1. PREVENTIVE AND INTERCEPTIVE ORTHODONTICS
Group 1

2. PREVENTIVE ORTHODONTIC
Definition :
It is an action taken to presrve the integrity of what appears to be a normal occlusion at a specific time.
Aim :
To prevent develoment of malocclusion.

3. PROCEDURES Parent education : Caries control :
Physiologic nipples, proper toothbrushing technique, maintain good OH
Caries control :
Monitor caries progression, prevent early loss
Monitoring of primary dentition and transition stage :
Monitor eruption and exfoliation time, application of preventive procedures

4. Extraction of retained deciduous or supernumerary teeth :
Can interfere with eruption of permanent and cause displacement or erupt abnormally.
Habit correction :
Thumb sucking habit, tongue thrusting. Can cause anterior open bite. Use habit breaker appliances.
Space maintainer :
To maintain space created by premature loss of deciduous teeth.

5. PHYSIOLOGIC NIPPLE, PACIFIER
SPACE MAINTAINER
HABIT BREAKER

6. INTERCEPTIVE ORTHODONTICS

7. Definitions.
Any procedure that eliminates or reduces the severity of malocclusion in the developing dentition. (Popovich and Thompson 1979, Hiles 1985.)
All simple measures that eliminate the developing malocclusion (Ackerman and Profit 1980).

8. Indications. Impacted canine Impacted molars Hypodontia
Supernumerary teeth.
Correction of anterior and posterior crossbite
Sagittal problems- class II
Sagittal problems- class III

9. Treatment involved Serial extraction
Correction of developing cross bite
Control of abnormal habits
Space regaining
Muscle exercises
Interception of skeletal mal relation
Removal of soft tissue or bony barrier to enable eruption of teeth

10. 1. Serial extractions
1940s to treat Class I malocclusion complicated by severe labial segment crowding
Aim: to spontaneously guide the developing dentition into good alignment w/o
use of appliance treatment by selectively timing deciduous
and permanent tooth extractions

11. should allow spontaneous alignment of the incisors
Extraction of four deciduous canines
~ 8 years in a child of average dental development, at the time of eruption of the maxillary lateral incisors.
should allow spontaneous alignment of the incisors
at the expense of canine space
Extraction of the first
deciduous molars
~ 9 years when the roots of the first premolars are half formed.
Aim: to encourage the first premolars to erupt before the canines, which is often not the case in the lower arch
Extraction of the first premolars
~ time of eruption of the canines
after confirming that they are buccaly palpable and mesially angulated
if there is sufficient crowding to warrant premolar extractions and
if all other teeth are present and sound.

12. Disadvantages serial Xn
• Multiple Extractions under GA > a stressful experience for the patient. • Early loss of the 1st deciduous molar > mesial drift of the buccal segments with further space loss. • The lower canine may still erupt into the first deciduous molar space before the first premolar resulting in first premolar impaction. • No spontaneous correction of an incorrect incisor relationship, hence it is only useful in Class I cases. • A risk of lower incisor retroclination and deepening of the overbite. • Patients may still require later appliance treatment.

13. Current approach
Serial xn rarely practice due current wide availability of fixed appliances
a modified version of the procedure may be carried out
(e.g. extraction of deciduous canines to allow alignment of the incisors or for interceptive treatment of palatal maxillary canines) to simplify later appliance treatment

14. 2. Treatment for crossbites
Quad helix
Micro screws

15. 3. Control of abnormal habits
Thumb / digit sucking
Mouth breathing
Tongue thrusting
Lip sucking / biting

16. Treatments for thumb sucking
Tongue crib
Lip bumper

17. 4. Space regaining
Mesial tipping or drifting of permanent first molars on premature loss of deciduous second molar , reducing the arch length
Extensive caries
Ecotopic eruption
Premature extraction of primary molars

18. Treatments Timing of distalization 7-10 yrs of age
Incomplete root formation
Second molars are not erupted

19. Treatment procedures Fixed appliances Removable appliance
Open coil / herbst space regainer
Jackscrew space regainer
Gerber space regainer
Removable appliance
Hawley’s appliance
With helical spring\
Split acrylic dumb
bell spring
With sling shot elastic
Palatal spring
Expansion screws

20. 6. Interception of skeletal malocclusion
Class II
Class III
Functional appliances
Tooth borne
Active
Passive
Tissue borne

21. 7. Removal of soft tissue / bony barrier
Retained deciduous teeth
Supernumerary teeth
Fibrous / bony obstruction of the erupting tooth bud