Clinical implications/ dental implant courses by Indian dental academy

CLINICAL IMPLICATIONS IN ORTHODONTICS

INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com

Clinical Implications The orthodontist would like to make some estimate of the following in each patient: • 1. Is a change in the vertical or horizontal relationship in the upper to the lower jaw indicated?

• 2. Should the lower incisor be repositioned both horizontally and vertically?

• 3. What movement of the upper incisor is required?

• 4. Should anchorage be prepared or preserved in lower arch? www.indiandentalacademy.com

• 5. Is movement or stabilization required for the upper molars?

• 6. Will the tooth movement bring about a desired esthetic result which will still be acceptable at maturity?

• 7. Will post treatment growth affect retention?

• 8. Will there be space for the third molars, given a specific treatment?

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• Every orthodontist will consider these questions before he begins treatment.

• In a typical class II div I, M.O. there are basic possibilities by which such a M.O. would be corrected They are : • The maxilla could be influenced backward by extraoral traction www.indiandentalacademy.com

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The upper teeth could be moved posteriorly, without altering the growth of the skeletal base

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The midface could be held while the lower jaw was allowed to grow forward

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The lower teeth could be moved forward on the basal mandibular body. www.indiandentalacademy.com

• In many cases, combinations of all the above may be used • The desired movement of the maxilla to correct convexity depend upon the amount of convexity that the clinician estimates will be reduced naturally with future growth • Use of headgear to produce straight profile may be undesirable, if considerable future horizontal growth of the mandible is anticipated www.indiandentalacademy.com

• In order to estimate the required movement of the upper dentition, an estimate is made for the position of the lower teeth at the end of treatment • This inturn requires an estimate of the position of the upper and lower jaws at the end of treatment which requires a long range estimate of forward growth of the mandible.

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• Quite often in borderline extraction cases, the potential eruption of 3rd molar plays a part in the decision • Recent research work; has shown that the probability of eruption of 3rd molar is a predictable function of the space between the centre of the ramus and the lower 2nd molar • This space can be predicted at the age of 8 to within 2 mm. www.indiandentalacademy.com

• An orthodontist who uses growth forecast begins with the cephalometric head film and draws up a proposed treatment plan including expected growth • In this manner, he can deliberately assess each of the previously described factors.

• If the orthodontist has specifically drawn up his objective with expected growth built into it, he is better able to determine the source of problems when progress of treatment do not go according to plan www.indiandentalacademy.com

• The principle proponents of growth forecasting notably Ricketts and holdaway have suggested that the major value of the technique is the completion of all the treatment factors • Like mechanics, growth, skeletal and soft tissue together on paper to see how they interrelate.

www.indiandentalacademy.com

www.indiandentalacademy.com Leader in continuing dental education

www.indiandentalacademy.com