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                                                   1
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                           Or t h od o nt i c s



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                            in Preadolescent Children



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                            *+!,&--.$!/%0123"4,&-123"56!
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Friday, February 4, 2011
The Purpose Of This
                               Presentation..




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Friday, February 4, 2011
Aims..




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Friday, February 4, 2011
Concept




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                     "Guidance of the development of the dentition through




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                    minimal intervention, with the aim of preventing, reducing




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                    or correcting existing or potential abnormal tooth
                    positions."



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                                                                  F. Van der Linden
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                                          Orthodontic Concepts and Strategies. 2004
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Friday, February 4, 2011
Concept




                                                                    1
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                   "Any treatment procedure which eliminates or reduces the




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                   severity of a developing malocclusion, as this may reduce




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                   the need for further treatment or make it simpler."



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                                                                Chung CK & Kerr WJ. 1987
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                Interceptive orthodontics: application and outcome in a demand population.
                                                                           BDJ, 162;73-76
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Friday, February 4, 2011
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Friday, February 4, 2011
Limitation




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                   “ .. Interceptive treatment can be very helpful in reducing




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                   the severity of problems, but rarely is so successful that




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                   later stages of treatment are unnecessary ! ”



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                                                         William R. Proffit
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                                                      “Contemporary Orthodontics”
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Friday, February 4, 2011
Timing




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                           The Late Mixed Dentition Stage ?




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                                             Nimri & Richardson, BJO, 1997
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                                                          Bjork, TEOS, 1972

Friday, February 4, 2011
Advantages Of Early Tx




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              A F:E/";G:;/%#@&#$>#<3#C.:'&Shaw et al, BJO, 1980




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Friday, February 4, 2011
Drawbacks Of Early Tx




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                           =.2(#<.<3&$.<3%3%;<'&Little et al, AJODO, 1990
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Friday, February 4, 2011
Diagnostic Knowledge




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Friday, February 4, 2011
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Friday, February 4, 2011
" The Dental Norm "




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Friday, February 4, 2011
" The Skeletal Norm "




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Friday, February 4, 2011
"The Functional Norm"




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Friday, February 4, 2011
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           Indications




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Friday, February 4, 2011
Types of Problems




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Friday, February 4, 2011
Eruption Problems




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Friday, February 4, 2011
Eruption Problems




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Friday, February 4, 2011
Eruption Problems




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Friday, February 4, 2011
Eruption Problems




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                           A Z[&%<&#<3.2%;2&(#N%@@#,&DiBiase, 1969



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Friday, February 4, 2011
Eruption Problems




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Friday, February 4, 2011
Eruption Problems




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Friday, February 4, 2011
Eruption Problems




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                                       As a General Rule:


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Friday, February 4, 2011
Eruption Problems




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Friday, February 4, 2011
Eruption Problems




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Friday, February 4, 2011
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Friday, February 4, 2011
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Friday, February 4, 2011
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Friday, February 4, 2011
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Friday, February 4, 2011
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Friday, February 4, 2011
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Friday, February 4, 2011
Eruption Problems




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Friday, February 4, 2011
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Friday, February 4, 2011
Eruption Problems




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                                                         Angle Orthodontist
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Friday, February 4, 2011
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Friday, February 4, 2011
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Friday, February 4, 2011
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Friday, February 4, 2011
Ectopic Eruption




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Friday, February 4, 2011
Ectopic Eruption




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Friday, February 4, 2011
Ectopic Eruption




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Friday, February 4, 2011
Ectopic Eruption




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Friday, February 4, 2011
Ectopic Eruption




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Friday, February 4, 2011
Ectopic Eruption




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Friday, February 4, 2011
Ectopic Eruption




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Friday, February 4, 2011
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Friday, February 4, 2011
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Friday, February 4, 2011
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Friday, February 4, 2011
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Friday, February 4, 2011
Recommended Reading




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Friday, February 4, 2011
Thank You.. & Good Luck!




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Friday, February 4, 2011

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Interceptive Orthodontics

  • 1. In t e r c e p t i ve 1 01 Or t h od o nt i c s i2 aw in Preadolescent Children m iSa ad !"#$%&!'&!#(#)% Sh *+!,&--.$!/%0123"4,&-123"56! © Friday, February 4, 2011
  • 2. The Purpose Of This Presentation.. 1 01 i2 aw 7&85.92.:".28&;9&;23";$;<3%/&%<3.2/.=3%>.& m Sa /;</.=3:&?&32.#3(.<3&(;$#@%3%.:&%<& =2.#$;@.:/.<3&/"%@$2.<' i ad Sh © Friday, February 4, 2011
  • 3. Aims.. 1 01 i2 aw A !"#$%"&'()*+,-#.%(/0%(-%%)(1#"(2+-+,%2%-/( #1(/0%()%3%&#$*-,(#44&5.*#- m Sa A 6-#7(/0%(*-)*4+/*#-.(+-)(4#-/"+*-)*4+/*#-.( #1(3+"*#5.(*-/%"4%$/*3%(2%+.5"%.8(/"%+/2%-/( i ad 2#)+&*/*%.(9(+$$&*+-4%.: Sh © Friday, February 4, 2011
  • 4. Concept 1 01 "Guidance of the development of the dentition through i2 minimal intervention, with the aim of preventing, reducing aw or correcting existing or potential abnormal tooth positions." m i Sa ad F. Van der Linden Sh Orthodontic Concepts and Strategies. 2004 © Friday, February 4, 2011
  • 5. Concept 1 01 "Any treatment procedure which eliminates or reduces the i2 severity of a developing malocclusion, as this may reduce aw the need for further treatment or make it simpler." m i Sa ad Chung CK & Kerr WJ. 1987 Sh Interceptive orthodontics: application and outcome in a demand population. BDJ, 162;73-76 © Friday, February 4, 2011
  • 6. 1 01 i2 !B/"&CB%$#</.&:";B@$&/;<32%DB3.&3;&3".& aw $.>.@;=(.<3&;9&#&=.2(#<.<3&$.<3%3%;<& m 3"#3&%:&%<&#&"#2(;<%;B:,&9B</3%;<#@&#<$& Sa .:3".3%/#@@E&#//.=3#D@.&;//@B:%;<' i ad Sh © Friday, February 4, 2011
  • 7. Limitation 1 01 “ .. Interceptive treatment can be very helpful in reducing i2 the severity of problems, but rarely is so successful that aw later stages of treatment are unnecessary ! ” m i Sa ad William R. Proffit Sh “Contemporary Orthodontics” © Friday, February 4, 2011
  • 8. Timing 1 01 The Late Mixed Dentition Stage ? i2 aw A ;%%7+'(.$+4%.(./*&&($"%.%-/:: A <+-'(4+.%.(2+'(./*&&(=%(/"%+/%)(#-(+(-#-> m %?/"+4/*#-(=+.*.( Sa A @/*&*A+/*#-(#1(B"#7/0 i ad A C0#"/%"(#3%"+&&(/"%+/2%-/(/*2%D(*:%E(F-%>!0+.% Sh Nimri & Richardson, BJO, 1997 © Bjork, TEOS, 1972 Friday, February 4, 2011
  • 9. Advantages Of Early Tx 1 01 i2 A F:E/";G:;/%#@&#$>#<3#C.:'&Shaw et al, BJO, 1980 aw A 5.$B/.&;9&2%:H&;9&%</%:;2&;2&C%<C%>#@&32#B(#'& m Todd & Dodd, HMSO, 1985 A I(=2;>.$&6;;=.2#3%;<' i Sa ad A 62#<%;9#/%#@&3%::B.:&(;2.&(#@@.#D@.&J Sh © Friday, February 4, 2011
  • 10. Drawbacks Of Early Tx 1 01 i2 A K;::&;9&=#3%.<3&/;;=.2#3%;<&LL&F2;@;<C.$&MNO aw A PN32#/3%;<&/";%/.&%:&$%99%/B@3&)"%@:3&E;B<C' m A K#3.&:;93&3%::B.&(#3B2%3E&#<$&/;<3%<B.$& Sa C2;)3"'&Vig & Cohen, AJO, 1979 i ad A K;::&;9&(;:3&#2/"&@.<C3"&C#%<:&)".<&%<& Sh =.2(#<.<3&$.<3%3%;<'&Little et al, AJODO, 1990 © Friday, February 4, 2011
  • 11. Diagnostic Knowledge 1 01 7<3%/%=#3%;<&;9& i2 F;3.<3%#@&RB3B2.&6;(=@%/#3%;<: aw m i Sa ad Q;2(#@&!H.@.3#@&? P#2@E&5./;C<%3%;<& Sh &+.<3#@&+.>.@;=(.<3 ;9&7D<;2(#@%3%.: © Friday, February 4, 2011
  • 12. 1 01 i2 aw m Sa i ad Sh What is "Normal" Anyway?? © Friday, February 4, 2011
  • 13. " The Dental Norm " 1 01 A 6;(=@.3.&$./%$B;B:& i2 $.<3%3%;<& G"#5-)(G,%(H>I aw A -%@$&:=#/%<C&G& F2%(#3.&:=#/%<C' m A R@B:"G3.2(%<#@& Sa 2.@#3%;<:"%=&;9&P:' i ad A P$C.G.$C.&%</%:;2& 2.@#3%;<:"%=&0@#3.2& Sh :3#C.:4 © A Q;&62;::GD%3.:' Friday, February 4, 2011
  • 14. " The Skeletal Norm " 1 01 i2 aw A 6@#::&I&:H.@.3#@&=#33.2<&8#==.#2#</.8'' m A Q;&>.23%/#@,&32#<:>.2:.&<;2&7<3.2;G Sa =;:3.2%;2&$%:/2.=#</%.:' i ad Sh © Friday, February 4, 2011
  • 15. "The Functional Norm" 1 01 i2 aw A Q;2(#@&:)#@@;)%<C&D."#>%;2' m A Q#:#@&D2.#3"%<C' Sa A R2..&92;(&"#D%3:S&3"B(D&;2&$%C%3& i ad :B/H%<C,&3;<CB.G3"2B:3%<C,&.3/'' Sh © Friday, February 4, 2011
  • 16. 1 01 Indications i2 aw J#"( m F"/0#)#-/*4( K-/%"4%$/*#- Sa i ad Sh © Friday, February 4, 2011
  • 17. Types of Problems 1 01 A L%-/#>#@>.;@#2E A !H.@.3#@L i2 aw A P2B=3%;<&=2;D@.(: A M2#<:>.2:.&=2;D@.(: m A P/3;=%/&.2B=3%;< A T.23%/#@&=2;D@.(: i Sa A !=#/.G2.@#3.$&=2;D@.(: A 7GF&=2;D@.(: ad A 1//@B:#@&=2;D@.(: A 6;(D%<.$&=2;D@.(: Sh A R#/%#@&7:E((.32E © Friday, February 4, 2011
  • 18. Eruption Problems 1 01 U' 1>.2G2.3#%<.$&F2%(#2E&M..3" i2 aw m ''&(#E&/#B:.& $.9@./3.$&.2B=3%;<&Sa =#3":&2.:B@3%<C&%<& i ad /2;)$%<C&#<$V;2& Sh @;/#@%W.$&/2;::GD%3.:' © Friday, February 4, 2011
  • 19. Eruption Problems 1 01 U' 1>.2G2.3#%<.$&F2%(#2E&M..3" i2 aw G(!%"2+-%-/(/##/0(.0#5&)("%$&+4%(*/.( $"%)%4%..#"(70%-(MNO(#1(*/.("##/(0+.(1#"2%): m i Sa Proffit, 2007 ad Sh © Friday, February 4, 2011
  • 20. Eruption Problems 1 01 U' 1>.2G2.3#%<.$&F2%(#2E&M..3" i2 aw -#<#C.(.<3L m P?/"+4/*#-(#1(#11%-)*-,($"*2+"'(/##/0N/%%/0: i Sa *XML ad M#H.&5#$%;C2#="&RI5!MO Sh © Friday, February 4, 2011
  • 21. Eruption Problems 1 01 i2 Y' !B=.2<B(.2#2E&M..3" aw A Z[&%<&#<3.2%;2&(#N%@@#,&DiBiase, 1969 m A 6#B:.&:=#/%<C&0(%$@%<.&$%#:3.(#4&%<&ZU&;9& Sa /#:.:,&Ranta, 1986 i ad A +.@#E.$&.2B=3%;<&;9&#<3.2%;2&3..3"&=#23%/B@#2@E& /.<32#@&%</%:;2:' Sh A !%<C@.&0(#E&.2B=34&;2&(B@3%=@.&0B<@%H.@E&3;&.2B=34 © Friday, February 4, 2011
  • 22. Eruption Problems 1 01 ]' !B=.2<B(.2#2E&M..3" i2 aw I' !%(=@.&6#:.:L m A -#<#C.(.<3& %<>;@>.:& . N 3 2 # / 3 % ; <& ; 9& 3 " .& Sa :B=.2<B(.2#2E& 3;;3"& %9& :B=.29%/%#@& ;2& .2B=3.$,& i ad ) % 3 " ; B 3& # 9 9 . / 3 % < C& #$^#/.<3&3..3"' Sh © Friday, February 4, 2011
  • 23. Eruption Problems 1 01 i2 Y' !B=.2<B(.2#2E&M..3" aw II' 6;(=@%/#3.$&6#:.:L m A -#<#C.(.<3&(#E&%<>;@>.&8'''&$.@#E%<C& Sa .N32#/3%;<&;9&3".&:B=.2<B(.2#2E&3;;3"&0;2& 3..3"4&B<3%@&/;<3%<B.$&C2;)3"&"#:&%(=2;>.$& i ad D;3"&#//.::&#<$&/"%@$_:&#D%@%3E&3;&3;@.2#3.& :B2C.2E8 Sh Proffit, 2007 © Friday, February 4, 2011
  • 24. Eruption Problems 1 01 i2 Y' !B=.2<B(.2#2E&M..3" aw As a General Rule: m Sa The earlier the supernumerary teeth are removed, the more likely normal teeth will i ad erupt without intervention. Sh © Friday, February 4, 2011
  • 25. Eruption Problems 1 01 i2 ]' +.@#E.$&I</%:;2&P2B=3%;< aw A 1>.2G2.3#%<.$&=2%(#2E&%</%:;2: m A !B=.2<B(.2#2E&3..3" Sa A M"%/H.<%<C&;9&;>.2@E%<C&H.2#3%<%W.$&3%::B.& i ad %<&@;<CG:3#<$%<C&.$.<3B@;B:&:=#/.:' Sh DiBiase D., 1970 © Friday, February 4, 2011
  • 26. Eruption Problems 1 01 ]' +.@#E.$&I</%:;2&P2B=3%;< i2 aw A -#<#C.(.<3L m A !B=.29%/%#@L&!%(=@.&:;93&3%::B.&%</%:%;< Sa A +..=.2L&7=%/#@@EG2.=;:%3%;<.$&9@#=&#<$&/2;)<& .N=;:B2.''' i ad A T.2E&+..=L&PN=;:B2.&#<$&;23";$;<3%/&32#/3%;<& Sh )%3"&D;<$.$&#33#/"(.<3&0=2.9.2#D@E&#&C;@$G /"#%<&#33#/"(.<34''' © Friday, February 4, 2011
  • 27. 1 01 i2 aw m Sa i ad Sh Surgical Exposure & Orthodontic Traction © Friday, February 4, 2011
  • 28. 1 01 i2 aw m Sa i ad Sh Surgical Exposure & Orthodontic Traction © Friday, February 4, 2011
  • 29. 1 01 i2 aw m Sa i ad Sh Surgical Exposure & Orthodontic Traction © Friday, February 4, 2011
  • 30. 1 01 i2 aw m Sa i ad Sh Surgical Exposure & Orthodontic Traction © Friday, February 4, 2011
  • 31. 1 01 i2 aw m Sa i ad Sh Surgical Exposure & Orthodontic Traction © Friday, February 4, 2011
  • 32. 1 01 i2 aw m Sa i ad Sh Surgical Exposure & Orthodontic Traction © Friday, February 4, 2011
  • 33. 1 01 i2 aw m Sa i ad Sh Surgical Exposure & Orthodontic Traction © Friday, February 4, 2011
  • 34. 1 01 i2 aw m Sa i ad Sh Surgical Exposure & Orthodontic Traction © Friday, February 4, 2011
  • 35. Eruption Problems 1 01 i2 `' 7<HE@;:.$&F2%(#2E&M..3" aw A !%(%@#2&.99./3:&3;&#<E&;>.2G2.3#%<.$& m =2%(#2E&3;;3" Sa A -#<#C.(.<3&$.=.<$:&;<&)".3".2& =.2(#<.<3&:B//.::;2&%:&=2.:.<3&;2&<;3'' i ad Sh © Friday, February 4, 2011
  • 36. Eruption Problems 1 01 i2 `' 7<HE@;:.$&F2%(#2E&M..3" aw A !B//.::;2&=2.:.<3L& m (#%<3#%<&B<3%@&%<3.29.2.</.&)%3"&.2B=3%;<&;2& Sa $2%93%<C&;9&#$^#/.<3&3..3"&;//B2:,&3".<&.N32#/3& i #<$&=@#/.&:=#/.G(#%<3#%<.2&;2&9%N.$& ad #==@%#</.:' Sh © Friday, February 4, 2011
  • 37. Eruption Problems 1 01 i2 `' 7<HE@;:.$&F2%(#2E&M..3" aw A !B//.::;2&<;3&=2.:.<3L& m PN32#/3&#<HE@;:.$&3;;3"&D.9;2.&#&@#2C.&>.23%/#@& Sa ;//@B:#@&$%:/2.=#</E&;//B2:,&#<$&3;&#>;%$& @;<CG3.2(&=.2%;$;<3#@&=2;D@.(:&JJJ i ad Kurol & Thilander, 1984 Sh Angle Orthodontist © Friday, February 4, 2011
  • 38. Eruption Problems 1 01 `' 7<HE@;:.$&F2%(#2E&M..3" i2 aw A !B//.::;2&<;3&=2.:.<3L& m <#"%("%4%-/&'8(7*/0(/0%(+)3+-4%2%-/.(*-(K2$&+-/(L%-/*./"'E( Sa <+*-/%-+-4%(#1(/0%(+-Q'&#.%)($"*2+"'(/##/0D i ad >(K1(-#(.5=2%",%-4%(#"(#44&5.+&(*-/%"1%"%-4%.(%3*)%-/: >(K1(/0%'(+"%(1*"2(9(-#/("%.#"=*-,(='(/0%2.%&3%.R Sh >(K1(#44&5.*#-(9(.Q%&%/+&($+//%"-($%"2*/: © Friday, February 4, 2011
  • 39. 1 01 i2 aw m iSa ad Sh Ankylosed Primary 2nd Molars © Friday, February 4, 2011
  • 40. 1 01 i2 aw m iSa ad Sh Ankylosed Primary 2nd Molars © Friday, February 4, 2011
  • 41. 1 01 i2 aw m iSa ad Sh Ankylosed Primary 2nd Molars © Friday, February 4, 2011
  • 42. 1 01 i2 aw m iSa ad Sh Ankylosed Primary 2nd Molars © Friday, February 4, 2011
  • 43. 1 01 i2 aw m iSa ad Sh Ankylosed Primary 2nd Molars © Friday, February 4, 2011
  • 44. Ectopic Eruption 1 01 i2 ''&a".<&#&=.2(#<.<3&3;;3"&/#B:.:& aw 2.:;2=3%;<&;9&#&=2%(#2E&3;;3"&%3&%:&<;3& m :B==;:.$&3;&2.=@#/.& i Sa 15& ad 2.:;2=3%;<&;9&#<&#$^#/.<3&=.2(#<.<3&3;;3"' Sh © Friday, February 4, 2011
  • 45. Ectopic Eruption 1 01 U' K#3.2#@&I</%:;2: i2 A S%.#"$/*#-(#1($"*2+"'(4+-*-%.(*.(4#22#- aw A ;#..(#1(#-%(#"(=#/0($"*2+"'(4+-*-%.(/0*.(7+'( m *-)*4+/%.(+(&+4Q(#1(.$+4%(1#"(+&&($%"2+-%-/( Sa *-4*.#".(*-(2#./(4+.%.: i ad A C$+4%(2+*-/%-+-4%(9N#"(=+&+-4*-,( %?/"+4/*#-.(5.5+&&'(-%%)%)(/#($"%3%-/(2*)&*-%( Sh .0*1/.(+-)(15"/0%"(.$+4%(&#.. © Friday, February 4, 2011
  • 46. Ectopic Eruption 1 01 i2 Y' -#N%@@#2E&R%2:3&-;@#2: aw A L5%(/#(.2+&&8()*./+&&'>&#4+/%)(2+?*&&+(T m A C/%%$&'(+-,5&+/%)(&+",%($%"2+-%-/(U./( Sa 2#&+".(T(Pulver, J Dent Child, 1968 i ad A V#(.Q%&%/+&("%&+/*#-.0*$.(1#5-)T(Bjerklin & Kurol, Am J Orthod, 1983 Sh © Friday, February 4, 2011
  • 47. Ectopic Eruption 1 01 i2 Y' -#N%@@#2E&R%2:3&-;@#2: aw A F=.%"3+/*#- m A I9&<;&;2&:(#@@&#(;B<3&;9&P&2.:;2=3%;< A K-/%"3%-/*#- i Sa ad A *@;/H#C.&=.2:%:3.<3&b&c&(;<3": Sh A 5.:;2=3%;<&%</2.#:%<C''' © Friday, February 4, 2011
  • 48. Ectopic Eruption 1 01 i2 aw K#/H&;9&3%(.@E&%<3.2>.<3%;<&(#E&/#B:.&@;::& m ;9&=2%(#2E&Y-)&(;@#2&#<$&/;<:%$.2#D@.&:=#/.& Sa @;::&#:&U./&=.2(#<.<3&(;@#2&.2B=3:&(.:%#@@E' i ad Sh © Friday, February 4, 2011
  • 49. Ectopic Eruption 1 01 i2 Y' -#N%@@#2E&R%2:3&-;@#2: aw A K-/%"3%-/*#- m Sa A *2#::&)%2.&V&:3..@&:=2%<C&/@%=&V&.@#:3;(.2%/& :.=#2#3;2&(;$B@.: i ad A !.>.2.&/#:.:L&9%N.$&#==@%#</.:&)%@@&D.&<..$.$' Sh © Friday, February 4, 2011
  • 50. Ectopic Eruption 1 01 i2 ]' -#N%@@#2E&6#<%<.: aw A <#./(1"%W5%-/(%4/#$*4(%"5$/*#-($+//%"-: m A S%&+/%)(/#(.2+&&(N(2*..*-,(&+/%"+&(*-4*.#". Sa A S%&+/%)(/#(&#-,(/#"/5#5.($+/0(#1(%"5$/*#- i ad A C/"#-,(%3*)%-4%(#1(+(,%-%/*4(=+.*. Sh Baccetti TA. , Angle, 1998 © Brin et al, EJO, 1986 Friday, February 4, 2011
  • 51. Ectopic Eruption 1 01 ]' -#N%@@#2E&6#<%<.: i2 A <+*-($"#=&%2.E aw A I(=#/3%;<&19&F.2(#<.<3&6#<%<.:& m A I</%$.</.&d&ZY&J&e&R0Zf4&b&-0Z]4 Sa A F#@#3#@&0Z[g4&L&*B//#@&0ZUg4 i A 5.:;2=3%;<&19&5;;3:&19&K#3.2#@&I</%:;2:& ad A I<&ZUY&;9&/#:.:&e&R&b&- Sh © Mossey et al, BJO, 1994 Ericson & Kurol , AJODO, 1987 Bishara SE , Semin Orthod, 1998 Ericson & Kurol , Angle, 1998 Friday, February 4, 2011
  • 52. Ectopic Eruption 1 01 i2 ]' -#N%@@#2E&6#<%<.: aw A F!B(*-)*4+/%)(+/(G,%(X>UYE m A I9&=2%(#2E&/#<%<.:&<;3&(;D%@., Sa A *B@C.&;9&=.2(#<.<3&/#<%<.:&<;3&>%:%D@.&;2& i =#@=#D@.&@#D%#@@E&%<&3".&:B@/B:' ad Sh Ericson & Kurol , Commnity Dent Oral Epidemiol, 1986 © Friday, February 4, 2011
  • 53. Ectopic Eruption 1 01 i2 ]' -#N%@@#2E&6#<%<.: aw K1(/0%($%"2+-%-/(4+-*-%(4"#7-(#3%"&+$.(0+&1(#"( m 2#"%(#1(&+/%"+&(*-4*.#"("##/("+)*#,"+$0*4+&&'( i Sa ad High risk of resorption of lateral incisors root! Sh Ericson & Kurol , Eur J Orthod, 1988 © Friday, February 4, 2011
  • 54. Ectopic Eruption 1 01 Ericson & Kurol , Eur J Orthod, 1988 i2 aw Interceptive Extraction Of Primary Canines: m -;:3&P99./3%>.&*.3)..<&7C.:&UGU] Sa a".<&=.2(#<.<3&/#<%<.&/2;)<& ;>.2@#==%<C&"#@9&;9&@#3.2#@&%</%:;2:&2;;3 i ad Sh © Z(XU([0+-4%(F1(V#"2+&*A+/*#- Friday, February 4, 2011
  • 55. Ectopic Eruption 1 01 Ericson & Kurol , Eur J Orthod, 1988 i2 aw Interceptive Extraction Of Primary Canines: m -;:3&P99./3%>.&*.3)..<&7C.:&UGU] Sa a".<&=.2(#<.<3&/#<%<.&/2;)<& ;>.2@#==%<C&b&"#@9&;9&@#3.2#@&%</%:;2:&2;;3 i ad Sh © Z(IO([0+-4%(F1(V#"2+&*A+/*#- Friday, February 4, 2011
  • 56. Space-related Problems 1 01 U' P#2@E&K;::&19&+./%$B;B:&M..3" i2 aw A !"%2+/5"%(%?1#&*+/*#- A !&+--%)(%?/"+4/*#- m Sa A [+"*%.R(0#==2;N'&Zcf&%<&h;2$#<O4 i ad Sh © Friday, February 4, 2011
  • 57. Space-related Problems 1 01 P#2@E&K;::&19&+./%$B;B:&M..3" i2 aw A P?/%-/(#1(*/.(%11%4/(*.("%&+/%)(/#E m A 0%(.*/%(#1(/##/0(&#.. A 0%(]+7 i Sa ad A !"%>%?*./*-,()%,"%%(#1(4"#7)*-, Sh A G,% © Friday, February 4, 2011
  • 58. Early Loss Of Deciduous Teeth 1 01 -.:%#@&+2%93 -%$@%<.&!"%93 i2 7i* ? ? ? ? aw m 6 i Sa ad + Sh © P Friday, February 4, 2011
  • 59. Space-related Problems 1 01 Management i2 aw !=#/.&-#%<3.<#</.V5.C#%<%<C m i Sa ^+"*#5.(1*?%)(9("%2#3+=&%(.$+4%(2+*-/+*-%". ad ;*-,5+&(+"40(N(V+-4%(_5//#-( Sh N(J*?%)(G$$&*+-4%.(T © Friday, February 4, 2011
  • 60. 1 01 i2 aw m Sa i ad Sh © Friday, February 4, 2011
  • 61. Lip Bumper 1 01 i2 aw m i Sa ad Sh Nevant et al, Am J Orthod, 1991 © O'Donell et al, Am J Orthod, 1998 Friday, February 4, 2011
  • 62. Space-related Problems 1 01 Management i2 aw Balancing Extractions m i Sa ad PN32#/3%;<&;9&3".&/;<32#@#3.2#@&3;;3"& %<&3".&:#(.&#2/"' Sh © Friday, February 4, 2011
  • 63. Space-related Problems 1 01 Management i2 aw Compensating Extractions m iSa ad PN32#/3%;<&;9&3".&;==;:%<C&3;;3"& %<&3".&;==;:%<C&#2/"' Sh © Friday, February 4, 2011
  • 64. Space-related Problems 1 01 Serial Extractions ? i2 aw m Kjellgren, Acta Odonto Scand, 1948 Sa A&!.jB.<3%#@&PN32#/3%;<&;9&6:,&+:&3".<&`:&)".<&.2B=3.$' i ad A&7%(:&3;&2.@%.>.&#<3.2%;2&/2;)$%<C'' Sh © Friday, February 4, 2011
  • 65. Space-related Problems 1 01 Indications for Serial Extractions i2 aw A&-%@$&3;&(;$.2#3.&7<3.2%;2&/2;)$%<C&#2;B<$&#C.&[Gk A&6@#::&I&(#@;//@B:%;< m A&Q;2(#@&1>.2D%3. Sa A&7@@&=.2(#<.<3&3..3"&=2.:.<3&?&;9&C;;$&=2;C<;:%: i ad A&`:&#".#$&;9&]:&%<&.2B=3%;< Sh © Friday, February 4, 2011
  • 66. Space-related Problems 1 01 Drawbacks of Serial Extractions i2 aw A&X<=2.$%/3#D@.&2.:B@3:O m A&!"%93:&/2;)$%<C&=;:3.2%;2@E Sa A&!.>.2#@&.=%:;$.:&;9&.N32#/3%;<&9;2&#&E;B<C&=#3%.<3 i A&&R%N.$&#==@%#</.:&:3%@@&<..$.$&9;2&9%<%:"%<C&?&/;22./3%;<& ad ;9&#D<;2(#@&3;;3"&#<CB@#3%;<:&0.:=./%#@@E&/#<%<.:4 Sh Stephens, Dent Update, 1989 © Friday, February 4, 2011
  • 67. Space-related Problems 1 01 Y'&-.$%#<&+%#:3.(#: i2 aw m F"E:%;@;C%/#@& i Sa ad Zk[&;9&c&E.#2G;@$: Z`k&;9&UU&E.#2G;@$: Sh Zf&;9&UYGU[&E.#2G;@$: © 7D<;2(#@& Friday, February 4, 2011
  • 68. Space-related Problems 1 01 i2 A X=&3;&Y(('' aw A `@,&'(L54Q&*-,`(./+,% m A b&Y(('' Sa A a'$#N<*4"#)#-/*+(T i ad A C5$%"-52%"+"'(/##/0(N(<%.*#)%-.(T Sh A ;#7>+//+40%)(#"(1&%.0'(J"%-52(T © Friday, February 4, 2011
  • 69. Space-related Problems 1 01 Low-attachment frenum ? i2 aw A 6@%<%/#@@E,&/"./HL m A _&+-40*-,(#1(*-4*.*3%($+$*&&+%(5$#-(./"%/40*-,( Sa #1(/0%(5$$%"(&*$(T i ad A _#-'(-#/40(*-(*-4*.*3%(+"%+("+)*#,"+$0*4+&&'(T Sh © Friday, February 4, 2011
  • 70. Space-related Problems 1 01 1B3@%<.&;9&+%#:3.(#:_&-#<#C.(.<3& i2 aw A L%/%"2*-%(%?+4/(%/*#&#,'( m A S%2#3%(+-'($0'.*4+&(#=./"54/*#-.T Sa A [&#.%(5.*-,("%2#3+=&%(#"(1*?%)(+$$&*+-4%. i ad A !#./>/"%+/2%-/(J"%-%4/#2'T Sh A S%/+*-(7*/0(=#-)%)("%/+*-%". © Friday, February 4, 2011
  • 71. Space-related Problems 1 01 ]' 6;<C.<%3#@@EG-%::%<C&K#3.2#@&I</%:;2: i2 aw A&ZY&;9&=;=B@#3%;< m A&R#(%@%#@&3.<$.</E&9;2&(%::%<C&?&=.CG:"#=.$&@#3.2#@: Sa A&193.<&#::;/%#3.$&)%3"&./3;=%/&.2B=3%;<&;9&/#<%<.: i ad Zilberman et al, EJO, 1990 Sh Brin et al, EJO, 1986 © Friday, February 4, 2011
  • 72. Space-related Problems 1 01 ]' 6;<C.<%3#@@EG-%::%<C&K#3.2#@&I</%:;2: i2 aw Two Main Scenarios... m A&F.2(#<.<3&/#<%<.&.2B=3:&%<&@#3.2#@&%</%:;2&=;:%3%;< Sa A&F.2(#<.<3&/#<%<.&.2B=3:&<;2(#@@E&#<$&=2%(#2E& i ad @#3.2#@&%</%:;2&2.3#%<.$' Sh © Friday, February 4, 2011
  • 73. Space-related Problems 1 01 ]' 6;<C.<%3#@@EG-%::%<C&K#3.2#@&I</%:;2: i2 aw m Sa i ad Sh © Friday, February 4, 2011
  • 74. Space-related Problems 1 01 ]' 6;<C.<%3#@@EG-%::%<C&K#3.2#@&I</%:;2: i2 aw m Sa i ad Sh © Friday, February 4, 2011
  • 75. Space-related Problems 1 01 i2 aw m Sa i ad Sh © Friday, February 4, 2011
  • 76. Space-related Problems 1 01 i2 aw m Sa i ad Sh © Friday, February 4, 2011
  • 77. Space-related Problems 1 01 i2 aw m Sa i ad Sh © Friday, February 4, 2011
  • 78. Space-related Problems 1 01 i2 aw m Sa i ad Sh © Friday, February 4, 2011
  • 79. Occlusal Problems 1 01 U' 62;::D%3.: i2 aw 7==2;N'&Zf'f&;9&=;=B@#3%;< Q;3&:.@9G/;22./3%<C&#<$&.#2@E&%<3.2>.<3%;<&2.jB%2.$ m Ninou & Stephens Dent Update, 1994 i Sa ad A &+.<3#@&;2%C%< A 7<3.2%;2 Sh A&!H.@.3#@&;2%C%< A&F;:3.2%;2 © Friday, February 4, 2011
  • 80. Occlusal Problems 1 01 i2 aw A 7<3.2%;2&62;::D%3. m Sa A M2B.&6@#::&III&J i A F:.B$;G6@#::&III&J ad Sh © Friday, February 4, 2011
  • 81. Occlusal Problems 1 01 A 7<3.2%;2&62;::D%3. i2 A 1<.&GM);&%</%:;2:& aw +.<3#@&6;(=;<.<3&J %<&/2;::D%3.&15& 7<3.2%;2&+%:=@#/.(.<3&J P$C.G.$C.&%</%:;2: m i Sa ad Sh © Friday, February 4, 2011
  • 82. Occlusal Problems 1 01 A 7<3.2%;2&62;::D%3. i2 aw A ]&;2&(;2.&%</%:;2:& !H.@.3#@&6;(=;<.<3L %<&/2;::D%3. M2B.&6@#::&III m i Sa ad Sh © Friday, February 4, 2011
  • 83. Occlusal Problems 1 01 U' 62;::D%3.: i2 aw Impo r tant Dif ferentiation Criteria m 7&RB@@G/B:=&D%@#3.2#@&/2;::D%3.&%:&(;:3&@%H.@E&:H.@.3#@&%<&;2%C%<'' Sa 7&B<%@#3.2#@&=;:3.2%;2&/2;::D%3.&%:&(;:3&@%H.@E&$.<3#@&%<&;2%C%<&J i ad I9&(B@3%=@.&#<3.2%;2&3..3"&#2.&%<&/2;::D%3.,& Sh %3:&(;:3&@%H.@E&:H.@.3#@&%<&;2%C%<&%'.L&6@#::&III&J © Proffit, 2007 Friday, February 4, 2011
  • 84. Occlusal Problems 1 01 U' 62;::D%3.: i2 aw Should be corrected as early as possible. m Sa !+"/*45&+"&'(*-(/0%($"%.%-4%( #1(+()*.$&+4%2%-/: i ad Sh Thilander et al, EJO, 1984 © Richardson A., Interceptive Orthodontics, 2nd Ed, 1989 Friday, February 4, 2011
  • 85. Occlusal Problems 1 01 U' 62;::D%3.: i2 aw A(C%&%4/*3%(B"*-)*-,T m A(@SG(b<*)&*-%(P?$+-.*#-c Sa A(d5+)(a%&*?(#"(e>G"40 i ad A(a'"+?(P?$+-.*#-(bS<Pc Sh © Friday, February 4, 2011
  • 86. Occlusal Problems 1 01 i2 &!3#D%@%3E&;9&7<3.2%;2&/2;::D%3.&/;22./3%;<& aw $.=.<$:&(#%<@E&;<&#/"%.>%<C& m Sa #&l;;$&1>.2D%3.' i ad Houston et al, 1993 Sh © Friday, February 4, 2011
  • 87. Occlusal Problems 1 01 i2 &!3#D%@%3E&;9&F;:3.2%;2&/2;::D%3.& aw /;22./3%;<&$.=.<$:&(#%<@E&;<&#/"%.>%<C& m Sa l;;$&*B//#@&I<3.2/B:=#3%;<' i ad Houston et al, 1993 Sh © Friday, February 4, 2011
  • 88. Occlusal Problems 1 01 i2 aw Harrison & Ashby, 2001 m "Orthodontic Treatment of Posterior Crossbites" Sa Cochrane Database Systematic Review i ad Sh © Friday, February 4, 2011
  • 89. Occlusal Problems 1 01 Y'&12#@&m#D%3: i2 aw A&M"B(DVR%<C.2&!B/H%<C m A&M;<CB.&M"2B:3%<C&J A&7D<;2(#@&!)#@@;)%<C& i Sa *."#>%;2&J ad Sh © Friday, February 4, 2011
  • 90. Occlusal Problems 1 01 A M"B(DVR%<C.2&:B/H%<C i2 aw @$(/#(H>I('%+".(#1(G,% m Sa little or no Effect i on permanent dentition and skeleton ad Sh © Friday, February 4, 2011
  • 91. Occlusal Problems 1 01 A M"B(DVR%<C.2&!B/H%<C i2 aw I<&3".&-%N.$&#<$&F.2(#<.<3&+.<3%3%;< m A(@$$%"(K-4*.#"(!"#4&*-+/*#- Sa A(;#7%"(K-4*.#"(S%/"#4&*-+/*#- i ad A(F3%"=*/%(*:%E(G.'22%/"*4(GF_( Sh A(CQ%&%/+&()%3%&#$2%-/E %'.L&-#N%@@#2E&6;<:32%/3%;<&#<$&F;:3.2%;2&62;::D%3. © Friday, February 4, 2011
  • 92. Occlusal Problems 1 01 A M"B(DVR%<C.2&!B/H%<C i2 aw Frequency m !"#"$%&'()( iSa Duration ad Sh Intensity © Friday, February 4, 2011
  • 93. Occlusal Problems 1 01 A M"B(DVR%<C.2&!B/H%<C i2 aw m Sa i ad Sh © Friday, February 4, 2011
  • 94. Occlusal Problems 1 01 A M"B(DVR%<C.2&!B/H%<C i2 aw m Sa i ad Sh © Friday, February 4, 2011
  • 95. Occlusal Problems 1 01 A M"B(DVR%<C.2&!B/H%<C i2 aw m Sa i ad Sh © Friday, February 4, 2011
  • 96. Skeletal Problems... 1 01 i2 A M2#<:>.2:.&+%(.<:%;< aw A T.23%/#@&+%(.<:%;< m Sa A 7<3.2;G=;:3.2%;2&+%(.<:%;< i ad A 6;(D%<#3%;<:&19&1<.&12&-;2.&19&M".&7D;>. Sh © Friday, February 4, 2011
  • 97. Recommended Reading 1 01 i2 aw m *(+,-&"./,$0$'(1$&2,3,-&%456(78(9$,::%&6(;<<=(+28(>;?>@ Sa *(A$%5&,B(C-%#"$5%&'(D0-3E,,FG(9,5&H$03I0&"(J,&"5(%-(1$&2,3,-&%45 i ad *(K%420$35,-(L86(M-&"$4"/&%#"(1$&2,3,-&%456(;-3(N36(>OPO Sh © Friday, February 4, 2011
  • 98. Thank You.. & Good Luck! 1 01 i2 aw m Sa i ad Sh © Friday, February 4, 2011