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