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Treatment of class I malocclusio
Definition of class I occlusion
*Classification of class I
occlusion:
Class I occlusion can be divided in to :
-1Normal class I occlusion.
-2class I malocclusion
This defect includes :
)1Crwoding of the teeth.
)2Disecrepancy in the transverse relationship {cross bite.}
)3Over bite {deep bite or open bite}
)4localized malposition.
)5Spacing.
Etiology of malocclusion-:
)1skeletal.
)2Soft tissue factors.
)3Dental factors.
Treatment of class I malocclusion-:
)1Crowding (irregularities of the teeth):either
#Hereditary tooth size arch length discrepancy.
or
#Premature loss of the deciduous teeth.
Tilting or displaced teeth in to space created .
*The aspects can be considered in the treatment of crowding-:
a) The site of the crowding.
b) The degree of the crowding.
c) The position of the crowding.
What are the common sites of the crowding?
a) The upper arch-:
-1lateral incisors crowded labially or palataly.
-2Canines buccaly or palataly displaced
2 -3nd premolars crowded palataly.
2 -4nd or third molars buccaly.
b) The lower arch-:
-1Lateral incisors lingually.
-2Canines buccaly crowded.
2 -3nd premolar lingually.
2 -4nd and 3rd molars mesioangular or impaction.
Treatment either spontaneous correction of the crowding like
Exo. of the 4c to correct the lateral incisors .
{serial extraction}
# every 6 months .
# if not after 1 Y. can be used R.A.
For every crowded we should create a space to correct it by any
methods of creation of spaces according to the severity of the
malocclusion .
Always exo. with sever cases:
Exa: Buccaly or palattaly canine exo. 4 upper or lower
according to the position can used either R.A or F.A
Exa: 2nd premolars excluded from the arch can exo it or if the
1st premolar very badly carious can exo it and than correct the
2nd premolar either by using R.A or F.A
Mild with exo lead to residual spaces used F.A .
In a very sever crowded the exo. may lead to the spontaneous
closure of the spaces but not the irregularities. these depend on
the :
-1Position of the teeth particularly there apical position.
-2The rotation of the teeth .
Crowded in the lower arch need special mention so should be
used F.A not R.A were we need to treat the lower arch first than
the upper arch build up on it.
In general Mild crowded can
used R.A but if need bodily or
apical movement used F.A.
Late lower incisors crowding ?
This is due to the-:
))1Mesial migration of the posterior teeth due to the forces of
the occlusion.
3 ))2rd molar.
))3continue forward mandibular growth after maxillary
growth has ceased about 2 years produce a pressure by the soft
tissues.
)3Deep bite :if we have gingival trauma corrected either by-:
R.A anterior bite plan or
F.A if need correction of deep bite and angulations (inter incisor
angle) torque movement
)4Open bite :need vertical movement of the incisors only by F.A.
)5Spacing-:
a) Generalized spacing by F.A.
b) Hypodontia by F.A + crowns{ prosthetic }
C) Diastema ------ Frenectomy than F.A
d) Proclination of the teeth ------ R.A or F.A
Treatment of spacing depend on a good communication between
the orthodontist and prosthodontist as spaced closed , addition
of synthetic teeth are required.
-6Localized malposition:*Result from the abnormality of the tooth germ e.g; laterals;
canines; and 2nd premolars.
Treatment depend on the general state of the dental arch
{crowded or spacing
Why these teeth are more susceptible for displacement?
Bimaxillary Proclination:characterize by -:
)1Proclination of the upper &lower anterior teeth.
)2Class I malocclusion with normal O.J .
)3Decrease of the interincisal angle less than 105 degree.
)4Occur normally in Negroid race
Treatment of the Bimax. Very difficult & need for specialist
orthodontics ; why ?Due to the action of the tongue and a
hypotonic muscles ton with competent lip all these may lead to a
high risk of relapse.
What are the Aims of treatment of class I Malocclusion?
.1To improve esthetic of the patient.
.2To improve function of the teeth and jaws.
.3To relieve crowding & improve a good oral hygiene. that lead
to a periodonic problems and carious lesion.
Post treatment retention:this depend on the-:
)1Severity of case.
)2Type of tooth movement.
)3Type of the treatment.
Dr. Thaer Al- Khafaji