CROWDING RELOADED /fixed orthodontic courses by IDA

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Published on May 9, 2014

Author: indiandentalacademy

Source: authorstream.com

Etiology and Management of Crowding: Etiology and Management of Crowding www.indiandentalacademy.com PowerPoint Presentation: INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com PowerPoint Presentation:  Aetiology can be described as the science which deals with the causation or origin of any disease. This can be attributed to any branch of science. Finding the cause is curing half the disease www.indiandentalacademy.com The Orthodontic Equation: The Orthodontic Equation CAUSE TIMES TISSUES RESULTS ACT AT ON PRODUCING www.indiandentalacademy.com Dockrell classification: Dockrell classification Heredity Developmental causes of unknown origin Trauma Physical agents Habits Disease Malnutrition www.indiandentalacademy.com Primary Etiological Sites: Primary Etiological Sites NEUROMUSCULAR SYSTEM BONE TEETH SOFT PARTS www.indiandentalacademy.com TIME: TIME PERIOD DURING WHICH CAUSE OPERATES AGE AT WHICH IT IS SEEN www.indiandentalacademy.com THE ORTHODONTIC EQUATION ELABORATED: THE ORTHODONTIC EQUATION ELABORATED CAUSE TIMES TISSUES RESULTS ACT AT ON PRODUCING SOME PREDISPOSING SOME EXCITING 1.HEREDITY 2.DEVELOPMENTAL CAUSES OF UNKNOWN ORIGIN 3. TRAUMA 4.PHYSICAL AGENTS 5.HABITS 6.DISEASE 7.MALNUTRITION 1.CONTINUOUS OR INTERMITTENT 2.MAY ACT AT DIFF. AGE LEVELS 1.NEUROMUSCULAR TISSUE 2.TEETH 3.BONE AND CARTILAGE 4.SOFT TISSUE OTHER THAN MUSCLE 1.MALFUNCTION 2.MALOCCLUSION 3.OSSEOUS DYSPLASIA www.indiandentalacademy.com PowerPoint Presentation: Dental crowding can be defined as a discrepancy between tooth size and jaw size that results in misalignment of the tooth row Arch length a measurement of space available in the dental arch for alignment of teeth Arch length deficiency defined as a negative difference between the space available in the dental arch and space required to align the teeth Arch length discrepancy a difference between the space available in the dental arch and space required to align the teeth www.indiandentalacademy.com ETIOLOGY OF CROWDING: ETIOLOGY OF CROWDING Disproportion bw arch size and tooth size or arch length discrepancies Prolonged retention of deciduous teeth Altered path of eruption Premature loss of deciduous teeth Delayed eruption of permanent teeth Presence of supernumerary teeth Trauma Localized abnormal size and shape of teeth Late horizontal growth of mandible Mesial migration of buccal segments www.indiandentalacademy.com HEREDITY: HEREDITY Child is the product of parents who have dissimilar genetic material. Thus conflicting traits may be inherited from both parents resulting in abnormalities. Racial, ethnic and regional inter-mixture www.indiandentalacademy.com PowerPoint Presentation: According to Lundstrom there exists a number of human traits that are influenced by the genes that include the following TOOTH SIZE ARCH DIMENSIONS CROWDING ABNORMALITIES OF TOOTH SHAPE ABNORMALITIES OF TOOTH NUMBER OVERJET INTERARCH VARIATIONS FRENUM www.indiandentalacademy.com GENETIC INFLUENCES: GENETIC INFLUENCES MALOCCLUSION CAN BE INHERITED IN TWO WAYS INHERITED DISPROPORTION BW SIZE OF THE TEETH AND SIZE OF THE JAWS WHICH WOULD CAUSE IMPROPER OCCLUSAL RELATIONSHIP INHERITED DISPROPORTION BW SIZE OR SHAPE OF UPPER AND LOWER JAWS WHICH WOULD CAUSE IMPROPER OCCLUSAL RELATIONSHIPS www.indiandentalacademy.com PowerPoint Presentation: PRIMITIVE POPULATION : MALOCCLUSION WAS LESS FREQUENT CHARACTERISTICS OF CIVILIZATIONS STOCKARDS EXPERIMENTS CHUNG ET AL : HAWAIIAN MELTING POT COMPARISON OF MONOZYGOTIC AND DIZYGOTIC TWINS LAUWERYNS ET AL CORRUCINI AND CO WORKERS HARRIS AND JOHNSON IN BOLTON BRUSH GROWTH STUDY www.indiandentalacademy.com DEVELOPMENTAL DEFECTS OF UNKNOWN ORIGIN: DEVELOPMENTAL DEFECTS OF UNKNOWN ORIGIN These are gross defects of rare type originating in failure of differentiation at a critical period in embryonic development Congenital absence of muscles Micrognathia Facial clefts Oligodontia Anodontia www.indiandentalacademy.com CONGENITAL DEFECTS SEEN AT TIME OF BIRTH: CONGENITAL DEFECTS SEEN AT TIME OF BIRTH GENERAL ABNORMAL STATE OF MOTHER DURING PREGNANCY MALNUTRTION ENDOCRINOPATHIES INFECTITIOUS DISEASES METABOLIC/ NUTRITIONAL DISEASES ACCIDENTS AT CHILD BIRTH INTRAUTERINE PRESSURE ACCIDENTAL TRAUMA TO FOETUS BY EXTERNAL FORCES LOCAL ABNORMALITIES OF JAW DEV. DUE TO INTRAUTERINE PRESSURE CLEFTS OF THE FACE AND PALATE MACROGLOSSIA/ MICROGLOSSIA CLEIDOCRANIAL DYOSTOSIS www.indiandentalacademy.com TRAUMA: TRAUMA PRENATAL/ BIRTH INJURIES HYPOPLASIA OF THE MANDIBLE VOGELGESICHT PRESSURE OF KNEE OR LEG FOETUS HEAD FLEXED TIGHTLY AGAINST THE CHEST www.indiandentalacademy.com PowerPoint Presentation: POSTNATAL TRAUMA FRACTURES OF THE JAW AND TEETH HABITS MAY PRODUCE MICRO TRAUMA TRAUMA TO THE TMJ www.indiandentalacademy.com PHYSICAL AGENTS: PREMATURE EXTRACTION OF PRIMARY TEETH NATURE OF FOOD PHYSICAL AGENTS www.indiandentalacademy.com HABITS: HABITS DELETRIOUS HABITUAL PATTERNS OF MUSCLE BEHAVIOUR OFTEN ARE ASSOCIATED WITH PERVERTED OR IMPEDED OSSEOUS GROWTH, TOOTH MALPOSITIONS, DISTURBED BREATHING HABITS, DIFFICULTIES IN SPEECH, UPSET BALANCE IN FACIAL MUSCULATURE AND PHYSIOLOGICAL PROBLEMS THEREFORE ONE CANNOT CORRECT MALOCCLUSION WITHOUT INVOLVMENT IN SUCH REFLEX ACTIVITIES www.indiandentalacademy.com DISEASE: DISEASE SYSTEMIC DISEASES FEBRILE DISEASES KNOWN TO UPSET DENTITIONAL DEVELOPMENT TIME TABLE DURING INFANCY AND EARLY CHILDHOOD MORE LIKELY TO AFFECT QUALITY RATHER THAN QUANTITY OF GROWTH MALOCCLUSION SECONDARY TO CERTAIN NEUROPATHIES AND NEUROMUSCULAR DISORDERS SEQUALAE OF TREATMENT OF SUCH PROBLEMS AS SCOLIOSIS BY PROLONGED WEARING OF APPLIANCES TO IMMOBILIZE THE SPINE www.indiandentalacademy.com PowerPoint Presentation: ENDOCRINE DISEASES PRENATALLY Manifest as hypoplasia of teeth POSTNATALLY Retard or hasten the direction of facial growth Rate of ossification of bones Time of suture closure Time of eruption of teeth Rate of resorption of primary teeth www.indiandentalacademy.com PowerPoint Presentation: LOCAL DISEASES NASOPHARYNGEAL DISEASES AND DISTURBED RESPIRATORY FUNCTION GINGIVAL AND PERIODONTAL DISEASES TUMORS CARIES A) PREMATURE LOSS OF PRIMARY TEETH B) DISTURBANCES IN SEQUENCE OF ERUPTION OF PERMANENT TEETH C) LOSS OF PERMANENT TEETH www.indiandentalacademy.com ETIOLOGY OF LATE LOWER ARCH CROWDING: ETIOLOGY OF LATE LOWER ARCH CROWDING MARGARET RICHARDSON Late lower arch crowding: facial growth/ drift ( Eur J Orthod 1979:1; 219-225) Late lower arch crowding in reln. to primary crowding ( Angle orthod 1982:52;300-312) Role of the third molar in the cause of late lower arch crowding (AJO-AO 1989:95; 79-83) www.indiandentalacademy.com PowerPoint Presentation: Pressure from the back of the arch because of physiologic mesial drift, the anterior component of the force of occlusion on mesially inclined teeth, mesial vectors of muscular contraction, or the presence of a developing third molar may cause forward movement of the buccal teeth, with shortening of the arch and an increase in crowding. www.indiandentalacademy.com PowerPoint Presentation: Pressure from the front of the arch may cause reduction in arch length and depth with resultant crowding. SELMER AND OLSEN R The normal development of the mandibular teeth and the crowding of the incisors as a result of growth and function. Dent Rec 1937;57:465-77 . www.indiandentalacademy.com LATE MANDIBULAR GROWTH: LATE MANDIBULAR GROWTH CAN LEAD TO INCREASED PRESSURE IN FRONT OF THE MOUTH LANDE Growth behaviour of the human bony facial profile as revealed by serial cephs Angle Orthod 1952;22:78-90. BJORK AND PALLING, HUMER FELT AND SLAGSVOLD AND SIATOWSKI www.indiandentalacademy.com PowerPoint Presentation: LUNDSTROME A study of the correlation between mandibular growth direction and changes in incisor inclination, overjet, overbite and crowding . Eur Orthod Soc Trans 1975:131-40. www.indiandentalacademy.com SKELETAL STRUCTURE/ COMPLEX GROWTH PATTERNS: SKELETAL STRUCTURE/ COMPLEX GROWTH PATTERNS CROWDING INCREASED DUE TO PARTICULAR TYPE OF SKELETON/ SPECIFIC TYPE OF GROWTH PATTERN (SAKUDA ET AL) INCREASED LOWER ARCH CROWDING WAS SEEN TO BE ASSOCIATED WITH INCREASED MANDIBULAR PLANE ANGLE, LARGE OVERJET, RETROGNATHIC FACE AND INCREASED OVERBITE (MENG ET AL) EXTREME DEGREES OF MANDIBULAR GROWTH INCREASED CROWDING (BJORK) www.indiandentalacademy.com SOFT TISSUE MATURATION: SOFT TISSUE MATURATION DENTOALVEOLAR STRUCTURES ARE RESPONSIVE TO SOFT TISSUE PRESSURES AND ADAPT TO A POSITION OF BALANCE OF LIPS CHEEKS AND TONGUE FRANKEL /LOFFLER WOODSIDE /LINDER ARONSON www.indiandentalacademy.com PERIODONTAL FORCES: PERIODONTAL FORCES TEETH ARE JOINED TOGETHER UNDER TENSION BY THE TRANS SEPTAL FIBRES ( PICTON AND MOSS) ANY IMBALANCE CREATED BY THE TONGUE ON ONE SIDE AND THE CHEEK AND LIPS ON THE OTHER ARE COUNTER ACTED BY FORCES IN THE PDL BY ACTIVE METABOLISM ( PROFITT ) CONTINUOUS FORCE ON THE MANDIBULAR DENTITION TO MAINTAIN PROXIMAL CONTACTS IN A STATE OF COMPRESSION. FORCE INCREASED DURING OCCLUSAL LOADING ( SOUTHARD ) www.indiandentalacademy.com TOOTH STRUCTURE: TOOTH STRUCTURE PECK AND PECK SMITH ET AL/ PUNEKY ET AL/ GLEN ET AL/ GILMORE AND LITTLE www.indiandentalacademy.com OCCLUSAL FORCES: OCCLUSAL FORCES ALTERATION IN FUNCTION MAY PRODUCE A DIFFERENT PATTERN OF MASTICATORY FORCES OR AN OCCLUSION WITH PREMATURE CONTACTS www.indiandentalacademy.com CONNECTIVE TISSUE CHANGES: CONNECTIVE TISSUE CHANGES BONE LOSS AS A RESULT OF AGING OR PERIODONTAL DISEASE MAY ALLOW TEETH TO MOVE UNDER PRESSURE THEY CAUSE CROWDING IN LATER LIFE www.indiandentalacademy.com Diagnosis: Diagnosis Classification of crowding According to amount of crowding in mixed dentition (Hotz 1980) First degree Second degree Third degree According to etiology of malocclusion Primary = heriditary Secondary = acquired anomaly Tertiary www.indiandentalacademy.com What is supporting zone?: What is supporting zone? www.indiandentalacademy.com PowerPoint Presentation: www.indiandentalacademy.com PowerPoint Presentation: Second degree Third degree www.indiandentalacademy.com PowerPoint Presentation: Primary crowding www.indiandentalacademy.com PowerPoint Presentation: Secondary crowding www.indiandentalacademy.com PowerPoint Presentation: Coronal and apical crowding www.indiandentalacademy.com Odontometry: Odontometry PREDICTION OF UNERUPTED TOOTH SIZE ( MIXED DENTITION ANALYSIS LIKE MOYERS, NANCE, BALLARD, STAHLLE AND HIXON) ASSESSMENT OF TOOTH SIZE- ARCH SIZE COMPATABILITY WITHIN THE SAME ARCH (NANCE, HOWES, CAREY, REEZ AND BEAZLEY) ASSESSMENT OF TOOTH SIZE COMPATABILITY BW 2 ARCHES (LUNSTROM A ) www.indiandentalacademy.com BOLTONS TOOTH RATIO ANALYSIS: BOLTONS TOOTH RATIO ANALYSIS www.indiandentalacademy.com SANIN- SAVARA TOOTH SIZE ANALYSIS: SANIN- SAVARA TOOTH SIZE ANALYSIS www.indiandentalacademy.com PowerPoint Presentation: www.indiandentalacademy.com HOWES ANALYSIS: HOWES ANALYSIS www.indiandentalacademy.com PONTS ANALYSIS: PONTS ANALYSIS Determination of sum of incisors Determination of measured premolar value Determination of measured molar value Determination of calculated premolar value S.I x 100/ 80 Determination of calculated molar S.I x 100/64 www.indiandentalacademy.com CAREYS ANALYSIS: CAREYS ANALYSIS DETERMINATION OF ARCH LENGTH DETERMINATION OF TOOTH MATERIAL DETERMINATION OF DISCREPANCY www.indiandentalacademy.com MIXED DENTITION ANALYSIS: MIXED DENTITION ANALYSIS CAN BE DIVIDED INTO 2 CATEGORIES THOSE IN WHICH THE SIZES OF UNERUPTED CUSPIDS AND PREMOLARS ARE ESTIMATED FROM MEASUREMENTS OF THE RADIOGRAPHIC IMAGE THOSE IN WHICH THE SIZES ARE DERIVED FROM KNOWLEDGE OF THE SIZES OF PERMANENT TEETH ALREADY ERUPTED IN THE MOUTH www.indiandentalacademy.com PowerPoint Presentation: www.indiandentalacademy.com Peck and Peck analysis: Peck and Peck analysis www.indiandentalacademy.com PowerPoint Presentation: www.indiandentalacademy.com Conventional method: Conventional method 4 mandibular incisors measured with a boleys gauge Unerupted canines and premolars are obtained by measuring the greatest M-D crown diameter on radiographic images Reduce radiographic enlargement by using Huckabas formula x = y x’/ y’ www.indiandentalacademy.com PowerPoint Presentation: Space required = sum of incisors + values of canines and premolars Space available measured using brass wire from M-B cusp of first permanent molar to opposite molar Amount of discrepancy = space required- space available www.indiandentalacademy.com Tweed method: Tweed method relations of axial inclinations of mand incisors and basal bone made on lateral cephs FMA is bw 21 º – 29 º FMIA should be 68 º FMA ≥ 30 º FMIA 65 FMA ≤ 20 º IMPA should not exceed 92 º º www.indiandentalacademy.com PowerPoint Presentation: Dist bw the objective line and the line that passed through the actual axial inclinations of mand incisors was measured with vernier calipers Measured value x 2 to include both right and left sides www.indiandentalacademy.com Total space analysis: Total space analysis Method is divided into three areas Anterior Tooth measurement = sum of mand incisors + radiographic image of canines Cephalometric correction Soft tissue modification Z angle is measured Z angle + cephalometric correction Upper lip thickness Total chin thickness Anterior deficit = Measured value – total space required www.indiandentalacademy.com PowerPoint Presentation: Middle area Tooth measurement = crown widths of first permanent mandibular molars + values of premolars obtained from radiographs Curve of occlusion right side + left side/ 2 + 0.5 Space available M-B cusp of primary first molar to D-B of permanent first molars www.indiandentalacademy.com PowerPoint Presentation: Posterior area sum of M-D widths of 2 nd and 3 rd molars which are unerupted permanent mandibular molars were substituted for primary second molar third molars not visible – wheelers measurement of molar was used www.indiandentalacademy.com PowerPoint Presentation: X = y – x’/ y’ Space presently available + estimated increase or prediction = space available www.indiandentalacademy.com Littles irregularity index: Littles irregularity index Labiolingual displacements of the digitized anatomic contact points of anterior teeth measured perpendicular to the arch form from the mesial of left canine to mesial of right canine ( AM J ORTH 75; 68:554- 63) www.indiandentalacademy.com Treatment modalities: Treatment modalities BEGGS VERTICAL LOOPS www.indiandentalacademy.com REFINED BEGGS: REFINED BEGGS www.indiandentalacademy.com PowerPoint Presentation: HIGHLY PLACED CANINES OPEN BITE CASES www.indiandentalacademy.com PowerPoint Presentation: AMOUNT OF CANINE DISTALIZATION NEEDED TO CREATE SPACE FOR RELIEVING CROWDING www.indiandentalacademy.com PowerPoint Presentation: V BENDS www.indiandentalacademy.com PowerPoint Presentation: www.indiandentalacademy.com PowerPoint Presentation: SINGLE LOOP www.indiandentalacademy.com PEA: PEA FORCES SHOULD BE KEPT LIGHT SAGITTAL, VERTICAL AND LATERAL ANCHORAGE NEEDS SHOULD BE IDENTIFIED LACE BACKS AND BEND BACKS USED POSTERIOR SEGMENTS SHOULD BE SUPPORTED WITH HEAD GEAR/ TPA IN MAX ANCHORAGE CASES www.indiandentalacademy.com PowerPoint Presentation: Thank You www.indiandentalacademy.com www.indiandentalacademy.com Leader in continuing dental education

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