ABHIJITH B
Final Year Part 1
Roll No:1
Occlusion is the relationship of the maxillary and mandibular teeth when the
jaws are in a fully closed position.
Classification of teeth :-
• Class I (normal occlusion)
• Class I malocclusion
• Class II malocclusion
• Class III malocclusion
*Prevalence of malocclusion :-
Class I normal occlusion: 30%
Class I malocclusion: 50-55%
Class II malocclusion: 15%
Class III malocclusion < 1%
More class II in whites and more class
III in Asians.
Class III and open bite are more
frequent in African than European
populations
1. Developmental
causes
-The : encountered developmental disturbances are:
most
-Congenitally missing teeth.
-Malformed teeth.
-Supernumerary teeth.
-Impacted teeth.
-Ectopic eruption.
2- Genetic causes :-
Genetics play major role for malocclusion when there is discrepancy between
size of the jaws & size of teeth.
3. Environmental causes:
It is caused by injures which has two types:-
1. Birth Injures:
It comes under two major categories:
Fetal molding (when a limb of the fetus presses another part leading to distortion of that
part ).
Traumaduring birth from usage of forceps .
2-Injures throughout life :
Trauma to teeth can lead to development of malocclusion in three ways:
Damage to permanent tooth budwhenprimary tooth is traumatized.
Premature loss of primary teeth leading to permanent tooth movement.
Direct injury to permanent teeth.
Note :- both dental and skeletal factors are incorporated in class 1
malocclusion.
*Comparison of Mesiodistal Tooth Width between Normal Occlusion
and Malocclusion :-
In the malocclusion group the mesiodistal tooth width of the upper and lower central
incisors, lower left lateral incisor, and lower first molars were significantly higher than in
Bimaxillary proclination
Increased incisal angle
Spacing between teeth
Normal molar and canine
relationship
Steep mandibular plane angles
SKELETAL FEATURES:
Harmonious face
Straight to convex
profile
Nothing really abnormal
* Diagnosis :-
-History
-Clinical examination
-Study models
-
Radiograph
y -OPG
-Periapical
radiographs
• Crowding: the most significant contributor to malocclusion
• Vertical problems: open bites ordeep bites
• Transverse problem: relatively rare.
** SPACING :-
1-Generalized:
Eliminate the cause.
2-Microdontia
-Eliminate spaces between anteriors,leaving a space between canine and 1st
premolar
-Prosthesis
3-Spacing with proclination:
Labial bow
Elastics with fixed or removable appliance.
Localized spacing with
proclination:-
Labial bow with finger
spring :-
-Eliminate cause i.e. high labial frenum
attachment.
-Removable appliances:-
#Finger spring.
#Finger spring with
labial bow.
#Split labial bow.
-Fixed appliances:
Pin and tube appliance.
Analyze space discrepancy using model analysis.
Treatment is planned on the amount of space required.
Mild Crowding:
If the space discrepancy is up to
4mm: usually resolves without
extraction.
Proximal stripping
Alignment of teeth by labial bow, finger
spring. Moderate crowding:
If space discrepancy is in the range of 5-9mm, treated without
extractions by :-
-Arch expansion
-Molar anchorage or
-Enamel reduction.
Severe crowding :
*Patients with space discrepancy of 10 mm or
more: Extract all 1st premolars
Retract canine by canine retractor
Align anteriors by labial bow
ANTERIOR :-
-Z-spring with posterior bite plane.
-Expansion screw with posterior bite
plane.
*POSTERIOR :
--Single tooth:
Cross-elastics
-Unilateral:
Unilateral expansion screw
Functional appliance
-Bilateral:
# Maxillary expansion is done to relieve cross bite by:
# Coffin spring
Quadhelix appliance :-
A patient with his upper right lateral incisor and upper left central incisor
in crossbite. B, The lingual
inclination of the teeth in crossbite-a favorable condition. C and D, A
fixed appliance in the upper arch and a removable
acrylic posterior bite block in the lower arch that opened the bite enough
to
easily move the teeth forward out of
crossbite. E and F, The occlusion and upper arch after removal of the
appliances.
ANTERIOR:
◦ Eliminate habit
Thumb sucking
Tongue thrust
Mouth breathing
◦ Skeletal openbite
i. during mixed dentition:
Frankel IV or chin cap with high pull headgear
ii. In permanent dentition,before puberty
Fixed appliance with box elastics
iii. In permanent dentition after puberty:
Surgery
◦ If due to supra-erupted posteriors:
Posterior segmental osteotomy
Single
Tooth:
Removable Appliance:
Couple force by flapper spring/ double cantilever spring and
labial bow
Semi-fixed Appliance:
Whip spring
High labial bow with soldered ‘T’ spring
Multiple rotations:
Treated by fixed appliance
Overcorrection is done and retention is given for
atleast 1 year….
High Labial
bow
T
spring
Extract all 1st premolars, or 1st molars.
Treatment depends on angulation of
canine:
Distally inclined canine:
Retract canine and align incisors using retainers
Mesially inclined canine:
Fixed appliance
THANK YOU
