interceptive ortho Flashcards
What is interception?
Early identification and management of potential problems
Avoidance of worse malocclusion
Early appliance
What is the normal development of the primary dentition?
Established by 30 months
Positive OJ and OB
Spacing is normal
What are problems that can happen in the primary dentition?
Delayed eruption (different on contra lateral, abnormal sequence)
Missing teeth (might indivate missing permanent, <1% pts)
Supernumary teeth (30-35% pts also in permanent)
Abnormal teeth (fusion/germination)
Crowding (need >6mm spacing usually)
Overjet (no tx at this stage, probably in permanent)
Class III (no tx, probably permanent)
Crossbite (skeletal- tend to persist, dental- variable)
Caries
Trauma (possible ankylosis if A/B, may deflect/damage permanent)
Habits (dummy/thumb sucking- AOB, unilateral posterior xb)
What would you expect at the early mixed dentition?
6 eruption
Incisor eruption

Often when first molar erupts- it’s a half unit class II, it then corrects into class I due to leeway space
Incisors may erupt lingually compared to primary due to path of eruption
What is the size discrepancy between primary and permanent incisors?
Upper- 7mm more
Lower- 5mm more
How?
Already space in primary
Permanent teeth more proclined
There’s an increase in intercanine width- so more space
What are problems that may occur in the early mixed dentition?
Delayed eruption (usually due to supernumary)
Early loss (centre line shift/crowding)
6s (poor prognosis/impacted)
Median diastema (due to supernumary, general spacing, class II div 1, sucking, trauma, pathology)
Increased OJ (tx or wait- need to weigh up)
Crowding (x primary)
Anterior xb (treat early- 2x4 sectional or URA
Posterior xb of 6s (tx early if mandibular displacement on closure- URA w midline expansion screw)
Habits (educate and cessation)
Class III (face masks, RME, elastics)
How should you manage supernumerary teeth?
Erupted mesiodens- x and align
Unerupted supernumary- xga, RCS guidelines
Supplemental- x of most displaced/poorly formed
How should you manage early loss of primary teeth in the early mixed dentition?
If there’s a loss of C/D- may affect centre line, teeth shift to side of x= should consider balancing to avoid this
Loss of E- mesial movement of 6 which can learn to crowding= do not balance as disrupts occlusion, don’t compensate as overeruption is temporary 
Can consider space maintainer (fixed- band and loop or removable- URA)
Problems- pt unsuitable (poor OH), must for immediately, unnecessarily
What are indications of x of Cs?
Allows laterals to align
Allows incisor to move over bite
May improve position of palatally displaced 3
What are problems that can occur in the late mixed dentition?
Missing teeth (monitor, refer, multidisciplinary)
Infraoccluded (monitor and xla)
Crowding (monitor/refer)
Poor prognosis 6s (refer for timing of x)
Ectopic canines (refer)
Habits (educate/cessation/appliances URA or hay rake)
Increased OJ (refer, functional works best at this stage)
What are some problems that can come with adult treatment?
Lack of growth- slow tx (no functional)
Mutilated dentition (heavily restored, perio)
Difficult cooperation
Different expectations
