The preventive orthodontics of handicapping dentofacial anomaly

Xi’an jiaotong univercity stomatology hospitalOrthodontic DepartmentZou 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 st

age(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 deve

lopment environment of Stomatognathic system Block the negative interference dental deformities Setting up the normal exercise of the occlusal functi

on of the environment Improving the poor relationship between the mandib

ular 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, fa

cial normal growth and development Protecting the deciduous teeth and permanent teet

h 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 orthopedi

c 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 deformi

ty, 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 sp

ace, 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 d

uring fetal period Infancy Sleep position

Living environment

Feeding method

Early preventionChildhood

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 inte

grity, 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 retenti

on

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 t

eeth 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

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

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, geneti

c ) No congenital missing teeth The overjet and overbite of incisor is not to la

rge

serial extractionComprehensive 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

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 abnor

mal growth and development