orthodontics (dda214)

47
ORTHODONTICS DDA 214 Prepared By Dr. Hana Omar Al- Balbeesi ORTHODONTIC CONSULTANT

Upload: qirat

Post on 03-Apr-2015

203 views

Category:

Documents


4 download

TRANSCRIPT

Page 1: ORTHODONTICS (DDA214)

ORTHODONTICS DDA 214

Prepared By Dr. Hana Omar Al- Balbeesi

ORTHODONTIC CONSULTANT

Page 2: ORTHODONTICS (DDA214)

DEFINATION: Orthodontics is a specialty in dentistry

that concerned with prevention, interception & correction of the growing and mature Dentofacial structures. (Dentofacial structures are teeth, jaws, & surrounding facial bones).

Page 3: ORTHODONTICS (DDA214)

INDICATIONS FOR ORTHODONTIC TRETMENT:

1. Unattractive facial esthetic.2. Dysfunction of TMJ.3. Susceptibility to dental caries.4. Susceptibility to periodontal

disease.5. Impaired speech caused by

malposition of teeth and\or jaws.

Page 4: ORTHODONTICS (DDA214)

CONTRAINDICATIONS OF ORTHODONTIC TREATMENT:

1. Poor oral hygiene and lack of cooperation.

2. Lack of bony support for the dentition.

3. Poor general or mental health.4. Lack of interest.

Page 5: ORTHODONTICS (DDA214)

Benefits of orthodontic treatment:

Orthodontic treatment may aid in eliminating or reducing three types of adverse effect for the patient:

1. Psychosocial function. 2. Oral function.3. Dental disease.

Page 6: ORTHODONTICS (DDA214)

1. PSYCHOSOCIAL FUNCTION:

Severe malocclusion & dental facial deformities strongly influences child self-esteem and if left untreated it can cause difficulty in psychological and social adjustment as the child matures.

Page 7: ORTHODONTICS (DDA214)

2. ORAL FUNCTION:

Malocclusion may compromise oral function:

1. Difficulty in chewing.2. Jaw discrepancy change manner of

swallowing.3. Difficulty for certain speech sounds. 4. TMJ joint pain from minor

imperfection in occlusion (clenching & grinding).

Page 8: ORTHODONTICS (DDA214)

3. DENTAL DISEASE:

Malocclusion can contribute in dental decay & periodontal disease because of difficulty in maintaining good oral hygiene due to lack of normal occlusion and natural cleansing benefits.

Page 9: ORTHODONTICS (DDA214)

VARIABLES AFFECTING ORTHODONTIC TREATMENT: Physical conditions: Chronic diseases such as heart

problems, asthma, diabetes, or blood disorders.

Habits: Prolonged habits over the years can

cause changes in Dentofacial structures of the child such as thumb sucking ,tongue thrusting ,& mouth breathing.

Page 10: ORTHODONTICS (DDA214)

Causes of orthodontic problems :

1. Developmental causes.2. Genetic causes.3. Environmental causes.4. Functional causes. Interaction among these

causes give rise to orthodontic problem.

Page 11: ORTHODONTICS (DDA214)

1. Developmental causes :The most encountered

developmental disturbances are:

Congenitally missing teeth. Malformed teeth. Supernumerary teeth. Impacted teeth. Ectopic eruption.

Page 12: ORTHODONTICS (DDA214)

2. Genetic causes :

Genetics play major role for malocclusion when there is discrepancy between size of the jaws & size of teeth.

Page 13: ORTHODONTICS (DDA214)

3. Environmental causes:

It is caused by injures which has tow types:

1. Birth Injures:It comes under tow major

categories: Fetal molding (when a limb of the

fetus presses another part leading to distortion of that part ).

Trauma during birth from usage of forceps .

Page 14: ORTHODONTICS (DDA214)

2. Injures throughout life :

Trauma to teeth can lead to development of malocclusion in three ways:

Damage to permanent tooth bud when primary tooth is traumatized.

Premature loss of primary teeth leading to permanent tooth movement.

Direct injury to permanent teeth.

ContinContinue;ue;

Page 15: ORTHODONTICS (DDA214)

Management of orthodontic problems

Treatment include interceptive & corrective measures that can be treated by general practitioners & pediatricians, while more sever cases should be referred to the orthodontists.

Page 16: ORTHODONTICS (DDA214)

1. PREVENTIVE ORTHODONTICS:

It allows the dentist to prevent or eliminate irregularities & malposition of the teeth in the developing dentition.

It includes:- Prevention of primary tooth loss due to caries. Usage of space maintainer to save space for

permanent tooth eruption. Correction of oral habits leading to damage of

permanent dentition. Early detection of genetic & congenital anomalies. Natural exfoliation of primary teeth (because

retained teeth lead to impaction or malposition of permanent teeth).

Page 17: ORTHODONTICS (DDA214)

2. INTERCEPTIVE ORTHODONTICS :

It allows the dentist to intercede or correct problems as they are developing.

It includes:- A. Interceptive treatment. B. Corrective treatment.

Page 18: ORTHODONTICS (DDA214)

A. Interceptive includes:

Removal of primary teeth that contribute to Malalignment of permanent teeth.

Correction of cross bite. Correction of jaw size

discrepancy by fixed or removable appliance.

Extraction of primary or permanent teeth to correct over crowding.

Page 19: ORTHODONTICS (DDA214)

B. Corrective include: Movement of teeth by applying

forces through usage of fixed appliance ,and redirection & stimulation of functional forces within the Dentofacial structure.

Removable appliances for correction or maintenance of treatment.

Orthognathic surgery in sever cases.

Page 20: ORTHODONTICS (DDA214)

OCCLUSAL DEVELOPMENT:

It includes four developmental stages from childhood to adulthood.

1. Pre-dental jaw relationship.2. Primary dentition.3. Mixed dentition.4. Permanent dentition.

Page 21: ORTHODONTICS (DDA214)

OCCLUSION CAN BE CLACCIFIED INTO:-

Normal occlusion

or Malocclusion

Page 22: ORTHODONTICS (DDA214)

Normal occlusion :- It is the usual or accepted

relationship of the teeth in the same jaw with the teeth in the opposing jaw when they are in centric occlusion.

Page 23: ORTHODONTICS (DDA214)

Deviation from normal occlusion can be given to these characteristics:

Midline deviation. Over jet & overbite of anterior

teeth. Axial position of teeth in each

arch. Relationship of all teeth in their

normal position. Relationship of dental arches to

each other.

Page 24: ORTHODONTICS (DDA214)

MALOCCLUSION :- According to Angle any deviation

from normal occlusion can be a malocclusion.

Class I ,or neutroocclusion. Class II ,or distoocclusion.

Class II div 1. Class II div 2. Class III ,or mesioocclusion.

Page 25: ORTHODONTICS (DDA214)

1. CLASS I (NEUTROOCCLUSION) :

When the jaws are at rest & teeth are in centric relation ,the mandibular arch is in normal mesiodistal relationship to the maxillary arch.

Mesiobuccal cusp of maxillary first molar occludes in the buccal groove of the mandibular permanent first molar.

Page 26: ORTHODONTICS (DDA214)

2. CLASS II

(DISTOOCCLUSION) : The mandibular arch is in distal relationship

to the maxillary arch by half width of the permanent first molar or mesiobuccal cusp width of a premolar.

Mesiobuccal cusp of the maxillary first molar occludes in the interdental space between mandibular 2nd premolar & the mesial cusp of the mandibular 1st molar.

The maxillary anterior teeth are protruded or retruded over the mandibular anterior teeth.

Page 27: ORTHODONTICS (DDA214)

Class II subdivisions:-

A . Class II div 1:

Maxillary incisors are protruded. Lips are usually a part, with lower

lip tucked behind the upper incisors & upper lip appears short.

Page 28: ORTHODONTICS (DDA214)

B. Class II div 2 :

Maxillary incisors are Retruded. Maxillary lateral incisors may tipped labially and mesially.

Page 29: ORTHODONTICS (DDA214)

3. CLASS III (MESIOOCCLUSION):

Mandibular arch is in mesial relationship to maxillary arch (Protruded mandible).

Mesiobuccal cusp of maxillary 1st molar occludes in the interdental space between the distal cusp of mandibular 1st molar & mesial cusp of 2nd molar.

The mandibular anterior teeth are protruded over maxillary teeth.

Page 30: ORTHODONTICS (DDA214)

Factors associated with malocclusion :

Crowded teeth (Most common problem).

Over jet , protrusion of maxillary incisors.

Overbite ,increased vertical overlap of maxillary incisors.

Open bite ,lack of vertical overlap of maxillary incisors.

Page 31: ORTHODONTICS (DDA214)

PRINCIPLES OF ROOT RESORPTION

When force is applied for any period of time causing compression in one side of the periodontal ligament (PDL) & tension on the other side .

These forces causes resorption & deposition of bone in the tissues.

Page 32: ORTHODONTICS (DDA214)

RESORPTION Compression of periodontal

ligament reduce the vascular supply to the supporting tissues in that area within 48 -72 hours this causes the cells of the PDL to differentiate into osteoclasts and the resorption process starts.

Page 33: ORTHODONTICS (DDA214)

DEPOSITION Tension side starts to activate

osteoblasts .This resulted on new bone development & deposition.

The tooth moves in direction of compression as the resorption takes place .

On the opposite side the space created by the tension is filled in by deposition of new bone.

Page 34: ORTHODONTICS (DDA214)

THE FORCES OF MOVEMENT

Application of heavy forces is avoided because it may cause excessive tooth destruction and tooth loosening.

Page 35: ORTHODONTICS (DDA214)

TYPES OF TOOTH MOVEMENT:

1. TIPPING Moving the tooth more upright. 2. BODILY Cause the tooth to migrate slowly

in its position in the arch. 3. ROTATION The force will move the tooth to

the right or left in its socket.

Page 36: ORTHODONTICS (DDA214)

Orthodontic Records & Treatment Planning Orthodontic diagnosis & treatment

planning is based on certain records that are taken for the patient in the 1st appointment.

These information's comes from three major sources:-

1. Patient interview.2. Clinical examination.3. Evaluation of diagnostic records.

Page 37: ORTHODONTICS (DDA214)

I. Interview Information:

1. Medical & dental history: Comprehensive physical condition is necessary

to evaluate specific orthodontic concerns.2. Physical growth evaluation: Evaluation of the child physical growth stage

is important to aid in orthodontic treatment.3. Social & behavioral evaluation: It is important to explore patient reasons for

Tx Motivation & cooperation of the child is very essential for Tx success.

Adults seek Tx to improve their esthetic & function.

Page 38: ORTHODONTICS (DDA214)

II. Clinical examination:

It’s purpose is to document, measure , evaluate facial aspects, occlusal relationship & functional characteristics of the jaws. a. Evaluation of the facial esthetics. b. Evaluation of oral health. c. Evaluation of jaw & occlusal function.

Page 39: ORTHODONTICS (DDA214)

a. Evaluation of facial esthetics:

Orthodontic goal is to improve facial symmetry & profile.

A. Frontal evaluation * Bilateral symmetry. * Midline. * Vertical proportion. B. Profile evaluation * Jaws proportion. * lip protrusion due to incisor protrusion. * Vertical facial proportion & mandibular plane

angle.

Page 40: ORTHODONTICS (DDA214)

b. Evaluation of oral health:

Hard & soft tissue examination, oral hygiene assessment & prophylaxis, periodontal pocket charting must be examined.

Patient should be referred for Tx before any orthodontic Tx is conducted.

Page 41: ORTHODONTICS (DDA214)

c. Evaluation of jaw & occlusal function: Examination of patient occlusion, TMJ palpation & any mandibular lateral or anterior shifts are important for orthodontic purposes .

Page 42: ORTHODONTICS (DDA214)

III. Diagnostic records:

It includes photographs, radiographs, & diagnostic casts, best done during intra oral examination.

Diagnostic records document tooth angulations ,crowding & presence of unerupted teeth.

Page 43: ORTHODONTICS (DDA214)

A. PHOTOGRAPHS Intra oral & extra oral photographs should be

taken. It is useful for patient identification ,Tx

planning ,case presentation ,case documentation & patient education.

Frontal & profile views are taken with lips in relaxed position .

Three intra oral photographs full direct view with teeth in occlusion ,maxillary occlusal view, right buccal view (from distal of the canine to last molar).

Page 44: ORTHODONTICS (DDA214)

B. RADIOGRAPHS Cephalometric radiograph is taken before ,

during & after Tx to evaluate jaw & tooth position changes.

Cephalometric radiograph is important to evaluate malocclusion ,skull ,bones, &soft tissue.

Cephalometric analysis is carried out on a tracing paper, or digitized on the computer.

Certain land marks are identified on cephalometric radiograph.

Page 45: ORTHODONTICS (DDA214)

C. Diagnostic casts It is used to complete the

measurement & for case presentation.

They are made of plaster rather than stone to provide a more finished product for case presentation.

Page 46: ORTHODONTICS (DDA214)

CASE PRESENTATION

Case then will be presented to the patient or his guardian to explain Tx plan ,time & how patient should cooperate to have a successful results then patient will sign a consent form.

Tx fees also will be discussed .

Page 47: ORTHODONTICS (DDA214)

THANK YOU