The preventive orthodontics of handicapping dentofacial anomaly

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

2. 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.

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

4. 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.

5. 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

6. 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

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

8. 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.

9. 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

10. 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

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

12. 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

13. Forces of dental in oral

14. 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

15. Preventive corrective • Abnormal shedding of deciduous teeth Early loss of deciduous teeth Retention of deciduous teeth

16. 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

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

18. Early loss of Permanent teeth

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

20. 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

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

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

23. Movable type of space retainer • Composition • Indications • Advantages and disadvantages

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

25. 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

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

27. Abnormal eruption of permanent teeth • early eruption of permanent tooth • delayed eruption or impacted of permanent tooth

28. 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

29. 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

30. 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

31. supernumerary tooth

32. supernumerary tooth • Cause:Genetic, congenital factors Influence: Treatment: removal as soon as possible, or observation Diagnosis:X-ray, shape

33. The gap of incicor

34. 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

35. 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

36. Early loss of deciduous teeth

37. adjacent surface caries

38. Earlier eruption second molar Stranded under the second deciduous molars

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

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

41. General steps of serial extraction • extraction of deciduous canine • extraction of deciduous molar • extraction of deciduous premolar

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

43. serial extractionComprehensive analysis • Periapical radiographs • Cephalometrics • Facial photos • Oral photos • Study Mode • Case Introduction • Diagnosis

44. 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.

45. Harmful habits of oral cavity

46. 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.

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

48. 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

49. 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

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