orthodontics seminar

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ORTHODONTICS SEMINAR Fatimah Che Rahimi Laila Azwa Hassan Ahmad Zulkhairi Resali Nurmarzura Abdul Latif Aishah Shahrir Nur Amalina Zulkepre Akmal Khalis Doreyat Masyitah Mustaffa Aimi Amalina Ahmad

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ORTHODONTICS SEMINAR. Fatimah Che Rahimi Laila Azwa Hassan Ahmad Zulkhairi Resali Nurmarzura Abdul Latif Aishah Shahrir Nur Amalina Zulkepre Akmal Khalis Doreyat Masyitah Mustaffa Aimi Amalina Ahmad. Early loss of deciduous teeth. - PowerPoint PPT Presentation

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Page 1: ORTHODONTICS SEMINAR

ORTHODONTICS SEMINARFatimah Che RahimiLaila Azwa HassanAhmad Zulkhairi ResaliNurmarzura Abdul LatifAishah ShahrirNur Amalina ZulkepreAkmal Khalis DoreyatMasyitah MustaffaAimi Amalina Ahmad

Page 2: ORTHODONTICS SEMINAR

Early loss of deciduous teeth

• It happened as a result of extraction due to caries or trauma

• The degree of space loss is influence by: Unilateral / bilateral Age of loss --> more effect if the tooth lost at earlier age Crowding/spacing the more inherent the crowding present, the more

potential for space Tooth typeposition of the affected tooth in arch influence subsequent

space distribution timevery early extraction can delay successional tooth eruption, later

extraction have opposite effect Degree of intercuspation-less effect Skeletal factors-less effect

Page 3: ORTHODONTICS SEMINAR

Balancing and compensating extraction

Aim: to preserve arch symmetry and occlusal relationship

Balance enforced extractions • A balancing extraction is a tooth from the opposite side of the same arch,

designed to minimise centreline shift.

Compensate enforced extractions • Compensation means extraction of a tooth from the opposing quadrant to

the enforced extraction. It is designed to minimise occlusal interferance by allowing teeth to maintain occlusal relationships as they drift. It is more difficult to justify compensation than balance, especially when it would involve removal of a tooth from an intact arch.

Page 4: ORTHODONTICS SEMINAR

Which deciduous teeth need balancing and compensating extraction?

Tooth Influence Need balancing or compensating extraction

Deciduous incisor - -

Deciduous canine Centreline shift Need balancing extraction

1st deciduous molar Centreline shift Need balancing extraction

Lower 1st deciduous molar - Need compensating extraction

2nd deciduous molar - Need compensating extraction (if it contribute to significant alteration in molar relationship)

Page 5: ORTHODONTICS SEMINAR

Digit sucking habit

Page 6: ORTHODONTICS SEMINAR

Digit sucking habit• Most prevalent of oral habits, 13% - 100%• If the habit ceases before the permanent teeth begin to

erupt, any effects on the dentition are unlikely to be long-term.

• If however the habit persists into the mixed and permanent dentition malocclusion

• Thumb sucking may develop early in life and continue from infancy through the primary dentition and into the mixed and permanent dentition. In many cases, if the thumb habit continues into the mixed dentition a malocclusion may develop

(Kaplan 1950; Ruttle et al. 1953; Graber 1959).

Page 7: ORTHODONTICS SEMINAR

Factors that Affecting the Degree of Damage to Teeth and Investing Tissue

• Frequency of habit– The more frequency the more the damage

• Duration of habit– The more duration the more the damage

• Intensity of habit– Active vs passive

*Prolonged digit sucking habit may affect occlusion and dentofacial structures.

Page 8: ORTHODONTICS SEMINAR

Factors

• Not all habits will result in tooth movement. It is related to frequency, duration and intensity.

• Studies suggest that it only takes very light forces to move teeth, if the force is of long enough duration.

• The threshold is believed to be 6 hours.

Page 9: ORTHODONTICS SEMINAR

Maxillary changes1. Proclination of maxillary incisors

2. Increased maxillary arch length

3. Anterior placement of maxillary apical base

4. Increased sella-nasion point A angle

5. Decreased palatal arch width

Page 10: ORTHODONTICS SEMINAR

Mandibular changes1. Proclination of mandibular

incisors

2. Decreased sella-nasion B point angle

3. Increased intermolar distance

Page 11: ORTHODONTICS SEMINAR

Others:-arch assymmetry-increased overjet-anterior openbite-posterior crossbite

Page 12: ORTHODONTICS SEMINAR

How to stop?

1. Gentle discouragement2. Oral appliances/ habit breaker

-palatal crib-acrylic appliance on finger

Page 13: ORTHODONTICS SEMINAR

Approaches to treat chronic thumb sucking

These can be split intothree distinct categories: Behavioural – rewarding a child for notexercising the habit; Mechanical – preventing or interruptingthe process of thumb sucking; Aversive – generating negativesensations when the habit is exercised,such as bad taste, pain or major discomfort

Page 14: ORTHODONTICS SEMINAR

Fig 1: URA with acrylic ridge Fig 2: Blueglass roller

Fig 3: The Rake appliance

Page 15: ORTHODONTICS SEMINAR

Space Maintainer

Page 16: ORTHODONTICS SEMINAR

Space Maintainer• Definition

– An intraoral appliance used to preserve arch length following premature loss of primary tooth/teeth in order to allow permanent teeth erupt into proper alignment and occlusion

• Objectives:– Prevent drifting/tipping– Prevent loss of arch length– Prevent midline shift– Prevent crowding of permanent teeth– Prevent impactions– As orthodontic intervention including extraction

Page 17: ORTHODONTICS SEMINAR

Types of Space Maintainer

Types of Space Maintainer

Anterior VS

Posterior

Fixed VS

Removable

Unilateral VS

Bilateral

Page 18: ORTHODONTICS SEMINAR

Types of Space

Maintainer

Fixed

Band and loop

Crown and loop

Lingual / Palatal arch Distal shoe

Removable

URA (Hawley retainer)

Partial denture

Page 19: ORTHODONTICS SEMINAR

Band and Loop

• Loss of D (unilateral/bilateral)

Indication :

• Ease of fabrication for clinician• Ease of maintenance for patient

Advantage :

• Opposing tooth may be over-erupt

Disadvantages :

Page 20: ORTHODONTICS SEMINAR

Crown and Loop

• Loss of D with significant loss of tooth substance of abutment tooth (unilateral/bilateral)

Indication :

• Ease of fabrication for clinician• Ease of maintenance for patient

Advantage :

• More difficult to fabricate than band & loop

Disadvantages :

Page 21: ORTHODONTICS SEMINAR

Palatal Arch/Lingual Arch

• Loss of bilateral E’s

Indication :

• Maintains tooth space & Leeway space• Prevents tipping of molars

Advantage :

• Meticulous hygiene required• 6 prone to decalcification

Disadvantages :

Page 22: ORTHODONTICS SEMINAR

Palatal Arch

Lower Lingual Arch

Page 23: ORTHODONTICS SEMINAR

Distal Shoe/Intra-alveolar

• Loss of E prior to eruption of 6

Indication :

• Maintain E’s space

Advantage :

• Difficult to fabricate• Contraindicated in medically compromised patient

(Subacute bacterial endocarditis, chemotherapy, radiotherapy)

Disadvantages :

Page 24: ORTHODONTICS SEMINAR

Upper Removable Appliance

• Multiple teeth are lost and space maintenance and mastication are of concern

Indication :

• Maintain space• Aid in mastication

Advantage :

• Susceptible to fracture / loss

Disadvantages :

Page 25: ORTHODONTICS SEMINAR

Infraoccluded 55 & Impacted 15 15 erupting rotated

Page 26: ORTHODONTICS SEMINAR

Thank You