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Practical Research 1 Lesson 9 Scope and delimitation.pptx
Orthodontics an overview /certified fixed orthodontic courses by Indian dental academy
1. ORTHODONTICS- -AN OVERVIEW
INDIAN DENTAL ACADEMY
Leader in continuing dental education
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2. Small minds discuss people
Big minds discuss events
Great minds discuss ideas
Extraordinary minds act in silence
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3. What is Orthodontics?
1911, In Noyes defined orthodontics
as”the study of the relation of the teeth to
the development of the face ,and the
correction of arrested and perverted
development.
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4. In 1922 British society of orthodontics
proposed that”orthodontics includes the
study of growth & development of the jaws
and face particularly ,and the body
generally,as influencing the position of the
teeth;the study of action and reaction of
internal and external influences on the
development,and the prevention and
correction of arrested and perverted
development.”
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5. Orthodontics-Defined by -AAO
• Area of dentistry concerned with the
supervision,guidance and correction of the growing
and mature Dentofacial structures,including those
conditions that require movement of teeth or
correction of malrelationships and malformations of
related structures,by the adjustment of relationships
between and among teeth and facial bones by the
application of forces and /or the stimulation and
redirection of the functional forces within the
craniofacial complex.
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10. Edward Hartley Angle-(1855-1930)
Father of modern Orthodontics-Born on 1st june
1855,in Herrick,Pennsylvania.
In 1900 in-St.Louis-started his first school of
orthodontics.
American society of orthodontists was founded
in 1901-under angles leadership.
Introduced-most universally used classification
of malocclusion.
Developed a number of appliances-
‘E’arch,Pin & tube, Ribbon arch (bracket
refurbished & revamped & now it is an integral
part of begg technique).
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11. SO WHY DO PEOPLE
SEEK ORTHODONTIC
TREATMENT ??
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12. Facial Appearance :-The most
important characteristic in
relation to self image and self
esteem
People Dissatisfied with Facial
appearance express more
dissatisfaction with teeth than
any other feature !!
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14. SIX KEYS OF NORMAL OCCLUSION
1.MOLAR INTER-ARCHRELATIONSHIP
2.MESIODISTAL CROWN ANGULATION
3.LABIOLINGUAL CROWN INCLINATION
4.ABSENCE OF ROTATION
5.TIGHT CONTACTS
6.CURVE OF SPEE
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16. REASONS FOR CLASSIFYING
TO GROUP CERTAIN MALOCCLUSIONS
TOGETHER WHICH MAY OR MAY NOT
HAVE THE SAME ETIOLOGY.
EASE OF REFERENCE, COMPARISON AND
COMMUNICATION.
THINKING OF THE POSSIBLE TREATMENT
MODALITIES THAT MAY BE NEEDED IN A
PARTICULAR CASE.
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17. VARIOUS SYSTEMS OF CLASSIFICATION
ANGLE SYSTEM AND ITS MODIFICATIONS
SIMONS SYSTEM
AETIOLOGICAL CLASSIFICATION
BAUME CLASSIFICATION OF PRIMARY TEETH
ACKERMANN AND PROFITT CLASSIFICATION
BALLARDS CLASSIFICATION
WHO CLASSIFICATION
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18. ANGLE SYSTEM
BY EDWARD HARTLEY
ANGLE
WAS CONSIDERED THE
FATHER OF MODERN
ORTHODONTICS
BASED ON THE ANTERO
POSTERIOR RELATIONSHIP
OF THE
JAWS WITH EACH OTHER
CONSIDERS MAXILLARY
FIRST PERMANENT MOLAR
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20. CLASS II
DIVISION I
DIVISION II
TYPE A
TYPE B
TYPE C
CLASS II SUB DIV
TRUE
CLASS III
PSUEDO
CLASS III SUB DIV
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21. Angle’s classification of
malocclusion
• It was given by Edward Angle in 1899
• Based on the mesio-distal relation of the
teeth, dental arches and jaws
• Maxillary 1st permanent molar- key to
occlusion
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22. Class I malocclusion
Class I molar relationship
Mesiobuccal cusp of the maxillary first
molar occludes in the buccal groove of
the mandibular 1st permanent molar
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24. Class II div 2
• Class II molar relation
• Lingually inclined upper central incisors
• Labially tipped lateral incisors overlapping
the centrals
• Normal perioral muscle activity
• Abnormal backward path of closure
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27. Class II subdivision
» Class II molar relation on one side and class I on
other
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28. Class III MALOCCLUSION
CLASS III MOLAR RELATIONSHIP-
MESIOBUCCAL CUSP OF MAXILLARY FIRST
MOLAR OCCLUDES IN THE INTERDENTAL
SPACE BETWEEN THE DISTAL CUSP OF
MANDIBULAR FIRST MOLAR AND SECOND
MOLAR.
• CLASSIFIED INTO-
TRUE CLASS III
PSEUDO CLASS III
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31. TRUE CLASS III
• Class III molar relation
• LOWER INCISORS LINGUALLY
INCLINED
• LOWER TONGUE POSTURE- NARROW
UPPER ARCH
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32. PSEUDO CLASS III
• CAUSED BY FORWARD MOVEMENT OF THE
MANDIBLE- POSTURAL OR HABITUAL
CLASS III
• CAUSES OF PSEUDO CLASS III:-
OCCLUSAL PREMATURITY
LOSS OF DECIDUOUS MOLARS
LARGE ADENOIDS
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33. Purpose of Cephalometrics
•Study craniofacial growth
•Diagnosis
•Planning orthodontic treatment
•Evaluation of treated cases
Cephalometrics is a technique
employing oriented radiographs
for the purpose of making head
measurements.
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34. Purpose of Cephalometrics
• Study craniofacial growth
• Diagnosis
• Planning orthodontic treatment
• Evaluation of treated cases
Cephalometrics is a technique employing
oriented radiographs for the purpose of
making head measurements.
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35. Cephalostat
60"
60" 15"
15"
Film Plane
Film Plane
Source Plane
Source Plane
X-ray Source
X-ray Source
X-ray Film in
X-ray Film in
Mid-saggital Plane
Mid-saggital Plane Cassette
Cassette
Patient in Head Positioning
Patient in Head Positioning
Device
Device
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38. Standard Cephalometric
Landmarks
Sella Nasion
Porion Orbitale
Articulare ANS
A Point
B Point
Gonion Pogonion
PNS
Menton Gnathion
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54. The Optimal Force
“High enough to stimulate cellular activity
without completely occluding blood vessels in
the PDL” (Proffit et al. 2000).
Actively being investigated in a scientific field
known as mechanotransduction.
57. Force --- fluid flow --- cell-level strain
Deformation of cell membrane leading to cytoskeletal changes
Second messenger pathways
Gene upregulation in fibroblasts, osteoblasts and osteoclasts
58. Effects of LIGHT forces on the
periodontium
Light, continuous forces
Osteoclasts formed
Removing lamina dura
Tooth movement begins
This process is called “FRONTAL RESORPTION”.
60. LIGHT forces leading to FRONTAL RESORPTION
Phase 1 – Mechanical compression and tension of the periodontium
Phase 2 --- Mechanically induced cellular and genetic responses; no tooth
movement
Phase 3 --- Accelerated tooth movement due to frontal bone resorption
Tooth movement (mm)
Phase 3
Phase 2
Phase 1
Time (Arbitrary Unit)
61. Effects of HEAVY forces on the
periodontium
Heavy, continuous forces
Blood supply to PDL occluded
Aseptic necrosis
PDL becomes “hyalinized” – “HYALINIZATION”
This process is called “UNDERMINING
RESORPTION”.
64. Orthodontics and dentofacial orthopedics requires thorough knowledge in
biology (of bone, cartilage, teeth, muscles, nerves and other soft tissues),
biomechanics, biometrics, material science, clinical skills and practice
management in addition to interpersonal skills.
65. W study tooth movement?
hy
Up to 80% of the U.S. population have malocclusion that
warrants orthodontic correction.
Currently, 36% of the U.S. population seeks orthodontic
treatment (Brunelle et al., 1996).
67. Introduction
Chronological age is often not sufficient for
assessing the developmental stage and
somatic maturity of the patient.
The biological age is determined from the
skeletal, dental and morphologic age and
the onset of puberty.
Due to individual variations in timing, duration
and velocity of growth, skeletal age
assessment is essential in formulating viable
orthodontic treatment plans.
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69. METHODS AVAILABLE TO ASSESS THE
SKELETALMATURITY OF AN INDIVIDUAL--
1.USE OF HAND WRIST X-RAYS
2.EVALUATION OF SKELETAL
MATURATION
USING CERVICAL VERTEBRAE
3.ASSESMENT OF MATURITY BY
CLINICAL AND RADIOGRAPHIC
EXAMINATION OF DIFFERENT
STAGES OF TOOTH DEVELOPMENT.
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70. Orthognathic surgery
Orthognathic surgeries
are surgical procedures carried out along
with orthodontic treatment to correct
dento facial deformities of severe
orofacial disproportions, involving
maxilla,the mandible or both in
combination
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72. The various classification proposed
are:
White and Gardiner
Salzmann’s classification
Moyer’s classification
Graber’s classification
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73. Local factors
1. Anomalies in number of teeth
2. Anomalies of tooth size
3. Anomalies of tooth shape
4. Abnormal labial frenum
5 Premature loss of deciduous teeth
6. Prolonged retention of deciduous teeth
7. Delayed eruption
8. Abnormal eruptive pathway
9. Ankylosis
10.Dental caries
11.Improper dental restorations
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74. General factors
Heredity: It includes factors that result in
malocclusion and are inherited from the
parents by the off springs. These factors can
influence-
Neuromuscular system
Dentition
Skeletal structures
Soft tissues
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75. Environmental factors
Prenatal factors
Abnormal fetal posture : -
-Interferes with symmetric development
of face
-Not directly associated with
malocclusion but may be associated
with abnormal pressure or imbalance.
-Most of the deformities are temporary
and disappears with time
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76. Maternal infections such as German measles and
use of certain drugs during pregnancy like
thalidomide can cause congenital deformities like
cleft
Post natal factors
- Trauma
- Forceps delivery can result in injury to the TMJ area
which can undergo ankylosis retarded mandibular
growth
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78. Indications for Orthognathic
Surgery
Severity of skeletal and dental malocclusion
When growth modification can not be
achieved
Esthetic and psychosocial considerations
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79. Indications for
orthognathic surgery
• Facial imbalances or
asymmetries
– Long lower face, gummy smile
• Limitations of tooth movements
• Relapse potential of orthodontic
treatment
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80. Contraindications
Minor skeletal problem
Patients with only dentoalveolar
problems
Uncontrolled systemic disease
Unstable patients with poor personality
or pathologic personality
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81. Aims of orthognathic surgery
Optimum facial aesthetics
Optimum dental aesthetics
Functional occlusionsss
Future health of oro-facial structures
Rapid treatment
A stable result
Minimum morbidity(unhealthy, sick, sickly,
gruesome, ghastly, macabre, dreadful.)
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82. THANK YOU
INDIAN DENTAL ACADEMY
Leader in continuing dental education
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