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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-bite
3. Control of abnormal habits
4. Space regaining
5. Muscle exercises
6. Interception of skeletal mal-relation
7. 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 problem
2. To prevent obvious problems from becoming
worse
3. To correct obvious problems
4. 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 discrepancies
5. Pseudo class III
6. Dental and / or skeletal Class II
7. Maxillary mid face deficiency
8. 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 extractions
2. Decreased extent or possible elimination of the need
for a second phase of treatment.
3. Reduced need for surgical orthodontics
4. 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 resorption
7. Reduced incidence of mucogingival problems
8. 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 cost
4. Discrepancy in growth patterns tend to re-establish
after some time
5. 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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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 bite
pseudo 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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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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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 Incompetent
Etiology Habit Hereditary
Tongue Positioned in
the open bite
region
Not necessary
placed in open
bite region
