Introduction to Orthodontics 1

Definition of Orthodontic Definition Æ Orthodontic is that branch of dentistry concerned with facial growth, with development of the dentition and occlusion, and with the diagnosis and treatment of malocclusion. Thus, the study of orthodontics includes the growth, development and function of the total oro-facial complex, whilst orthodontic techniques are concerned with the technique of the treatment of malocclusion. ORTHODONTICS OCCLUSION & FACE s

Occlusion and malocclusion Is the relationship of the maxillary and mandibular teeth when they are brought into contact. Ideal occlusion A theoretical concept based on the ideal teeth position and arches relationships. Normal occlusion. An occlusion with minor irregularity of teeth position and or malrelationship between the arches which is satisfactory aesthetically and functionally. Malocclusion. An occlusion in which there is irregularity of teeth position and or malrelationship between the arches in any planes of space which is unsatisfactory aesthetically and functionally.

Ideal Occlusion It is a theoretical concept based on the ideal teeth position and arches relationships. It is rarely, if ever, found in nature. However, it provides a standard by which all other occlusions may be judged.

Normal occlusion An occlusion with satisfactory irregularity of the teeth position and or relationship of the dental arches “Six keys of normal occlusion” Andrews (1972) 1) Molars relation. 2) Angulation. 3) Inclination. 4) No rotations. 5) Contacts. 6) Curve of Spee. These are also treatment objectives.

Malocclusion An occlusion with Unsatisfactory irregularity of the teeth position and or relationship of the dental arches

Malocclusion An occlusion with Unsatisfactory irregularity of the teeth position and or relationship of the dental arches Convex Class II Straight Class I Concave Class III

Malrelationship of Malposition of Malocclusion dental arches teeth Malocclusion is associated with one or more of the following Malrelationship of Malposition of Malocclusion dental arches teeth Antero-posterior Single teeth Class II Class III Rotation Tipping Vertical Displacement infra-occlusion Supra-occlusion Transposition Openbite Deepbite Transverse Space discrepancy Crossbite Scissorbite Crowding Spacing Introduction to Orthodontics

Etiology of malocclusion. Malocclusion can occur as a result of different factors which are inherited or acquired 1) Skeletal factors. 2) Soft tissue factors. 3) Dental and local factors. Etiology of malocclusion 4) Combinations. Skeletal factor Soft tissue factor Malocclusion Dental & Local factor Introduction to Orthodontics

Etiology of malocclusion • Skeletal Factors; 1) Anteroposterior. 2) Vertical. Skeletal factors 3) Transverse. 4) Combinations. Anteroposterior Class II Class III Malocclusion Vertical Low angle High angle Transverse Crossbite Scissor bite - Introduction to Orthodontics

Etiology of malocclusion Skeletal factors - Introduction to Orthodontics

Etiology of malocclusion Soft tissue factor. 1) Lips. 2) Tongue. 3) Combinations. Soft tissue factors Lips Morphology Function Malocclusion Tongue Position Size - Introduction to Orthodontics

Etiology of malocclusion - soft tissue factors Introduction to Orthodontics

Etiology of malocclusion Dental & local factors 14) Trauma 13) Pathology 1) Teeth/arch size discrepancies 12) Abnormal labial fraenum 2) Ectopic eruption 11) Chronic mouth breathing 3) Impaction Malocclusion 4) Abnormal form 10) Habits 9) Retention of deciduous 5) Missing teeth 8) Transposition 6) Early loss of deciduous or permanent 7) Supernumerary 181 DENT - Introduction to Orthodontics

Dental and local factors Transposition Supernumerary Early loss of incisor Size discrepancies - Introduction to Orthodontics

Dental and local factors Early loss of molars Thumb sucking Ectopic eruption Introduction to Orthodontics

Need and demand for treatment Need for orthodontic treatment is the decision of the professional for the necessity of the treatment. Whereas, demand for orthodontic treatment is the patient desire to seek treatment. Ethically, no treatment should be started unless the benefit to the patient is feasible. - Introduction to Orthodontics

Benefit and risk of orthodontic treatment Benefit is the gain to the patient by the treatment, while risk is the adverse event, harm, might occur during treatment. Benefits Risks *Improve psychological well being *Improve self-esteem *Root resorption *Enamel decalcification *Gingival swelling, gingivitis *Ulceration, appliance trauma *Allergies, nickel *Improve dental attractiveness *Improve function *Reduce risk of incisor trauma *Reduce tooth migration *Incomplete treatment *Relapse *Align teeth *Improve perio-support *Reduce problem of impaction *Support multidisciplinary treatment *Loss of tooth vitality *Bacteramia * Patient not satisfied with result Introduction to Orthodontics

Data base [case summary] Steps for orthodontic diagnosis and treatment plan Patient Interview Clinical Examination Radiographs Study models Data base [case summary] Problem list Possible solutions Final Treatment Plan 1) 1) 1) 2) 2) 2) 3) 3) Applicability Alternative Consent 3) 4) 4) 4) etc etc etc - Introduction to Orthodontics

Orthodontic treatment options Several options for orthodontic treatment; 1) No active treatment. 2) Interceptive treatment. 3) Conventional treatment. 4) Multidisciplinary treatment. a) Orthognathic surgery b) Ortho-implant c) Ortho-periodontal - Introduction to Orthodontics

Timing of orthodontic treatment 1) Deciduous dentition. No active orthodontic treatment 2) Early mixed dentition. Interceptive Treatment 3) Late mixed and early permanent dentition. Conventional treatment 4) Permanent dentition. Conventional treatment Multidisciplinary treatment - Introduction to Orthodontics

Orthodontic appliances Definition. Orthodontic appliances are devices to correct or maintain the tooth position and or the occlusal relationship. Type of orthodontic appliances. Three types, removable, fixed and functional. 1) Removable appliances are orthodontic devices made from acrylic and wires that is clasped to the teeth and can be removed from the mouth by the patient. 2) Fixed appliances are orthodontic devices where attachments are fixed to the teeth and the arch wires or auxiliaries move teeth. 3) Functional appliances are orthodontic devices utilizes the forces of the orofacial musculature to correct arch malrelationship. Introduction to Orthodontics

Orthodontic appliances Type of orthodontic appliances. Orthodontic Appliances Removable Fixed Functional Active Retainers Activator Frankel Others Straight-wire Tip-Edge Introduction to Orthodontics

Removable Orthodontic appliances Removable appliances are orthodontic devices made from acrylic and wires that is clasped to the teeth and can be removed from the mouth by the patient. Components of a removable appliance The main components are. 1) Active components. 2) Retention. 3) Anchorage. 4) Base plate. Introduction to Orthodontics

Fixed orthodontic appliances Fixed appliances are orthodontic devices where attachments are fixed to the teeth and the archwires or auxiliaries move teeth. The components of fixed orthodontic appliances; Tube Archwire Bracket Spring Ligature wire Elastic Modules Hook Elastic An illustration of the components of fixed appliance. Introduction to Orthodontics

Functional Orthodontic Appliances Functional appliances are orthodontic devices utilizes the forces of the orofacial musculature to correct arch malrelationship. There are several types of functional appliance. Activator Frankel 2 Twin-block - Introduction to Orthodontics