Interceptive orthodontics Flashcards
what is interceptive orthodontics?
any tx which eliminates or reduces the severity of a developing malocclusion
it should eliminate or simplify the need for future tx
list the 7 aims of interceptive orthodontics
what sorts of questions should we ask in the history
During clinical examination what 3 planes are we assessing?
- AP
- Vertical
- transverse
In EOE, what are we looking for in AP ?
class 1 2 or 3
In EOE, what are we looking for vertically?
facial thirds
angle of lower border of mandible to maxilla
in EOE, what are we looking for transversely ?
facial symmetry
what else can we look for EOly
smile aesthetics
TMJ
soft tissues
In IOE, what are we looking for APly?
incisal classification
Overjet
canine guidance
molar relationship
anterior cross bite
in IOE, what are we looking for vertically ?
over bite
anterior over bite
lack of over bite
in IOE, what re we looking for transversely?
- posterior cross bite
- centre lines
in IOE, that else can we look out for>?
teeth present
crowding
spacing
perio health
tooth quality
when is interceptive orthodontics undertaken?
what problems come under failure/ delayed eruption ?
- impacted first permanent molars
- unerupted central incisors
- infra occluded deciduous teeth
- unerrupted upper canine
when do we see first permanent molars coming through?
5-6 yrs
what is the incidence of impacted first permanent molars ?
4.3%
M>F
what is the aetiology of impacted first permanent molars ?
multifactorial :
1. Increased m-d width of 6
2. Increased eruption angle of 6
3. Crowding posterior maxilla
4. Genetic eg. cleft lip and palate
what are the potential problems with impacted first permanent molars ?
- Caries of second deciduous molar tooth and first
permanent molar tooth - Root resorption of second deciduous molar tooth
- Space loss if the second deciduous molar tooth is
lost early
what is the management of impacted first permanent molars?
- Reversible
* 90% will self correct by 7yrs 100% self
correct by 8yrs - Irreversible - need interceptive tx
- Whether the E is viable
* Disimpact by placing separator/brass wire = place on Distal of E an medial aspect of 6
* Distalise 6 with URA
* If non viable xla E and distalise 6 once erupted
when do upper permanent central incisors erupt?
7-8 yrs
what is the incidence of an unerupted upper central incisor?
0.13%
M:F 2.7:1
What is the aetiology of unerupted upper central incisors?
1.Developmental - supernumeraries
2.Genetic - Holoprosencephaly
3.Environmental – previous trauma causing dilaceration
what is the management for unerupted upper centra incisors ?
*Remove cause of impaction/create space
*?Give time for eruption in younger patients – if
having intervention(removing supernumeraries) usually attach gold chain on unerupted tooth
* May need active intervention in older patients
what is the incidence of infraoccluded deciduous teeth ?
1-9%
what is the aetiology of infraoccluded deciduous teeth?
1.Genetic
2.Disturbed local metabolism
3.Gaps in the periodontal membrane
4.Local mechanical trauma
5.Local infection