Preventive orthodontics aims to educate patients and parents, monitor growth and development, diagnose potential malocclusions, and treat issues before they arise. Preventive procedures include parent education, caries control, managing deciduous teeth, extracting supernumerary teeth, and treating habits. Space maintainers are used to preserve space from lost deciduous teeth. Removable space maintainers are easy to clean but can be lost, while fixed types do not interfere with eruption but require more skill. Common space maintainers include band and loop, lingual arch, distal shoe, and acrylic partial dentures.

1. PREVENTIVE ORTHODONTICS
PROF (Dr.) SAIBEL FARISHTA

2. ‘PREVENTIVE ORTHODONTICS’
IT IS THAT PART OF ORTHODONTIC PRACTICE WHICH
IS CONCERNED WITH THE PATIENT’S AND PARENTS
EDUCATION, SUPERVISION OF THE GROWTH AND
DEVELOPMENT OF THE DENTITION AND THE
CRANIOFACIAL STRUCTURES, THE DIAGNOSTIC
PROCEDURES UNDERTAKEN TO PREDICT THE
APPEARANCE OF MALOCCLUSION AND THE
TREATMENT PROCEDURES INSTITUTED
TO PREVENT THE ONSET OF MALOCCLUSION.

3. CLINICAL PREVENTIVE PROCEDURES
1. PARENT EDUCATION
2. CARIES CONTROL
3. CARE OF DECIDUOUS DENTITION
4. EXTRACTION OF SUPERNUMERARY TEETH
5. OCCLUSAL EQUILIBRIATION IF THERE ARE ANY OCCLUSAL
PREMATURATIES
6. MAINTENANCE OF QUADRANT WISE TOOTH SHEDDING
TIME TABLE
7. MANAGEMENT OF ANKYLOSED TOOTH
8. MANAGEMENT OF ABNORMAL FRENAL ATTACHMENTS
9. CHECKUP FOR ORAL HABITS AND HABIT BREAKING
APPLIANCE IF NECESSARY
10. PREVENTION OF DAMAGE TO OCCLUSION. EG. MILWAUKEE
BRACES
11. MANAGEMENT OF DEEPLY LOCKED FIRST PERMANENT
MOLAR
12. SPACE MAINTAINANCE

4. SPACE MAINTAINERS
PREMATURE LOSS OF DECIDUOUS TEETH CAN
CAUSE DRIFTING OF ADJACENT TEETH INTO THE
SPACE, MAY RESULT IN ABNORMAL AXIAL
INCLINATION OF TEETH, SPACING BETWEEN TEETH
AND SHIFT IN THE DENTAL MIDLINE. IN CASES OF
PREMATURE LOSS OF DECIDUOUS SECOND MOLARS,
THE PERMANENT FIRST MOLARS MIGRATE
MESIALLY, LEAVING VERY LITTLE SPACE FOR THE
SECOND PREMOLARS.
SPACE MAINTAINER IS A DEVICE USED TO MAINTAIN
THE SPACE CREATED BY THE LOSS OF A DECIDUOUS
TOOTH.

5. CLASSIFICATION OF SPACE MAINTAINERS
HITCHKOCK:
1. REMOVABLE/FIXED/SEMI-FIXED
2. WITH BANDS OR WITHOUT BANDS
3. FUNCTIONAL OR NON FUNCTIONAL
4. ACTIVE OR PASSIVE
5. CERTAIN COMBINATIONS OF THE ABOVE
R THUROW:
1. REMOVABLE
2. COMPLETE ARCH
- LINGUALARCH
- EXTRA ORALANCHORAGE
3. INDIVIDUAL TOOTH

6. HINRICHSEN:
1. FIXED SPACE MAINTAINERS
CLASS I A) NON FUNCTIONAL TYPES
1. BAR TYPE
2. LOOP TYPE
B) FUNCTIONAL TYPES
1. PONTIC TYPE
2. LINGUALARCH TYPE
CLASS II – CANTILEVER TYPE (DISTAL SHOE,
BAND AND LOOP)
2. REMOVABLE SPACE MAINTAINERS:
ACRYLIC PARTIAL DENTURES

7. REQUIREMENTS OF SPACE MAINTAINERS
1. IT SHOULD MAINTAIN THE ENTIRE MESIODISTAL SPACE
CREATED BY A LOST TOOTH
2. IT MUST RESTORE THE FUNCTION AS FAR AS POSSIBLE AND
PREVENT OVER ERUPTION OF OPPOSING TEETH
3. IT SHOULD BE SIMPLE IN CONSTRUCTION
4. STRONG ENOUGH TO WITHSTAND FUNCTIONAL FORCES
5. NOT EXERT EXCESSIVE STRESS ON ADJOINING TEETH
6. MUST PERMIT MAINTAINANCE OF ORAL HYGIENE
7. NOT RESTRICT NORMAL GROWTH AND DEVELOPMENT
8. SHOULD NOT COME IN THE WAY OF OTHER FUNCTIONS

8. REMOVABLE SPACE MAINTAINERS
1. EASY TO CLEAN AND HELPS IN MAINTAINING GOOD ORAL
HYGIENE
2. MAINTAINS OR RESTORES THE VERTICAL DIMENSION
3. AS THEY CAN BE WORN PART TIME, THEY ALLOW
CIRCULATION OF THE BLOOD TO THE SOFT TISSUES
4. THEY SERVE OTHER FUNCTIONS, LIKE MASTICATION,
ESTHETICS AND PHONETICS
5. DENTAL CHECK UP FOR CARIES DETECTION CAN BE
UNDERTAKEN EASILY
6. SPACE CAN BE MADE FOR PERMANENT TEETH TO ERUPT,
WITHOUT CHANGING THE APPLIANCE
7. THEY STIMULATE THE ERUPTION OF PERMANENT TEETH
8. BAND CONSTRUCTION IS NOT REQUIRED
9. THEY HELP IN PREVENTING DEVELOPMENT OF TONGUE
THRUST HABIT INTO THE EXTRACTION SPACE
ADVANTAGES -

9. DISADVANTAGES -
1. THEY MAY BE LOST OR BROKEN BY THE PATIENT
2. UN-COOPERATIVE PATIENTS MAY NOT WEAR THE APPLIANCE
3. LATERAL JAW GROWTH MAY BE RESTRICTED, IF CLASPS ARE
INCORPORATED
4. THEY MAY CAUSE IRRITATION OF THE UNDERLYING SOFT
TISSUES
INDICATIONS -
1. THEY ARE INDICATED WHERE ESTHETICS IS OF IMPORTANCE
2. IN CASES WHERE THE ABUTMENT TEETH CANNOT SUPPORT A
FIXED APPLIANCE
3. IN CASE THE RADIOGRAPH REVEALS THAT THE UNERUPTED
PERMANENT TOOTH IS NOT GOING TO ERUPT IN LESS THAN
FIVE MONTHS TIME, A REM. SPACE MAINTAINER CAN BE
GIVEN

10. 4. IN CLEFT PALATE PATIENTS WHO REQUIRE OBTURATION OF
THE PALATAL DEFECT
5. IN PARTIALLY ERUPTED TEETH, WHERE BANDING IS
DIFFICULT
6. MULTIPLE LOSS OF DECIDUOUS TEETH, WHICH MAY REQUIRE
FUNCTIONAL REPLACEMENT IN THE FORM OF PARTIAL OR
COMPLETE DENTURE
CONTRAINDICATIONS -
1. LACK OF PATIENT COOPERATION
2. PATIENTS WHO ARE ALLERGIC TO ACRYLIC MATERIALS
3. EPILYPTIC PATIENTS WHO HAVE UNCONTROLLED SEIZURES
COMMONLY USED REMOVABLE SPACE MAINTAINERS
1. ACRYLIC PARTIAL DENTURES
2. FULL OR COMPLETE DENTURES
3. REMOVABLE DISTAL SHOE SPACE MAINTAINER

11. FIXED SPACE MAINTAINERS
ADVANTAGES -
1. BANDS AND CROWNS ARE USED WHICH REQUIRE MINIMUM
OR NO TOOTH PREPARATION
2. THEY DO NOT INTERFERE WITH PASSIVE ERUPTION OF
ABUTMENT TEETH
3. JAW GROWTH IS NOT HAMPERED
4. THE SUCCEDANEOUS PERMANENT TEETH ARE FREE TO
ERUPT INTO THE ORAL CAVITY
5. THEY CAN BE USED IN UN-COOPERATIVE PATIENTS
6. MASTICATORY FUNCTION IS RESTORED, IF PONTICS ARE
PLACED

12. DISADVANTAGES -
1. ELABORATE INSTRUMENTATION WITH EXPERT SKILL IS
NEEDED
2. THEY MAY RESULT IN DECALCIFICATION OF TOOTH
MATERIAL UNDER THE BANDS
3. SUPRA-ERUPTION OF OPPOSING TEETH CAN TAKE PLACE, IF
PONTICS ARE NOT USED
4. IF PONTICS ARE USED, IT CAN INTERFERE WITH VERTICAL
ERUPTION OF THE ABUTMENT TOOTH AND MAY PREVENT
ERUPTION OF REPLACING PERMANENT TEETH IF PATIENT
FAILS TO REPORT

13. 1. BAND AND LOOP
2. CROWN AND LOOP
3. LINGUAL ARCH
4. PALATAL ARCH
5. TRANSPALATAL ARCH
6. DISTAL SHOE
7. ESTHETIC ANTERIOR SPACE MAINTAINER
8. BAND AND BAR
COMMONLY USED FIXED SPACE MAINTAINERS

14. PHOTOGRAPHS

15. ERUPTING 5
PALATAL HOLDING ARCH

16. REMOVABLE BILATERAL
SPACE MAINTAINER
REMOVABLE UNILATERAL
SPACE MAINTAINER

17. BAND AND LOOP SPACE MAINTAINER

18. HOW TO BEND
A BAND LOOP
SPACER
1. WIRE CUTTERS
2. BAND ADAPTOR
3. BAND REMOVER
4. BAND SEATER
5. 3 PRONG PLIER
6. BIRD BEAK PLIER
7. CAST
INSTRUMENTS
REQUIRED

19. CUT 2.5’’ OF 0.36 WIRE
3 PRONG PLIERS
FOR CONTOUR

20. TRY ON CAST
FOR CLOSE FIT
3 PRONG PLIER
FOR VERTICAL CONTOUR

21. VERTICAL CONTOUR
ACHIEVED
CHECK IT FOR FIT
ON THE CAST

22. CONTOUR THE BUCCAL
AND LINGUAL ARMS
WITH THREE PRONG
SPACE MAINTAINER
CONTACTS IN THE
MIDDLE THIRD
OF TOOTH, MESIAL
OF THE SPACE

23. MARK FOR ‘S’ BEND,
CONTOUR IS ABOUT
1 mm ABOVE TISSUE
45 DEGREES BEND
WITH BIRDBEAK PLIER

24. 45 DEGREES ‘UP’ BEND
WIRE AT JUNCTION
OF OCCLUSAL AND
MIDDLE ONE THIRD
OF THE BAND

25. WIRE SHOULD NOW BE
CONTOURED TO THE
BUCCAL AND LINGUAL
CONTOUR OF THE TOOTH
IMPROVED BUCCAL
CONTOUR

26. PROPER CONTOUR,
HORIZONTAL PART OF WIRE
IS AT THE JUNCTION OF
THE MIDDLE AND OCCLUSAL
THIRD OF THE BAND
OCCLUSAL VIEW,
THE APPLIANCE MAY
NOW BE SOLDERED

27. CROWN AND LOOP
SPACE MAINTAINER
DISTAL SHOE
SPACE MAINTAINER

28. LINGUALARCH
SPACE MAINTAINER
LINGUALARCH
SPACE MAINTAINER

29. DISTAL SHOE
SPACE MAINTAINER
DISTAL SHOE
SPACE MAINTAINER

30. NANCE HOLDING ARCH
REMOVABLE BILATERAL
SPACE MAINTAINER

32. THANK YOU