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ORTHODONTICS SEMINAR. Fatimah Che Rahimi Laila Azwa Hassan Ahmad Zulkhairi Resali Nurmarzura Abdul Latif Aishah Shahrir Nur Amalina Zulkepre Akmal Khalis Doreyat Masyitah Mustaffa Aimi Amalina Ahmad. Early loss of deciduous teeth. - PowerPoint PPT Presentation

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Early loss of deciduous teeth

ORTHODONTICS SEMINARFatimah Che RahimiLaila Azwa HassanAhmad Zulkhairi ResaliNurmarzura Abdul LatifAishah ShahrirNur Amalina ZulkepreAkmal Khalis DoreyatMasyitah MustaffaAimi Amalina AhmadEarly loss of deciduous teethIt happened as a result of extraction due to caries or trauma

The degree of space loss is influence by:Unilateral / bilateralAge of loss --> more effect if the tooth lost at earlier ageCrowding/spacing the more inherent the crowding present, the more potential for space Tooth typeposition of the affected tooth in arch influence subsequent space distributiontimevery early extraction can delay successional tooth eruption, later extraction have opposite effectDegree of intercuspation-less effectSkeletal factors-less effect

Balancing and compensating extractionAim: to preserve arch symmetry and occlusal relationship

Balance enforced extractions A balancing extraction is a tooth from the opposite side of the same arch, designed to minimise centreline shift.

Compensate enforced extractions Compensation means extraction of a tooth from the opposing quadrant to the enforced extraction. It is designed to minimise occlusal interferance by allowing teeth to maintain occlusal relationships as they drift. It is more difficult to justify compensation than balance, especially when it would involve removal of a tooth from an intact arch. Which deciduous teeth need balancing and compensating extraction?Tooth Influence Need balancing or compensating extractionDeciduous incisor--Deciduous canineCentreline shiftNeed balancing extraction1st deciduous molarCentreline shiftNeed balancing extractionLower 1st deciduous molar-Need compensating extraction2nd deciduous molar-Need compensating extraction (if it contribute to significant alteration in molar relationship)

Digit sucking habitDigit sucking habitMost prevalent of oral habits, 13% - 100%If the habit ceases before the permanent teeth begin to erupt, any effects on the dentition are unlikely to be long-term. If however the habit persists into the mixed and permanent dentition malocclusionThumb sucking may develop early in life and continue from infancy through the primary dentition and into the mixed and permanent dentition. In many cases, if the thumb habit continues into the mixed dentition a malocclusion may develop (Kaplan 1950; Ruttle et al. 1953; Graber 1959).

Factors that Affecting the Degree of Damage to Teeth and Investing TissueFrequency of habitThe more frequency the more the damageDuration of habitThe more duration the more the damageIntensity of habitActive vs passive

*Prolonged digit sucking habit may affect occlusion and dentofacial structures.

FactorsNot all habits will result in tooth movement. It is related to frequency, duration and intensity.Studies suggest that it only takes very light forces to move teeth, if the force is of long enough duration.The threshold is believed to be 6 hours.

Maxillary changesMandibular changes

Others:-arch assymmetry-increased overjet-anterior openbite-posterior crossbiteHow to stop?Gentle discouragementOral appliances/ habit breaker-palatal crib-acrylic appliance on finger

Approaches to treat chronic thumb sucking These can be split intothree distinct categories: Behavioural rewarding a child for notexercising the habit;Mechanical preventing or interruptingthe process of thumb sucking; Aversive generating negativesensations when the habit is exercised,such as bad taste, pain or major discomfort

Fig 1: URA with acrylic ridgeFig 2: Blueglass rollerFig 3: The Rake applianceSpace MaintainerSpace MaintainerDefinitionAn intraoral appliance used to preserve arch length following premature loss of primary tooth/teeth in order to allow permanent teeth erupt into proper alignment and occlusionObjectives:Prevent drifting/tippingPrevent loss of arch lengthPrevent midline shiftPrevent crowding of permanent teethPrevent impactionsAs orthodontic intervention including extraction

Types of Space MaintainerBand and Loop

Crown and Loop

Palatal Arch/Lingual Arch

Palatal ArchLower Lingual ArchDistal Shoe/Intra-alveolar

Upper Removable Appliance

Infraoccluded 55 & Impacted 1515 erupting rotatedThank You