outline orthodontic directions medical and dental history klinical examination model analysis angle...
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Outline Outline
••Orthodontic directionsOrthodontic directions
••Medical and dental Medical and dental
historyhistory••
Klinical examination Klinical examination ••
Model analysisModel analysis••
Angle diagnostic Angle diagnostic systemsystem
Extraoral examination
Orthodontic directions Orthodontic directions
Orthodontic directionsOrthodontic directions
Sagittal (mesial-distal)Sagittal (mesial-distal)
Vertical (deep bite, open bite)Vertical (deep bite, open bite)
Transversal (narrow)Transversal (narrow)
Angle Class I.Angle Class I.
Class I. Cuspid
Angle II.Angle II.
Angle II/1Angle II/1
Overjet
Distocclusion
Deep bite 70-80 %
Mouth breathing (often)
Incomplett lip closure
Acquired anomalies
DistoocclusionOverbite (always)Retrusion of upper incisors
Angle II./2 rendellenességek Angle II./2 rendellenességek jellemzőijellemzői
Hereditary anomalyHereditary anomaly Excessive function of Excessive function of
the upper lipthe upper lip Pronounced sulcus Pronounced sulcus
mentolabialis (deep mentolabialis (deep bite)bite)
Nose breathingNose breathing „„Forced distooclusion”Forced distooclusion”
Angle III – progenie - mesiocclusionAngle III – progenie - mesiocclusion
CLASS III MALOCCLUSION
LATE MIXED DENTITIONCLASS III MALOCCLUSIONANTERIOR CROSSBITE
CLASS III MALOCCLUSION
DEEP OVERBITEMAXIMUM INTERCUSPATION
Sceletal or dentoalveolar anomalies –
Vertical anomalies
Deep bite Open bite
Deep bite
The six keys of occlusion (by Andrews) are:
Molar inter-arch relationship Mesio-distal crown angulation Labio-lingual crown inclination Absence of rotation Tight contacts Curve of spee
Asymetrical forms Asymetrical forms
By narrowing of the archesBy narrowing of the arches
the lateral cusps forces thethe lateral cusps forces the
mandible to lateral directionmandible to lateral direction
Sceletal assimetrySceletal assimetry
Angle Angle subdivion -subdivion - if the occlusion on the right side and if the occlusion on the right side and left side are differentleft side are different
III Class
Tongue –thrust swallowingTongue –thrust swallowing
Lip-pressure swallowing Lip-pressure swallowing
Thumb suckingThumb sucking
23.04.18.23.04.18. 4040
-Consequences of thumb sucking
-Open bite-Protrusion of upper incisors-Retrusion of lower incisors- Distalocclusion
Mouth breathingMouth breathingthe nasal cavity is usually (nasal gland, polyp etc.)the nasal cavity is usually (nasal gland, polyp etc.)
Upper incisors are protrudedOpen biteInflammated marginal gingiva
Mouth breathing Mouth breathing Oral breathing
Deviation
Maximum mouth opening
Place analysisPlace analysis
The lower jaw is more important, because The lower jaw is more important, because we are not able to increase the size of the we are not able to increase the size of the mandible !!!mandible !!!
Leeway space
The primary molars are smaller than the premolars
Curve of spee.
Measurements Measurements
Arch perimeter analysis (place analysis)Arch perimeter analysis (place analysis) Pont- indexPont- index Schmuth- indexSchmuth- index Moyers- indexMoyers- index Bolton analysis (77,2%)Bolton analysis (77,2%)
ISD 75.5%-78,9%ISD 75.5%-78,9%
or extraction
Steiner analysisSteiner analysisWidth of 3,4,5Width of 3,4,5 Width of 2,1,1,2
Measured valueMeasured value
Measured value
Calculated value =
Measured valueCalculated valueDifference
Sum of differences
Pont- and Schmuth- index Pont- and Schmuth- index
Pont-indexPont-index
Pont-Index
If the difference between the optimal premolar, molar distance and the measured premolar, molar distance is less then 5 mm EXPANSION
If the difference between the optimal premolar, molar distance and the measured premolar, molar distance is more then 8 mm EXTRACTION
Between 5-8 mm BORDERLINE CASE
ModellanalysisSchmuth - indexSIpremol.: SI + 8 mmmol.: SI + 8 + 8 mmmag.: SI / 2
Anterior length of the dental arch
Distance between the premolarsLength of the arch (12 teeth mesiodistal width)
Moyers- index Moyers- index
7272
Orthodontic treatment in primary dentition
1.Progenia appliance: chin cap 2.Bad habits: thumb sucking, appl.: oral screen 3.Cleft lip and cleft palate 4.Loss of primary teeth appl.: space maintenier 5.Crossbite appl.: inclined plane
Orthodontic treatment in mixed dentition
1.Crossbite appl.: inclined plane 2.Early loss of primary teeth appl.: space maintener 3.Functional jaw orthopedic Sagittal anomalies: Angle II. – distalocclusion Angle III. – mesialocclusion Vertical anomalies: open bite deep bite appl.: bimaxillary functional appliances activator, bionator, Frankel-appl., Hansa-appl. etc. 4.Diasthema medianum appl.: removable appliance with springs brackets 5.Crowding with or without lateral crossbite appl.: expansion of the dental arch with activ removable plates or quad-helix 6. Timing of first molar’s extraction ( reason: gangrena, periostitis, periodontitis etc. ) 7.Hotz serial extractio
–primary canines–primary first molars–permanent first premolars
1. Treatment with fixed appliances - multiband, multibond - lingual and palatinal arches - Hyrax 2. Orthodontic treatment with extraction ( most
frequently: first premolars ) reason: crowding or overjet 3. Orthodontic treatment with surgical
intervention f.e.: impacted teeth 4. Treatment with missing teeth space closure or preprosthetic orthodontic
treatment -reason: aplasia, accidents, caries 5. Dysgnathia operations ( age: 18 ) progenia, prognathia, open bite 6. Orthodontic treatment in periodontal deseases 7. Problems with wisdom teeth
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