*PAEDO ORTHO
INTERFACE
* the patient’s awareness of their malocclusion (the
complaint, if any);
* • their general level of dental awareness;
* • an extra-oral examination of facial form (skeletal
pattern and soft tissues);
* • general oral condition—oral hygiene and tooth
quality;
* • the presence or absence of all teeth; • the
alignment and form of each arch;
* • the teeth in occlusion.
*RECOGNITION OF
MALOCCLUSION
*AGE???
*WHAT RADIOGRAPH IS REQUIRED??
*STUDY MODELS
*PHOTOS
*1. DENTAL HEALTH COMPONENT:
* Grade 1 no need
* Grade 2 little need
* Grade 3 borderline need
* Grade 4 need
* Grade 5 great need
*ACRONYM “MOCDO”
*IOTN
*2. The Aesthetic Component uses a scale of 10
photographs showing different levels of dental
attractiveness.
*Grades 1–4 indicate little or no need for
treatment on aesthetic grounds, grades 5–7 are
borderline, and patients in grades 8–10 would
clearly benefit from orthodontic treatment
*The right time for orthodontic intervention will
vary according to the condition, but if
specialist advice is needed it is better to refer
too early than too late. Often, a good time is
as the first premolar teeth are erupting. The
majority of orthodontic treatments are carried
out in the late mixed and early permanent
dentition, but some conditions can be treated
earlier
*Timing of referral
*The term balancing extraction refers to the
contralateral tooth in the same arch. This is
usually carried out to prevent centre-line shift.
*Compensating extraction refers to the
equivalent tooth in the opposite arch. The
rationale for this is based on the assumption
that such an extraction will maintain the
occlusal relationship.
*BALANCING VS
COMPENSATING
EXTRACTION
*Serial extraction is a form of interceptive
orthodontic treatment which aims to relieve
crowding at an early stage so that the
permanent teeth can erupt into good
alignment, thus reducing or avoiding the need
for later appliance therapy. It consists of a
planned sequence of extractions.
*SERIAL EXTRACTION
*. Primary canines—extracted as the permanent
lateral incisors erupt to allow them space to
align.
*First primary molars—about 1 year later, or
when the roots of the first primary molars are
at least half resorbed, to encourage eruption
of the first premolars. In the lower arch these
often tend to erupt after the canines.
*First premolars—on eruption to make space for
the eruption of the permanent canines into
alignment
*BALANCING EXTRACTIONS ARE NECESSARY
*GREATER IN MAXILLA
*GREATER IN POSTERIOR SEGMENT
*ANTERIOR SEGMENT LEAST
*SPACE LOSS AFTER
PREMATURE PRIMARY
TOTH EXTRACTION
*AT 8.5 TO 9.5 YEARS
*COMPENSATING EXTRAXCTION IS PREFERRED IF
LOWER MOLAR IS BEING EXTRACTED. NOT FOR
MAXILLARY TEETH EXTRACTIONS
*PERMANENT FIRST
MOLAR EXTRACTION
*The effect of the thumb or fingers depends
upon the duration and method of sucking.
Classically they cause:
*• asymmetric anterior open bite;
*• increased overjet with proclined upper
incisors and retroclined lower incisors;
*• class II buccal segment relationship;
*• unilateral posterior cross-bite with
displacement
*Effects of digit
sucking
* An anterior open bite caused by a sucking habit
will usually resolve if the habit is broken early
enough and the incisors still have significant
eruption potential (<10 years) although the class II
buccal segment relationship will not.
* If the anterior open bite persists it is often because
the tongue has adapted to the open bite by
contacting the lower lip to make an anterior seal
during swallowing. This is known as an ‘adaptive
tongue position’.
*Lesions affecting
soft tissues
*Herpes simplex infection
*Varicella zoster infection
*Mumps
* Usually bilateral
* Treatment??
*Measles
* Koplik’s spots
*Viral infections
*Candidosis
* Easily removed white patches on an
erythematous or bleeding base are found
* Treatment with nystatin or miconazole is
effective
*Aphthous ulcers (major vs minor??)
*5 mm
*Treatment??
*Ulceration
*Mucocele?
*Mucocoeles are caused by trauma to minor
salivary glands or ducts and are often located
on the lower lip. They are the most common
non-infective cause of salivary gland swelling in
children
*Cysts
*Ranula
*Lesions of the jaws
* Eruption cyst
* Dentigerous cyst
* Most common jaw cyst in children
* Tooth eruption is affected
* Radicular cyst
* These cysts, which are related to the apex of a
non-vital tooth, do occur in children although they
are rare in the primary dentition. They are often
symptomless and are discovered radiographically.
Extraction, apicectomy, or conventional endodontics
will effect a cure
*Formerly known as the odontogenic
kerato-cyst, is the most aggressive of the jaw
cysts.
*Rates of recurrence of around 60% have been
reported because fragments remaining after
subtotal removal will regenerate.
*Keratinizing
odontogenic tumour
*THANK YOU