General Etiology of Malocclusion

8/9/2019 General Etiology of Malocclusion

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GENERAL ETIOLOGICAL

FACTORS OFMALOCCLUSION


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INTRODUCTION:

Factors causing malocclusion can b broa!l"classi#i! into :

$ Gnral tiological #actors

$ Local tiological #actors

A gi%n cas o# malocclusion ma" it&r b

!u to singl or multi'l local or gnral

#actors or a combination o# local ( gnral

#actors An un!rstan!ing o# tiolog" is ssntial #or

'r%ntion) intrc'tion ( corrction o#

malocclusion


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CLASSIFICATION:

Nuro*

muscular

s"stm +on So#t tissu

,rnatal

trauma (

birt&

in-uris ,ostnatal

trauma

,rmatur

.traction o#

'rimar" tt& Natur o# #oo!

S"stmic !isass En!ocrin !isor!rs Local !isass

Naso'&ar"ngal

!isass ( !isturb!

rs'irator" #unction Gingi%al ( 'rio!ontal

!isass Tumours Caris


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GENERAL FACTORS LOCAL FACTORS

/0 1EREDITAR230 CONGENITAL40 EN5IRONMENTAL

,RENATAL 6TRAUMA) MATERNALDIET) GERMAN MEASLES) MATERNALMETA+OLISM7

,OSTNATAL 6+IRT1 IN8UR2)CELE+RAL ,ALS2) TM8 IN8UR27

90 ,REDIS,OSING META+OLIC CLIMATE (DISEASE

ENDOCRINE IM+ALANCE META+OLIC DISTUR+ANCES INFECTIOUS DISEASES

0 DIETAR2 ,RO+LEMS 6NUTRITIONALDEFICIENC27

;0 A+NORMAL ,RESSURE 1A+ITS (FUNCTIONAL A+ERRATIONS

A+NORMAL SUC


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WHITE & GARDINERS CLASSIFICATION

DENTAL BASE

ABNORMALITIES

PRE-ERUPTION

ABNORMALITIES

POST-ERUPTION

ABNORMALITIES

/0 ANTERO*,OSTERIORMALRELATIONS1I,

30 5ERTICALMALRELATIONS1I,

40 LATERALMALRELATIONS1I,

90 DIS,RO,ORTION OFSIE +ET=EENTEET1 ( +ASAL+ONE

0 CONGENITALA+NORMALITIES

/0 A+NORMALITIES IN,OSITION OFDE5ELO,INGTOOT1 GERM

30 MISSING TEET140 SU,ERNUMERAR2

TEET1 ( TEET1A+NORMAL IN FORM

90 ,ROLONGEDRETENTION OFDECIDUOUS TEET1

0 A+NORMAL LA+IALFRENUMATTAC1MENT

;0 TRAUMATIC IN8UR2

/0 MUSCULAR ACTI5E MUSCLE

FORCE REST ,OSITION

OFMUSCULATURE

SUCTRACTION OF,ERMANENT TEET1


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DENTITION: Folloing c&aractristics ar in#lunc! b" &r!it"*

S1A,E ( SIE OF TOOT1

$ Macro!ontia

$ Micro!ontia

$Abnormalitis o# toot& s&a') g: 'g latral

$ ,atints it& cto!rmal !"s'lasia .&ibit conical s&a'!

incisors ( s%ral congnitall" missing tt&

NUM+ER OF TEET1

$ Su'rnumrar" tt&

$ Congnitall" missing

ARC1 DIMENSION

$Arc& lngt& ( i!t&


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CRO=DING ( S,ACING

$Arc& lngt&*toot& matrial !iscr'anc"

$ Rsult o# !is&armonious in&ritanc o# toot& si #rom

on 'arnt ( -a lngt& #rom ot&r 'arnt

S1EDDING ,ATTERN OF DECIDUOUS TEET1 (

SEUENCE OF ERU,TION OF ,ERMANENT TEET1

INTER*ARC1 5ARIATION

$ D%iation in t& trans%rs sagittal ( %rtical 'lan

rlations&i' o# u''r ( lor -a

O5ER8ET


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S


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NEUROMUSCULAR S2STEM

D#ormitis in si) 'osition) tonicit")

contractilit" ( nuromuscular coor!ination

'attrn o# #acial) oral ( tongu

musculatur


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SOFT TISSUE

E.am's:

$ Si)s&a' ( attac&mnt o# labial #rnum

$An"loglossia

$ Microstomia


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CONGENITAL DEFECTS D%lo'mntal mal#ormation at tim o# birt&

Ma" b caus! b" local or gnral #actors

Gnral Congnital Factors

$Abnormal stat o# mot&r !uring 'rgnanc"

$ Malnutrition

$ En!ocrino'at&is$ In#ctious !isass) g: congnital s"'&ilis) matrnal rublla

in#ction

$ Mtabolic ( nutritional !isturbancs

$ Intrautrin 'rssur

$Acci!nts !uring 'rgnanc" ( c&il! birt&

$Acci!ntal trauma to #tus b" .trnal #orcs) g: #orc' !li%r"


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Local Congnital Factors:

$Abnormalitis o# -a !%lo'mnt !u to

abnormal intrautrin 'osition

$ C"st o# #ac ( 'alat

$ Macroglossia

$ Microglossia$ Cli!ocranial !"stosis


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CLEFT LI, ( ,ALATE

Most commonl" sn congnital !#ormit"

Ma" &a% 'ro#oun! in#lunc on

cranio#acial !%lo'mnt ( ma" caus

malocclusion o# %ar"ing !grs o#

s%rit"

Cl#t 'alat ma" rtar! normal

!%lo'mnt o# ma.illa t&rb" causing

Class III malocclusion


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Features: Congnitall" missing tt& in t& cl#t rgion

Su'rnumrar" tt& Micro!ontia ( 'g s&a'! tt& s' u''r latral

incisor

Cro!ing o# tt& in ara o# cl#t Insu##icint !%lo'mnt o# 'rma.illa

Crossbit !u to narro ma.illar" arc&

Rotation o# tt&

Abnormal o%r-t ( o%rbit


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CLEIDOCRANIAL D2SOSTOSIS:

,artial or com'lt absnc o# cla%icl on

on or bot& si!s

Features:

$ Ma.illar" rtrusion

$ ,ossibl man!ibular 'rotrusion

$ Rtain! !ci!uous tt&

$ Rtar!! ru'tion o# 'rmannt tt&

$ Numrous im'act! su'rnumrar" tt&


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MATERNAL RU+ELLA INFECTION DURING

,REGNANC2:

Rublla in#ction in a 'rgnant mot&r can

caus !ntal !#cts in t& c&il! suc& as:

$ Rtar!! ru'tion o# tt&

$ 1"'o'lasia o# tt&

$ E.tnsi% caris


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CONGENITAL S2,1ILIS:

Features:

$ 1utc&insonHs incisors

$ Mulbrr" molars

$ Ma.illar" !#icinc"

$Antrior crossbit

$ E.tnsi% !ntal caris


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EN5IRONMENTAL CAUSES:

,rnatal or 'ostnatal

Prenatal environmental factors:

$Abnormal #tal 'ostur !uring gstation

$ Matrnal #ibroi!s

$Amniotic lsions

$ Matrnal !it ( mtabolism

$ Inta o# crtain !rugs !uring 'rgnanc") g:

t&ali!omi! inta can caus congnital

!#ormitis li cl#ts


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Postnatal environmental factors:

$ Traumatic in-uris to t& con!"l ( TM8 ara !uring

birt& can caus man!ibular grot& rtar!ation$An"losis o# t& TM8 ma" la! to &"'o'lastic

man!ibl ( mar! #acial as"mmtr" in cas o#

unilatral an"losis

$ ,rsnc o# scar tissu) caus! b" cl#t 'alatsurgr" ma" caus malocclusion as t&" can rstrict

grot& o# ma.illa

$ Milau bracs us! #or t& tratmnt o# scoliosis

!ri% su''ort #rom t& man!ibl) t&us can causrtar!ation o# man!ibular grot&


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,REDIS,OSING META+OLIC CLIMATE

( DISEASES:

En!ocrinal imbalanc ma" 'r!is'os to

!%lo'mnt o# malocclusion

T&"roi! &ormons 'la" an im'ortant rol

in normal !%lo'mnt o# bons ( tt&

,arat&ormon &as an acti% rol in

calcium mtabolism ( is !irctl" in%ol%!

in !%lo'mnt o# tt& ( bons


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Hypothyroidism:$ Rtar!ation in rat o# calcium !'osition in bon (

tt&

$ Dla"! toot& bu! #ormation ( ru'tion$ ,rolong! rtntion o# 'rimar" ( !la"! ru'tion o#

'rmannt tt&

$ Irrgularitis in toot& arrangmnt ( cro!ing o# tt&

ma" occurHyperthyroidism:

$Associat! it& incras! mtabolic rat ( incras!

rat o# maturation

$ ,rmatur ru'tion o# 'rimar" ( 'rmannt !ntition


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Hypoparathyroidism:

$ O#tn associat! it& !la"! ru'tion o# tt&) altr!

mor'&olog" ( &"'o'lasia o# tt&

Hyperparathyroidism:

$ Causs an incras in bloo! calcium l%ls b" rsor'tion

o# bon0 Trabcular 'attrn o# -a ma" gt !isru't! !u

to !minralisation o# bon

$ In c&il!rn) toot& !%lo'mnt ma" bcom mobil !uto loss o# cortical bon ( rsor'tion o# al%olar bon

$ Osto'orosis in suc& 'arts contrain!icats ort&o!ontic

toot& mo%mnt

$Acut #bril !isas !uring !%lo'mnt "ars ma"caus !isturbancs in toot& ru'tion ( s&!!ing 'attrn)

'r!is'osing to malocclusion


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DIETAR2 ,RO+LEMS

NUTRITIONAL DEFICIENCIES: Nutritional !#icincis ma" caus malocclusion

'rimaril" b" u'stting t& !ntal !%lo'mntal

tim tabl ( rsulting in 'rmatur loss)

'rolong! rtntion ( abnormal ru'ti% 'at& Disturbancs) suc& as ricts) scur%" ( bribri

can 'ro!uc s%r malocclusion

Nutritional !#icincis !uring 'rgnanc" &a%

bn associat! it& crtain mal#ormations in

t& c&il!) inclu!ing crtnism ( cl#t li' ( 'alat


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A+NORMAL ,RESSURE 1A+ITS (

FUNCTIONAL A+ERRATIONS:

Abnormal 'rssur &abits li !igit

sucing) tongu t&rusting) li' biting (

#unctional abrration suc& as mout&

brat&ing ma" caus a %arit" o#malocclusions


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,OSTURE:

Man!ibular rtrusion &as bn obsr%! in

som stoo' s&oul!r! c&il!rn it& &a!

&ung so t&at t& c&in rsts on t& c&st ( in

som c&il!rn &o rst t&ir c&in on t&&an! to su''ort t&ir &a!

1o%r) 'oor 'ostur as a caus o#

malocclusion is not 'ro%! N%rt&lss) it ma" accntuat an .isting

malocclusion


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ACCIDENT ( TRAUMA:

Traumatic in-uris to t& !nto#acial rgion ar Juit

common !uring arl" "ars o# li# &n c&il! larns to

cral) al ( %n &il 'la"ing

Suc& traumatic .'rincs o#tn go unnotic! ( ma"

rsult in #olloing 'roblms 'r!is'osing to

malocclusion:

$ Non %ital !ci!uous tt& t&at !o not rsorb

$ D#lction o# 'rmannt toot& grms

$Abnormal ru'tion 'at& o# 'rmannt succssors0


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T1AN< 2OUKKK

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General Etiology of Malocclusion