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ORTHODONTICS SEMINAR. Fatimah Che Rahimi Laila Azwa Hassan Ahmad Zulkhairi Resali Nurmarzura Abdul Latif Aishah Shahrir Nur Amalina Zulkepre Akmal Khalis Doreyat Masyitah Mustaffa Aimi Amalina Ahmad. Early loss of deciduous teeth.
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ORTHODONTICS SEMINAR Fatimah CheRahimi LailaAzwa Hassan Ahmad ZulkhairiResali Nurmarzura Abdul Latif AishahShahrir NurAmalinaZulkepre AkmalKhalisDoreyat MasyitahMustaffa AimiAmalina Ahmad
Early loss of deciduous teeth • It happened as a result of extraction due to caries or trauma • The degree of space loss is influence by: • Unilateral / bilateral • Age of loss --> more effect if the tooth lost at earlier age • Crowding/spacing the more inherent the crowding present, the more potential for space • Tooth typeposition of the affected tooth in arch influence subsequent space distribution • timevery early extraction can delay successional tooth eruption, later extraction have opposite effect • Degree of intercuspation-less effect • Skeletal factors-less effect
Balancing and compensating extraction Aim: to preserve arch symmetry and occlusal relationship Balance enforced extractions • A balancing extraction is a tooth from the opposite side of the same arch, designed to minimisecentreline shift. Compensate enforced extractions • Compensation means extraction of a tooth from the opposing quadrant to the enforced extraction. It is designed to minimiseocclusalinterferance by allowing teeth to maintain occlusal relationships as they drift. It is more difficult to justify compensation than balance, especially when it would involve removal of a tooth from an intact arch.
Which deciduous teeth need balancing and compensating extraction?
Digit sucking habit • Most prevalent of oral habits, 13% - 100% • If the habit ceases before the permanent teeth begin to erupt, any effects on the dentition are unlikely to be long-term. • If however the habit persists into the mixed and permanent dentition malocclusion • Thumb sucking may develop early in life and continue from infancy through the primary dentition and into the mixed and permanent dentition. In many cases, if the thumb habit continues into the mixed dentition a malocclusion may develop (Kaplan 1950; Ruttle et al. 1953; Graber 1959).
Factors that Affecting the Degree of Damage to Teeth and Investing Tissue • Frequency of habit • The more frequency the more the damage • Duration of habit • The more duration the more the damage • Intensity of habit • Active vspassive *Prolonged digit sucking habit may affect occlusion and dentofacial structures.
Factors • Not all habits will result in tooth movement. It is related to frequency, duration and intensity. • Studies suggest that it only takes very light forces to move teeth, if the force is of long enough duration. • The threshold is believed to be 6 hours.
Others: -arch assymmetry -increased overjet -anterior openbite -posterior crossbite
How to stop? • Gentle discouragement • Oral appliances/ habit breaker -palatal crib -acrylic appliance on finger
Approaches to treat chronic thumb sucking These can be split into three distinct categories: • Behavioural – rewarding a child for not exercising the habit; • Mechanical – preventing or interrupting the process of thumb sucking; • Aversive – generating negative sensations when the habit is exercised, such as bad taste, pain or major discomfort
Fig 1: URA with acrylic ridge Fig 2: Blueglass roller Fig 3: The Rake appliance
Space Maintainer • Definition • An intraoral appliance used to preserve arch length following premature loss of primary tooth/teeth in order to allow permanent teeth erupt into proper alignment and occlusion • Objectives: • Prevent drifting/tipping • Prevent loss of arch length • Prevent midline shift • Prevent crowding of permanent teeth • Prevent impactions • As orthodontic intervention including extraction
Lower Lingual Arch Palatal Arch
Infraoccluded 55 & Impacted 15 15 erupting rotated