interceptive orthodontics applications.ppt

interceptive orthodontics applications

1. INTERCEPTIVE
ORTHODONTICS
PRESENTED BY
DR.PRINCYMOLK
FIRST YEAR PG
MBDC

2. INTERCEPTIVE
ORTHODONTICS
•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
mal occlusion. (Ackerman and Proffit 1980)

3. INTERCEPTIVE
ORTHODONTICS
The aetiology of malocclusion could be:
1-Skeletal discrepancy
2-Soft tissue
3-local factors
4-Crowding and spacing
5-Displacements

4. INTERCEPTIVE
ORTHODONTICS
Local factors: DELAYED ERUPTION OF UPPER
PERMANENT CENTRAL INCISOR .
•Definition: 1 is considered to be delayed if the
contra-lateral tooth was fullyerupted or if teeth later
in the usual eruption sequence were present.
•Interceptive treatment: removal of supernumerary
with or without tooth exposure.
•Treatment timing: as soon as the supernumerary
tooth is detected.

11. INTERCEPTIVE
ORTHODONTICS
Local factors:RETAINED DECIDUOUS
TEETH.
•Definition: the deciduous tooth is considered to be
over retained if it made enamel contact with its
successor.
•Interceptive treatment: extraction.

12. INTERCEPTIVE
ORTHODONTICS
Local factors: INFRAOCCLUSION
•Definition: the tooth loses its vertical position
relative to the adjacent teeth and assumes a
position below the occlusal plane
•Frequent site: lower 2
nd
and 1
st
primary molars.
•Interceptive treatment: nothing unless the
permanent successor was absent or the
infraoccluded tooth is likely to disappear .

15. INTERCEPTIVE
ORTHODONTICS
Local factors: UNILATERAL RETAINED
DECIDUOUS CANINE.
•Definition: premature loss of one deciduous canine
as a result of early root resorption by a crowded
lateral incisor.
•Interceptive treatment: extraction of the primary
canine on the opposite side of the arch to preserve
the midline.

16. INTERCEPTIVE
ORTHODONTICS
Local factors: DOUBLE TEETH
•Definitions:
Gemination: the attempt of a single tooth bud to
form two distinct morphological entities.
Fusion: the result of joining two adjacent tooth buds.

18. INTERCEPTIVE
ORTHODONTICS
Local factors: DOUBLE TEETH
•In the deciduous dentition double teeth are
usually associated with absent permanent
successor, or ectopic or delayed eruption of the
permanent successor if it was present. Treatment
therefore involve the extraction of the
malformed tooth.
•In the permanent dentition treatment options
are: Mask, Split and Extract

19. INTERCEPTIVE
ORTHODONTICS
Local factors: ECTOPIC ERUPTION OF THE
PERMANENT FIRST MOLAR .
•Definition: the molar erupts at an angle mesial to its
normal path of eruption.
•Types : reversible and irreversible
•Treatment: extraction of E or distalisation of
permanent molar

22. INTERCEPTIVE
ORTHODONTICS
Local factors: Hypodontia
•Definition: Absent teeth.
•Common teeth: lower 2
nd
premolar & upper lateral
incisor.
•Treatment: space closure or space maintenance for
future prosthesis.

26. INTERCEPTIVE
ORTHODONTICS
Local factors:DIASTEMA
•Definition: space between the two upper central
incisors.
•Treatment if indicated: removal of pathology
(supernumerary, odontome, fraenum?….)

28. INTERCEPTIVE
ORTHODONTICS
Local factors: ECTOPIC UPPER CANINE
•Definition: the canine erupts out of its normal
eruption path.
•Diagnosis: If the 3 was not palpable in the buccal
sulcus after the age of 10 years.
•Treatment: Extraction of the deciduous canine.

32. INTERCEPTIVE
ORTHODONTICS
Local factors:ECTOPIC UPPPER CANINE
Rate of eruption of the permanent canine after the
extraction of the deciduous canine depends on the
amount by which the permanent canine overlap the
lateral incisor:
overlap < 1\2 of lateral root: success rate 91%
overlap > 1\2 of lateral root: success rate 64%
(Ericson & Kurol 1988)

33. INTERCEPTIVE
ORTHODONTICS
Local factors:THUMB SUCKING
•Effect: no malocclusion 14.6%
anterior open bite 48.1%
posterior cross bite 07.2%
ant OB +post X-bite 30.1%
(Da Silva et al. 1991)

37. INTERCEPTIVE
ORTHODONTICS
Local factors: THUMB SUCKING
•At what age should treatment be started?
-Da Silva et al (1991)“from the 5
th
year of age”
-Proffit (1993) “before the eruption of
permanent incisors”
-Houston (1993) “ by 7-8 years of age “
-Mills (1982) “before permanent dentition”
-Larsson (1987) “before pubertal growth spurt”

38. INTERCEPTIVE
ORTHODONTICS
Local factors: THUMB SUCKING
•Treatment:
1-Adult approach.
2-Deterrent appliance.

39. INTERCEPTIVE
ORTHODONTICS
Local factors: TRANSPOSITION
•Definition: unusual type of ectopic eruption were
two permanent teeth have interchanged their location
in the dental arch.
•Frequent sites: upper canine and first premolar
lower canine and lateral incisor.
•Interceptive treatment: extract transposed tooth.
align before canine eruption
•Treatment timing: before eruption of canine.

42. INTERCEPTIVE
ORTHODONTICS
Crowding:
•Treatment:
1-Space management.
2-Molar distalisation.
3-Serial extraction.
4-Premolar extraction.
5-First molar extraction.
6-lower incisor extraction.
7-Second molar extraction.

43. INTERCEPTIVE
ORTHODONTICS
Crowding: SPACE MANAGEMENT.
•Definition: utilization of Lee Way space to relieve
anterior crowding.
•Indications:1-Cl I molar relation ship.
2-E,s are still present in the.
crowded side(s).
3-Mild crowding.

44. INTERCEPTIVE
ORTHODONTICS
Crowding:SPACE MANAGEMENT
•Methods:1-Space maintainer extract E,s
Or
2-Slice the mesial surface of the
deciduous canine and molars
before the eruption of permanent
canine and premolars.

45. INTERCEPTIVE
ORTHODONTICS
Crowding:SERIAL EXTRACTION
•Definition: ”.. The early recognition or anticipation
of a deformity that will occur unless teeth are
removed at a strategic interval to relieve in intensity
the developing malocclusion.”

46. INTERCEPTIVE
ORTHODONTICS
Crowding:SERIAL EXTRACTION
•Indications:
-The incisors are substantially crowded.
-Age 8-9 years.
-Normal arch relation ship.
-Reduced or normal overbite.
-All permanent teeth are present.
-The first molars should have a good prognosis.
-The first premolars should be closer to eruption than canines.

47. INTERCEPTIVE
ORTHODONTICS
Crowding:SERIAL EXTRACTION
•Disadvantages:
1-Increasing the overbite.
2-Lingual tipping of lower incisors
3-Retarding future development in arches.
4-Lack of aesthetic fullness of the lips.
5-Rotated incisors do not align spontaneously.

48. INTERCEPTIVE
ORTHODONTICS
Crowding:SERIAL EXTRACTION
•Methods:
1-When the lateral are erupting in a crowded position,
all deciduous canines are removed.
2-When the roots of the first deciduous molars are half
resorbed. They are removed.
3-As soon as the first premolars erupt they are
removed.

49. FIRST MOLAR
EXTRACTION
As an interceptive orthodontic measure

55. FIRST MOLAR EXTRACTION
•Indications:
-At least one permanent first molar have poor
prognosis.
-Crowding in the relevant quadrant.
-The development of second molar roots did not reach
more than half way.
-No other missing teeth in the same quadrant.
-Normal arch relation ship.
-The overbite is not deep.
-The second premolar is contained within the E roots

57. FIRST MOLAR EXTRACTION
•Advantages:
•No need for future prosthesis
•Reduce incisor crowding
•Eliminate buccal segment crowding
•Less chance for third molar impaction.

58. FIRST MOLAR EXTRACTION
•Disadvantages:
•The uncertainty of the final contact point between the
second molar and second premolar.

59. FIRST MOLAR EXTRACTION0
20
40
60
80
100
Thunold Thilander
good
poor
•Contact point:
•Good result could be
expected in patients:
•Having buccal segment
crowding.
•having third molars.
•First molars were
extracted early.

62. FIRST MOLAR EXTRACTION
•Compensatory extraction:
•Extraction of upper first molar does
not necessitate the compensatory
extraction of lower first molar
•Extraction of lower first molar
necessitates the compensatory
extraction of upper first molar