1. PREVENTIVE ORTHODONTICS
Dr Debaleena Chowdhury
Dept. of Orthodontics
KGF Dental College

2. PREVENTIVE ORTHODONTICS
Definitons
“Action taken to preserve the integerity of what appears to be a normal occlusion at a specific time.” - Graber (1966)
“Prevention of potential interferences with occlusal development.”
- Proffit & Ackerman .

3. Preventive measures
Parent counselling
Caries control
Space maintanence
Management of abnormal frenal attachments

4. Preventive measures (contd.)
Treatment of locked permanent first molars
Abnormal oral musculature & management of related habits
Extraction of supernumerary teeth

5. Parental education A. Prenatal counselling
Education of the expecting mother
B. Postnatal counselling
Associated with the clinical examination of the child at
a. 6months - 1 year c. 3 years
b. 2 years d years

6. Caries control
Caries of decidious teeth can cause malocclusion
a. Nursing bottle caries
b. Rampant caries

7. Nursing bottle caries

8. Rampant caries

9. Proximal caries causes loss of arch length
Treatment
-Diet counselling -Pulpectomy &
pulpotomy
-Topical flouride application
-Stainless steel crown

10. Stainless steel crown

11. Space maintenance Indicated in early loss of decidious teeth
Two types of space maintenance
Removable
Functional ( teeth incorporated )
Non functional
Fixed
-Band & loop Nance holding arch
-Crown & loop Lingual arch
-Distal shoe

12. Band and loop
Crown and loop

13. Distal shoe

14. Nance holding arch
Lingual holding arch

15. Treatment of locked permanent first molars
Prominent distal bulge of second decidious molar prevents proper eruption of first permanent molars.
Treatment
- Proximal stripping

16. Management of abnormal frenal attachments
Gingival frenal attachments lead to malocclusion ,e.g. midline diastema
Ankyloglossia
Surgical treatment

17. Ankyloglossia

18. INTERCEPTIVE ORTHODONTICS
Dept. of Orthodontics
Yenepoya Dental College

19. INTERCEPTIVE ORTHODONTICS
Interceptive orthodontics has been defined as that phase of the science and art of orthodontics employed to recognize and eliminate potential irregularities and malpositions of the developing dentofacial complex

20. Interceptive Procedures
Serial extraction
Correction of developing cross bite
Control of abnormal habits
Space regaining
Muscle exercises
Interception of skeletal malrelation
Removal of soft tissue or bony barrier to enable eruption of teeth

21. Serial extraction
Procedure that indicates the planned extraction of certain decidious teeth and later specific permanent teeth in an orderly sequence and predetermined pattern to guide the erupting permanent teeth into a more favorable position

22. Rationale for serial extraction
Arch length tooth -material discrepancy
Physiologic tooth movement : By selective removal of some teeth the rest of the teeth which are in the process of eruption are guided by the natural forces into extraction spaces

23. Serial extraction :Indications
Class 1 malocclusion showing harmony between skeletal and muscular system
Arch length deficiency ; features:
Absence of physiologic spacing
Malpositioned or impacted laterals
Crowded upper and lower anteriors
Abnormal eruption pattern
Ankylosis of one or more teeth

24. Serial extraction indications (contd.)
where growth is not enough to overcome the discrepancy
Patients with pleasing and straight profile

25. Serial extraction - Contraindications
Class II & III malocclusions with skeletal abnormalities
spaced dentition
Oligodontia
Open bite & deep bite
Midline diastema
Mild discrepancy between arch length and tooth material

26. Methods of serial extraction
Dewel’s method
Tweed’s method
Nance method

27. Dewel’s method
C D 4

28. Tweed’s & Nance method
D C 4

29. Nance method

30. DEVELOPING ANTERIOR CROSSBITE
Condition characterised by reverse overjet wherein one or more maxillary anterior teeth are in lingual relation to the mandibular teeth.
Early interception is necessary.

31. ANTERIOR CROSS BITE Reasons for early treatment:
crossbite in deciduous dentition may progress to permanent dentition.
simple problem may progress towards more complex skeletal problems.

32. CLASSIFICATION OF ANTERIOR CROSSBITE
DENTOALVEOLAR
 Rx – tongue blade, Catalan’s appliance, double cantilever spring with P.B.P.
SKELETAL
 Best treated during growth by growth modification procedures
FUNCTIONAL (pseudo-crossbites)
 Rx - removal of occlusal interferences.

33. INTERCEPTION OF HABITS
Thumb sucking
Rx  bitter solvents
thumb cap
palatal crib
Tongue thrust
Rx  palatal crib
tongue exercises

34. Mouth breathing
Rx  oral screen
 surgical removal of nasal
obstructions

35. SPACE REGAINING
Space gained by distalization of first molar which have been moved mesially due to early loss of deciduous molars.

36. Gerber space regainer

38. Space regainer using jack screws

39. Space regainer using cantilever spring

40. MUSCLE EXERCISES Exercises for masseter muscle
 clenching of teeth by patient while counting to 10.
Exercises for lips (circumoral muscles)
Holding and pumping of water back and forth behind the lips.
Massaging of the lips
Button pull exercises
Tug of war exercises

41. Exercises for tongue
One elastic swallow
Tongue holding exercises
Two elastic swallow
Hold-pull exercise

42. INTERCEPTION OF SKELETAL MALRELATION
Interception of Class II malrelation
Face bow with headgear
Myofunctional appliances
Interception of Class III
Chincup with headgear
FR III
Facemask therapy

43. REMOVAL OF SOFT AND HARD TISSUE BARRIERS
Surgical excision of soft tissue and any overlying bone above the crown of unerupted tooth