate deep caries or spacing issues. Studies have found SSCs to have low microleakage and
Space regaining involves moving a displaced permanent tooth into its proper position after premature loss of a deciduous tooth. Methods include fixed appliances like open coil springs and removable appliances like Hawley's retainers. Removable appliances are activated gradually over weeks to exert light distal force on molars and regain up to 2mm of space. Fixed appliances can regain space faster but require proper cementation. Space regaining is best done between ages 7-10 years when tooth roots are still developing.
Oral habits & habits breaking appliances + night guardRahaf Sn
This document discusses various oral habits in children including thumb sucking, tongue thrusting, lip habits, and bruxism. For each habit, it provides information on prevalence, potential impacts, and management approaches. Thumb sucking management can include counseling, reminders, rewards systems, and intraoral appliances. Tongue thrusting management involves training correct swallowing and tongue posture, as well as speech therapy and appliances. Lip habits may require correction of malocclusion or use of appliances. Bruxism management uses approaches like psychotherapy, occlusal adjustments, and bite guards. The document concludes with a list of references.
1) Space regainers are appliances used to regain space lost due to drifting of teeth after primary teeth are lost. They can be either fixed or removable.
2) Common causes of space loss include caries of primary molars which allows permanent molars to tip mesially. Space regainers work to distalize permanent molars and correct shifted teeth.
3) Various space regainer designs are discussed, including removable appliances with helical springs and fixed appliances using loop springs, jackscrews, and headgear. The document provides details on indications and mechanics of different space regainer options.
Buccolingual malrelationship of upper and lower
teeth.Anterior or posterior (unilateral or bilateral) with or
without mandibular displacement.
Buccal crossbite: Lower teeth occlude buccal to
corresponding upper teeth .
Lingual crossbite (scissors bite): Lower teeth occlude
lingual to palatal cusps of upper teeth.
The document discusses preventive and interceptive orthodontics. Preventive orthodontics aims to preserve normal occlusion and involves procedures like patient education, caries control, space maintenance, and extraction of supernumerary teeth. Interceptive orthodontics is undertaken when a malocclusion has developed and involves procedures like serial extraction to correct developing issues. Serial extraction specifically refers to the planned removal of certain deciduous and permanent teeth to allow other teeth to align normally through physiologic tooth movement into extraction spaces.
Interceptive orthodontics refers to treatments undertaken when a malocclusion has developed or is developing to prevent it from becoming more severe. Some common procedures include serial extraction to guide erupting teeth, correcting developing crossbites, controlling habits like thumb sucking, and regaining space when primary molars are lost early. Local factors treated interceptively include delayed tooth eruption, retained primary teeth, infraocclusion, diastema, ectopic eruption, hypodontia, and tooth transposition or crowding. The goal is to address developing problems early before they worsen.
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.
Stainless steel crowns in pediatric dentistry pptdrvinodini
This document provides an overview of stainless steel crowns (SSCs), including their history, composition, indications, contraindications, placement procedure, and modifications. SSCs were first described in 1950 as a semi-permanent restoration option for primary and young permanent teeth. They are made of stainless steel or nickel-chromium alloys. SSCs are indicated for restoring teeth with extensive decay, fractures, pulpotomies, or as a space maintainer. Placement involves tooth preparation, selection and fitting of the crown, contouring, crimping, cementation, and finishing. Modifications include altering crown size or adding material to accommodate deep caries or spacing issues. Studies have found SSCs to have low microleakage and
Space regaining involves moving a displaced permanent tooth into its proper position after premature loss of a deciduous tooth. Methods include fixed appliances like open coil springs and removable appliances like Hawley's retainers. Removable appliances are activated gradually over weeks to exert light distal force on molars and regain up to 2mm of space. Fixed appliances can regain space faster but require proper cementation. Space regaining is best done between ages 7-10 years when tooth roots are still developing.
Oral habits & habits breaking appliances + night guardRahaf Sn
This document discusses various oral habits in children including thumb sucking, tongue thrusting, lip habits, and bruxism. For each habit, it provides information on prevalence, potential impacts, and management approaches. Thumb sucking management can include counseling, reminders, rewards systems, and intraoral appliances. Tongue thrusting management involves training correct swallowing and tongue posture, as well as speech therapy and appliances. Lip habits may require correction of malocclusion or use of appliances. Bruxism management uses approaches like psychotherapy, occlusal adjustments, and bite guards. The document concludes with a list of references.
1) Space regainers are appliances used to regain space lost due to drifting of teeth after primary teeth are lost. They can be either fixed or removable.
2) Common causes of space loss include caries of primary molars which allows permanent molars to tip mesially. Space regainers work to distalize permanent molars and correct shifted teeth.
3) Various space regainer designs are discussed, including removable appliances with helical springs and fixed appliances using loop springs, jackscrews, and headgear. The document provides details on indications and mechanics of different space regainer options.
Buccolingual malrelationship of upper and lower
teeth.Anterior or posterior (unilateral or bilateral) with or
without mandibular displacement.
Buccal crossbite: Lower teeth occlude buccal to
corresponding upper teeth .
Lingual crossbite (scissors bite): Lower teeth occlude
lingual to palatal cusps of upper teeth.
The document discusses preventive and interceptive orthodontics. Preventive orthodontics aims to preserve normal occlusion and involves procedures like patient education, caries control, space maintenance, and extraction of supernumerary teeth. Interceptive orthodontics is undertaken when a malocclusion has developed and involves procedures like serial extraction to correct developing issues. Serial extraction specifically refers to the planned removal of certain deciduous and permanent teeth to allow other teeth to align normally through physiologic tooth movement into extraction spaces.
Interceptive orthodontics refers to treatments undertaken when a malocclusion has developed or is developing to prevent it from becoming more severe. Some common procedures include serial extraction to guide erupting teeth, correcting developing crossbites, controlling habits like thumb sucking, and regaining space when primary molars are lost early. Local factors treated interceptively include delayed tooth eruption, retained primary teeth, infraocclusion, diastema, ectopic eruption, hypodontia, and tooth transposition or crowding. The goal is to address developing problems early before they worsen.
This document discusses various oral habits and their management through appliances. It defines oral habits and notes that thumb sucking and tongue thrusting are common in young children. For thumb sucking, reminders and appliances can be used if the habit persists past age 4. described appliances for thumb sucking include the quad helix, bluegrass, palatal crib and hayrake. Tongue thrusting can be managed through speech therapy, mechanotherapy using beads or palatal cribs, and swallowing exercises. Lip habits and bruxism are also discussed along with their clinical features and treatment options like occlusal adjustments or bite guards.
Transient malocclusions are self-correcting developmental variations that occur during dental development. In the pre-dentate period, infants have a retrognathic mandible that corrects over time. In the primary dentition, children commonly have an anterior open bite, deep anterior bite, spacing between teeth, and an edge-to-edge anterior bite that self-correct. In the mixed dentition, a deep bite and crowding are common but resolve with time. The permanent dentition may show increased overjet and overbite during transition that lessen without treatment.
1) Space maintainers are appliances used to preserve space created by the premature loss of primary teeth to guide the eruption of permanent teeth.
2) They come in fixed and removable forms and include band and loop, lingual arch, and distal shoe space maintainers.
3) The document discusses the requirements, planning, classification, fabrication techniques, indications, and modifications of various space maintainers used to maintain space and proper alignment of permanent teeth.
The document discusses the history and use of expansion screws in removable orthodontic appliances. It describes how expansion screws work to move teeth and skeletal structures as needed. Guidelines are provided for properly positioning expansion screws. Various types of expansion screw appliances are outlined, including the Schwarz expander, transverse expander, fan expander, Nord expander, and lower Schwarz appliance. Advantages and disadvantages of expansion screw appliances are also summarized.
This document discusses removable orthodontic appliances. It describes the advantages as being able to be removed for cleaning, being less conspicuous, and allowing for treatment by general practitioners. Disadvantages include only being able to correct simple malocclusions. Indications include growth modifications and limited tooth movement needs. Components include retentive components like clasps and active components like springs. Different types of clasps and their uses are outlined, along with various spring designs and their applications.
1. Orthodontic tooth movement occurs through remodeling of the alveolar bone in response to prolonged mechanical forces on teeth. Bone resorbs on the pressure side and forms on the tension side of the periodontal ligament.
2. Physiologic tooth movements include eruption, drift, and minor movements during mastication. Eruption occurs through growth of the root and forces from the periodontal ligament.
3. When forces are within physiologic limits, tooth movement occurs through frontal resorption on the pressure side and bone formation on the tension side. Excessive forces cause hyalinization and undermining resorption.
This document discusses the assessment and treatment of Class III malocclusions. It begins by defining Class III as when the lower incisor edge lies anterior to the upper incisors. It then discusses the incidence, classification, etiology, features, and treatment options for Class III malocclusions. For early treatment of Class III, protraction facemasks are commonly used to protract the maxilla anteriorly through orthopedic forces applied to the maxilla. Protraction facemasks are most effective when used in the early mixed dentition stage in patients with mild skeletal discrepancies. Short term effectiveness of protraction facemasks shows mostly skeletal and dental changes, while long term effectiveness maintains favorable dentoskeletal relationships in about 73%
Preventive and Interceptive Orthodontics in Pediactric DentistryDr Tridib Goswami
The document summarizes preventive and interceptive orthodontics. It discusses various aspects of preventive orthodontics including parent education on proper feeding habits, caries control through restoration and fluoride application, timely extraction of supernumerary teeth before they cause malocclusion, and use of space maintainers to prevent drifting after premature tooth loss. It also describes interceptive orthodontics including procedures like serial extractions and correction of developing cross-bites. Details are provided on different types of space maintainers including removable, fixed band and loop, and lingual arch appliances.
Removable appliances are orthodontic devices that can be removed by the patient for cleaning. They apply forces to teeth using springs, screws, and other mechanical components. Removable appliances have several advantages including being less conspicuous, allowing for cleaning, and treating simple malocclusions inexpensively. However, they also have disadvantages like only being able to move teeth one at a time, prolonging treatment duration. Common components include clasps and labial bows for retention and applying forces. Different types of clasps and labial bows exist to engage teeth and apply various movements. Springs are another active component that can apply different force systems depending on their design and properties.
This document provides an overview of mixed dentition and orthodontic appliances used during this period. Mixed dentition refers to the stage when primary teeth are being replaced by permanent teeth, between ages 6-13 years. Common orthodontic problems in mixed dentition include increased overjet and open bite. Functional appliances discussed include oral screens, lip bumpers, activators, and Frankel's regulator. Other appliances mentioned are space maintainers, tongue blades for crossbite correction, and space regainers. The document outlines the principles, advantages, limitations and indications for different appliances used in intercepting and correcting malocclusions during mixed dentition.
Functional appliances utilize the natural forces of the orofacial musculature to produce skeletal and dental changes. They are based on Moss's functional matrix theory which proposes that muscles and glands influence bone growth. Functional appliances can be active or passive and produce orthopedic, dentoalveolar, and muscular changes through forces of compression, elimination of restrictive influences, and mandibular repositioning. Common functional appliances discussed in the document include Bionators, Twin-Blocks, Herbst, Frankel Regulator, and Jasper Jumper. They vary in their mode of action, indications, advantages, and disadvantages.
This document discusses anchorage, which refers to resistance to unwanted tooth movement. It is classified based on the manner of force application, jaws involved, site of anchorage, and number of anchorage units. Factors like tooth morphology, position, and mutual support affect anchorage. Sources include individual/multiple teeth, basal bone, and musculature. Anchorage planning depends on the number/type of teeth to be moved and treatment factors. Different anchorage techniques are described like intra/inter-maxillary, simple, stationary, and reciprocal anchorage. Anchorage loss and demand vary based on the case. Recent advancements have improved anchorage control.
The lingual arch space maintainer is a passive bilateral mandibular appliance used to control tooth movement and arch perimeter after the loss of lower primary molars. It consists of bands on the first molars connected by a stainless steel wire. The wire is positioned to contact the lower incisors and rest on the gingiva of the molared and molar bands. It maintains the arch shape and leeway space until the permanent teeth erupt. Advantages include allowing eruption of permanents without interference and maintaining oral hygiene, while disadvantages include not preventing opposing tooth extrusion and potential for distortion.
This document summarizes Nance appliances, transpalatal arches, and quad helix appliances. It describes the design, indications, and disadvantages of each appliance. For transpalatal arches, it notes they are used to prevent mesial migration of upper first molars and can provide anchorage, arch width stabilization, and be used as a retainer. Quad helix appliances are used to expand arches and derotate molars through a fan-like sweeping action. Nance appliances maintain posterior tooth positions and can be modified to provide an anterior bite plane.
Orthodontic tooth movements and biomechanics.Sk Aziz Ikbal
The document discusses biomechanics principles related to orthodontic tooth movement. It covers topics such as:
- Forces applied to teeth can cause movement through bone remodeling.
- Biomechanics refers to mechanics applied to biological systems. Knowledge of forces is needed to control orthodontic treatment.
- Teeth can move through light forces during normal function but heavier sustained forces over 1 second are needed for orthodontic tooth movement.
- Forces have magnitude and direction, while scalars only have magnitude. Resultant forces and moments from multiple applied forces are calculated.
- Different force systems and moment-to-force ratios produce different types of tooth movement such as tipping, translation, rotation, and torque.
This document discusses several types of palatal appliances used in orthodontic treatment, including TPAs (transpalatal arches), Nance appliances, lingual arches, and quadhelix appliances. It describes the design, materials, and indications for passive and active uses of TPAs, including as space maintainers, for arch width stabilization, vertical anchorage, and anterior-posterior anchorage. Studies comparing the anchorage effects of TPAs to other methods like TADs or EOT are summarized. Complications and clinical management of quadhelix appliances are also mentioned.
This document discusses various methods and appliances for distalizing maxillary molars, including removable and fixed options. Removable appliances discussed include extraoral traction using headgear as well as removable appliances with finger springs or sliding jigs. Fixed appliances discussed include intramaxillary devices like Wilson's 3D appliance as well as intermaxillary appliances like Herbst or Jasper Jumper. Factors like the presence of second molars, skeletal pattern, and growth prognosis must be considered when determining whether molar distalization is indicated.
The document discusses the importance of preventive and interceptive orthodontics, which aims to recognize and address potential orthodontic issues early on through procedures like parent education on oral hygiene and diet, caries control methods, management of conditions affecting tooth eruption, and early treatment of oral habits that could interfere with proper occlusion development. It emphasizes starting orthodontic prevention from the prenatal period through childhood by examining the dentition regularly and addressing any emerging problems to minimize the need for future comprehensive treatment.
Restorative Dentistry For Children PAEDIATRIC DENTISTRYJamil Kifayatullah
This document discusses restorative dentistry for children. It covers the importance of maintaining a dry field for clear vision and preventing contamination during restorative procedures. It describes various methods for achieving a dry field, including cotton rolls, saliva ejectors, and rubber dams. It discusses the aims and general principles of restorative dentistry in primary teeth, including cavity classification, preparation, and choices of restorative materials. It also covers the use of preformed crowns for primary teeth, including stainless steel crowns and strip crowns. Finally, it discusses early childhood caries (ECC), including definitions, prevalence, risk factors, clinical presentations, consequences, and approaches for prevention and treatment.
This document discusses various oral habits and their management through appliances. It defines oral habits and notes that thumb sucking and tongue thrusting are common in young children. For thumb sucking, reminders and appliances can be used if the habit persists past age 4. described appliances for thumb sucking include the quad helix, bluegrass, palatal crib and hayrake. Tongue thrusting can be managed through speech therapy, mechanotherapy using beads or palatal cribs, and swallowing exercises. Lip habits and bruxism are also discussed along with their clinical features and treatment options like occlusal adjustments or bite guards.
Transient malocclusions are self-correcting developmental variations that occur during dental development. In the pre-dentate period, infants have a retrognathic mandible that corrects over time. In the primary dentition, children commonly have an anterior open bite, deep anterior bite, spacing between teeth, and an edge-to-edge anterior bite that self-correct. In the mixed dentition, a deep bite and crowding are common but resolve with time. The permanent dentition may show increased overjet and overbite during transition that lessen without treatment.
1) Space maintainers are appliances used to preserve space created by the premature loss of primary teeth to guide the eruption of permanent teeth.
2) They come in fixed and removable forms and include band and loop, lingual arch, and distal shoe space maintainers.
3) The document discusses the requirements, planning, classification, fabrication techniques, indications, and modifications of various space maintainers used to maintain space and proper alignment of permanent teeth.
The document discusses the history and use of expansion screws in removable orthodontic appliances. It describes how expansion screws work to move teeth and skeletal structures as needed. Guidelines are provided for properly positioning expansion screws. Various types of expansion screw appliances are outlined, including the Schwarz expander, transverse expander, fan expander, Nord expander, and lower Schwarz appliance. Advantages and disadvantages of expansion screw appliances are also summarized.
This document discusses removable orthodontic appliances. It describes the advantages as being able to be removed for cleaning, being less conspicuous, and allowing for treatment by general practitioners. Disadvantages include only being able to correct simple malocclusions. Indications include growth modifications and limited tooth movement needs. Components include retentive components like clasps and active components like springs. Different types of clasps and their uses are outlined, along with various spring designs and their applications.
1. Orthodontic tooth movement occurs through remodeling of the alveolar bone in response to prolonged mechanical forces on teeth. Bone resorbs on the pressure side and forms on the tension side of the periodontal ligament.
2. Physiologic tooth movements include eruption, drift, and minor movements during mastication. Eruption occurs through growth of the root and forces from the periodontal ligament.
3. When forces are within physiologic limits, tooth movement occurs through frontal resorption on the pressure side and bone formation on the tension side. Excessive forces cause hyalinization and undermining resorption.
This document discusses the assessment and treatment of Class III malocclusions. It begins by defining Class III as when the lower incisor edge lies anterior to the upper incisors. It then discusses the incidence, classification, etiology, features, and treatment options for Class III malocclusions. For early treatment of Class III, protraction facemasks are commonly used to protract the maxilla anteriorly through orthopedic forces applied to the maxilla. Protraction facemasks are most effective when used in the early mixed dentition stage in patients with mild skeletal discrepancies. Short term effectiveness of protraction facemasks shows mostly skeletal and dental changes, while long term effectiveness maintains favorable dentoskeletal relationships in about 73%
Preventive and Interceptive Orthodontics in Pediactric DentistryDr Tridib Goswami
The document summarizes preventive and interceptive orthodontics. It discusses various aspects of preventive orthodontics including parent education on proper feeding habits, caries control through restoration and fluoride application, timely extraction of supernumerary teeth before they cause malocclusion, and use of space maintainers to prevent drifting after premature tooth loss. It also describes interceptive orthodontics including procedures like serial extractions and correction of developing cross-bites. Details are provided on different types of space maintainers including removable, fixed band and loop, and lingual arch appliances.
Removable appliances are orthodontic devices that can be removed by the patient for cleaning. They apply forces to teeth using springs, screws, and other mechanical components. Removable appliances have several advantages including being less conspicuous, allowing for cleaning, and treating simple malocclusions inexpensively. However, they also have disadvantages like only being able to move teeth one at a time, prolonging treatment duration. Common components include clasps and labial bows for retention and applying forces. Different types of clasps and labial bows exist to engage teeth and apply various movements. Springs are another active component that can apply different force systems depending on their design and properties.
This document provides an overview of mixed dentition and orthodontic appliances used during this period. Mixed dentition refers to the stage when primary teeth are being replaced by permanent teeth, between ages 6-13 years. Common orthodontic problems in mixed dentition include increased overjet and open bite. Functional appliances discussed include oral screens, lip bumpers, activators, and Frankel's regulator. Other appliances mentioned are space maintainers, tongue blades for crossbite correction, and space regainers. The document outlines the principles, advantages, limitations and indications for different appliances used in intercepting and correcting malocclusions during mixed dentition.
Functional appliances utilize the natural forces of the orofacial musculature to produce skeletal and dental changes. They are based on Moss's functional matrix theory which proposes that muscles and glands influence bone growth. Functional appliances can be active or passive and produce orthopedic, dentoalveolar, and muscular changes through forces of compression, elimination of restrictive influences, and mandibular repositioning. Common functional appliances discussed in the document include Bionators, Twin-Blocks, Herbst, Frankel Regulator, and Jasper Jumper. They vary in their mode of action, indications, advantages, and disadvantages.
This document discusses anchorage, which refers to resistance to unwanted tooth movement. It is classified based on the manner of force application, jaws involved, site of anchorage, and number of anchorage units. Factors like tooth morphology, position, and mutual support affect anchorage. Sources include individual/multiple teeth, basal bone, and musculature. Anchorage planning depends on the number/type of teeth to be moved and treatment factors. Different anchorage techniques are described like intra/inter-maxillary, simple, stationary, and reciprocal anchorage. Anchorage loss and demand vary based on the case. Recent advancements have improved anchorage control.
The lingual arch space maintainer is a passive bilateral mandibular appliance used to control tooth movement and arch perimeter after the loss of lower primary molars. It consists of bands on the first molars connected by a stainless steel wire. The wire is positioned to contact the lower incisors and rest on the gingiva of the molared and molar bands. It maintains the arch shape and leeway space until the permanent teeth erupt. Advantages include allowing eruption of permanents without interference and maintaining oral hygiene, while disadvantages include not preventing opposing tooth extrusion and potential for distortion.
This document summarizes Nance appliances, transpalatal arches, and quad helix appliances. It describes the design, indications, and disadvantages of each appliance. For transpalatal arches, it notes they are used to prevent mesial migration of upper first molars and can provide anchorage, arch width stabilization, and be used as a retainer. Quad helix appliances are used to expand arches and derotate molars through a fan-like sweeping action. Nance appliances maintain posterior tooth positions and can be modified to provide an anterior bite plane.
Orthodontic tooth movements and biomechanics.Sk Aziz Ikbal
The document discusses biomechanics principles related to orthodontic tooth movement. It covers topics such as:
- Forces applied to teeth can cause movement through bone remodeling.
- Biomechanics refers to mechanics applied to biological systems. Knowledge of forces is needed to control orthodontic treatment.
- Teeth can move through light forces during normal function but heavier sustained forces over 1 second are needed for orthodontic tooth movement.
- Forces have magnitude and direction, while scalars only have magnitude. Resultant forces and moments from multiple applied forces are calculated.
- Different force systems and moment-to-force ratios produce different types of tooth movement such as tipping, translation, rotation, and torque.
This document discusses several types of palatal appliances used in orthodontic treatment, including TPAs (transpalatal arches), Nance appliances, lingual arches, and quadhelix appliances. It describes the design, materials, and indications for passive and active uses of TPAs, including as space maintainers, for arch width stabilization, vertical anchorage, and anterior-posterior anchorage. Studies comparing the anchorage effects of TPAs to other methods like TADs or EOT are summarized. Complications and clinical management of quadhelix appliances are also mentioned.
This document discusses various methods and appliances for distalizing maxillary molars, including removable and fixed options. Removable appliances discussed include extraoral traction using headgear as well as removable appliances with finger springs or sliding jigs. Fixed appliances discussed include intramaxillary devices like Wilson's 3D appliance as well as intermaxillary appliances like Herbst or Jasper Jumper. Factors like the presence of second molars, skeletal pattern, and growth prognosis must be considered when determining whether molar distalization is indicated.
The document discusses the importance of preventive and interceptive orthodontics, which aims to recognize and address potential orthodontic issues early on through procedures like parent education on oral hygiene and diet, caries control methods, management of conditions affecting tooth eruption, and early treatment of oral habits that could interfere with proper occlusion development. It emphasizes starting orthodontic prevention from the prenatal period through childhood by examining the dentition regularly and addressing any emerging problems to minimize the need for future comprehensive treatment.
Restorative Dentistry For Children PAEDIATRIC DENTISTRYJamil Kifayatullah
This document discusses restorative dentistry for children. It covers the importance of maintaining a dry field for clear vision and preventing contamination during restorative procedures. It describes various methods for achieving a dry field, including cotton rolls, saliva ejectors, and rubber dams. It discusses the aims and general principles of restorative dentistry in primary teeth, including cavity classification, preparation, and choices of restorative materials. It also covers the use of preformed crowns for primary teeth, including stainless steel crowns and strip crowns. Finally, it discusses early childhood caries (ECC), including definitions, prevalence, risk factors, clinical presentations, consequences, and approaches for prevention and treatment.
The document provides information on orthodontic diagnosis and clinical examination. It discusses examining the patient's age, medical history, dental history, chief complaint, and habits which help in diagnosis and treatment planning. The clinical examination evaluates the skeletal, facial, and occlusal characteristics to determine the cause of malocclusion which can be skeletal, dental, soft tissue, or a combination. This includes assessing the anteroposterior, vertical, and transverse jaw relationships to classify the skeletal pattern and guide orthodontic treatment.
Preventive orthodontic is that part of orthodontic practice that concerned with patient and parents education, supervision and development of dentition and craniofacial structures
The document provides anticipatory guidance for dental care from prenatal counseling through adolescence. It discusses oral development milestones, nutrition and diet, oral hygiene, fluoride use, habits, injury prevention, and other topics. Guidelines are provided for different age groups, outlining what parents and dentists should discuss and assess. The goal is to educate parents and prevent oral health issues by addressing risk factors at each stage of a child's development.
Preventive orthodontics aims to preserve normal occlusion and includes patient education, caries control, management of eruption problems, space maintenance, and addressing oral habits. Key aspects are maintaining the deciduous dentition to allow proper eruption of permanent teeth, identifying issues like ankylosed or supernumerary teeth, and using space maintainers like crown-loop or distal shoe appliances as needed. Regular exams are important from an early age to monitor development and catch any issues requiring treatment or referral.
Feeding plate for a newborn with Cleft Palate.pptxSatvikaPrasad
A feeding plate is a prosthetic device used for newborns with a cleft palate to assist in feeding and improve nutrition intake. From a prosthodontic perspective, this plate acts as a barrier between the oral and nasal cavities, facilitating effective sucking and swallowing by providing a more normal anatomical structure. It helps to prevent milk from entering the nasal passage, thereby reducing the risk of aspiration and enhancing the infant's ability to feed efficiently. The feeding plate also aids in the development of the oral muscles and can contribute to better growth and weight gain. Its custom fabrication and proper fitting by a prosthodontist are crucial for ensuring comfort and functionality, as well as for minimizing potential complications. Early intervention with a feeding plate can significantly improve the quality of life for both the infant and the parents.
This document provides guidelines for providing anticipatory guidance to parents at different stages of their child's development. It covers topics such as oral development, nutrition, oral hygiene, fluoride use, habits, and injury prevention. Guidelines are provided for prenatal counseling, and ages 6-12 months, 12-24 months, 2-6 years, 6-12 years, and adolescence. The document emphasizes educating parents on establishing good oral health habits and preventing dental injuries at each stage.
an any other group age
Poor oral hygiene among older people has traditionally been manifest in high level of tooth loss, dental caries, and periodontal disease as well as xerostomia and oral cancer
1- Bone:
= Increasing age is associated with progressive reduction in bone mass resulting in osteoporosis
= atrophy of alveolar bone is related mainly to tooth loss and increase by age that resulting in:
- Absence of denture
- Loss of facial height
- Upward and forward posturing of mandible
= loss of alveolar bone occurs more rapidly in mandible than maxilla
= level of cyclo-oxygenase 2(cox2) enzyme, which play essential role in bone repair, decline dramatically with age, this explain the delayed bone healing in older age
2- T M J:
= The main age changes related to remodeling of the articular surface and disc in response to functional changes following tooth loss
= remodeling may result in disc displacement, particularly anterior displacement
= the retrodiscal tissue may show decreased vascularity and cellularity and increased density of collagen
= in severe cases displacement may lead to perforation of the disc resulting in progressive damage
3- Nerve and musculature:
= continued muscle function in a major requirement for the maintenance of speech and mastication, in all patient with advancing age, there is reduction in total muscle mass which occurs through a reduction in the number of muscle fiber rather than a major reduction in muscle fiber size
= by age there is a loss of motor unit specially over 60 age
= manifestations:
- Reduced masticatory force
- Reduce muscle strength
- Lengthening of chewing process
- Changes in chewing behavior
4- Oral mucosa:
= the clinical appearance of the oral mucosa in older patients is indistinguishable from younger one, however changes by time as:
- Mucosal trauma
- Mucosal disease
- Salivary gland hypo-function
Can alter the clinical features and character of oral tissues
= the stratified squamous epithelium become thinner, loss of elasticity and atrophies with age with increased oral disorders
5- Sensory changes:
= it is known that taste and smell sensitives changes throughout life and often decline with aging
= these changes can make the foods become tasteless resulting in reduction in appetite
= diminution of taste results from degeneration of taste buds and reduction of their total numbers
= elderly people cannot detect the pleasantness of food compared with younger people, this can lead to the older people to added more ingredients such as sugar or salts to food stuff that can lead to adverse health effect
6- Salivary glands:
Dry mouth –xerostomia and diminished salivary glands output are common in older age, some cases have decreased salivary output due to high intake of drugs as:
- Anti-depressant
- Anti-hypertensive
- Cytotoxic and anti-parkinsonism
Some cases with neck cancer may exposed to irradiation which cause:
- Severe and permanent salivary hypo-function
- Xerostomia
Some disease as: Diabe
This document provides guidance on managing avulsed permanent anterior teeth in children. It discusses evaluating the injury, immediately replanting or storing the tooth, performing root canals as needed, splinting the tooth, and following up over time. The goal is to replant the tooth promptly and monitor for signs of infection or need for additional treatment like apexification to encourage healing and prevent loss of the tooth. Immediate management and follow up care are important for the best prognosis of a replanted tooth.
This document contains the objectives and content from an interhospital case presentation on early childhood caries. The presentation includes two case studies of children with dental caries, a review of dental anatomy and development, and a discussion of early childhood caries. It emphasizes the role of pediatricians in the prevention, early diagnosis, and management of early childhood caries.
Cleft lip and palate is a birth defect caused by failure of fusion of the facial prominences during embryonic development between 4-12 weeks of gestation. It can involve the lip, alveolus, hard and soft palate. The document discusses the anatomy, embryology, classification, clinical manifestations, diagnostic evaluation, management including surgical techniques, and nursing care of infants with cleft lip and palate. Key aspects of nursing management include addressing feeding difficulties, preparing parents for surgery and their infant's needs, and educating on postoperative care to support healing.
This document discusses infant oral health and anticipatory guidance. It provides definitions of terms like risk assessment and anticipatory guidance. It outlines the goals and steps of early infant oral health care visits, including examination, counseling, risk assessment, and establishing anticipatory guidance. The document discusses counseling topics at different developmental stages from infancy to adolescence. It emphasizes the importance of early intervention, prevention of oral diseases, and establishing good oral hygiene habits from an early age through anticipatory guidance.
Role of Pediatric Dentist - Orthodontic In Cleft Lip and Cleft Palate Patientsiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Importance of Oral and Dental Health in College StudentsMessiMasino
This note covers the following topics: Bacterial Diversity in the Oral Cavity, Oral-Systemic Link, Tooth Brushing, Flossing, Common Oral Hygiene Mistakes, Oral Cavity and Oropharyngeal Cancers, Oral Cavity and Oropharyngeal Cancer, Acute Dental Trauma, Controlling Bleeding and Swelling, Complications of Oral Piercings.
This document discusses oral habits including digit sucking, bruxism, mouth breathing, lip biting, and tongue thrusting. It provides definitions, etiologies, effects, and treatment approaches for each habit. It also discusses prevention of traumatic dental injuries through early orthodontic treatment and use of mouth guards. Finally, it outlines the role of dental professionals in detecting and preventing oral cancer through recognition of risk factors, examination of lesions, and simple diagnostic tests like oral cytology and Toluidine blue staining.
JOURNAL CLUB PRESENTATION IN PROSTHODONTICS ON FEEDING APPLIANCES USED IN CLE...NAMITHA ANAND
This document describes a case report of fabricating a modified feeding plate for a newborn infant with cleft palate. A traditional feeding plate can injure soft tissues due to rigidity. The presented case fabricated a plate with a soft, flexible bulb covering the cleft palate to allow synchronized movement and prevent irritation. The plate helped the infant feed adequately and gain weight normally until surgical correction could be performed. Adjustments were made regularly to the border to allow dental arch growth without interference.
The study compared the reproducibility of two techniques for recording centric relation: Dawson's Bilateral Manipulation and Gysi's Gothic Arch Tracing. Twenty subjects underwent each technique five times over a week. The average standard error was calculated, with Gothic Arch Tracing (0.27) showing less variability than Bilateral Manipulation (0.94). Statistical analysis found Gothic Arch Tracing to be more accurate in reproducing centric relation records.
Infection control in community settingKaushal Goti
This document discusses infectious disease transmission and infection control methods in dental settings. It covers the chain of infection, modes of transmission, risk factors for infection, personal protective equipment, sterilization and disinfection procedures, dental waterline maintenance, portable dental kits for community outreach, and the importance of immunization and training healthcare workers to prevent occupational transmission. The overall goal of infection control is to control disease transmission between patients and healthcare workers.
This document discusses various techniques for managing the gag reflex. Behavior modification techniques like systematic desensitization aim to reduce anxiety and help patients gradually get used to stimuli that trigger gagging. Training with objects placed in the mouth for increasing durations can also help retrain the gag reflex. Pharmacological techniques include local anesthesia injections and conscious sedation to suppress the reflex. Prosthetic modifications like plateless dentures or attaching saliva ejectors can also help prevent triggering the gag reflex during dental procedures.
This document discusses the gag reflex and management of patients who experience excessive gagging. It begins by introducing gagging as a clinical problem that can complicate dental treatment. It then defines the gag reflex and discusses its role as a healthy defense mechanism. The document outlines the multifactorial etiology of gagging, including local/systemic disorders, anatomic factors, psychological factors, and iatrogenic factors. Management approaches aim to reduce anxiety, identify triggers, and "unlearn" behaviors that provoke gagging using relaxation, distraction, suggestion, and desensitization techniques. The goal is to allow patients to receive necessary dental care with minimum stress.
1) The document discusses various types of orthodontic expansion appliances including slow expansion appliances like coffins springs and quad helix expanders as well as rapid maxillary expansion appliances.
2) It describes the indications, contraindications, and effects of rapid maxillary expansion, which involves using a jackscrew-type device to widen the maxilla.
3) The types of rapid maxillary expansion appliances discussed are removable appliances, tooth-borne appliances like the Isaacson and Hyrax types, and tooth-and-tissue borne appliances like the Derichsweiler and Hass types.
How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
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Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
The simplified electron and muon model, Oscillating Spacetime: The Foundation...RitikBhardwaj56
Discover the Simplified Electron and Muon Model: A New Wave-Based Approach to Understanding Particles delves into a groundbreaking theory that presents electrons and muons as rotating soliton waves within oscillating spacetime. Geared towards students, researchers, and science buffs, this book breaks down complex ideas into simple explanations. It covers topics such as electron waves, temporal dynamics, and the implications of this model on particle physics. With clear illustrations and easy-to-follow explanations, readers will gain a new outlook on the universe's fundamental nature.
Thinking of getting a dog? Be aware that breeds like Pit Bulls, Rottweilers, and German Shepherds can be loyal and dangerous. Proper training and socialization are crucial to preventing aggressive behaviors. Ensure safety by understanding their needs and always supervising interactions. Stay safe, and enjoy your furry friends!
2. Orthodontics-the art and science-s. i.
bhalajhi-fifth edition- arya publication-
page no.281
Introduction
What is preventive orthodontics?
Preventive orthodontics is that part of
orthodontics practice which is concerned with
patient's and parents' education , supervision of
the growth and development of the dentition
and the cranio-facial structtures, the diagnostic
procedures undertaken to predict the
appearance of malocclusion and the treatment
procedures instituted to prevent the onset of
malocclusion.
3. contemporary orthodontics-william
proffit-third edition- elsevier
History
• 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 to9
years"
• 1966: Graber has defined preventive orthodontics has the
action taken to preserve the integrity of what appears to be a
normal occlusion at a specific time.
• 1977: Begg stated that"proper time to begin the treatment is
as the beginning of the variation from the normal, in the
process of the development of dental apparatus, as possible"
• 1980: Profit and Ackermann has defined it as a prevention if
potential interference with occlusal development.
4. Orthodontics-the art and science-s -s. i.
bhalajhi-fifth edition- arya publication-
page no.282
The following are some of the procedures undertaken
in preventive orthodontics:
1. Parent counseling
2. Caries control
3. Space maintenance
4. Exfoliation of deciduous teeth
5. Abnormal frenal attachments
6. Treatment of locked permenent first molars
7. Abnormal oral musculature and related habits.
5. Orthodontics-the art and science-s -s. i.
bhalajhi-fifth edition- arya publication-
page no.282
PARENTS COUNSELING
• Parent counseling though the most neglected,
is the most effective way to practice
preventive orthodontics.
• 2 types of parents counseling:
1. prenatal counseling
2. postnatal counseling
6. Orthodontics-the art and science-s -s. i.
bhalajhi-fifth edition- arya publication-
page no.282
Prenatal Counseling
1. This is the most effective time to get across to the
expecting parents.They are open to ideas and recieve
the suggestions regrading better welfare of the child's
well being.
• The gynecologists would benefit immensly on their
patients counseled on dental health.
• Prenatal counseling may involve the following:
1. The importance of oral hygiene maintenance by the
mother.
2. How irregular eating and hunger pangs by the
mother can result in her developing decayed teeth,
which can be quite painful involvement, especially
during the third trimester of pregnancy.
7. Orthodontics-the art and science-s -s. i.
bhalajhi-fifth edition- arya publication-
page no.282
3. A mother sufering from pregnancy induced diabetes
mellitus, would be more difficult to manage during
the pregnancy period especially if her oral hygiene is
poor.
4.The increased risk of a mother suffering from poor
oral hygiene transmitting the food with the same are
high.
5. Have natural foods containing calcium and
phosphorus,e.g. milk, milk products,egg
etc.especially during the third trimester, as they
would allow adequate formation of decidupous teeth
crowns.
8. Orthodontics-the art and science-s -s. i.
bhalajhi-fifth edition- arya publication-
page no.281
Postnatal Counseling
Age group Postnatal Counseling
Six months to One year of Age
1. Teething and the associated
irritation, slight loose motions are
possible in mildly elevated febrile
condition.
2. Most of the parents are palled on
seeing the deciduous teeth erupting
in rotated positions.
3. Awareness to be brought about as
to how they are in that position and
that they would eventually
straighten out on erupting fully.
4. No sugar addition to bottle milk,
however mothers' milk mis preferred
and the best for the TMJ
development as well as for non-
development of tongue thrusting
habits.
9. Orthodontics-the art and science-s -s. i.
bhalajhi-fifth edition- arya publication-
page no.281
5. Brushing with the help of a finger
brush during bathing should be
introduced. Cleaning of the
deciduous dentition with a clean,
soft cotton cloth dipped in warm
saline is also recommended,
to prevent the initiation nursing or
rampant caries.
6. Child should be initiated to
drinking from a glass by one year of
age.
10. Orthodontics-the art and science-s -s. i.
bhalajhi-fifth edition- arya publication-
page no.281
5. Brushing with the help of a finger
brush during bathing should be
introduced. Cleaning of the
deciduous dentition with a clean,
soft cotton cloth dipped in warm
saline is also recommended,
to prevent the initiation nursing or
rampant caries.
6. Child should be initiated to
drinking from a glass by one year of
age.
11. Orthodontics-the art and science-s -s. i.
bhalajhi-fifth edition- arya publication-
page no.281
Two years of Age
1. Bottle - feeding if previously initiated
should never be given during the passage to
sleep.
2. Bottle feeding to be withdrawn completely
by 18 to 24 months of age. These would
decrease the chances of initiation of decayed
and the potential for nursing caries.
3. Brushing to be initiated post- breakfast and
post dinner.
4. Clinical examination to assess any incipient
decay and eruption status of teeth.
12. Orthodontics-the art and science-s -s. i.
bhalajhi- fifth edition- arya publication-
page no.281
Three years of Age
1. Clinical examination- generally the full
compliment of deciduous dentition
should have erupted by now.To assess
the occlusion, molar and canine
relationships and if there is the presence
of any discrepancies away from the
normal, e.g. unilateral cross
bite,supernumerary teeth, missing teeth,
fused teeth etc.
2. The child should be on 3 square meals a
day.
3. Oral habits such as thumb sucking,oral
breathing,etc. and their effects on the
development of occclusion should be
considered.
4. Parents to be informed accordingly.
The use of muscle training appliances to
be considered to assess clinically for
incomplete eruption of deciduous second
molars/ perocoronal flaps may lead to
decay on the same.
13. Orthodontics-the art and science-s -s. i.
bhalajhi-fifth edition- arya publication-
page no.281
Five to Six years of Age
1. Parents to be informed about the
initiation of exfoliation of deciduous
teeth and that it would go up to 12
to 13 years of age.
2. Clinical examination.
3. The need for constant review and
recall on a regular basis.
4. In case of extraction of deciduous
teeth due to decay, etc. the need,
advantages and importance of space
maintainers should be explained.
14. Orthodontics-the art and science-s -s. i.
bhalajhi-fifth edition- arya publication-
page no.283
CARIES CONTROL
• Caries involving the deciduous teeth, especially the
proximak caries is the main cause of development of
a malocclusion.
• There has been a sudden spurt of nursing and
rampant caries, involving the deciduous and the
mixed dentition generally, which has resulted in a
sudden demand for preventive and interceptive
orthodontics.
• The importance of maintaining and preseving the
deciduous dentition should be counseled to the
parents and pediatricians.
15. Orthodontics-the art and science-s -s. i.
bhalajhi-fifth edition- arya publication-
page no.283
• Most of the parents first seek the opinion of their
pediatrician regarding their child’s decayed teeth.
• In case of proximal decay ,the adjacent tooth tends to
tilt into the proximally decayed area resulting in the
loss of arch length, thereby resulting in lesser space
for succedaneous tooth erupted m their rightful place
and position .therefore,the proximal decay should be
restored accurately at the earliest and many problems
may not arise provided arch length loss is equal to or
less than the Leeway Space of Nance.
16. • In case of pulpal
involvement due to
caries,partial pulpectomy or
pulpotomy is done followed
by the placement of
stainless steel crown.
• Caries intiation can be
prevented by diet
counseling,topical flouride
application,pit and fissure
sealants and educating
parents.
Orthodontics-the art and science-s -s. i.
bhalajhi-fifth edition- arya publication-
page no.283
17. • Caries-preventive and remineralizing effect
• of fluoride gel in orthodontic patients after 2 years.
• Splieth CH, Treuner A, Gedrange T, Berndt C.
• Source
• Department of Orthodontics, Preventive and Pediatric Dentistry, Center for Oral Health, Ernst Moritz
Arndt University Greifswald, Rotgerberstraße 8, 17487 Greifswald, Germany. splieth@uni-greifswald.de
• Abstract
• Patients with orthodontic appliances exhibit a higher caries risk, but they are often excluded from
preventive studies. Thus, the aim of this observational study was to assess the caries-preventive and
remineralizing effect of a high-fluoride gel in orthodontic patients. Two hundred twenty-one orthodontic
patients (age, 6-19 years; mean, 13.1±2.3; n=104 with use of a 1.25% fluoride gel weekly at home, 117
participants without) were recruited and followed for 2 years, recording caries (decayed/missing/filled
teeth (DMFT)/decayed/missing/filled surface (DMFS), active/inactive lesions), orthodontic treatment, use
of fluorides, plaque and gingivitis. Baseline values regarding demographic and clinical parameters were
equivalent for the 75 participants using fluoride gel and the 77 individuals of the control group who
completed the study. The initial plaque and gingivitis values (approximal plaque index (API), 37%±34 and
42%±39, resp.; papillary bleeding index (PBI), 19%±28 and 22%±27, resp.) deteriorated slightly during the
2-year study (API, 54%/56%; PBI, 25%/28%). The increase in carious defects or fillings was minimal in both
groups (fluoride, 0.75 DMFT±1.2, 1.27 DMFS±1.9; control, 0.99±1.3 and 1.62±2.6, resp.) without
reaching statistical significance (p=0.12 for DMFT, 0.44 for DMFS). The main statistically significant effect
of the fluoride use was the reversal of active initial lesions diagnosed (fluoride group, -0.96±1.82; control,
-0.19±2.0, p=0.004), while the number of inactive initial lesions increased (2.3±2.1 and 1.7±2.1, resp.; p=
0.02). In conclusion, the weekly application of a fluoride gel in orthodontic patients can reduce their caries
activity. Initial caries lesions in orthodontic patients can be inactivated by weekly fluoride gel use at home.
18. SPACE MAINTENANCE
• Space maintenance is defined as the measures or
procedures that are brought into use due to premature
loss of deciduous tooth/teeth,to prevent loss of arch
development.
• Space maintainers are defined as the appliances that
prevent loss of arch length and which in turn guide
the permanent tooth into a correct position,intire
dental arch
• A tooth is maintained in its correct relationship in
the dental arch as a result of the action of series of
forces.
Orthodontics-the art and science-s -s. i.
bhalajhi-fifth edition- arya publication-
page no.289
19. The following factors are important when space
maintenance is considered after the untimely loss of
primary teeth .
• Time elapsed since loss of tooth:maximum loss of
space occurs within 2 weeks to 6 months of the
premature loss of deciduous tooth.it is recommended
to fabricate the space maintainer before the extraction
and to be inserted at the time of extraction .
• Dental age of patient: the dental age is more
important than the chronological age of patient.Orthodontics-the art and science-s -s. i.
bhalajhi-fifth edition- arya publication-
page no.295
20. • Amount of bone covering the developing succedaneous
tooth bud:The developing premolars usually require 3-5
months to move through 1mm of covering alveolar bone, as
observed on a bitewing radiograph.
• Stage of root formation: The developing tooth buds begins
to erupt actively if the root is three- fourth formed.
• Sequence of teeth eruption: The status of the developing and
erupting tooth buds adjacent to the space created by the
premature loss of the deciduous tooth is important.Orthodontics-the art and science-s -s. i.
bhalajhi-fifth edition- arya publication-
page no.295
21. • Congenitally missing teeth: If detected before the
tooth distal to them erupts, it is advisable to extract
their precursor deciduous tooth.
• Eruption of the permanent tooth in the opposing arch
to the prematurely lost tooth has erupted, then an
occlusal stop should be placed on the planned space
maintainer so as to prevent the supra-eruption of the
opposing permanent tooth, which in turn would
maintain an acceptable curve of spee.
Orthodontics-the art and science-s -s. i.
bhalajhi-fifth edition- arya publication-
page no.296
22. Ideal requirements of space maintainers:
• Maintain entire mesio-distal space created by loss of
teeth.
• Restore function as far as possible.
• Prevent over-eruption of opposing tooth.
• Simple in constuction.
• Strong enough to withstand functional forces.
• Should not exert excessive stress on opposing teeth.
• permit maintenance of oral hygiene.
• It should not come in the way of other functions.Orthodontics-the art and science- -s. i.
bhalajhi-fifth edition- arya publication-
page no.289
23. CLASSIFICATION OF SPACE MAINTAINERS
According to Hitchcock
• Removable or fixed or
semifixed.
• With bands or without
bands.
• Active or passive.
• Combinations of the above.
According to Raymond C.
Thurow
a) Removable.
b) Complete arch
Lingual arch
Extraoral anchorage
a) Individual tooth space
maintainer.Orthodontics-the art and science- -s. i.
bhalajhi-fifth edition- arya publication-
page no.288
24. According to Hinrichsen
1. Fixed space maintainers:
Class 1
a.Non-functional types
1. Bar types.
2. Loop type
b.Functional type
1.Pontic type
2.Lingual arch type
Class 2- Cantilever type
2. Removable Space
maintainers:
Acrylic partial dentures.
Orthodontics-the art and science- -s. i.
bhalajhi-fifth edition- arya publication-
page no.288
25. Removable space maintainers
• It can be functional or
non-functional.
• Functional: teeth
provided to aid in
mastication,speech and
esthetics.
• Non-unctional: only an
acrylic extension over
edentulous area to
prevent space closure.
Orthodontics-the art and science- -s. i.
bhalajhi-fifth edition- arya publication-
page no.290
26. Indications: Contraindications:
• When esthetics is of importance.
•When abutment teeth cannot
support fixed appliance
• Cleft palate patients: for obturation
of palatal defects.
• If radiographs reveal that the
unerupted permanent tooth is not
going to erupt in less than 5 months.
• If permanent teeth are not fully
erupted so a band cannot be
adapted.
• Multiple loss of deciduous teeth
requiring functional replacement.
• Lack of patient co-operation
• Allergy to acrylic
•Epileptic patients having
uncontrolled seizures.
Orthodontics-the art and science- -s. i.
bhalajhi-fifth edition- arya publication-
page no.290
27. Fixed Space Maintainers
Advantages Disadvantages
• Bands & crowns are used so
minimum or no tooth
preparation
• Do not interfere with passive
eruption of abutment teeth.
•jaw growth is not hampered.
•the succedaneous permanent
teeth are free erupt into the
oral cavity.
•useful in uncooperative
patients
•masticatory function is
restored if pontics are placed.
• Elaborate instrumentation
•Experts skill
•May reslt in decalcification of
tooth material under bands
•supra eruption of opposing
tooth if no pontics are placed
if pontics used,it may interfere
with vertical eruption of
abutment teeth & may prevent
eruption of replacing
permanent teeth, if the patient
fails to report.Orthodontics-the art and science- -s. i.
bhalajhi-fifth edition- arya publication-
page no.291-292
28. Space
Maintainance for
the First and
Second Primary
Molar and the
Primary Canine
Area
Orthodontics-the art and science- -s. i.
bhalajhi-fifth edition- arya publication-
page no.293
29. Loss of the Second
Primary Molar
Before Eruption of
the First
Permanent Molar
Space Maintenance
for Primary and
Permanent Incisor
Area
Removable Partial Dentures
Fixed Appliances
Space Maintenance
for Areas of
Multiple Tooth Loss
Orthodontics-the art and science- -s. i.
bhalajhi-fifth edition- arya publication-
page no.294
30. Loss of the First Permanent Molar
The treatment of patients with the loss
of first permanent molars must be
approached on an individual basis
Loss of the First Permanent Molar
Before the Eruption of the second
permanent Molar
The removal of the opposing first
permanent molar, even when the
tooth appears to be sound and caries
free, is sometimes recommended in
preference to allowing it to extrude
or to subjecting the child to
prolonged space maintenance and
eventual fixed replacement
If the first permanent molars are
removed several years before the
eruption of the second permanent
molars, there is an excellent chance
that the second molars will erupt in
an acceptable position
Orthodontics-the art and science- -s. i.
bhalajhi-fifth edition- arya publication-
page no.294
31. • Modified distal shoe appliance for the loss of a primary second molar: a case report.
• Dhull KS, Bhojraj N, Yadav S, Prabhakaran SD.
• Source
• Department of Pedodontics and Preventive Dentistry, Institute of Dental Sciences,
Bhubaneswar, Orissa, India. kanikasingh.dhull@gmail.com
• Abstract
• Preservation of primary teeth until their normal exfoliation plays a crucial role in
preventive and interceptive dentistry. Premature loss of the primary second molar prior
to the eruption of the permanent first molar in the absence of the primary second molar
can lead to mesial movement and migration of the permanent molar before and during its
eruption. In such cases, an intra-alveolar type of space maintainer to guide the eruption
of the permanent first molar is indicated. In certain cases, however, the conventional
design is not practical. This paper describes a new design for distal shoe appliances in
cases of primary second molar loss prior to the eruption of the permanent mandibular
first molar.
32. EXFOLIATION OF DECIDUOUS TEETH
• Generally the deciduous teeth should exfoliate in about 3
months of exfoliation of the one in the contralateral arch.
• any delay more than should be considered with suspicion and
the following should be ruled out:
a) over-retained deciduous root stumps.The greatest damage that
may result from over retained primay teeth comes in wake of
ankylosed primary olars
b) Fibrous gingiva.
c) Ankylosed submerged deciduoud teeth to be
• Assessed radiographically :Absence PDL membrane in a small
area or whole for the root surface.
• They do not resorb : prevent permanent teeth from erupting,or
deflect them to erupt in abnormal positions.
Orthodontics-the art and science- -s. i.
bhalajhi-fifth edition- arya publication-
page no.285
33. • Diagnose such tooth and surgical removal at an appropriate
time for permanent tooth eruption.
d). Restoration overhangs of the adjacent tooth.
e). Presence of any supernumerary tooth: Supernumerary
&supplemental teeth can interfere with eruption of nearby
normal teeth.
• They deflect adjacent teeth and erupt in abnormal positions.
• They should be identified and extracted before they cause
displacement of other teeth.
Orthodontics-the art and science- -s. i.
bhalajhi-fifth edition- arya publication-
page no.285
34. • Clinical implications of early loss of a lower deciduous canine.
• Martins-Júnior PA, Marques LS.
• Source
• Universidade Vale do Rio Verde (UNINCOR), Brazil. paulo_martins86@hotmail.com
• Abstract
• In crowded dental arches, the permanent lateral incisors often erupt and resorb the mesial
portion of the root of deciduous canines, causing their premature loss. Therefore, knowledge
on clinical aspects related to etiologic factors is necessary to pediatric orthodontists and
clinical dentists for diagnosis and treatment with regard to incisor crowding and adjustment.
The aim of the present study was to describe a clinical case characterized by the unilateral loss
of a lower deciduous canine, offering clinical considerations on this issue and discussing the
various procedures implemented to prevent potential problems. A patient, 8 years of age, had
the lower right deciduous canine prematurely lost, resulting in a deviation from the midline to
the same side of the loss caused by the migration of the permanent incisors. The antimeric
canine was removed and a fixed apparatus was attached to the lower arch associated to a
spring to correct the midline. Next, a lip bumper device was employed to promote the
vestibular conduction of the lower incisors to accommodate the permanent canines in the arch.
Although early loss of deciduous canines occurs frequently, treatment possibilities are
controversial and further studies on the subject are necessary Orthodontic evaluation should
be always considered to minimize the need to extract permanent teeth and/or future
orthodontic treatment.
• PMID:
35. ABNORMAL FRENAL
ATTACHMENTS
• Thick and fleshy maxillary labial frenum may cause the
development of diastema / excess spacing between the teeth,
which in turn may not allow the eruption of succedaneous
teeth.
• Surgical correction of the high frenal attachments is therefore
advised. The tongue should also be assessed for ankyloglossia/
tongue-tie.
Orthodontics-the art and science- -s. i.
bhalajhi-fifth edition- arya publication-
page no.287
36. • Diagnosis –blanch test.
• Treated at an early stage for prevention.
• If orthodontics closure is advocated , it should occur
before surgery to reduce the chance that scar tissue
will impade tooth movement. If there is sufficiently
arch space for the eruption of incisors and canines, it
is best to delay frenum surgery until these teeth have
fully erupted.
• Tongue-tie may cause problems with articulation of
sounds such as ’t’, ‘d’, ‘th’and ‘s’ because it restricts
the ability to elevate the tongue.
Orthodontics-the art and science- -s. i.
bhalajhi-fifth edition- arya publication-
page no.287
37. LOCKED PERMANENT FIRST MOLARS
• The permanent first molars may get locked
distal to the deciduous second molars, at times.
• Slight distal stripping of the deciduous second
molar allows the permanent first molar to erupt
in their proper place.
Orthodontics-the art and science- -s. i.
bhalajhi-fifth edition- arya publication-
page no.289
38. ABNORMAL MUSCULATURE AND
RELATED HABITS
• Bruxism.
• Bruxism is a nonfunctional grinding or gnashing of teeth.
• The habit usually occurs at night and, if continued over a
prolonged period, can result in abrasion of primary and
permanent teeth occlusal interference may trigger bruxism,
particularly if it is combined with nervous tension. Therefore
occlusal adjustment should be the first approach to the
problem if interferences are presents the constuction of a
palatal bite plate, which allows the continued eruption of the
posterior teeth. This eruption is desirable if the teeth have been
abraded by the habit. contemporary orthodontics-william
proffit-third edition- elsevier-page
no.441
39. • A vinyl plastic bite guard that covers the
occlusal surfaces of all teeth plus 2 mm of the
buccal and lingual surfaces can be worn at
night to prevent continuing abrasion. The
occlusal surface of the bite guard should be
flat to avoid occlusal interference. A mouth
guard may also help in overcoming the habit.
contemporary orthodontics-william
proffit-third edition- elsevier-page
no.441
40. Digit and Nonnutritive Sucking Behaviors
• Many children suck their thumbs or fingers for short
periods during infancy or early childhood. Although
the habit may be considered normal during the first 2
years of life, many children never develop a digit-
sucking habit.
• Many children stop the habit during the preschool
years, but some continue into the teenage or adult
years.
• Even if there were no ill effects on occlusion, thumb
sucking is not socially acceptable; it should be
discouraged when the habit is persistent and when the
patient is mentally capable of understanding why
it should be stopped. contemporary orthodontics-william
proffit-third edition- elsevier-page
no.444
41. Methods use to prevent digit sucking
• The use of a corrective appliance to manage oral habits is
indicated only when the child wants to discontinue the habit
and needs only a reminder to accomplish the task.
• If an appliances is used, it should not be painful or
interfere with occlusion; instead , it should merely
act as a reminder.
• A removable partial retainer with a series of smooth loops
placed lingual to the incisors has proved successful in helping
the child overcome the habit.
contemporary orthodontics-william proffit-
third edition- elsevier-page no.444
42. • An entirely different approach has been practiced by some dentists when it
is evident that a child wants to discontinue the habit. This requires
cooperation of the parents and their consent to disregard the habit and not
mention it to the child.
• In a private conversation with the child, the dentist discusses the problem
and its effect. The child is asked to keep a daily record on a card of each
episode of thumb sucking and to call the dentist each week and report on
progress in stopping the habit. A decrease in the number of times of times
that the habit is practiced is evidence of progress and indicates that the
child will discontinue the habit.
• The parents’ role in the correction of an oral habit is important. Parents are
often overanxious about the habit and its possible effects. This anxiety may
result in nagging or punishment that often creates a greater tension and
intensification of the habit. Change in the home environment and routine
are often necessary before the child can overcome the habit.
contemporary orthodontics-william proffit-
third edition- elsevier-page no.444
43. • Haskell and Mink have used the Bluegrass appliance
with a program of positive reinforcement to stop
thumb sucking in children. A modified, six-sided
roller machined from Teflon which permits purchase
of the tongue, is constructed to skip over a 0.045 inch
stainless steel wire that is soldered to molar
orthodontic bands previously fitted and in place on a
poured plaster model.
contemporary orthodontics-william proffit-
third edition- elsevier-page no.444
44. Tongue and Swallowing Habits
• Abnormal tongue position and a deviation from the so-called
normal movement of the tongue during swallowing have long
been associated with anterior open bite and protrusion of the
maxillary incisors.
• Three major problems are usually associated with the anterior
tongue position, these problems are open bite; protrusion of
the incisors, particularly the maxillary incisors; and lisping.
contemporary orthodontics-wiliam proffit-
third edition- elsevier-page no.444
45. • The two major reasons for it relate to the physiology of the child and to
anatomy.
• Normal infants position the tongue anteriorly in the mouth at rest and
during swallowing.
• An infant’s normal swallow is characterized by strong lip activity to seize
the nipple, placement of the tongue tip against the lower lip beneath the
nipple, and relaxation of the elevator muscle of the mandible so that mouth
is wide open
• As oral function matures, there is gradual activation of the elevator
muscles of the mandible so that mandible is bought up toward what
ultimately will be occlusal contact of teeth. This act occurs while the
tongue tip is still placed against the lower lip.
contemporary orthodontics-william proffit-
third edition- elsevier-page no.444
46. • Physiologic transition is swallowing begins during the first
year of life and normally continues years.
• A mature swallowing pattern is characterized by relaxation of
the lips, placement of the tongue behind the maxillary
incisors, elevation of the mandible until posterior teeth are
contact. This pattern is not usually observed before a child is 4
or 5 years of age.
contemporary orthodontics-william proffit-
third edition- elsevier-page no.444
47. Methods to prevent tongue
thrusting
• Although appliances are often recommended for treatment of
tongue thrust, myofunctional therapy should be attempted
first.
• Andrews recommends that the patient be instructed to
practice swallowing correctly 20 times before each meal.
Holding a glass of water in one hand and facing a mirror, the
child takes a sip of water, closes the teeth into occlusion,
places the tip of the tongue against the incisive papilla, and
swallows. This is repeated and each time is followed by the
relaxation of the muscles until the swallowing progresses
smoothly.
contemporary orthodontics-william proffit-
third edition- elsevier-page no.445
48. • The use of a sugarless mint has also resulted in successful
management of simple tongue thrusting. The child is
instructed to use the tip of the tongue to hold a mint on the
roof of the mouth until it meals. As the mint is held, saliva
flows and makes it necessary for the child to swallow. After
the patient has trained the tongue and muscles to function
properly during swallowing, a mandibular lingual arch with a
crib or an acrylic palatal retainer with a fence may be
constructed as a reminder to position the tongue properly
during swallowing.
contemporary orthodontics-william proffit-
third edition- elsevier-page no.445
49. • Mouth breathing- the child can be given adequate medical
attention, regarding recurrent respiratory tract infection. Oral
screens the recently introduced myofunctional appliances such
as the pre –orthodontic trainers, train the child breate through
the nose, thus allowing the proper development of nasal
passage, regression of adenoid mass and the development of a
shallow, broad palate.
contemporary
orthodontics-william
proffit-third edition-
elsevier-page no.445
51. conclusion
• As the word goes, PREVENTION IS ALWAYS
BETTER THAN CURE, preventing orthodontic
malocclusion at a very early age can do so much good
for the children than interceptive and corrective
procedures at a later age. Hence it is the need of the
age, for children and parent to be well informed,
educate and motivated to take preventive measure
against dental malocclusion.
52. Is orthodontic treatment without premolar extractions
always non-extraction treatment? Kandasamy S, Woods MG.
• Source
• School of Dental Science, The University of Melbourne, Victoria.
• Abstract
• While it is common in contemporary orthodontic and orthopaedic
treatment to commence treatment for many growing patients during the
mixed-dentition, the creation of anterior space, often involving the
attempted distalization or holding-back of the upper and lower permanent
molar teeth has been shown to commonly result in posterior space
deficiencies. Although the extractions of permanent premolar teeth may
have been avoided, the developing second and third permanent molars are
often affected, so that third molar impaction results in many cases. This is
not to say that orthodontic treatment carried-out without premolar
extractions is not ideal in many cases, but on the available evidence, so-
called absolute 'non-extraction' protocols should be questioned, so that
both the dental profession and the public at large are not misled.
•