interceptive orthodontics 1 / orthodontic courses by indian dental academy

INTERCEPTIVE ORTHODONTICS

05/02/23 1www.indiandentalacademy.com

INDIAN DENTAL ACADEMY

Leader in continuing dental education www.indiandentalacademy.com

www.indiandentalacademy.com 205/02/23

DEFINITION : Intervention in the incipient stages of a

problem to lessen its severity or possible future adverse effects and to eliminate its causes

Intercept a malocclusion that has already developed or is developing.


Such treatment may take place in deciduous or transitional dentition and may include

redirection of ectopically erupting teeth, slicing or extraction of deciduous teeth, correction of isolated dental crossbites or recovery of minor space loss


DIFFERENCE BETWEEN PREVENTIVE & INTERCEPTIVE ORTHODONTICS

Unlike preventive orthodontic procedures that are aimed at elimination of factors that may lead to malocclusion.

Interceptive orthodontics is undertaken at a time when the malocclusion has already developed or is developing.


Interceptive orthodontics basically refers to measures undertaken to prevent a potential malocclusion from progressing into a more severe one.

The procedures undertaken are:1. Serial extractions 2. Correction of developing cross-bite3. Control of abnormal habits4. Space regaining 5. Muscle exercises6. Interception of skeletal mal-relation7. Removal of soft tissue or bony barrier to enable eruption of teeth


PURPOSE OF EARLY ORTHODONTIC TREATMENT

1. To intercept developing problem2. To prevent obvious problems from becoming

worse 3. To correct obvious problems4. To remove the etiologic factors and restore

normal growth 5. To reduce the severity of skeletal problems,

making possible easier and more precise tooth positioning in adolescence.


INDICATIONS FOR EARLY ORTHODONTIC INTERVENTION

1. Anterior and posterior cross-bite : not only for the functional improvement brought about by therapy but also for the improved esthetics that occur with the anterior cross-bite correction.

2. Severe anterior and lateral open-bites 3. Ectopic eruption 4. Severe arch length discrepancies5. Pseudo class III6. Dental and / or skeletal Class II 7. Maxillary mid face deficiency8. Deep bite 9. Habits 10. Midline discrepancies 11. Management of supernumery teeth 12. Ankylosed teeth


BENEFITS OF EARLY TREATMENT

1. Reduced incidence of premolar extractions2. Decreased extent or possible elimination of the need

for a second phase of treatment.3. Reduced need for surgical orthodontics4. Increased stability of transverse & antero-posterior

dimension changes with phase 1 treatment.5. Increased long term stability of lower incisor alignment 6. Reduced incidence of root resorption7. Reduced incidence of mucogingival problems8. Reduced incidence of ectopic cuspid eruptions


DISADVANTAGES

1. Sometimes requiring two phase / three phase of treatment leading to patient burnout and patient dissatisfaction.

2. Prolonged treatment time 3. Increased cost4. Discrepancy in growth patterns tend to re-establish

after some time5. Can not be used in cases like bimaxillary protrusion

when extraction of teeth is required. As in such cases 1 phase treatment is beneficial.


CONDITIONS

1. Anterior cross bite 2. Posterior cross bite3. Open bite4. deep bite5. Ectopic eruption6. Midline deviation 7. Midline diastema8. Space regainers


CROSS BITE

Definition An abnormal relationship of one or

more teeth to one or more teeth of the opposing arch in the bucco-lingual or labio-lingual direction


Classification of cross bite

Cross bite can be :1. Anterior / posterior cross bite2. Buccal / lingual cross bite3. Dental / skeletal / functional in etiology


Scissor bite

Situation in which posterior teeth overlap vertically in habitual occlusion with their antagonists without contact of their occlusal surfaces

The deviation of the affected teeth from their ideal positions could occur either in a buccal or a lingual direction.


Dental cross bite

An abnormal relationship between antagonist teeth, that is due to deviations in the position or inclination of one or few teeth.

The relationship between the maxilla and the mandible is harmonious.

Such cross bites are treated by tooth movement alone.


Skeletal cross bite

Anterior or posterior (unilateral or bilateral) cross bite that is due to a sagittal or transverse in coordination in the size or shape of the maxilla and or mandible.

Treatment usually requires a skeletal expansion by means of rapid maxillary expansion or orthognathic surgery.


Functional cross bitepseudo cross bite

A cross bite that is due to a shift of mandible into faulty habitual occlusion because of premature occlusal interference.

This shift may occur in an anterior and or lateral direction.


Etiology Hereditary Over retained deciduous teeth. Displacement due to trauma. Constricted maxillary arch. Large mandible. Cross bite due to a shift of mandible ,into faulty

habitual occlusion . Multiple loss of post. Deciduous teeth can cause

anterior cross bite.


Treatment –dental cross bite.(single tooth cross bite)

Correct the inclination or position of teeth Erupting maxillary incisor – with tongue

blade. Removable appliance with Z spring and

posterior bite plate. Fixed appliance with posterior bite plate.


Treatment -skeletal cross bite (segmental cross bite)

In mixed dentition – Skeletal expansion of maxilla with rapid

maxillary expansion for lateral cross bite. Mid –face deficiency –face mask can be

given Large mandible—chin cap to restrict the

growth , F.R. III


Treatment Functional cross bite (pseudo)

Remove the occlusal interference


Open bite


Definition of open bite

Localized absence of occlusion. Failure of teeth to meet the antagonist in the

opposing arch. Failure of overlapping of upper and lower teeth

in centric occlusion. (amount of separation measured.)

Failure of some opposing teeth to occlude when others are in maximum intercuspation.


CLASSIFICATION

LOCATION- ANTERIOR / POSTERIOR TYPE SKELETAL / DENTAL


ETIOLOGY OF OPEN BITE

1)-Disturbance in the eruption of teeth Ankylosis due to infection Primary failure of eruption 2)-mechanical interference Habits like tongue thrust, thumb sucking etc.

3)-osseous dyspasia Endocrine disturbance- Downs syndrome Hemi mandibular hypertrophy.


Differences between dental and skeletal open bite

Dental Skeletal

Profile Normal Convex

vertical proportion

Normal increased

Lips Competent IncompetentEtiology Habit HereditaryTongue Positioned in

the open bite region

Not necessary placed in open bite region


Long face syndrome Thank you

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interceptive orthodontics 1 / orthodontic courses by indian dental academy

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