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Treatment of Angle class I. General...

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fg.angol A.i. general 1dia Treatment of Angle class I. General anomalies
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Page 1: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

fg.angol A.i. general 1dia

Treatment of Angle class I.General anomalies

Page 2: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Outline

• Deep bite• Open bite• Transversal anomalies Lateral cross bite, Scissor bite,

Crowding

Page 3: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Deep bite

• Dento alveolarOver eruption of incisorsLack of laterals eruption Multiple extraction

• SkeletalUsually together with Angle II/2

Page 4: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Analysis of the cephalogram

• ML-NL angle• ML-NSL angle• NL-NSL angle• Gonion angle

Page 5: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Treatment of deep bite

• Intrusion of incisors• Extrusion of molars• Appliances:Multiband or removable appliance

Utility ív

Page 6: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Treatment with fixed appliance

Deep bite (Angle II/2)

Page 7: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Passive plate with bite raising block in the front

Page 8: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Open bite

• Anterior• LateralUnilateral Bilateral

• Dento alveolarHabitual dysfunction

• SkeletalVertical development of the

mandible

Page 9: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Analysis of the cephalogram

• ML-NL angle• ML-NSL angle• NL-NSL angle• Gonion angle

Page 10: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Typical skeletal and dentoalveolar open bite

Page 11: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Treatment of open bite• Elimination of the

causes• Correction of the

vertical relation between the upper and lower jaws

• Appliances:Oral screenActivatorFixed appliance with

intermaxillary elastics

oral screen

Page 12: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

ORAL SCREEN

Page 13: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Az aktivátor

• Andresen• Häupl—funkciós

állcsontortopédia

• Merev akrilátblokk• Labiálív• Öntött kapcsok

• Aktiválás

• vertikális irányú becsiszolás

Page 14: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Dentoalveolar open bite due to habitual dysfunction Treatment with tongue cribs

Tongue trust swallowing

Page 15: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Treatment of the open bite with fixed appliance

Page 16: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Treatment of the open bite with fixed appliance

Tongue trust swallowing

Utility arch

Page 17: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Transversal anomalies Lateral cross bite

• Unilateral• Bilateral• Dentoalveolar• Skeletal

Lateral scissorsLateral cross bite

Page 18: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Analysis of the model

• Measurement of the indexes

• Analysis of the relation between the apical and the coronal base

Pont- and the Schmuth- index

Page 19: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Treatment alternatives of lateral cross bite

• In the deciduas dentition grinding and functional training (bite exercise)

• Functional appliance with screw

• Frankel I • Active plate• Quad-helix• Hyrax screw

Page 20: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Hasund-féle Hansa készülék:

• --felső lemezrész tágító csavarral, torqueáló-rugóval, Adams-kapoccsal

• Alsó lemezke • -- speciális rugóval,• -- ajakráccsal

Page 21: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

• --Buccális pajzs• --pelották• --transzpalatinális ív• --segédrugók

• Periosteum viszkoelasztikus elhúzódása

Frankel appliance

Page 22: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Upper and lower active plates

Page 23: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Unilateral cross biteforced bite

Page 24: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Transversal widening

Page 25: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Treatment of scissors bite

• Closing the upper arch• Expanding the lower

arch• Appliances: multiband,

activator (with screw) active plate

Page 26: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Transversal anomalies Crowding

• Primer: Size of tooth arch Size of teeth • Secounder: Early deciduous extraction and its

consequence • Tertier: Eruption of the wisdom

Page 27: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Crowding

• Primary ⇐ Jaw size ⇒ Tooth dimension• Secondary ⇐ Early extraction of deciduous• Tertiary ⇐ Third molar

Page 28: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Treatment of crowding

• Prevention• Space creation

Transversal and or sagittal widening (help: Pont index )

• Tooth material reduction

extraction or stripping of enamel(help: Bolton analysis)

Stripping of enamel

Hyrax

Page 29: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Treatment of crowding

• Prevention• Provision of space

Pont index sagittal and or transversal expansion)

• Reduction of tooth material (extraction

stripping)

Page 30: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Non extraction treatment

• Crowding• Large scale deep bite• (Angle II/1.)

Page 31: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics
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persistant decidous

Page 33: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics
Page 34: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

After the treatment

Page 35: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

After the treatment

Page 36: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

Extraction treatment• Consideration : Expansion ⇔ extraction • The measure of the narrow: 0-5mm, 5-

10mm, 10-• Consideration of the protrusion• Consideration of the vertical relation

Page 37: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

systemic extraction

• Extraction of deciduous canines

• Extraction of first deciduous molars

• Extraction of first premolar

Page 38: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics
Page 39: Treatment of Angle class I. General anomaliessemmelweis.hu/gyermekfogaszat/files/2012/10/Orthodontics-3.-Dr.-Fábián-dia.pdfActivator Fixed appliance with intermaxillary elastics

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