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PREVENTIVE AND INTERCEPTIVE ORTHODONTICS

PREVENTIVE AND INTERCEPTIVE ORTHODONTICS . Group 1 . PREVENTIVE ORTHODONTIC. Definition : It is an action taken to presrve the integrity of what appears to be a normal occlusion at a specific time. Aim : To prevent develoment of malocclusion. PROCEDURES. Parent education :

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PREVENTIVE AND INTERCEPTIVE ORTHODONTICS

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  1. PREVENTIVE AND INTERCEPTIVE ORTHODONTICS Group 1

  2. PREVENTIVE ORTHODONTIC • Definition : • It is an action taken to presrve the integrity of what appears to be a normal occlusion at a specific time. • Aim : • To prevent develoment of malocclusion.

  3. PROCEDURES • Parent education : • Physiologic nipples, proper toothbrushing technique, maintain good OH • Caries control : • Monitor caries progression, prevent early loss • Monitoring of primary dentition and transition stage : • Monitor eruption and exfoliation time, application of preventive procedures

  4. Extraction of retained deciduous or supernumerary teeth : • Can interfere with eruption of permanent and cause displacement or erupt abnormally. • Habit correction : • Thumb sucking habit, tongue thrusting. Can cause anterior open bite. Use habit breaker appliances. • Space maintainer : • To maintain space created by premature loss of deciduous teeth.

  5. PHYSIOLOGIC NIPPLE, PACIFIER SPACE MAINTAINER HABIT BREAKER

  6. INTERCEPTIVE ORTHODONTICS

  7. Definitions. • Any procedure that eliminates or reduces the severity of malocclusion in the developing dentition. (Popovich and Thompson 1979, Hiles 1985.) • All simple measures that eliminate the developing malocclusion (Ackerman and Profit 1980).

  8. Indications. • Impacted canine • Impacted molars • Hypodontia • Supernumerary teeth. • Correction of anterior and posterior crossbite • Sagittal problems- class II • Sagittal problems- class III

  9. Treatment involved • Serial extraction • Correction of developing cross bite • Control of abnormal habits • Space regaining • Muscle exercises • Interception of skeletal mal relation • Removal of soft tissue or bony barrier to enable eruption of teeth

  10. 1. Serial extractions • 1940s to treat Class I malocclusion complicated by severe labial segment crowding • Aim: to spontaneously guide the developing dentition into good alignment w/o • use of appliance treatment by selectively timing deciduous • and permanent tooth extractions

  11. Disadvantages serial Xn • Multiple Extractions under GA > a stressful experience for the patient. • Early loss of the 1st deciduous molar > mesial drift of the buccal segments with further space loss. • The lower canine may still erupt into the first deciduous molar space before the first premolar resulting in first premolar impaction. • No spontaneous correction of an incorrect incisor relationship, hence it is only useful in Class I cases. • A risk of lower incisor retroclination and deepening of the overbite. • Patients may still require later appliance treatment.

  12. Current approach • Serial xn rarely practice due current wide availability of fixed appliances • a modified version of the procedure may be carried out • (e.g. extraction of deciduous canines to allow alignment of the incisors or for interceptive treatment of palatal maxillary canines) to simplify later appliance treatment

  13. 2. Treatment for crossbites • Quad helix • Micro screws

  14. 3. Control of abnormal habits • Thumb / digit sucking • Mouth breathing • Tongue thrusting • Lip sucking / biting

  15. Treatments for thumb sucking • Tongue crib • Lip bumper

  16. 4. Space regaining • Mesial tipping or drifting of permanent first molars on premature loss of deciduous second molar , reducing the arch length • Extensive caries • Ecotopic eruption • Premature extraction of primary molars

  17. Treatments • Timing of distalization • 7-10 yrs of age • Incomplete root formation • Second molars are not erupted

  18. Treatment procedures • Fixed appliances • Open coil / herbst space regainer • Jackscrew space regainer • Gerber space regainer • Removable appliance • Hawley’s appliance • With helical spring\ • Split acrylic dumb • bell spring • With sling shot elastic • Palatal spring • Expansion screws

  19. 6. Interception of skeletal malocclusion • Class II • Class III • Functional appliances • Tooth borne • Active • Passive • Tissue borne

  20. 7. Removal of soft tissue / bony barrier • Removal of soft tissue / bony barrier • Retained deciduous teeth • Supernumerary teeth • Fibrous / bony obstruction of the erupting tooth bud

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