interceptive ortho
TRANSCRIPT
-
8/11/2019 interceptive ortho
1/122
-
8/11/2019 interceptive ortho
2/122
Interceptive Corrective
Preventive
-
8/11/2019 interceptive ortho
3/122
Interceptive
orthodontics
-
8/11/2019 interceptive ortho
4/122
Definitions
Steps in interceptive orthodontics Serial extraction
Muscle exercises
Removal of soft / hard tissue barriers
Management of ectopic eruption
Management of missing permanent teeth
Resolution of crowding
CONTENTS
-
8/11/2019 interceptive ortho
5/122
CONTENTS
Correction of midline diastema
Correction of developing crossbite
Functional appliancesOrthopedic appliances
Maxillary intrusive splint
Pre orthodontic trainer
Bent wire systemInvisalign
Conclusion
References.
-
8/11/2019 interceptive ortho
6/122
DEFINITION - AAO (1969)
That phase of the science & art of orthodont
employed to recognize & eliminate potential
irregularities & malpositions in the developin
dentofacial complex.
-
8/11/2019 interceptive ortho
7/122
Interceptive orthodontics basically refers measures undertaken to prevent a potent
malocclusion from progressing into a more seveOne.
Is undertaken at a time when the malocclusion h
already developed or still developing.
Procedures, are aimed at elimination of facto
that may lead to malocclusion.
-
8/11/2019 interceptive ortho
8/122
Serial extraction
Dev. Cross bite
Abnormal habits
Space regaining
Muscle exercises
Removal of ba
eruption
Interception of
skeletal
malrelation
-
8/11/2019 interceptive ortho
9/122
SERIAL EXTRACTION
Historical review-
Kjellgren (1929) : Serial extraction
Hotz (1970) : Guidance of eruption
Palsson & Bunon: (1743) first ref to the extractio
of deci teeth (Publication- Diseases of Teeth)
Nance (1940) : popularized the technique
Father of serial extraction
-
8/11/2019 interceptive ortho
10/122
SERIAL EXTRACTION
DEFINITION:
Dewel (1967) : orderly removal of selected prima
& permanent teeth in predetermined sequence
-Tweed :planned & sequential removal of prima
& permanent teeth to intercept & reduce dentalcrowding problems
-
8/11/2019 interceptive ortho
11/122
I: On the basis of hereditary determined toothsize arch length discrepancy:
Midline line shift of
mandibular Incisorpremature exfoliation
of pri C
INDICATIONS
-
8/11/2019 interceptive ortho
12/122
2. Gingival recession on a
labially displaced
incisor.
3. Crowded maxillary or
mandibular teeth thatare excessively
inclined labially.
-
8/11/2019 interceptive ortho
13/122
4. Labially but unerupted
permanent canine that are
extremely prominent.
5. Splayed out perm Max /
Mandi Incisor due to crowded
position of unerupted canines
-
8/11/2019 interceptive ortho
14/122
6. Unusual shape, size and no of teeth.
7. Ectopic eruption of maxillary 1st molar
8. Premature loss of primary canine
9. Abnormal / pathological root resorption of primary canine.
10. Crowded anteriors
-
8/11/2019 interceptive ortho
15/122
1. Unusual resorptionpattern of certain
primary teeth.
2. Aberrant eruption
pattern of perm teeth
II : Indications due to loss of
arch length :
-
8/11/2019 interceptive ortho
16/122
3. Prolonged
retention of
primary teeth /
ankylosis
4. Transposition
-
8/11/2019 interceptive ortho
17/122
5. Rotation of teeth
6. Suppression of primaryteeth
-
8/11/2019 interceptive ortho
18/122
CONTRAINDICATIONS
1. Skeletal Class II and Class III malformation.
2. Spaced dentitions
3. Anodontia / oligodontia
4. Open bite & deep bite
5. Midline diastema
6. Class I malocclusions with minimal space def.
7. Unerupted malformed teeth Eg: dilacerations
8. Mild disproportions b /w arch length & tooth materia
that can be treated by proximal stripping.
-
8/11/2019 interceptive ortho
19/122
DIAGNOSTIC RECORDS
Intra oral radiographs:
Panoramic radiograph
Cephalometric radiographs:
Facial Photographs:
Study models
Model analysis
-
8/11/2019 interceptive ortho
20/122
IOPA radiographs:
Detection of congenital absences of teeth.
Detection of supernumerary teeth
Calculations of total space analysis.
Determine the root resorption before & after treatment.
Determine size, shape, relative position of perm teeth.
Detection of pathologic conditions in the early stages
Eruptive patterns of the unerupted teeth
-
8/11/2019 interceptive ortho
21/122
Cephalometric radiographs:
Evaluation of craniofacial relationship before treatment
Assessment of soft tissue matrix.
Classification of facial patterns.
Calculation of toothsize / jaw- size discrepancies.
Prediction of growth & development
Detection pathologic conditions before, during and after treat
Determination of mandibular rest positions
Facial photographs
-
8/11/2019 interceptive ortho
22/122
Facial photographs
Evaluation of craniofacial (&dental) relationships& proportiobefore treatment.
Assessment of soft tissue profile.
Proportional facial analysis & Total space analysis
Monitoring treatment progress.
Study relationships before, immediately following & several
treatment.
Detecting & recording facial asymmetry.
Identifying patients
Intra oral photographs
-
8/11/2019 interceptive ortho
23/122
1. Total space analysis.
2. Dental anatomy.
3. The intercuspation.
4. Arch form.
5. Curves of occlusion
6. Measure progress during
treatment
7. Evaluate occlusion
ABO specificationsStudy models:
S l i
-
8/11/2019 interceptive ortho
24/122
Space analysis:
Conventional method Space required-four mandibular incisors were measured at MD
diameter by means of boley gauge. The values for unerupted canine and premolars were obtained
measuring their MD on the image on the periapical radiograph.
To reduce the radiographic enlargement the formula recommenby Huckaba is.
(y)(x')
X= y
X-is the estimated size of the permanent tooth.
X the radiographic size of the permanent teeth.
Y-is the size of the primary second molar on the cast.
Y-is the radiographic size of the primary molar.
-
8/11/2019 interceptive ortho
25/122
Space requiredMD width of mandibular incisors othe cast and canine and premolar on the radiograpwere added.
Space available-obtained by extending brass wirefrom the mesiobuccal of the first permanent molaron one side to mesiobuccal of the molar on theopposite side.
The difference in the value obtained for spacerequired and space available was the amount of thdiscrepancy.
-
8/11/2019 interceptive ortho
26/122
ADVANTAGES OF SERIAL
EXTRACTION
Removal of deciduous canines.
Extraction of deciduous 1stmolar.
Extraction of first premolar before crowding allows
It lessens the period of future appliance therapy an
cost of treatment.
ADVERSE EFFECTS
-
8/11/2019 interceptive ortho
27/122
S C S
First (Dewel-1967), tendency of developing
anterior deep bite following loss of posterior teeth.
Second side effect is failure of premolars to reach their normalocclusal level.
Third : Effect of Serial Extraction has on facial esthetics.
The over emphasis on straight profile..
Lip fullness is not a reliable criterion
The straight profile must be viewed with greater concern
because early removal of premolars
-
8/11/2019 interceptive ortho
28/122
Fourth : Nasal development is another unpredictable ha
Unrestrained extraction will accentuate nose promineby reducing skeletal development in dental area.
Moreover growth of chin is unpredictable. If growth in
and chin exceeds normal range a concave profile is
obtained.
M & d
-
8/11/2019 interceptive ortho
29/122
Most common & accepted
sequences:-
1. Tweeds method
2. Dewelsmethd
3. Nances method
4. Grewesmethod
D l M th d 1978 (CD4)
-
8/11/2019 interceptive ortho
30/122
Dewels Method: 1978 (CD4)
There are 3 stages in Serial Extraction Therapy:
Removal of deciduous canines:
Removal of first deciduous molars:
Removal of erupting premolars:
-
8/11/2019 interceptive ortho
31/122
REMOVAL OF DECIDUOUS
CANINES Extraction 8-9 yrs.
R l f i 1st l
-
8/11/2019 interceptive ortho
32/122
Removal of primary 1stmolar
REMOVAL OF ERUPTING
-
8/11/2019 interceptive ortho
33/122
REMOVAL OF ERUPTING
PREMOLARS
TWEEDS SEQUENCE OF
-
8/11/2019 interceptive ortho
34/122
TWEEDS SEQUENCE OF
EXTRACTION (1966)
Sequence is :DC4 At approx 8 years all deci 1st molars are extracted.
Deciduous canines maintained to retard eruption of
permanent canines.
1st premolarin advanced eruptive stage- crown above
bone. Deciduous canines along with first premolar are extracte
Treatment proced re in class
-
8/11/2019 interceptive ortho
35/122
Treatment procedure in class
I malocclusion Group A - Anterior discrepancy : crowding
Group B - Anterior discrepancy : Alveolodental protrusion
Group C - Middle discrepancy : impacted canine
Group D - Enucleation in mandible
Group E - Enucleation in mandible & maxilla
Group F - Alternative to enucleation
Group G - Interproximal stripping
Group H- congenital absence
Advantages of
-
8/11/2019 interceptive ortho
36/122
Closure of Residual Xn spaces
Improvement in axial inclination
Correction of rotation
Correction of Midline discrepancy
Correction of residual overbite and overjet
Correction of cross bites Improvement in arch form
Advantages of
mechanotherapy
MUSCLE EXERCISES
-
8/11/2019 interceptive ortho
37/122
MUSCLE EXERCISES
The dental tissues are blanketed from all directions
by the muscles
Normal occlusal development depends on normal
oro-facial muscle function.
Muscle exercises helps in improving aberrant musc
function.
-
8/11/2019 interceptive ortho
38/122
1. Exercise for the masseter muscle:
2. Exercise for the lips:
Stretching of upper lip to maintain lip seal for
short hypotonic lips
Holding a piece of paper between lips
Holding and pumping of water back and forth
behind the lips. Massaging of lips
Scotch tape
Button pull exercise:
-
8/11/2019 interceptive ortho
39/122
3. Exercise for the pterygoid muscles:
4. Exercise for the tongue: (5/16 inch intra oral elastic
One elastic swallow:
Tongue hold exercise:
Two elastic swallow:
The hold pull exercise: tongue tie exercise
Limitation of muscle
-
8/11/2019 interceptive ortho
40/122
Limitation of muscle
exercises Does not drastically alter any growth pattern
Are not substitute for corrective orthodontictreatment
Pt compliance is extremely important
REMOVAL OF SOFT /HARD TISSUE
-
8/11/2019 interceptive ortho
41/122
Retained deciduous teeth
Supernumerary teeth
Fibrous/ Bony obstruction of the erupting
tooth bud
Impacted teeth
REMOVAL OF SOFT /HARD TISSUE
BARRIERS IN THE PATHWAY OF
ERUPTION
ECTOPIC ERUPTION
-
8/11/2019 interceptive ortho
42/122
ECTOPIC ERUPTION
Lateral incisors crowding..aberrant tooth positioningLingual arch with spur to.
Already midline shift. BALANCED EXTRACTION
Prevalence 2-3%
Maxi
Boys
2/3rdof.
ECTOPIC ERUPTION OF 1STPERMMOLAR 3-6 month
-
8/11/2019 interceptive ortho
43/122
MOLAR
waitful watching
3 6 month
pulpo..SS crown on 2ndmolar
supplemented with band material
extending subgingivally
Difficult to do
Orthodontic elastic separators Replacement at 1-2wks..2mn
Brass ligature wire Periodic tightening 3-5 day in
Safety pin spring Gentle forc exrted, distally he
Humphrey appliance-S shaped loop-helical springs Continual forc, easy reactivatbonded composite to engage
Halterman appliance Elastomeric chain, changed
monthly
Removal of 2ndprimary molar extensive resorption..distal s
regain space
MISSING PERMANENT TEETH
-
8/11/2019 interceptive ortho
44/122
Management:arch length, adjacent tooth morphology andcolour,incisor position and esthetics
Congenitally missing LATERAL
INCISOR
Canine erupts normally
resin bonded bridge,
conventional bridge or imp
Canine erupts in lat incisor position moved backbridge or im
Substitution of canine with lateral
incisor
recontouring to improve
esthetics
Congenitally missing LI transplanted posterior
teeth..premolarsreshapi
Congenitally missing PREMOLAR
substitute primary molar
ankylosis and root
resorptionexn
primary molar removed space closed ortho
resin bonded bridge,
conventional bridge or imp
-
8/11/2019 interceptive ortho
45/122
Resolution of crowding
Anterior segment- incisal liability
Posterior segment- leeway space of nance
Management:
1. Observation2. Disking of primary teeth-hand held strip, tapered bur in
speed handpiece
3. Extractions and serialextraction
4. Corrective orthodontic referral
MAXILLARY MIDLINEDIASTEMAS
-
8/11/2019 interceptive ortho
46/122
DIASTEMASFrenum Attachments Diastema should be closed first..Scarred tissue.
Supernumerary teeth Removal without causing injury t
perm teeth..
Early removal..erupt normally..s
closes spontaneously
Faciolingual positioning Active labial bow.. Acrylic remov
from palatal side.. 2mm/mnth
Very protrusive Fixed orthodontic
appliances..rectangular arch wir
Faulty mesiodistal positioning (tipping)Finger spring appliance.
2mm/mnth
Shud not take more than 2 mnth
(bodily) bonded brackets with
elastomeric chain
-
8/11/2019 interceptive ortho
47/122
Correction of developing
Anterior and Posterior Cross
Bites Eliminates functional shifts and wear on the erupted permanen
Dentoalveolar asymmetry
Increases circumference and provides more room for permanen
-
8/11/2019 interceptive ortho
48/122
ANTERIOR CROSSBITES
tong e blade therap / i l
20 times before each meal,pt
counting to 5 each time shud b do
-
8/11/2019 interceptive ortho
49/122
tongue blade therapy/popsiclestick therapy
counting to 5 each time..shud b do
several times, at certain periods o
day
Anterior inclined plane 45degree to the long axis of lower
1/4thinch post.. bite jumping wthn
week.. results wthn 2 wks
Doubl helical spring- activated 2 mm to provide 1 mm o
tooth movmnt per month
Mild rotation..
POSTERIOR CROSSBITESCross arch elastics Isolated molars in 4-8 weeks
Fixed palatal wire designs
W arch
Quad helix
Slow expansion
4-5 mm of buccal expansion in 4-6
wks..left behind for 3 months
Fixed jackscrew expanders
HYRAX, RPE
1-2 turns per day for 4 weeks(1
turn=0.25mm)
-
8/11/2019 interceptive ortho
50/122
FUNCTIONAL APPLIANCES
-
8/11/2019 interceptive ortho
51/122
FUNCTIONAL APPLIANCES
Myofunctional appliances -harness the musclepressure
Functional appliances- elicit certain natural
functions of the orofacial region
BACKGROUND
-
8/11/2019 interceptive ortho
52/122
Functional appliances are conceptually based
on Mossfunctional matrix theory
orm follows function
These appliances either transmit, eliminate or
guide the natural forces of the masculature
-
8/11/2019 interceptive ortho
53/122
guide the natural forces of the masculature.
Are used for growth modification procedures that
are aimed at intercepting and treating jaw
discrepancies
They bring about following changes:
An increase or decrease in jaw size.
A change in spatial relationship of the jaws
Change in direction of growth of the jaws
Acceleration of desirable growth
classifications
-
8/11/2019 interceptive ortho
54/122
I) Tom Graber, when functionals were removable:
Group A-teeth supported appliances eg.Catalans, inclined planes, etc.
Group b- teeth/tissues supported appliances.
Eg. Activator, bionator, etc.
Group c- vestibular positioned appliances.
With isolated support from tooth / tissue eg. Oral
Screens, frankel, lip bumpers.
classification
-
8/11/2019 interceptive ortho
55/122
II) With the advent of fixed functionals another classifica
evolved:A)Removable functionals eg. Activator, Frankel etc.
B)semi fixed functionals eg. Den holtz, Bass appliances.
C)fixed functionals eg. Herbst, Jasper jumper, MARA, etc
classification
-
8/11/2019 interceptive ortho
56/122
III) With the awareness & acceptance of the concept o
hybridism by Peter Vig, functionals could be furtheclassified as
A)classic functional appliances like
Activator, Catalans, Frankel etc.
B)hybrid appliances like Propulsor, Double Oral
screen, Hybrid bionators, bass appliance.
classification
-
8/11/2019 interceptive ortho
57/122
IV)
1) Tooth borne passive appliances- myotonic appliances
Eg. Andresen/Haupl activator, Herren activator, Woodside activat
Balters bionator etc.
2) Tooth borne active appliances- myodynamic appliances
Eg. Elastic open activator (EOA), Bimler appliances, Modified bion
Stockfish appliances, Kinetor,etc.
3) Tissue borne passive appliances.
Eg. Oral screens, Lip plumpers
4) Tissue borne active appliances
Eg. Frankels appliances
5) Functional orthopedic magnetic appliances (FOMA)
ORAL SCREEN (NEWELL
-
8/11/2019 interceptive ortho
58/122
(
1912)MODE OF ACTION
both the principles of force application n elimination
Indications : i f h bi lik
-
8/11/2019 interceptive ortho
59/122
Interception of habits like Correction of mild disto-occlusion Muscle exercises for correction of hypotonic lip & cheek
muscles.
Correction of mild anterior proclination.
Fabrication : Impression Sealing of cast in occlusion Covering of labial surfaces of teeth & alveolar process with
wax of 2-3mm thickness. Fabrication of appliance with self cure or heat cure resin.
Patient is asked to wear the appliance in the night & 2-3 hrsduring the day time.Seen about once every 3 weeks or a month
Modification of vestibular
-
8/11/2019 interceptive ortho
60/122
screen1. Hotz modification- metal ring- muscle
exercises2. Double oral screen- tongue thrust
3. With holes- mouth breathers
LIP BUMPER
-
8/11/2019 interceptive ortho
61/122
Combined removable fixed appliance
Muscular force application or force elimination
Both maxilla and mandible
USES:
o Lip sucking
o Hyperactive mentalis- crowding of lower ant
o Distalization of first molars
Maxillary arch- Denholtz appliance
Appliance design
-
8/11/2019 interceptive ortho
62/122
-
8/11/2019 interceptive ortho
63/122
-
8/11/2019 interceptive ortho
64/122
Fabrication of appliance
-
8/11/2019 interceptive ortho
65/122
Impression
Bite registration
Articulation of the model
Preparation of wire element- labial bow-0.8 or
0.9mm wire
Fabrication of acrylic portiono Maxillary part
o Mandibular part
o Interocclusal part
CONSTRUCTION BITE
-
8/11/2019 interceptive ortho
66/122
Mandible is advanced by 4-5 mm and bite opened
2-3 mm
General considerations-
Trimming of the activator
-
8/11/2019 interceptive ortho
67/122
For vertical control
Intrusion of teeth-
Extrusion of teeth-
For sagittal control
-
8/11/2019 interceptive ortho
68/122
Class II correction
Protrusion & retrusion of incisors
For transverse control - Jack screw is incorpora
-
8/11/2019 interceptive ortho
69/122
Management:
1
st
week: 2-3 hrs during day 2ndweek: full night + 1-3 hr each day
3rdweek: appliance is checked to evaluate the trimm
Every 6 weeek: check up appointment
MODIFICATIONS
-
8/11/2019 interceptive ortho
70/122
Bow activator of Schwarz
Wunderersmodification
Propulsor
Reduced activator or cybernator of Schmuth
Cutout or palate free activator
Karwetzky modification
Herrensmodification
BIONATOR (BALTER 1950)
-
8/11/2019 interceptive ortho
71/122
Philosophy of bionator
-
8/11/2019 interceptive ortho
72/122
Does not activate the muscle
ACTIONS OF THE BIONATOR
-
8/11/2019 interceptive ortho
73/122
Causes sagittal repositioning of mandible thereby increasing
the oro functional space.
Causes anterior positioning of the tongue
prevents the external unfavorable muscle forces by means
vestibular arch and its buccal extension.
Intrusion and extrusion of teeth
-
8/11/2019 interceptive ortho
74/122
OPEN BITE APPLIANCE
-
8/11/2019 interceptive ortho
75/122
The interocclusal bite blocks prevent the extrusion
posterior teeth.
prevents thrusting of tongue
-
8/11/2019 interceptive ortho
76/122
FUNCTIONAL REGULATOR
-
8/11/2019 interceptive ortho
77/122
FRANKELS PHILOSOPHY AND MODE OF
ACTION1. VESTIBULAR ARENA OF OPERATION
Dentition is influenced by peri-oral muscle function.
Abnormal peri-oral muscle function creates a barrier
the optimal growth of the dento-alveolar complex.
-
8/11/2019 interceptive ortho
78/122
-
8/11/2019 interceptive ortho
79/122
Frankel-IcTypes of Frankel appliances
-
8/11/2019 interceptive ortho
80/122
Cl - II division 1 malocclusion
overjet >7mm.
Frankel-II
CL-II and division 1 & 2
Is modified by adding a stainless
steel protrusion bow behind the
maxillary incisors.
Frankel-III - CL-III malocclusion
Types of Frankel appliances
-
8/11/2019 interceptive ortho
81/122
Frankel III CL III malocclusion.
lip pads are situated in the maxillary vestibular labial sulcus
Labial bow rests against the mandibular teeth
There is a protrusive bow similar to that of Frankel-II
FRANKEL-IV
-
8/11/2019 interceptive ortho
82/122
correction of open bite & to a lesser extent
bimaxillary protrusion.
redirect the mandibular growth from a downward
backward growth rotation to a upper and forwa
rotation.
Frankle V
Used along with headgears
TWIN BLOCK APPLIANCE
-
8/11/2019 interceptive ortho
83/122
Occlusal inclined plane is the fundamental functionmechanism of the natural dentition.
Class I Class II
MODE OF ACTION OF TWIN
BLOCK
-
8/11/2019 interceptive ortho
84/122
BLOCK The unfavourable cuspal contacts of the distal occlusion
replaced by favourable proprioceptive contact on the inclin
plane of Twin block
Due to the inclined plane effect a mesial component of fo
is created
Case Selection
Angles class II div I with good arch form
-
8/11/2019 interceptive ortho
85/122
Angles class II div I with good arch form
Arches that uncrowded or decrowded
overjet10-12mm & a deep overbite
VTO positive
Actively growing individual
Angulation of inclined plane
70 degree- more horizontal
component of force- encourage
fwd mand growth
Stages of treatment
-
8/11/2019 interceptive ortho
86/122
Active phase 6-9 months
Support phase- 3-6 months Retention phase- 9 months
avg- 18 months
8-10 hours a day
2-3 months
Emil Herbst (1900s)
HERBST APPLIANCE
-
8/11/2019 interceptive ortho
87/122
Emil Herbst (1900s).
Pancherz 1982 & McNamara 1990 - both skeletal and den
adaptations This was previously used in the mixed dentition period b
now primarily used as an appliance in permanent dentition
holds lower jaw in a forward position
while pushing the upper jaw backward.
-
8/11/2019 interceptive ortho
88/122
INDICATIONS
In class II due to retrognathic mandible As an anterior repositioning splint in pt
having TMJ disorders
Uncooperative pts
Post adolescent
TREATMENT EFFECTS
-
8/11/2019 interceptive ortho
89/122
Class II to class I molar relation
Increase in mand growth
Distal driving of max molars
Overjet reduction
An inhibitory influence on sagittal max growth
-
8/11/2019 interceptive ortho
90/122
Acc Sassouni et al 1972
ORTHOPEDIC APPLIANCES
-
8/11/2019 interceptive ortho
91/122
Acc Sassouni et al- 1972
Orthodontic therapy- aimed at correction of
dentoalveolar malocclusion
Orthopedic therapy- correction skeletal imbalance
with correction of any dentoalveolar malocclusion
being of less importance
Orthopedic forces are heavier (400gm) when
compared to orthodontic forces( 50-100gm)
Basis for orthopedicappliances
-
8/11/2019 interceptive ortho
92/122
pp Makes use of teeth as a handle to transmit forces
to the underlying skeletal structures.
1. Amount of force -400-600gm/side
2. Duration of force- 12-14hrs /day
3. Direction of force- posteriorly &superiorly through
the centre of resistance of the maxilla.4. Age of the patient-
5. Timing of force application-
-
8/11/2019 interceptive ortho
93/122
HEAD GEARS
-
8/11/2019 interceptive ortho
94/122
Distalize the maxillary dentition or maxilla it self.
350 -450 gms on each side for 12-14 hrs / day.
COMPONENTS :
Force delivering unit- Face bow, J hook
Force generating unit ( elastic / springs )
Anchorage unit ( head strap/ cervical strap )
Types
-
8/11/2019 interceptive ortho
95/122
1. Cervical headgear-
2. Occipital headgear3. High pull(parietal )
4. Combination pull
CHIN CUP THERAPY
-
8/11/2019 interceptive ortho
96/122
Objective - to provide growth inhibition or redirection
& posterior positioning of mandible.
-
8/11/2019 interceptive ortho
97/122
Ideal patient for chin cup-
Acc to T M Graber
-
8/11/2019 interceptive ortho
98/122
A mild skeletal problem with the ability to bring incisors
edge to edge or nearly so
Short vertical facial height
normally positioned or protrusive , but not retrusive lower
incisors
Types of chin cup1. Occipital pull chin cup-
Classs III with mild to moderate prognathism
pt with short facial height also benefits from yhis type
2. Vetical pull chin cup- high angle cases or long face patients
PROTRACTION FACE MASK
-
8/11/2019 interceptive ortho
99/122
Hickham 1972.. Reverse head gear
Mainly used to pull the max ahead simultaneously pushingthe mandible distally.
250gm per side for 13 months
12-24 hrs/day.
MAXILLARY INTRUSIVESPLINT
-
8/11/2019 interceptive ortho
100/122
Indicationsevere gummy class II div 1
malocclusion
It reduces the visibility & vulnerability of the
maxillary incisors by
Achieving intrusion of max teeth
Restraining the max growth
Forward mandibular rotation
MAXILLARY INTRUSIVE SPLINT
FABRICATION-
-
8/11/2019 interceptive ortho
101/122
PRE ORTHODONTICTRAINER
-
8/11/2019 interceptive ortho
102/122
Technical Features
-
8/11/2019 interceptive ortho
103/122
1.Tooth channels
2. Labial bows
3.Tongue tag
4.Tongue guard
5. Lip bumpers
6. Jaw repositioning
Tooth guidance
system
Myofunctional
Training
Jaw positioning /
Functional appliance
-
8/11/2019 interceptive ortho
104/122
Phase 2
-
8/11/2019 interceptive ortho
105/122
Duration :612 months
much stiffer
same principle as orthodontic arch wire
Made of polyurethane
The TRAINER System
T4K The Pre orthodontic TRAINER
http://www.myoresearch.com/cms/index.php?t4khttp://www.myoresearch.com/cms/index.php?t4khttp://www.myoresearch.com/cms/index.php?t4khttp://www.myoresearch.com/cms/index.php?t4khttp://www.myoresearch.com/cms/index.php?t4khttp://www.myoresearch.com/cms/index.php?t4khttp://www.myoresearch.com/cms/index.php?t4khttp://www.myoresearch.com/cms/index.php?t4khttp://www.myoresearch.com/cms/index.php?t4khttp://www.myoresearch.com/cms/index.php?t4khttp://www.myoresearch.com/cms/index.php?t4k -
8/11/2019 interceptive ortho
106/122
T4K - The Pre-orthodontic TRAINER.
Improves facial & dental development in the growing
child (mixed dentition).
T4A - Aligns and retains anterior teeth in the
permanent dentition.
INFANT TRAINER - For habit correction.
To assist development of teeth & jaws in the
growing child.
The TRAINER System cont.,
http://www.myoresearch.com/cms/index.php?t4khttp://www.myoresearch.com/cms/index.php?t4khttp://www.myoresearch.com/cms/index.php?t4khttp://www.myoresearch.com/cms/index.php?t4khttp://www.myoresearch.com/cms/index.php?t4ahttp://www.myoresearch.com/cms/index.php?t4ahttp://www.myoresearch.com/cms/index.php?t4ahttp://www.myoresearch.com/cms/index.php?t4ahttp://www.myoresearch.com/cms/index.php?infanthttp://www.myoresearch.com/cms/index.php?infanthttp://www.myoresearch.com/cms/index.php?infanthttp://www.myoresearch.com/cms/index.php?infanthttp://www.myoresearch.com/cms/index.php?infanthttp://www.myoresearch.com/cms/index.php?infanthttp://www.myoresearch.com/cms/index.php?infanthttp://www.myoresearch.com/cms/index.php?infanthttp://www.myoresearch.com/cms/index.php?t4ahttp://www.myoresearch.com/cms/index.php?t4ahttp://www.myoresearch.com/cms/index.php?t4ahttp://www.myoresearch.com/cms/index.php?t4ahttp://www.myoresearch.com/cms/index.php?t4ahttp://www.myoresearch.com/cms/index.php?t4ahttp://www.myoresearch.com/cms/index.php?t4khttp://www.myoresearch.com/cms/index.php?t4khttp://www.myoresearch.com/cms/index.php?t4khttp://www.myoresearch.com/cms/index.php?t4khttp://www.myoresearch.com/cms/index.php?t4khttp://www.myoresearch.com/cms/index.php?t4khttp://www.myoresearch.com/cms/index.php?t4k -
8/11/2019 interceptive ortho
107/122
T4B - The TRAINER for Braces.
Shields the soft tissue from brackets.
T4CII - The TRAINER for Class II Correction.
Jaw alignment in combination with fixed
orthodontics.
LINGUA - Train the Tongue Day & Night.
tongue retraining.
The FARRELL BENT WIRESystem
The BWS allows arch development and anterior dental alignmen
http://www.myoresearch.com/cms/index.php?t4bhttp://www.myoresearch.com/cms/index.php?t4bhttp://www.myoresearch.com/cms/index.php?t4bhttp://www.myoresearch.com/cms/index.php?t4ciihttp://www.myoresearch.com/cms/index.php?t4ciihttp://www.myoresearch.com/cms/index.php?id=243,333,0,0,1,0http://www.myoresearch.com/cms/index.php?id=243,333,0,0,1,0http://www.myoresearch.com/cms/index.php?id=243,333,0,0,1,0http://www.myoresearch.com/cms/index.php?id=243,333,0,0,1,0http://www.myoresearch.com/cms/index.php?id=243,333,0,0,1,0http://www.myoresearch.com/cms/index.php?id=243,333,0,0,1,0http://www.myoresearch.com/cms/index.php?id=243,333,0,0,1,0http://www.myoresearch.com/cms/index.php?id=243,333,0,0,1,0http://www.myoresearch.com/cms/index.php?t4ciihttp://www.myoresearch.com/cms/index.php?t4ciihttp://www.myoresearch.com/cms/index.php?t4ciihttp://www.myoresearch.com/cms/index.php?t4ciihttp://www.myoresearch.com/cms/index.php?t4ciihttp://www.myoresearch.com/cms/index.php?t4bhttp://www.myoresearch.com/cms/index.php?t4bhttp://www.myoresearch.com/cms/index.php?t4bhttp://www.myoresearch.com/cms/index.php?t4bhttp://www.myoresearch.com/cms/index.php?t4b -
8/11/2019 interceptive ortho
108/122
The BWS allows arch development and anterior dental alignmen
combined without encroaching on the natural position of the tong
Therefore the force of the.. allowing the BWS to use very ligh
Fabrication:
-
8/11/2019 interceptive ortho
109/122
THE MYOBRACE SYSTEMFeatures 2 main elements-
A soft flexible outer , &
-
8/11/2019 interceptive ortho
110/122
A soft flexible outer , &
Dynamicore- a hard
inner core- producespositive arch
development & tooth
alignment
Used in late mixed &
early permanent
dentition
-
8/11/2019 interceptive ortho
111/122
Interceptive series- i-3
-
8/11/2019 interceptive ortho
112/122
1:A Frankel cage for maxillary development, with an offset
Class I/II incisor preset.
2:High extended reflex sides to discourage anterior
mandibular posture.
3:Positive tongue position elevator to raise tongue position
conjunction with the tongue tag used in the Pre-Orthodont
TRAINER (T4K)..
-
8/11/2019 interceptive ortho
113/122
-
8/11/2019 interceptive ortho
114/122
Correction of anterior crossbitPrarthana 7/F.. Tongue blade theray
-
8/11/2019 interceptive ortho
115/122
Chitra 9/F.. Hawleys with expansion screw
Kavana 8/F.. Anterior inclined plane
-
8/11/2019 interceptive ortho
116/122
Management of Class I malocclusion with crowding us
Trainer
Usha 12F
-
8/11/2019 interceptive ortho
117/122
Pre op
Post op
Arch expansion using Bent Wire System for management of cr
Brunda 11/F
-
8/11/2019 interceptive ortho
118/122
CONCLUSION
The earlier treatment begins, the more the
-
8/11/2019 interceptive ortho
119/122
g ,
face will adapt to your standards, the later
treatment begins the more your standards whave to adapt to the face.
C.Gugino
-
8/11/2019 interceptive ortho
120/122
Clinical Pedodontics: 4theditionFinn
REFERENCES
-
8/11/2019 interceptive ortho
121/122
Textbook of pedodontics:2ndedition- Tandon
Occlusal guidance in pediatric dentistryNakata
Pediatric dentistry .infancy through adolescence: 4theditio
Pinkham
Google search
Myobrace.com
-
8/11/2019 interceptive ortho
122/122