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INTERCEPTIVE ORTHODONTICS
05/02/23 1www.indiandentalacademy.com
INDIAN DENTAL ACADEMY
Leader in continuing dental education www.indiandentalacademy.com
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DEFINITION : Intervention in the incipient stages of a
problem to lessen its severity or possible future adverse effects and to eliminate its causes
Intercept a malocclusion that has already developed or is developing.
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Such treatment may take place in deciduous or transitional dentition and may include
redirection of ectopically erupting teeth, slicing or extraction of deciduous teeth, correction of isolated dental crossbites or recovery of minor space loss
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DIFFERENCE BETWEEN PREVENTIVE & INTERCEPTIVE ORTHODONTICS
Unlike preventive orthodontic procedures that are aimed at elimination of factors that may lead to malocclusion.
Interceptive orthodontics is undertaken at a time when the malocclusion has already developed or is developing.
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Interceptive orthodontics basically refers to measures undertaken to prevent a potential malocclusion from progressing into a more severe one.
The procedures undertaken are:1. Serial extractions 2. Correction of developing cross-bite3. Control of abnormal habits4. Space regaining 5. Muscle exercises6. Interception of skeletal mal-relation7. Removal of soft tissue or bony barrier to enable eruption of teeth
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PURPOSE OF EARLY ORTHODONTIC TREATMENT
1. To intercept developing problem2. To prevent obvious problems from becoming
worse 3. To correct obvious problems4. To remove the etiologic factors and restore
normal growth 5. To reduce the severity of skeletal problems,
making possible easier and more precise tooth positioning in adolescence.
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INDICATIONS FOR EARLY ORTHODONTIC INTERVENTION
1. Anterior and posterior cross-bite : not only for the functional improvement brought about by therapy but also for the improved esthetics that occur with the anterior cross-bite correction.
2. Severe anterior and lateral open-bites 3. Ectopic eruption 4. Severe arch length discrepancies5. Pseudo class III6. Dental and / or skeletal Class II 7. Maxillary mid face deficiency8. Deep bite 9. Habits 10. Midline discrepancies 11. Management of supernumery teeth 12. Ankylosed teeth
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BENEFITS OF EARLY TREATMENT
1. Reduced incidence of premolar extractions2. Decreased extent or possible elimination of the need
for a second phase of treatment.3. Reduced need for surgical orthodontics4. Increased stability of transverse & antero-posterior
dimension changes with phase 1 treatment.5. Increased long term stability of lower incisor alignment 6. Reduced incidence of root resorption7. Reduced incidence of mucogingival problems8. Reduced incidence of ectopic cuspid eruptions
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DISADVANTAGES
1. Sometimes requiring two phase / three phase of treatment leading to patient burnout and patient dissatisfaction.
2. Prolonged treatment time 3. Increased cost4. Discrepancy in growth patterns tend to re-establish
after some time5. Can not be used in cases like bimaxillary protrusion
when extraction of teeth is required. As in such cases 1 phase treatment is beneficial.
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CONDITIONS
1. Anterior cross bite 2. Posterior cross bite3. Open bite4. deep bite5. Ectopic eruption6. Midline deviation 7. Midline diastema8. Space regainers
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CROSS BITE
Definition An abnormal relationship of one or
more teeth to one or more teeth of the opposing arch in the bucco-lingual or labio-lingual direction
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Classification of cross bite
Cross bite can be :1. Anterior / posterior cross bite2. Buccal / lingual cross bite3. Dental / skeletal / functional in etiology
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Scissor bite
Situation in which posterior teeth overlap vertically in habitual occlusion with their antagonists without contact of their occlusal surfaces
The deviation of the affected teeth from their ideal positions could occur either in a buccal or a lingual direction.
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Dental cross bite
An abnormal relationship between antagonist teeth, that is due to deviations in the position or inclination of one or few teeth.
The relationship between the maxilla and the mandible is harmonious.
Such cross bites are treated by tooth movement alone.
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Skeletal cross bite
Anterior or posterior (unilateral or bilateral) cross bite that is due to a sagittal or transverse in coordination in the size or shape of the maxilla and or mandible.
Treatment usually requires a skeletal expansion by means of rapid maxillary expansion or orthognathic surgery.
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Functional cross bitepseudo cross bite
A cross bite that is due to a shift of mandible into faulty habitual occlusion because of premature occlusal interference.
This shift may occur in an anterior and or lateral direction.
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Etiology Hereditary Over retained deciduous teeth. Displacement due to trauma. Constricted maxillary arch. Large mandible. Cross bite due to a shift of mandible ,into faulty
habitual occlusion . Multiple loss of post. Deciduous teeth can cause
anterior cross bite.
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Treatment –dental cross bite.(single tooth cross bite)
Correct the inclination or position of teeth Erupting maxillary incisor – with tongue
blade. Removable appliance with Z spring and
posterior bite plate. Fixed appliance with posterior bite plate.
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Treatment -skeletal cross bite (segmental cross bite)
In mixed dentition – Skeletal expansion of maxilla with rapid
maxillary expansion for lateral cross bite. Mid –face deficiency –face mask can be
given Large mandible—chin cap to restrict the
growth , F.R. III
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Treatment Functional cross bite (pseudo)
Remove the occlusal interference
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Open bite
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Definition of open bite
Localized absence of occlusion. Failure of teeth to meet the antagonist in the
opposing arch. Failure of overlapping of upper and lower teeth
in centric occlusion. (amount of separation measured.)
Failure of some opposing teeth to occlude when others are in maximum intercuspation.
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CLASSIFICATION
LOCATION- ANTERIOR / POSTERIOR TYPE SKELETAL / DENTAL
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ETIOLOGY OF OPEN BITE
1)-Disturbance in the eruption of teeth Ankylosis due to infection Primary failure of eruption 2)-mechanical interference Habits like tongue thrust, thumb sucking etc.
3)-osseous dyspasia Endocrine disturbance- Downs syndrome Hemi mandibular hypertrophy.
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Differences between dental and skeletal open bite
Dental Skeletal
Profile Normal Convex
vertical proportion
Normal increased
Lips Competent IncompetentEtiology Habit HereditaryTongue Positioned in
the open bite region
Not necessary placed in open bite region
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Long face syndrome Thank you
For more details please visit www.indiandentalacademy.com