Interceptive Orthodontics Flashcards
Define interceptive orthodontics
Techniques to influence the growth an development of teeth and jaws with the aim of improving function and appearance
Ideal is class 1 malocclusion
- intercepting an occlusion that may not be a class 1 may prevent the need for more treatment in the future
Prevention of progression of severe malocclusion
Aims of IO
Maintain centre line
Maintain a class 1 relationship
Maintain a vertical and transverse relationship
Eliminate crossbites
Prevention of trauma
Minimise crowding
Minimise psychological factors - teasing
When is IO undertaken
- failed / delayed eruption
- crossbite
- poor prognosis teeth
- trauma
- skeletal discrepancies
Serial extractions
Recognising / anticipation of deformity that will occur unless teeth are removed at stages to receive malocclusion
Serial extractions
Planned extractions
- primary or permanent dentition
Indications
- class 1
- arch length discrepancies
- relieve lower incisor crowding
FPM
- compensation - removal of opposing tooth (eg XLA L6, U6)
(If XLA upper, no need to XLA lower)
(If XLA lower, must XLA upper due to risk of over eruption)
- balancing - removal of contralateral (eg XLA L6 + R6)
Disadvantages of serial extractions
Lingual tipping of incisors
Rotated incisors
Over eruption
Increased over bite
Contraindications of serial extractions
Class 2 / 3 malocclusions
Spaced dentition
Hypodontia
Open bite
Midline diastema
Caries / heavily filled FPM
Habits
Thumb / pacifier sucking
- proclamation upper incisors
- retroclination of lower incisors
- anterior open bite (AOB)
- posterior open bite (POB)
- posterior cross bite
- narrow upper arch
Tongue thrusting
Mouth breathing
- refer to ENT for assessment
Space regaining
Early loss of primary molars, failure to use space maintainers - mesial movement of 6
Management
- distalisation of 6 using URA
- space maintainer - band and loop
Skeletal malocclusion - class 2
Excess maxillary growth
Deficient mandibular growth
Combination of both
Skeletal malocclusion - class 3
Mandibular prognathism
Maxillary retrognathism
Hard and soft tissue factors
- failure of teeth to erupt
- interceptive via removal , exposure , surgical
Aetiology
- skeletal
- soft tissues
- local factors
- crowding / spacing
- displacement
Soft tissue factors
Diastema
Diastema is a space in the upper arch (usually between upper central incisors)
Aetiology:
Pathological (eg trauma)
Supernumerary (hard tissue element)
Odontome
Frenum
Hard tissue factors
Delayed eruption
- ectopic eruption of FPM, canines, incisors
Retained primary teeth
- primary incisors, molars
Infraocclusion
- often D’s, E’s
Unilateral retained primary canine
- CL shift upper anterior segment
Germination
- single tooth bud, fusion - joining of 2 tooth buds
Crowding and spacing management
Crowding
- space management
- molar distalisation / serial extraction
- premolar extractions
- FPM extractions
- lower incisor extractions
- SPM extractions
Spacing
- leeway space
— contraindications in class 1 molars
— indication - E’s present, mild crowding
