Incisor guidance and ectopic eruption/ dental implant courses by Indian dental academy

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INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com

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“LOWER INCISOR CROWDING IN THE EARLY MIXED DENTITION” www.indiandentalacademy.com


SPECIFIC OBJECTIVES: 1. Know how to approach the problem of lingually erupting lower incisors. 2. Know when to assess a child patient’s tooth sizearch length relationship. 3. Identify when discing of lower cuspids is required.

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SPECIFIC OBJECTIVES (cont): 4. Explain leeway space control and the role of the mandibular lingual arch in assisting lower incisor alignment. 5. Be able to design an appliance to improve lower incisor alignment. _____________________________________ REQUIRED READING: Preceding material in this Syllabus. www.indiandentalacademy.com


REQUIRED READING: (In manual) Article: Early Mixed Dentition Developmental Module Article:

Management of lower incisor crowding in the early mixed dentition. T. Foley, G. Wright, S. Weinberger, Journal of Dentistry for Children, May-June, 1996, pp 169-174.

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1.

Primate space

2.

General spacing

3.

Preservation of “leeway space”

4.

Sequences of eruption

5.

Tooth size and jaw in harmony

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Crowding and protrustion of the incisors must be considered two aspects of the same thing:

how crowded and irregular the

incisors are reflects both how much room is available and where the incisors are positioned relative to the supporting bone.

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Identify WHY incisor guidance is needed.

List WHAT is to be considered.

Indicate WHEN incisor guidance is appropriate.

Suggest HOW incisor guidance is performed.

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ď‚Ą

To help prevent orthodontic relapse.

ď‚Ą

Prevent unnecessary periodontic problems.

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Interdental spacing.

Intercanine distance.

Increase of the arch perimeter.

Size ratio between the primary and permanent teeth. www.indiandentalacademy.com


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1째 - 4 YEARS CROWDING NO SPACE 0-3 MM SPACE 3-6 MM SPACE > 6 MM SPACE

PERMANENT -

10/10 7/10 5/10 2/10 0/10

B. C. LEIGHTON www.indiandentalacademy.com


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Continue to observe the case.

Disc primary teeth.

Extract primary teeth.

Refer to an orthodontist.

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Those < 2mm. crowding may resolve into good alignment. (Profitt)

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Those with 3 – 4 mm. arch crowding.

The goal is to transfer the anterior crowding posteriorly into the leeway space.

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When arch crowding is 4 to 9 mm.

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The goal is improve incisor alignment (unraveling), perhaps preventing periodontal problems and improving post-orthodontic stabliity.

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Most class I cases having more than 10 mm. crowding should be referred to an orthodontic specialist by general dentists and (perhaps paediatric dentists). www.indiandentalacademy.com


7 years old

9 years old

14 years old

Changes in the axial inclination due to the eruption of the maxillary anterior teeth (Broadbent, 1957).

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Avoid unnecessary periodontal problems.

Enhance the long term stability of orthodontic treatments.

Involve more clinicians in guiding the developing dentition. www.indiandentalacademy.com


ECTOPIC ERUPTION AND SPACE REGAINING 2004-2005 www.indiandentalacademy.com


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GENERAL OBJECTIVE: To discuss the problem of ectopic eruption generally. To discus the problem of ectopic eruption the canine and first permanent molar and its management. www.indiandentalacademy.com


SPECIFIC OBJECTIVES: 1. Define ectopic eruption. 2. Know the frequency of ectopically eruption first permanent molars. 3. Explain the reasons for ectopic eruption occurring with first permanent molars. 4. Distinguish between a reversible and non-reversible ectopic eruption.

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SPECIFIC OBJECTIVES (continued): 5. Know methods for correcting ectopic molar eruption. 6. Explain why long term follow-up is needed for corrected ectopic eruption cases. REQUIRED READING Article:

Weinberger, S., Wright, G., “The Unpredictability of primary molar resorption following ectopic eruption of permanent molars”, Journal of Dentistry for Children, Nov-Dec, 1987. www.indiandentalacademy.com


REQUIRED READING (continued) Article:

Weinberger, S., “Correction of bilateral ectopic eruption of first permanent molars using a fixed appliance�, Pediatric Dentistry, Nov-Dec, 1992, Vol 14, No. 6

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Authors

Year of study

Country

Number Of

Children With

Ectopic Eruption

CHILDREN

NUMBER

PERCENT

Cheyne & Wessels

1947

USA

500

9

2

Young

1957

USA

1,619

52

2

O'Meara

1962

USA

315

6

2

Pulver

1968

USA

831

26

3.1

Bjerklin & Kurol

1981

Sweden

2,903

126

4.3

Mackerle-Heporauto

1981

Switzerland

543

32

6

Kimmel et al

1982

USA

5,277

250

3.8

Kurol-1986


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A ligature wire is passed through beneath the contact and then twisted tightly. www.indiandentalacademy.com


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GENERAL OBJECTIVE: Diagnose and regain the space loss. www.indiandentalacademy.com


SPECIFIC OBJECTIVES: 1. Explain how space loss occurs in the posterior region. 2. Describe indications for space regaining in regards to the magnitude of space loss. 3. Describe the differences between maxillary and mandibular arch space regaining. 4. Describe indications for tipping and bodily tooth movement to regain the space. www.indiandentalacademy.com


SPECIFIC OBJECTIVES (continued): 5. List the diagnostic aids required prior to initiating space regaining. 6. Present the maximum amount of space that can likely be regained with removable appliances and the time for the treatment. 7. Describe the most commonly used appliances for space regaining, such as: (a)

removable applicant with finger spring www.indiandentalacademy.com


SPECIFIC OBJECTIVES (continued): 7. (b)

removable appliance with jackscrew

(c)

fixed appliance with coil spring

(d)

lip bumper

REFERENCE: Proffit, Contemporary Orthodontics, 2nd ed., 1993, Chapter 13, pp. 382-387

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Thank you www.indiandentalacademy.com Leader in continuing dental education

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