Download - Methods of Space Gaining
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METHODS OF SPACE GAINING
Dr sasikumar M.D.S.,
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Calculate the amount of space required Model analysis Method depends on outcome of space analysis
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SPACE REQUIRED FOR ALIGNMENT OF CROWDED TEETH RETRACTION OF PROCLINED TEETH CORRECTION OF MOLAR RELATIONSHIP DEROTATION OF ANTERIOR TEETH LEVELING OF CURVE OF SPEE INTRUSION
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METHODS OF GAINING SPACE PROXIMAL STRIPPING ARCH EXPANSION DISTALIZATION OF MOLARS UPRIGHTING OF TILTED TEETH DEROTATION OF POSTERIOR TEETH PROCLINATION OF ANTERIOR TEETH EXTRACTION
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PROXIMAL STRIPPING Reproximation,slenderization,disking,proxi
mal Slicing, Teeth For Striping Depends Upon
Location of excess tooth material Amount of discrepancy Thickness of enamel present
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INDICATION OF PROXIMAL STRIPPING Space requirement is less than 3mm Boltan tooth excess is less thsn 2.5mm
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CONTRAINDICATION OF PROXIMAL STRIPPING Susceptible to caries Young individual bigger pulp chamber
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Amount of enamel to be stripped Iopa x ray
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Methods of stripping Metal abrasive strips Diamond disks Corborundum disks Thin fissure burs
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Advantages Tooth extraction can be avoided Broad contacts Localized malalignments can be corrected
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disadvantages Sensitivity Caries susceptibility Food impaction Difficult to reproduce exact morphology
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ARCH EXPANSION Classification
Rapid palatel expansion Slow expansion
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PHILOSOPHY OF RME Dentofacial orthopedic appliance Teeth are used to apply force on suture Splitting of mid palatine suture Bone growth in split gap
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Anatomy of suture Effects of RME
Max teeth and alveolar bone Maxillary skeletal effects Mandible Nasal cavity and adjacent bone
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MAXILLARY TEETH AND ALVEOLAR BONE Post teeth are used to transmit force on
maxilla Teeth tip buccaly Compression of bone- bending of alveolar
bone Midline diastema
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MAXILLARY SKELETAL EFFECTS Palatine process
separate in a triangular fashion
2 dimension Occlusal vertical
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EFFECTS ON MANDIBLE Rotates downward and backward
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NASAL CAVITY Increase in inter nasal
space The effect is sufficient
sometimes to correct the deviated nasal septum
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INDICATIONS FOR RME Posterior crossbite with maxillary
deficiency Cleft palate patients Class III case with mild maxillary
deficiency As part of interceptive orthodontics
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TYPES OF RME Tooth borne
Isaacson rme appliance Hyrax rme appliance
Tooth and tissue borne Derichsweiler rme appliance Hass rme appliance
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Activation Retention
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SLOW EXPANSION DEVICES Coffin spring Quadhelix Niti expanders Schwarz appliance
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DISTALIZATION OF MOLARS Pushing molar distally created space Before eruption of second molar Classification
Extra oral Cervical head gear
Intra oral
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Intra oral distalizers Schwartz plate First class appliance Open coil spring Jones jig Distel jet appliance Pendulum appliance K-loop appliance Lip bumper
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UPRIGHTING Tilted teeth occupy more space Extracted space /missing teeth Space regainers lipbumpers
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DEROTATION OF POSTERIOR TEETH Rotated posterior teeth occupy more
space Anterior teeth less space Derotate using couple forces Fixed appliance
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PROCLINATION OF ANTERIOR TEETH When teeth are retroclined Class II div 2 cases Fixed appliance
Reverse curve Removable appliance
Z- spring screws
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Extraction Common method of gaining space Need for extraction
Arch length tooth material discrepancy crowding
Correction of sagittal inter arch relationship Class I-ext in both arches classII – ext in upper arch Class III-ext in lower arch
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DIFFERENT EXTRACTION PROCEDURES Balancing extraction Compensating extraction Phased extraction Enforced extraction Wilkinson extraction therapeutic
extraction
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THERAPEUTIC EXTRACTIONS Maxillary incisors Mandibular incisors Canines 1st premolars 2nd premolars Ist molars 2nd molars 3rd molars
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