Interceptive Ortho Flashcards
interceptive ortho aka + definition
early treatment
treatment performed in either primary or mixed dentition in order to enhance the dental and skeletal development and minimize prospective future serious problems, before the eruption of the permanent dentition
key to succeess in interceptive ortho
timely diagnosis and referal
- know where and what to look at
objectives of interceptive ortho
- to restore arch length integrity (space management)
- to improve skeletal imbalances - (classII, Class III, asymmetries, transverse problems)
- to establish functional occlusion
- to maintain teeth and perio health
- to improve self esteem
benefits of interceptive ortho
- redirect growht of the jaws **
- coordinate the width of the upper and lower dental arches
- guide erupting permanent teeth into desirable positions
- decrease risk of trauma to protruded upper incisors
may potentially simpify later ortho tx and may decrease number of extractions and might simplify orthognathic surgery if needed
disadvantages to interceptive
longer tx time and additional retention
increased cost
potential for cooperation loss
irritation of oral tissues / bulky appliances
indications for interceptive therapy
- arch length managment
- eruption problems
- oral habits
- developmental problems/ syndromes
- dental / skeletal crossbites
- skeletal discrepencies
arch length management means
making sure we have enough room for the permanent teeth to erupt
strategic spaces exist
- primate spaces–> usually between lateral and canine on upper and canine and first molar on lower in primary teeth
- anterior spacing
- leeway space —> primary canine first and second molar replaced by canine first and second pre molars
early loss of incisors implication
early loss of primary incisors causes no space loss if primary canines are erupted
early loss of primary canines causes mesial drift of permanent molars, lingual / distal eruption of permanent incisors and midline discrepencies
early loss of primary canines implication?
causes mesial drift of primary molars, lingual / distal eruption of permanent incisors and misline discrepencies
early loss of primary 1st molars?
distal movement of canines, and it if happens before eruption of permanent 1st molar, than primary 2nd molar will mesially drift and permanent 1st molar
early loss of primary 2nd molars implication?
causes migration and tipping of 1st permanent molar
space loss occurs (time wise)
very quickly - more immeditalety after extraction or loss and occurs within a year (crucial 6 months)
space loss occurs with which teeth more in order
primary 2nd molar > primary 1st molar > primary canine >primary incisors
most with primary 2nd molar and least with primary incisor
highest prevalence and amount of space loss after premature loss of?
highest prevalence and amount of space loss after premature loss of maxillary e’s > mandibular e’s
e= primary second molar
early loss of d’s in primary implication
almost equal space loss in both mx and mn arches
- d’s = primary first molar
arch where space loss occurs faster?
maxilla
space maintainance
preservatino of spaces left by the primary teeth and sometimes the primate spaces
- avoid future crowding
- allow normal eruption of the permanent teeth
- allow for developing class I occlusion
potential space loss in arches depends on
position of the permanent teeth and adjacent to the edentulous site
indications for space maintainence in terms of primary 2nd molar
premature loss of primary 2nd molar - when more than 6 months delay before permanent molar erupts and if there is adequate space
indications for space maintainence in terms of primary 1st molar
needed if premature loss of primary 1st occurs prior to eruption of 1st permanent molar
missing permanent incisors
usually due to truama or congenitally - so need to maintain this space
indications for space maintainence in terms of primary canine
yes - if these are prematurely lost - need to maintain space
5 main space maintainers used
band - crown and loop
distal shoe
removable - partial dent type - space maint
lingual holding arch
nance appliance
band and loop use
holding space for missing ONE posterior tooth
most of the time the permanent first molar must be erupted - b/c anchor to this tooth
situations to apply band and loop application
- premature loss of 1st primary molar
- premature loss of 2nd primary molar, after eruption of 1st permanent molar
- premature bilateral loss of primary molars before eruption of permanent incisors (2 appliances)
crown and loop
when the abutment tooth is:
- highly carious
- exhibits marked hypoplasia
- has been pulpotomized
another approach is to place a band and loop over the crown if tooth is already crowned
distal shoe
controls the migration of unerupted teeth
loss of primary 2nd molar prior to eruption of permanent 1st molar
loss of permanent 1st molar prior to eruption of permanent 2nd molar
location of blade in distal show
1 mm BELOW mesial marginal ridge of the erupting tooth
loop contoured closely to the ridge
MUST take x-ray to confirm it has gone to the right height
distal shoe avoided in who
pts. with risk of bacterial endocarditis
in order to use lingual bar need
permanent incisors and permanent first molars
partial denture maintainer use?
unilateral loss of more than two primary molars
bilateral posterior space maintainence when more than one tooth has been lost per segment and permanent incisors have NOT yet erupted