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