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ORTHODONTICS Ortho means straight; odont means tooth

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Presentation on theme: "ORTHODONTICS Ortho means straight; odont means tooth"— Presentation transcript:

1 ORTHODONTICS Ortho means straight; odont means tooth
Chapter 27

2 What is orthodontics? Orthodontics is a specialty concerned with the guidance and correction of the dentofacial structure.

3 #1 Reason most orthodontists perform treatment

4 #1 Reason people seek orthodontic treatment

5 Indications for Ortho Treatment
Impaired chewing (Mastication) Crowding (Esthetics) TMJ dysfunction Dental caries Impaired speech

6 Contraindications for ortho Treatment
Lack of bone support Rampant caries Poor general health/mental health Poor OH/patient cooperation Lack of interest Lack of financial support

7 Factors affecting Malocclusions
Overjet Overbite Openbite Crossbite

When the patient bites together, there is an abnormal space between the lingual of the Max incisors & the facial of the Mand incisors.

Caused by the Max anterior teeth vertically overlapping the Mand anteriors. Slight overbite is normal.

10 OPENBITE Anterior or posterior teeth do not occlude. A space between the teeth.

11 Crossbites Anterior Crossbite: maxillary anterior teeth are positioned lingual to mandibular anterior teeth.

12 Crossbites Posterior crossbites: maxillary posterior teeth are positioned lingual to mandibular teeth.

13 Edge to Edge Bite Incisal edges of maxillary anterior teeth occlude on the incisal edges of mandibular anterior teeth

14 End to End bite Cusp tips of maxillary posterior teeth occlude with cusp tips of mandibular posterior teeth

15 Crowding Mild Moderate Severe

16 Angle’s Classification
Class I (Neutrocclusion): mesial buccal cusp of maxillary first molars is contacting the buccal groove of the mandibular first molars, remaining teeth are considered to be in normal occlusion.

17 Malocclusion Molars are in the same relationship as Class I, however, remaining teeth exhibit deviations from normal occlusion, such as: crowding, crossbite, or openbite.

18 Class II Malocclusion Class II (Distocclusion): mesial buccal cusp of maxillary first molars is contacting the mesial portion of the mandibular first molars, mesial to buccal groove.

19 Class II Division I Division I (refers to anterior teeth only): molars are in the same relationship as Class II with maxillary anteriors being flared out to the labial.

20 Class II Division II Division II (refers to anterior teeth only): molar relationship the same as Class II with maxillary centrals are tipped back to the lingual; they are touching the mandibular anterior teeth.

21 Class III Malocclusion
Class III (Mesiocclusion): Mesial cusp on maxillary first molars are touching distal of the buccal groove on the mandibular first molar.

22 Causes of Malocclusion
Genetic Systemic Local

23 Genetic Causes Congenitally missing teeth Malformed teeth
Supernumerary teeth Macrognathia Micrognathia Macrodontia Microdontia

24 Congenitally Missing Teeth
Patient missing Upper laterals

25 Malformed teeth Upper incisors misshapened

26 Supernumerary Teeth Supernumerary between upper centrals

27 Macrognathia Large Jaw

28 Micrognathia Small Jaw

29 Macrodontia Large Teeth

30 Microdontia Small Teeth

31 Systemic Causes Diseases and nutritional disturbances that upset the normal schedule of dentition development during infancy and early childhood

32 Local Causes Trauma/injury to permanent tooth buds, premature loss of primary teeth, and direct injury to permanent teeth.

33 Local Causes Thumb sucking/ can cause openbite and/or overjet
Tongue thrusting/ can cause openbite

34 Local Causes Mouth breathing Bruxim Nailbiting

35 Phases of Orthodontic treatment
Preventive Interceptive Corrective

36 Preventive Orthodontic treatment designed to correct problems, that if not stopped, will contribute to more serious problems in the future.

37 Interceptive Orthodontic treatment involving the correction of problems as they are developing.

38 Treatment for Preventive and Interceptive Phases
Space Maintainers Restoration to prevent tooth loss Observing growth patterns Correcting bad habits Serial extractions Recognizing deviation from normal development

39 Corrective Orthodontic treatment performed when the problems have already occurred and there were no steps taken to correct them previously.

40 Initial Exam/Initial Consultation
First appointment Review medical history Examine the patient Initial recommendations, review treatment options, and answer questions Next appointment Records

41 Records Second appointment Montage of patient
Intraoral and extraoral photographs Study models Panoramic Cephalometric Never review financial information at this appointment

42 Montage Photographs A series of usually eight photographs to allow the doctor a clear view of the patient mouth.

43 Study Models An exact replica of patients teeth and surrounding tissues Allows the doctor to view all aspects of patient’s teeth without patient having to be there

44 Panoramic A wide view of patient’s mouth Allows insight into placement of impacted teeth, 3rd molar location, and eruption patterns of unerupted teeth

45 Cepholometric Used for diagnosis of jaw relationships Tracings are designed to show how the jaw relates to certain landmarks in the skull

46 Consultation/Case Presentation
A detailed outline of the treatment for the patient How long it will take What style of braces and or appliances are being used Cost of treatment

47 Palmer Numbering System

48 Separators Elastic, circular shaped item placed between teeth to open contact between teeth to allow orthodontic band to fit around teeth.

49 Bands Orthodontic bands are placed on first molars, to act as an anchor in orthodontic treatment and to help stabilize the archwire. Brackets are soldered on the band, have tubes to hold archwire. Only upper first molar bands have headgear tubes Come in multiple sizes

50 Banding Appointment Teeth are pumiced
Orthodontic Assistant sizes bands Orthodontist checks Assistants prepares cements Orthodontist seats bands

51 Brackets Bonded to buccal/facial portion of teeth, transmits force of archwire to move teeth Can be silver, clear or gold in color Each bracket is specific to a tooth Archwire slot has a specific torque and tip to bring teeth into ideal occlusion May have wings for tying or doors

52 Bonding Appointment Pumice teeth to remove salvia and debris
Acid etch teeth for 30 seconds Apply bonding agent Apply cement to back of each bracket Place bracket on tooth Orthodontist positions bracket to precise location on tooth Light cure bracket to teeth or allow to self cure

53 Archwires Placed into bracket slot to control movement of teeth.
Held in place by elastic ligature ties or stainless steel ties.

54 Elastic Ties aka: O’s, A’s, colored ties
Used to hold AW into bracket slots.

55 Stainless Steel Ligature Ties
Used to hold arch firmly into archwire slot Can be preformed with pigtail or long Used to tie individual teeth or multiple teeth together.

56 Kobayashi Hooks Placed on Brackets to attach interarch elastics
Interarch elastics, used to correct Class II and Class III occlusion

57 Tooth Movement Teeth are allowed to move through the bone by resorption (osteoclasts). Teeth are held in place by deposition (osteoblasts). Active Phase=tooth movement Retention Phase=teeth held in place with retainers, osteogenesis takes 6-12 months Hawleys, Trutanes, Fixed Retainers

58 Retainers Hawley Trutanes Fixed Retainers

59 Oral Hygiene Special toothbrush and brushing instructions
Floss and floss threaders Proxibrush Fluoride rinse Wax Food Do’s and Don'ts list What to do when things break

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