Escolar Documentos
Profissional Documentos
Cultura Documentos
1) Serial extraction:
History :
Kjellgren in 1929 used the term serial
extraction.
Nance during 1940 popularized this technique
in U.S.A. & termed it planned & progressive
extraction.
Hotz in 1970 called such a procedure Active
supervision of teeth by extraction.
Rationale : is based on two basic principle
i. Arch length- tooth material discrepancy.
ii. Physiologic tooth movement.
Indication :
1. Class-I malocclusion showing harmony
between skeletal & muscular system.
2. Arch length deficiency-following factors.
Absence of physiologic spacing.
Unilateral / bilateral premature loss of
deciduous canine with mid-line shift.
Malpositioned or impacted lateral incisors that
erupt palatally out of the arch.
Localized gingival recession in the lower
anterior region is a characteristics feature of
arch length deficiency .
Contra-indication:
Cl-II & CI-III malocclusion with skeletal
abnormalities.
Spaced dentition.
Anodontia / Oligodontia.
Open bite & Deep bite.
Middle diaestema.
Cl-I malocclusion with minimal space
deficiency.
Disadvantage :
Good clinical judgment is required. no single
approach can be universally applied.
Treatment time is prolonged over 2-3 years.
Patient cooperation is very important.
Tendency to develop tongue thrust as
extraction spaces gradually.
Extraction of buccal teeth causes deepening of
the bite.
Residual spaces can remain between the
canine & 2nd premolar.
Diagnostic procedure:
Study models.
Radiographs.
Photographs.
Procedure: Three of the popular method
area.Dewels method.
b.Tweeds method.
c.Nance method.
Dewels method
2.Space regaining:
Primary molar is lost early & space
maintainers are not used.
Reduction in arch length by mesial
movement.
Preferably undertaken at an early age prior
to the eruption of 2nd molar.
Divided into two broad groups.
a. Fixed appliances.
b. Removable appliances.
a. Fixed appliances.
i. Gerber spacer regainer.
ii. Jack screw space regainer.
iii. Open coiled space regainer.
[ Herbst space regainer ]
b. Removable appliances.
upper/ lower Hawleys appliance with helical
spring.
Hawleys appliance with spilt acrylic dumbbell spring.
Hawleys appliance with slingshot elastic.
Hawleys appliance with palatal spring.
Hawleys appliance with expansion screws.
Thumb sucking:
Presence of this habit upto 21/2-3years is
consider quite normal.
Beyond 31/2-4years of age can have a
damaging influence on the dentoalveolar
structure.
Tongue thrust: Is defined as a condition in
which the tongue makes contact with any
teeth anterior to the molar during swallowing.
Present with open bite & anterior proclination.
Intercepted by using habit breaker.
Trained & educated on the correct technique
of swallowing.
Mouth breathing :
Can be obstructive or habitual in nature.
Nasal obstructive such as nasal polyps ,nasal tumors,
chronic nasal inflammatory conditions & deviated
nasal septum.
Persistence of habitual oral breathing is an indication
to use a vestibular screen to intercept the habit.
5.Muscle exercise :
a. Exercise for the masseter muscle:
To strengthen the masseter muscle .
Clenching of teeth by the patient while counting to ten.
Repeat the exercise for some duration of time.