William proffit, Graber vanarsdall

CONTENTS
o What is adult orthodontics?
o Why increased interest of adults in orthodontics?
o Goals of adult orthodontic treatment.
o Principles considerations in adult orthodontics.
o Treatment procedure for adult orthodontics.
WHAT IS ADULT ORTHODONTICS
When orthodontic treatment is carried out in adults
it is known as adult orthodontics.
Adult orthodontic treatment usually requires
adjunctive orthodontic procedure which by definition
is tooth movement carried out to facilitate other
dental procedures necessary to control disease,
restore function and/or enhance appearance.
Adults can be divided into 2 groups.
Younger adults Older adults
( 20- early 40’s) (30 -60’s)
Why increased interest in adult
orthodontics.
 Availability of cosmetic appliance.
Better management of joint dysfunction.
Advanced orthodontic surgical techniques.
Increased desire of patients for treatment of dental
mutilation.
Increased awareness
Development of technology - Implants, cu- NiTi
wires
Increase in longetivity of life.
How adult orthodontic is different
from adolescent treatment?
 To attain Andrews 6 keys is not always the objective
Cases may not require full arch bonding
Psychological considerations – concerns like
improvement in personal/ professional life.
Keep in consideration periodontal disease
Diagnose TMJ dysfunction
May require surgical management
A team effort is required for achieving desired results.
GOALS OF ADULT ORTHODONTIC
TREATMENT
So the goals of adult orthodontic treatment are :-
1. Aesthetics
2. Function
3. Stability of abutment teeth
4. Favourable distribution of forces – periodontally
compromised – group function occlusion
5. Favourable distribution of teeth
6. Improved crown to root ratio
7. Improved self maintainance of periodontal health
PRINCIPLES OF ADJUNCTIVE
TREATMENT/ADULT
ORTHODONTIC RX
Diagnostic and treatment planning consideration
1. Periapical’s of specific area might be needed
2. Articulator mounted casts might be needed
3. Lateral cephalograms may not be compulsory.
Biomechanical considerations :-
Appliance selection:
 0.022 slot P.E.A. recommended.
 esthetic appliances – ceramic brackets, clear aligner
therapy, lingual brackets.
 Effect of Reduced Periodontal support :-
 Adult patients have – bone loss – longer crown
shorter root – force should be reduced (lighter forces)
Timing & sequence of treatment

 CONTROL ACTIVE CARIES / PDL DISEASE.

TREATMENT PROCEDURES :-
 UPRIGHTING POSTERIOR TEETH :
CROSSBITE CORRECTION :
FORCED ERUPTION OF ROOTS FOR POST & CORE
OR TO INCREASE CROWN LENGTH
ALIGNMENT OF CROWDED TEETH
 ANTERIOR DIASTEMA CLOSURE & SPACE
REDISTRIBUTION.
ADULT CASES
BEING TREATED
IN OUR
DEPARTMENT
SYNDROMIC PATIENTS
MISSING TEETH
SKELETAL CLASS III-SURGICAL
RETAINED DECIDOUS/OPENBITE
MIDLINE DIASTEMA
CROWDING
SURGICAL-MUTILATED DENTITION
ANOMALIES IN TOOTHFORMATION
IMPACTED TEETH
MICRODONTIA
PERIODONTALLY COMPROMISED