Presentation on theme: "ORTHODONTICS SEMINAR Fatimah Che Rahimi Laila Azwa Hassan"— Presentation transcript:
1ORTHODONTICS SEMINAR Fatimah Che Rahimi Laila Azwa Hassan Ahmad Zulkhairi ResaliNurmarzura Abdul LatifAishah ShahrirNur Amalina ZulkepreAkmal Khalis DoreyatMasyitah MustaffaAimi Amalina Ahmad
2Early loss of deciduous teeth It happened as a result of extraction due to caries or traumaThe 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 spaceTooth 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
3Balancing and compensating extraction Aim: to preserve arch symmetry and occlusal relationshipBalance enforced extractionsA balancing extraction is a tooth from the opposite side of the same arch, designed to minimise centreline shift.Compensate enforced extractionsCompensation 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.
4Which deciduous teeth need balancing and compensating extraction? ToothInfluenceNeed balancing or compensating extractionDeciduous incisor-Deciduous canineCentreline shiftNeed balancing extraction1st deciduous molarLower 1st deciduous molarNeed compensating extraction2nd deciduous molar(if it contribute to significant alteration in molar relationship)
6Digit sucking habit Most 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).
7Factors that Affecting the Degree of Damage to Teeth and Investing Tissue Frequency 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.
8FactorsNot 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.
9Maxillary changes 1. Proclination of maxillary incisors 2. Increased maxillary arch length3. Anterior placement of maxillary apical base4. Increased sella-nasion point A angle5. Decreased palatal arch width
10Mandibular changes 1. Proclination of mandibular incisors 2. Decreased sella-nasion B point angle3. Increased intermolar distance
12How to stop? Gentle discouragement Oral appliances/ habit breaker -palatal crib-acrylic appliance on finger
13Approaches 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
14Fig 1: URA with acrylic ridge Fig 2: Blueglass rollerFig 3: The Rake appliance
16Space Maintainer Definition Objectives: An 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
17Types of Space Maintainer AnteriorVSPosteriorFixedRemovableUnilateralBilateral
18Types of Space Maintainer FixedBand and loopCrown and loopLingual / Palatal archDistal shoeRemovableURA (Hawley retainer)Partial denture
19Band and Loop Loss of D (unilateral/bilateral) Indication : Ease of fabrication for clinicianEase of maintenance for patientAdvantage :Opposing tooth may be over-eruptDisadvantages :
20Crown and LoopLoss of D with significant loss of tooth substance of abutment tooth (unilateral/bilateral)Indication :Ease of fabrication for clinicianEase of maintenance for patientAdvantage :More difficult to fabricate than band & loopDisadvantages :
21Palatal Arch/Lingual Arch Loss of bilateral E’sIndication :Maintains tooth space & Leeway spacePrevents tipping of molarsAdvantage :Meticulous hygiene required6 prone to decalcificationDisadvantages :
23Distal Shoe/Intra-alveolar Loss of E prior to eruption of 6Indication :Maintain E’s spaceAdvantage :Difficult to fabricateContraindicated in medically compromised patient (Subacute bacterial endocarditis, chemotherapy, radiotherapy)Disadvantages :
24Upper Removable Appliance Multiple teeth are lost and space maintenance and mastication are of concernIndication :Maintain spaceAid in masticationAdvantage :Susceptible to fracture / lossDisadvantages :