METHODS OF GAINIG SPACES DIVYA SINGH.pptx
- 3. CONTENTS INTRODUCTION PROXIMAL STRIPPING PERIODONTAL CONSIDERATION EXTRACTION AS A METHOD OF GAINING SPACE DEROTATION AND PROCLINATION CONCLUSION
- 4. The correction of many malocclusions requires space in order to move teeth into molar ideal solutions. Space is required for correction of crowding , retraction of proclined teeth, levelling a steep curve of spee , derotation of anterior teeth and for correction of unstable molar relation.
- 5. SOME OF THE METHODS OF GAINING SPACE INCLUDE: Proximal stripping Expansion and Extraction Distalization Up righting of Molars Derotation of Posterior Teeth Proclination of Anteriors
- 6. Click to edit Master title style PROXIMAL STRIPPING Proximal stripping is a method by which the proximal surfaces of the teeth are sliced in order to reduced the mesio-distal width of the teeth to create space. Also called
- 8. DIAGNOSTIC AIDS FOR PROXIMAL STIPPING 1.ARCH PERIMETER ANALYSIS 2.BOLTON,S ANALYSIS 3.INTRA – ORAL PERIAPICAL RADIOGRAPHS AMOUNT OF PROXIMAL STRIPPING ADANTAGE OF PROXIMAL STRIPPING DISADVANTAGE OF PROXIMAL STRIPPING
- 9. : Carey’s analysis showing a TTM excess of 0-2.5mm Bolton’s analysis showing mild tooth material excess For correction of minimal inter arch tooth material discrepancy In lower anteriors to aid retention In cases where individual tooth size prevents class I molar relation To obtain favourable overjet or overbite : o Young patients o Patients with high caries index o Patients with enamel hypoplasia
- 10. Minimizes potential consequences of extraction such as: ⚫Difficulty incompleting space closure ⚫Need forgreater anchorage ⚫Possibilityof space re- opening ⚫Difficulty in paralleling roots next toextraction sites Drawbacks include: ⚫Roughened proximal surfaces thatatrract plaque ⚫Increased caries susceptibility ⚫Sensitivityof teeth ADVANTAGE DISADVANTAGE
- 14. PERIODONTAL CONSIDERATION OF PROXIMAL STRIPPING PROCEDURE OF PROXIMAL STRIPPING 1.USE OF METALLIC ABRASIVE STRIPS 2.SAFE SIDED CARBORUNDUM OF DIAMOND DISCS 3.LONG THIN TAPERED FISSURE BURS. FLUORIDE APPLICATION
- 16. Click to edit Master title style ⚫Non-invasive method of space gaining ⚫Undertaken in patients having constricted arch ⚫Crossbite ⚫Crowding ⚫Skeletal class III malocclusion ⚫surgical orthodontics
- 19. EXTRACTION AS A METHOD OF GAINING SPACE
- 20. • eg: peg shaped laterals, mesodens , macrodontia Need for extractio n: 1.Arch length 2.Correction of inter arch relation 3.Abnormal size and shape of teeth
- 22. INDICATIONS FOR DISTALIZATION CONTRAINDICATION FOR DISTALIZATION 1.EXTRA-ORAL METHODS 2. INTRA-ORAL METHODS SAGITTAL APPLIANCE PENDULUM APPLIANCE 1>HIGHER PENDEX 2>T-REX APPLIANCE 3>THE HIGHER PhD APPLIANCE
- 23. ⚫First tried by Kingsley using headgear ⚫Aimed at moving the molarsdistally togain spoace ⚫Ideal timing mixed dentition period priortoeruption of second permanent molars Indications ⚫Straightprofile ⚫Functional : Normal, healthy temporomandibular joint Correct maxillo-mandibularrelationship
- 24. ⚫INDICATIONS ⚫Skeletal class I skeletal relationship skeletalclosed bite brachycephalicgrowthpattern ⚫Dental Class II orend on relationship Discrepancyof 2 to 3 mm Contraindications : Class I or III malocclusion Open bite Posteriorcrowding
- 25. Extra oral: (Using headgears) Components: o Force delivering unit : face bow/ J hook o Forcegenerating unit :elasticstrap o Anchoring unit: head cap/ neck strap
- 26. It brings about bodily movement or distal tipping of the molars in a posterior direction Tipping movement is recommended in case of horizontal growth pattern and deep bites. In such cases it helps in opening the bite and also increases lower anterior facial height. Headgears allow bilateral as well as unilateral distalization. Also, amount of distalization can be controlled individually
- 27. DISTALIZATION USING INTRA-ORAL MAGNETS USE OF OPEN COIL SPRINGS TO DISTALIZE MOLAR JONES JIG THE DISTAL JET AECO APPLIANCE THE FAST BOOK APPLIANCCE TRANSPALATAL ARCH FOR DISTALIZTION USE OF FIXED FUNCTIONAL
- 28. INTRA ORAL: Sagittal appliance • Removable appliance incorporating jackscrews • Consists of a split acrylic plate joined by jackscres • Acrylic plate is sectioned in such a way that the tooth to be distalised is isolated and the rest of the arch is used for anchorage • Retained using adams clasps • Jackscrews are parallel to surface of molars • Used for individual tooth distalization
- 29. Pendulum appliance Intra-oral distalization appliance introduced by Hilgers Incorporates a modified Nance button for anchorage and a stainless steel wire The wire has a helix the distal end of which is inserted into a sleeve at the palatal aspect of the molar to be distalised Activated by opening the helices and engaging the distal ends into the sleeves Types Heliger’s pendex Heliger’PhDappliance T-rex appliance
- 31. Click to edit Master title style Jones jig Open coil spring Placed on buccal aspect; generates required force when compressed Anchorage by Nance’s palatal button and Ni-Ti wire to bring about distal movement The assembly is ligated onto d first molar to prevent rolling
- 34. Distal jet appliance: • Lingual distalization appliance • Active components are placed palatally which provide more bodily movements • Consists of bilateral piston and tube arrangement • Tube is embedded in modified acrylic • Anchorage by Nance palatal button that are bonded to bands attached to 1 or 2 premolars • A Ni-Ti spring and activation collar are placed near each tube • Activation collar is retracted distally, causing compression and thereby activation • Advantage: less distal tipping DISTAL JET ACCO
- 37. Premature loss of teeth may result in tipping of the adjacent teeth Itcan beachieved by space regainer • A tipped teeth occupies more space. • Therefore upright of teeth allows for recoveryof some space
- 38. • Rotated teeth occupy more space • De-rotation provides some amountof space • Can be brought about by space regainers and springs