The preventive orthodontics of
handicapping dentofacial
anomaly
Xi’an jiaotong univercity
stomatology
hospitalOrthodontic
Department
Zou Min
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handicapping dentofacial anomaly,in the
growth medium , because of congenital,
acquired genetic, environmental factors such
as interference, teeth, oclussion, and facial
become non-normal growth. We call these
handicapping dentofacial anomaly.
The treatment of handicapping
dentofacial anomaly
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Preventive orthodontics
Interceptive orthodontics
Corrective orthodontics
Surgical orthodontics
10%
20%
45%
Introduction
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the concept of Early treatment
In early childhood growth and development
stage(Puberty before the peak period, peak
period), the children have been shown
dentofacial deformities, abnormal trends, we
should prevent, block , correction and guide
these cause.
the concept of Early treatmen
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Target
Maintenance and create the normal growth and
development environment of Stomatognathic system
Block the negative interference dental deformities
Setting up the normal exercise of the occlusal
function of the environment
Improving the poor relationship between the
mandibular growth pattern to promote the children's
and mental health craniofacial growth and
development
the concept of Early treatment
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Methods
Maintaining the health of deciduous teeth completed
and normal function
Eliminating the bad factors of all teeth, oclussion,
facial normal growth and development
Protecting the deciduous teeth and permanent
teeth replace nomally and set up the right oclussion
the concept of Early treatment
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Content
Early prevention and preventive treatment
Interceptive orthodontics
Early maxillary growth control and
orthopedic therapy
Favorable factorsof early treatment
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It can take full advantage of potential growth, cell
metabolism active periodontal and mandibular
plasticity, and reaction force on the appliance, and
adaptable to its own advantages
Early treatment can reduce some of the complexity
of the difficulty of Dental malformations
Methods and appliance of early correction is simple
Early treatment and timely elimination of the
deformity, physical and mental health benefit to the
child.
The characteristics of early treatment
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Clinical characteristics of early treatment
Treatment time is very important
Appliance should be suitable for power
Time of treatment should not be too long
Limited orthodontics
standard of judging the successfull of
early treatment
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Primary cause is under control
Normal tooth position must have sufficient
space, and be sustainable to the end of the
replacement teeth
Whether the original mandibular
abnormalities is under control and has been
improved and continue until the end of
skeletal growth
Preventive orthodontics
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Early prevention
Importance of maternal nutrition and health
during fetal period
Infancy Sleep position
Living environment
Feeding method
Early prevention
Childhood
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Food considerable hardness, easy to digest,
nutritious chew promote the development
Maintain and treat the integrity of the deciduous
teeth in time, filling of dental caries
Timely removal of remaining teeth and deciduous
teeth eruption of anti-permanent dislocation
Treat chronic nasopharyngeal inflammation and get
rid of bad habits
Systemic disease control, education
Forces of dental in oral
Handucaooubg dentofacial anomaly
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Incisor eruption in the early clearance have
space
Lateral teeth on distal crown tilt
Mild congestion
All the beginning of the first molar may be
built on the cusp to cusp relations
All anterior deep overbite
Preventive corrective
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Abnormal shedding of deciduous teeth
Early loss of deciduous teeth
Retention of deciduous teeth
early loss of primary tooth
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Diagnosis:age xray shows that the root less
than 1\ 2 of the root.All face still covered by
bone tissue
Cause:Caries injury Iatrogenic
Deciduous dentition of the existence and
integrity, may by its promotion of mandibular
masticatory function normal growth, will
guide normal eruption of permanent teeth
Early loss of the second molar
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Performance and harm
Forward of the first molar
Arch length will be short
Elongation of the opposite tooth
Early loss of Permanent teeth
Early loss of deciduous teeth
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treat Space retainer Wire loop-type
Movable type
Lingual arch-style
the requirements of gap retainer
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It can be able to maintain much of the last
gap
It can’t not affect the development of
competent and mandibular
It didn’t stimulate oral soft and hard tissue
restore masticatory function
easy to product simple structure good
retention
Wire loop-type of space retainer
Composition 0.9mmStainless Steel Wire
Band
Indications
Advantages and disadvantages
Attention: Order for changing teeth
Lingual arch-style of space retainer
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Composition:tongue bar,palatal bar ,nance
arch
Indications
Advantages and disadvantages
Movable type of space retainer
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Composition
Indications
Advantages and disadvantages
Space access
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Features
can access 3mm space
easier in Maxillary
easy for tilt gap than the overall movement
retained primary tooth
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Cause:
Deciduous root is not a typical absorption
Deciduous molar root adhesion
Congenital absence of permanent follow-up
Eruption of permanent translocation
Diagnosis:age, constant tooth case
Stranded in the second
deciduous molars , led
thecanine crowded
Stranded under the second
deciduous molars , led to the
first premolar impacted
Abnormal eruption of permanent teeth
 early
eruption of permanent
tooth
 delayed eruption or impacted of
permanent tooth
Abnormal eruption of permanent teeth
 early
eruption of permanent
tooth
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Diagnosis：age, root formation, loosening
Cause:Periapical inflammation of deciduous
teeth destroyed Constant capsule, endocrine
diseases (most of permanent tooth early
eruption )
Treat
delayed eruption or impacted of
permanent tooth
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Diagnosis :xray show that root formation
more than 1\2, contralateral teeth of the
same name has been eruption
Cause:teeth hold place，retention of
deciduous teeth, trauma, fibroma , early loss
of deciduous molars, eruption of permanent
teeth shortfall
Treat:open up space, eruption and help to
eruption
interceptive treatment
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Deciduous or mixed dentition period is a
active period of facial growth, all the fault
of this period often indicates that the
permanent teeth growing out of disorder,
using a small force to correct jaw surface
hinder normal growth and development or
affect the normal function of the fault of
the mouth and will make it no longer
continue,this is interceptive treatment
supernumerary tooth
supernumerary tooth
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Cause:Genetic, congenital factors
Influence:
Treatment: removal as soon as possible, or
observation
Diagnosis:X-ray, shape
The gap of incicor
Early correction of crowding
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Crowding=Perimeter of the existing arch width of Permanent tooth crown-1.7or0.9x2
the forecast of permanent tooth crown width
X-ray and model
Moyers Probability table projections
Tanaka
Early correction of crowding
Cause:
Primary: teeth do not tune the volume of bone
mass :crown, and have more teeth, dental
arch stenosis
Secondary: adjacent surface caries,early loss
of deciduous teeth
Temporary
Early loss of deciduous teeth
adjacent surface caries
Earlier eruption
second molar
Stranded under the
second deciduous
molars
Treatment of crowding
Interproximal enamel
stripping
Treatment of crowding
The treatment of mild congestion 2 ~ 4mm
Severe overcrowding –serial extraction
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Concept
The early mixed dentition in a planned, stepby-step periodic extraction, block the way to
serious crowding.
General steps of serial extraction
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extraction of deciduous canine
extraction of deciduous molar
extraction of deciduous premolar
serial extraction
Ideal indication
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Skeletal type Ⅰ
Mixed dentition period, is forming the angleⅠ’
More than moderately crowded (True,
genetic )
No congenital missing teeth
The overjet and overbite of incisor is not to
large
serial extraction
Comprehensive analysis
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Periapical radiographs
Cephalometrics
Facial photos
Oral photos
Study Mode
Case Introduction
Diagnosis
Congestion measurement
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General methods
Required space=the space of 4 the required
mandibular incisor +the required space of
the canine and premolar that didn’t
erupte.
Harmful habits of oral cavity
Harmful habits of oral cavity
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The occurrence of deformity is the result of
history of bad habits, the daily frequency of
each time occlusion pressure as well as the
healthy development of the situation of
children and so on.
mouth breathing habits
Cause:
Respiratory tract obstruction
Chronic rhinitis, sinusitis
Turbinate is too long, curved
Proliferation of prostatic hyperplasia
Tonsil hypertrophy
Short upper lip
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mouth breathing habits
Mechanism and manifestations, diagnosis
Mouth breathing tongue down, mandible arch
loss support, mandible arch is narrow,
crowding or protrusion, lip muscle relaxation,
palate covered highly.
Face gland proliferation: mouth breathing
habits, nasion subsidence, dental crowding
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mouth breathing habits
Treatment:
1. remove the cause and persuasion and
education
2. remind closing mouth breathing
Vestibular shield, special masks,
3. Symptomatic: expansion dental arch,
adductor anterior,
4. Lip muscle training
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sucking habits
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Performance and harm
Sucking thumb
Sucking forefinger
Treatment
Publicity and education
Drug-coated, fingerstall
Correction wire
Harmful habits of oral cavity
Spit tongue habits: Performance
Method
 Habit of licking tongue : Performance
Method
Habit of stretch tongue: Performance
Method
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Lip biting
Performance and harm
bite upper lip
bite lower lip
Methods
Vestibular shield
Lip Bumper
Summary
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Prevention dental caries, the prevention of early loss of
deciduous teeth and permanent teeth and maintain dental arch
length, to prevent the occurrence of handicapping dentofacial
anomaly
Removal of remaining teeth and deciduous teeth , prevent
dislocation eruption of permanent teeth
Get rid of all kinds of bad oral habits, blocking the handicapping
dentofacial anomaly
Attention and observation of mixed dentition crowding
Hinder dental treatment as soon as possible, or face the
abnormal growth and development