Orthodontic treatment MALOCCLUSION is a manifestation of genetic and environmental interaction on the development of the orofacial region GOALS OF TREATMENT: -Ideal functional occlusion -Ideal soft tissue proportions and adaptation -Ideal jaw, skeletal and dental relationship Ideal occlusion ncorrect relationship of molars ncorrect overjet and overbite ncorrect angulation,inclination of teeth nno rotated teeth nno spacing nflat plane of occlusion n postaveni zubu Objectives of orthodontic treatment nAesthetics nTreatment of impacted teeth nPrevention of dental injuries nBefore prosthetic treatment nDecay prevention nPrevention and treatment of chewing malfunction and jaw joint disorders n n Methods of orthodontic treatment nOrthodontics movement of teeth nOrthopedic movement – effects of growth nMyofunctional therapy nSerial extraction, controlled extraction nOrtho – prosthetic treatment nOrtho – surgical treatment Orthodontic treatment n1. Orthodontic treatment by infants n - clefts n - syndromes and defects that complicate nutrition and breathing n nWe use - individual removable plates n n Orthodontic treatment n2. Deciduous teeth n nWe treat - bite defects n inverted bite n cross bite n - bad habits nWe use – removable appliances n n C:\Users\User\Desktop\DSC_6576.JPG Orthodontic treatment n3. 6-9 years [ 1. phase of mixed dentition] n nThe best time for treatment : n - cross bite n - inverted bite n - impacted incisors n - diastema more than 3 mm n - big primary crowding n nWe use : removable appliances n small fixed appliances n face mask for inverted bite by class III Face mask Orthodontic treatment n 4. 9-12 year [second phase of mixed dentition] n -Large forming ability of the tissues -We can use and influence the growth -Growth mandible from the joints n nWe treat: - previous untreated anomalies n - crowding n - Angle class II – div. 1 and 2 n - overjet more than 5 mm n - deep bite n - movements teeth after the early loss of teeth and anodontia n - Controlled tooth eruption n - Suspected retention of canines, premolars n nThe best time for functional appliances n - removable appliances - - Small fixed appliances - - Headgear appliance - n n n headgear n Orthodontic treatment n5. Permanent teeth n nWe treat: -All anomalies, previous untreated anomalies, -Angle class III -Crowding -Open bite, deep bite -Impacted tooth -Skeletal anomalies - nAdult therapy – periodontics problems, preprosthetic therapy n - problems with TMJ n - bruxism n nWe use : fixed appliances n extraction n surgical treatment by big skeletal anomalies - - n Othodontic treatment nRemovable appliances: 1.Active 2.Passive 3.Functional n Therapy of ortodontical anomalies nConservativ northodontical appliances : n removable n fixed n nSurgical nextraction of teeth nsurgical expositions of crowns of retined tooth nsurgical movements of maxila, mandible nActive removable appliances n n-Treatment of anomalous position of teeth [inclination, rotation of incisors] n-Treatment the dental arch shape n -Individual resin plates -Active elements : springs, screws, wire bows Removable active appliances P1250006 P1250008 P1250009 P1250007 Removable appliances - active n C:\Users\User\Desktop\DSC_6585.JPG Functional appliances nmodifiyng extent and direction of orofacial growth nexploit muscular activity and soft tissue stretch to stimulate dental and bone n changes noperates at the time of maximum growth of orofacial region = 9-12 years old children nWe need construction bite nType of functional appliances : n Bionator, Klampt, Maxilator – class II and open bite n Fränkel appliance – class III Removable functional appliances P1250001 P1250005 P1250004 P1250003 Functional appliances-Maxilator n C:\Users\User\Desktop\DSC_6572.JPG C:\Users\User\Desktop\DSC_6573.JPG Functional appliances – Frankel n C:\Users\User\Desktop\DSC_6574.JPG C:\Users\User\Desktop\DSC_6575.JPG Functional appliances - Klampt n C:\Users\User\Desktop\DSC_6578.JPG Functional appliances - Bionator n C:\Users\User\Desktop\DSC_6582.JPG C:\Users\User\Desktop\DSC_6583.JPG Removable appliances-passive n C:\Users\User\Desktop\DSC_6580.JPG Fixed appliances -History multiband%20appliance%20po%20uprave%202 nidcr1 multiband%20appliance%20po%20uprave%202 nidcr1 Orthodontics brackets n Stainless steel brackets n n n n n n nAdvantages Disadvantages: n - strong, do not crack - Aesthetic - smooth, low profile - recyclable - low friction - price kovove_zamky_151940 rovnatka42 rovnatka39 rovnatka41 Stainless steel brackets metal bra Orthodontics brackets nCeramic brackets n n n n n n n n n n nAdvantages: Disadvantages: n - Aesthetics - repeated bonding problem - robust - crack - higher friction (avoid metal slot) - price srovnani rovnatka lr_keramicke_zamky_toothc Ceramic brackets srovnani rovnatka mouth Orthodontics brackets nSapphire brackets n n n n n n n n n n n nAdvantages Disadvantages: n- aesthetic - repeated bonding problem - robust - crack - higher friction (avoid metal slot) - price mouth Radiance1 Orthodontics brackets nGold-coated brackets n n n n n n n n n n nAdvantages: Disadvantages: n- suitable for allergy sufferers - price - strong, do not crack - smooth, low profile - recyclable - Low friction - Aesthetics gold-braces lr_kovove_zamky_goldbrac n zlato fr zlato l zlato p Orthodontics brackets nSelfligating brackets – metal and ceramic n n n n n n nAdvantages: Disadvantages: n - not suitable for all - minimum friction types of defects - low power - faster treatment n - Fewer office visits DSC_5636 str 7_4 Selfligating stainless steel brackets DSC_5636 Orthodontics brackets nLingual brackets – 2D,3D n n n n n n n n n nAdvantages: Disadvantages: n- Aesthetics - unsuitable for all types of defects - Difficulty hygiene - (patient discomfort) image_lingual-brackets Janačková nasaz P2 pospisilova prub P3 Lingual bracket Janačková nasaz P2 pospisilova prub P3 Žáková Jitka P2 Žáková ling Cizkova zac P1 Cizkova prub P2 Orthodontics brackets nDecorative brackets n WildSmileBrackets closeup C:\Users\brysova\Desktop\il plocha.png neviditelná rovnátka Invisalign http://cdn-img.health.com/sites/default/files/wp_migrated_images/9df14376_invisalign-2.xxxlarge_2x. jpg Fixed lingual retainer retainer nDirect bonding n1.cleaning 2. etching n n3.rinse 4. drying > > > > nDirect bonding n5. primer 6. bonding n n n n n7. remove excess 8. light or chemically cured n > > > DSC_0026 Indirect bonding neprime lepeni Case 1 : vestibular eruption 11, crowding, supernumerary 11 Case 1 : vestibular eruption 11, crowding, supernumerary 11 Case 1 : vestibular eruption 11, crowding, supernumerary 11 Case 1 : vestibular eruption 11, crowding, supernumerary 11 - Treatment nTreatment time – 11 months Case 1 : vestibular eruption 11, crowding, supernumerary 11 - Treatment Case 2 : retention 11,21 , crowding, supernumerary 11, 21 Case 2 : retention 11,21 , crowding, supernumerary 11, 21 _ERM_K_TELE_RTG Case 2 : retention 11,21 , crowding, supernumerary 11, 21 _ERM_K_PAVEL_CT3 _ERM_K_PAVEL_CT4 _ERM_K_PAVEL_CT6 _ERM_K_PAVEL_SSD4 Čerm sk1 _ERM_K_PAVEL_4D2 Case 2 : retention 11,21 , crowding, supernumerary 11, 21 CBCT 10 09 11 Case 2 : retention 11,21 , crowding, supernumerary 11, 21 Treatment - Extraction of the supernumerary 11,12 DSC_6109 Case 2 : retention 11,21 , crowding, supernumerary 11, 21 Treatment Case 2 : retention 11,21 , crowding, supernumerary 11, 21 Treatment DSC_6106 DSC_6085 – kopie DSC_6085 Case 2 : retention 11,21 , crowding, supernumerary 11, 21 After Treatment nTreatment time 16 months DSC_6108 DSC_6106 Case 2 : retention 11,21 , crowding, supernumerary 11, 21 Hlo z p hlo p Hlo l Case 3 : Crowding, deep bite hlo po pred Hlo z po p Hlo po z l Case 3 : Crowding, deep bite After Treatment with a fixed orthodontic appliance Treatment time – 1,5 years cun pred cun p cun l Case 4 : Crowding, inverted bite, vestibular eruption 13 cun po z cunpo z p cun po z l Case 4 : Crowding, inverted bite, vestibular eruption 13 Treatment – fixed appliance - expansion, leveling, bite correction Treatment time – 1,8 years lli11 li8 li9 li13 li 12 Case 5 : retention 25, no space for 25 eruption Treatment – fixed appliance - expansion, open space for 25 leveling li6 li 4 li 5 Case 5 : retention 25, no space for 25 eruption Treatment – fixed appliance - expansion, open space for 25 leveling Treatment time – 2 years 3 1 9 4 20 19 Case 6 : retention 23, no space for 23 eruption, crowding Treatment – fixed appliance - expansion, open space for 23, leveling Treatment time – 2 years kol 1 kolm kol2 14 12 11 10 Case 7 : retention 13,23, no space for 13,23 eruption, crowding Treatment – fixed appliance – extraction 14,24,34 44, leveling, bite correction Treatment time – 2 years Orthodontic – surgery treatment - by skeletal Class III. case Before treatment After treatment Lingual appliance 2D – crowding treatment Cizk zac P1 Ciz prub P2 n n n n n n n n n n n n n n n n ciz posej P3 ret AN zač1 AN prub AN pos 2