The preventive orthodontics of handicapping dentofacial anomaly Xi’an jiaotong univercity stomatology hospitalOrthodontic Department Zou Min

handicapping dentofacial anomaly,in the growth medium, because of congenital, acquired genetic, environmental factors such as interference, teeth, oclussion, and facial become non-normal growth. We call these handicapping dentofacial anomaly.

The treatment of handicapping dentofacial anomaly Preventive orthodontics 10% Interceptive orthodontics 20% Corrective orthodontics 45% Surgical orthodontics

Introduction the concept of Early treatment In early childhood growth and development stage(Puberty before the peak period, peak period), the children have been shown dentofacial deformities, abnormal trends, we should prevent, block, correction and guide these cause.

the concept of Early treatmen Target Maintenance and create the normal growth and development environment of Stomatognathic system Block the negative interference dental deformities Setting up the normal exercise of the occlusal function of the environment Improving the poor relationship between the mandibular growth pattern to promote the children's and mental health craniofacial growth and development

the concept of Early treatment Methods Maintaining the health of deciduous teeth completed and normal function Eliminating the bad factors of all teeth, oclussion, facial normal growth and development Protecting the deciduous teeth and permanent teeth replace nomally and set up the right oclussion

the concept of Early treatment Content Early prevention and preventive treatment Interceptive orthodontics Early maxillary growth control and orthopedic therapy

Favorable factorsof early treatment It can take full advantage of potential growth, cell metabolism active periodontal and mandibular plasticity, and reaction force on the appliance, and adaptable to its own advantages Early treatment can reduce some of the complexity of the difficulty of Dental malformations Methods and appliance of early correction is simple Early treatment and timely elimination of the deformity, physical and mental health benefit to the child.

The characteristics of early treatment Clinical characteristics of early treatment Treatment time is very important Appliance should be suitable for power Time of treatment should not be too long Limited orthodontics

standard of judging the successfull of early treatment Primary cause is under control Normal tooth position must have sufficient space, and be sustainable to the end of the replacement teeth Whether the original mandibular abnormalities is under control and has been improved and continue until the end of skeletal growth

Preventive orthodontics Early prevention Importance of maternal nutrition and health during fetal period Infancy Sleep position Living environment Feeding method

Early prevention Childhood Food considerable hardness, easy to digest, nutritious chew promote the development Maintain and treat the integrity of the deciduous teeth in time, filling of dental caries Timely removal of remaining teeth and deciduous teeth eruption of anti-permanent dislocation Treat chronic nasopharyngeal inflammation and get rid of bad habits Systemic disease control, education

Forces of dental in oral

Handucaooubg dentofacial anomaly Incisor eruption in the early clearance have space Lateral teeth on distal crown tilt Mild congestion All the beginning of the first molar may be built on the cusp to cusp relations All anterior deep overbite

Preventive corrective Abnormal shedding of deciduous teeth Early loss of deciduous teeth Retention of deciduous teeth

early loss of primary tooth Diagnosis:age xray shows that the root less than 1\ 2 of the root.All face still covered by bone tissue Cause:Caries injury Iatrogenic Deciduous dentition of the existence and integrity, may by its promotion of mandibular masticatory function normal growth, will guide normal eruption of permanent teeth

Early loss of the second molar Performance and harm Forward of the first molar Arch length will be short Elongation of the opposite tooth

Early loss of Permanent teeth

Early loss of deciduous teeth treat Space retainer Wire loop-type Movable type Lingual arch-style

the requirements of gap retainer It can be able to maintain much of the last gap It can’t not affect the development of competent and mandibular It didn’t stimulate oral soft and hard tissue restore masticatory function easy to product simple structure good retention

Wire loop-type of space retainer Composition 0.9mmStainless Steel Wire Band Indications Advantages and disadvantages Attention: Order for changing teeth

Lingual arch-style of space retainer Composition:tongue bar,palatal bar,nance arch Indications Advantages and disadvantages

Movable type of space retainer Composition Indications Advantages and disadvantages

Space access Features can access 3mm space easier in Maxillary easy for tilt gap than the overall movement

retained primary tooth Cause: Deciduous root is not a typical absorption Deciduous molar root adhesion Congenital absence of permanent follow-up Eruption of permanent translocation Diagnosis:age, constant tooth case

Stranded in the second deciduous molars, led thecanine crowded Stranded under the second deciduous molars, led to the first premolar impacted

Abnormal eruption of permanent teeth early eruption of permanent tooth delayed eruption or impacted of permanent tooth

Abnormal eruption of permanent teeth early eruption of permanent tooth Diagnosis ： age, root formation, loosening Cause:Periapical inflammation of deciduous teeth destroyed Constant capsule, endocrine diseases (most of permanent tooth early eruption ) Treat

delayed eruption or impacted of permanent tooth Diagnosis :xray show that root formation more than 1\2, contralateral teeth of the same name has been eruption Cause:teeth hold place ， retention of deciduous teeth, trauma, fibroma, early loss of deciduous molars, eruption of permanent teeth shortfall Treat:open up space, eruption and help to eruption

interceptive treatment Deciduous or mixed dentition period is a active period of facial growth, all the fault of this period often indicates that the permanent teeth growing out of disorder, using a small force to correct jaw surface hinder normal growth and development or affect the normal function of the fault of the mouth and will make it no longer continue,this is interceptive treatment

supernumerary tooth

Cause:Genetic, congenital factors Influence: Treatment: removal as soon as possible, or observation Diagnosis:X-ray, shape

The gap of incicor

Early correction of crowding Crowding=Perimeter of the existing arch - width of Permanent tooth crown-1.7or0.9x2 the forecast of permanent tooth crown width X-ray and model Moyers Probability table projections Tanaka

Early correction of crowding Cause: Primary: teeth do not tune the volume of bone mass :crown, and have more teeth, dental arch stenosis Secondary: adjacent surface caries,early loss of deciduous teeth Temporary

Early loss of deciduous teeth

adjacent surface caries

Earlier eruption second molar Stranded under the second deciduous molars

Treatment of crowding The treatment of mild congestion 2 ~ 4mm Interproximal enamel stripping

Severe overcrowding –serial extraction Concept The early mixed dentition in a planned, step- by-step periodic extraction, block the way to serious crowding.

General steps of serial extraction extraction of deciduous canine extraction of deciduous molar extraction of deciduous premolar

serial extraction Ideal indication Skeletal type Ⅰ Mixed dentition period, is forming the angle Ⅰ ’ More than moderately crowded (True, genetic ) No congenital missing teeth The overjet and overbite of incisor is not to large

serial extraction Comprehensive analysis Periapical radiographs Cephalometrics Facial photos Oral photos Study Mode Case Introduction Diagnosis

Congestion measurement General methods Required space=the space of 4 the required mandibular incisor + the required space of the canine and premolar that didn’t erupte.

Harmful habits of oral cavity

The occurrence of deformity is the result of history of bad habits, the daily frequency of each time occlusion pressure as well as the healthy development of the situation of children and so on.

mouth breathing habits Cause: Respiratory tract obstruction Chronic rhinitis, sinusitis Turbinate is too long, curved Proliferation of prostatic hyperplasia Tonsil hypertrophy Short upper lip

mouth breathing habits Mechanism and manifestations, diagnosis Mouth breathing tongue down, mandible arch loss support, mandible arch is narrow, crowding or protrusion, lip muscle relaxation, palate covered highly. Face gland proliferation: mouth breathing habits, nasion subsidence, dental crowding

mouth breathing habits Treatment: 1. remove the cause and persuasion and education 2. remind closing mouth breathing Vestibular shield, special masks, 3. Symptomatic: expansion dental arch, adductor anterior, 4. Lip muscle training

sucking habits Performance and harm Sucking thumb Sucking forefinger Treatment Publicity and education Drug-coated, fingerstall Correction wire

Harmful habits of oral cavity Spit tongue habits: Performance Method Habit of licking tongue : Performance Method Habit of stretch tongue: Performance Method

Lip biting Performance and harm bite upper lip bite lower lip Methods

Vestibular shield Lip Bumper

Summary Prevention dental caries, the prevention of early loss of deciduous teeth and permanent teeth and maintain dental arch length, to prevent the occurrence of handicapping dentofacial anomaly Removal of remaining teeth and deciduous teeth, prevent dislocation eruption of permanent teeth Get rid of all kinds of bad oral habits, blocking the handicapping dentofacial anomaly Attention and observation of mixed dentition crowding Hinder dental treatment as soon as possible, or face the abnormal growth and development