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Interceptive
Corrective
Preventive
Interceptive
orthodontics
Definitions
Steps in interceptive orthodontics
Serial extraction
Muscle exercises
Removal of soft / hard tissue barriers
Management of ectopic eruption
Management of missing permanent teeth
Resolution of crowding

CONTENTS
CONTENTS
Correction of midline diastema
Correction of developing crossbite
Functional appliances
Orthopedic appliances
Maxillary intrusive splint
Pre orthodontic trainer
Bent wire system
Invisalign
Conclusion
References.
DEFINITION - AAO (1969)


That phase of the science & art of orthodontics
employed to recognize & eliminate potential
irregularities & malpositions in the developing
dentofacial complex.




Interceptive orthodontics basically refers to
measures undertaken to prevent a potential
malocclusion from progressing into a more severe
One.

Is undertaken at a time when the malocclusion has
already developed or still developing.

Procedures, are aimed at elimination of factors,
that may lead to malocclusion.
Serial extraction
Dev. Cross bite
Abnormal habits
Space regaining
Muscle exercises
Removal of barrier-
eruption
Interception of
skeletal
malrelation
SERIAL EXTRACTION
Historical review-
Kjellgren (1929) : Serial extraction
Hotz (1970) : Guidance of eruption
Palsson & Bunon: (1743) first ref to the extraction
of deci teeth (Publication- Diseases of Teeth)
Nance (1940) : popularized the technique
Father of serial extraction
SERIAL EXTRACTION
DEFINITION:
Dewel (1967) : orderly removal of selected primary
& permanent teeth in predetermined sequence

-Tweed : planned & sequential removal of primary
& permanent teeth to intercept & reduce dental
crowding problems

I: On the basis of hereditary determined tooth
size arch length discrepancy:

Midline line shift of
mandibular Incisor
premature exfoliation
of pri C

INDICATIONS
2. Gingival recession on a
labially displaced
incisor.





3. Crowded maxillary or
mandibular teeth that
are excessively
inclined labially.

4. Labially but unerupted
permanent canine that are
extremely prominent.







5. Splayed out perm Max /
Mandi Incisor due to crowded
position of unerupted canines


6. Unusual shape, size and no of teeth.

7. Ectopic eruption of maxillary 1st molar

8. Premature loss of primary canine

9. Abnormal / pathological root resorption of primary canine.

10. Crowded anteriors
1. Unusual resorption
pattern of certain
primary teeth.







2. Aberrant eruption
pattern of perm teeth
II : Indications due to loss of
arch length :
3. Prolonged
retention of
primary teeth /
ankylosis







4. Transposition

5. Rotation of teeth









6. Suppression of primary
teeth


CONTRAINDICATIONS
1. Skeletal Class II and Class III malformation.
2. Spaced dentitions
3. Anodontia / oligodontia
4. Open bite & deep bite
5. Midline diastema
6. Class I malocclusions with minimal space def.
7. Unerupted malformed teeth Eg: dilacerations
8. Mild disproportions b /w arch length & tooth material
that can be treated by proximal stripping.
DIAGNOSTIC RECORDS
Intra oral radiographs:
Panoramic radiograph
Cephalometric radiographs:
Facial Photographs:
Study models
Model analysis
IOPA radiographs:



Detection of congenital absences of teeth.
Detection of supernumerary teeth
Calculations of total space analysis.
Determine the root resorption before & after treatment.
Determine size, shape, relative position of perm teeth.
Detection of pathologic conditions in the early stages
Eruptive patterns of the unerupted teeth


Cephalometric radiographs:


Evaluation of craniofacial relationship before treatment

Assessment of soft tissue matrix.

Classification of facial patterns.

Calculation of tooth size / jaw- size discrepancies.

Prediction of growth & development

Detection pathologic conditions before, during and after treatment.

Determination of mandibular rest positions

Facial photographs

Evaluation of craniofacial (&dental) relationships& proportions
before treatment.

Assessment of soft tissue profile.

Proportional facial analysis & Total space analysis

Monitoring treatment progress.

Study relationships before, immediately following & several years
treatment.

Detecting & recording facial asymmetry.

Identifying patients
Intra oral photographs
1. Total space analysis.
2. Dental anatomy.
3. The intercuspation.
4. Arch form.
5. Curves of occlusion
6. Measure progress during
treatment
7. Evaluate occlusion
ABO specifications: Study models:

Space analysis:
Conventional method
Space required-four mandibular incisors were measured at MD crown
diameter by means of boley gauge.
The values for unerupted canine and premolars were obtained by
measuring their MD on the image on the periapical radiograph.
To reduce the radiographic enlargement the formula recommended
by Huckaba is.
(y)(x')
X= y
X-is the estimated size of the permanent tooth.
X the radiographic size of the permanent teeth.
Y-is the size of the primary second molar on the cast.
Y-is the radiographic size of the primary molar.
Space required MD width of mandibular incisors on
the cast and canine and premolar on the radiograph
were added.

Space available-obtained by extending brass wire
from the mesiobuccal of the first permanent molar
on one side to mesiobuccal of the molar on the
opposite side.

The difference in the value obtained for space
required and space available was the amount of the
discrepancy.
ADVANTAGES OF SERIAL
EXTRACTION
Removal of deciduous canines.
Extraction of deciduous 1
st
molar.
Extraction of first premolar before crowding allows
It lessens the period of future appliance therapy and
cost of treatment.
ADVERSE EFFECTS
First (Dewel-1967), tendency of developing
anterior deep bite following loss of posterior teeth.


Second side effect is failure of premolars to reach their normal
occlusal level.
Third : Effect of Serial Extraction has on facial esthetics.
The over emphasis on straight profile..
Lip fullness is not a reliable criterion
The straight profile must be viewed with greater concern
because early removal of premolars
Fourth : Nasal development is another unpredictable hazard

Unrestrained extraction will accentuate nose prominence
by reducing skeletal development in dental area.

Moreover growth of chin is unpredictable. If growth in nose
and chin exceeds normal range a concave profile is
obtained.
Most common & accepted
sequences:-
1. Tweeds method
2. Dewels methd
3. Nances method
4. Grewes method
Dewels Method: 1978 (CD4)

There are 3 stages in Serial Extraction Therapy:
Removal of deciduous canines:
Removal of first deciduous molars:
Removal of erupting premolars:


REMOVAL OF DECIDUOUS
CANINES
Extraction 8-9 yrs.
Removal of primary 1
st
molars
REMOVAL OF ERUPTING
PREMOLARS
TWEEDS SEQUENCE OF
EXTRACTION (1966)
Sequence is :DC4
At approx 8 years all deci 1st molars are extracted.
Deciduous canines maintained to retard eruption of
permanent canines.
1st premolar in advanced eruptive stage- crown above alv
bone.
Deciduous canines along with first premolar are extracted
Treatment procedure in class
I malocclusion
Group A - Anterior discrepancy : crowding
Group B - Anterior discrepancy : Alveolodental protrusion
Group C - Middle discrepancy : impacted canine
Group D - Enucleation in mandible
Group E - Enucleation in mandible & maxilla
Group F - Alternative to enucleation
Group G - Interproximal stripping
Group H- congenital absence
Closure of Residual Xn spaces
Improvement in axial inclination
Correction of rotation
Correction of Midline discrepancy
Correction of residual overbite and overjet
Correction of cross bites
Improvement in arch form
Advantages of
mechanotherapy
MUSCLE EXERCISES
The dental tissues are blanketed from all directions
by the muscles

Normal occlusal development depends on normal
oro-facial muscle function.

Muscle exercises helps in improving aberrant muscle
function.
1. Exercise for the masseter muscle:

2. Exercise for the lips:
Stretching of upper lip to maintain lip seal for
short hypotonic lips
Holding a piece of paper between lips
Holding and pumping of water back and forth
behind the lips.
Massaging of lips
Scotch tape
Button pull exercise:
3. Exercise for the pterygoid muscles:

4. Exercise for the tongue: (5/16 inch intra oral elastic)

One elastic swallow:

Tongue hold exercise:

Two elastic swallow:

The hold pull exercise: tongue tie exercise
Limitation of muscle
exercises
Does not drastically alter any growth pattern
Are not substitute for corrective orthodontic
treatment
Pt compliance is extremely important
Retained deciduous teeth
Supernumerary teeth
Fibrous/ Bony obstruction of the erupting
tooth bud
Impacted teeth

REMOVAL OF SOFT /HARD TISSUE
BARRIERS IN THE PATHWAY OF
ERUPTION
ECTOPIC ERUPTION
Lateral incisors crowding..aberrant tooth positioning
Lingual arch with spur to.
Already midline shift. BALANCED EXTRACTION
Prevalence 2-3%
Maxi
Boys
2/3
rd
of.
ECTOPIC ERUPTION OF 1
ST
PERM
MOLAR
waitful watching

3-6 month
pulpo..SS crown on 2
nd
molar
supplemented with band material
extending subgingivally
Difficult to do
Orthodontic elastic separators Replacement at 1-2wks..2mnths
Brass ligature wire Periodic tightening 3-5 day interval
Safety pin spring Gentle forc exrted, distally helps..
Humphrey appliance-S shaped loop
-helical springs
Continual forc, easy reactivation,
bonded composite to engage..
Halterman appliance Elastomeric chain, changed
monthly
Removal of 2
nd
primary molar extensive resorption..distal shoe;
regain space
Management: arch length, adjacent tooth morphology and
colour,incisor position and esthetics

MISSING PERMANENT TEETH
Congenitally missing LATERAL
INCISOR
Canine erupts normally
resin bonded bridge,
conventional bridge or implant
Canine erupts in lat incisor position moved backbridge or implant

Substitution of canine with lateral
incisor
recontouring to improve
esthetics
Congenitally missing LI transplanted posterior
teeth..premolarsreshaping
Congenitally missing PREMOLAR
substitute primary molar
ankylosis and root
resorptionexn
primary molar removed space closed ortho
resin bonded bridge,
conventional bridge or implant
Resolution of crowding
Anterior segment- incisal liability
Posterior segment- leeway space of nance


Management:

1. Observation
2. Disking of primary teeth-hand held strip, tapered bur in a high
speed handpiece
3. Extractions and serialextraction
4. Corrective orthodontic referral
MAXILLARY MIDLINE
DIASTEMAS
Frenum Attachments Diastema should be closed first..
Scarred tissue.
Supernumerary teeth Removal without causing injury to
perm teeth..
Early removal..erupt normally..space
closes spontaneously
Faciolingual positioning Active labial bow.. Acrylic removed
from palatal side.. 2mm/mnth
Very protrusive Fixed orthodontic
appliances..rectangular arch wires
Faulty mesiodistal positioning (tipping)Finger spring appliance..
2mm/mnth
Shud not take more than 2 mnths.
(bodily) bonded brackets with
elastomeric chain
Correction of developing
Anterior and Posterior Cross
Bites
Eliminates functional shifts and wear on the erupted permanent teeth
Dentoalveolar asymmetry
Increases circumference and provides more room for permanent teeth
ANTERIOR CROSSBITES
tongue blade therapy/ popsicle
stick therapy
20 times before each meal,pt
counting to 5 each time..shud b done
several times, at certain periods of d
day
Anterior inclined plane 45degree to the long axis of lower inci
1/4
th
inch post.. bite jumping wthn 1
week.. results wthn 2 wks
Doubl helical spring- activated 2 mm to provide 1 mm of
tooth movmnt per month
Mild rotation..
POSTERIOR CROSSBITES
Cross arch elastics


Isolated molars in 4-8 weeks
Fixed palatal wire designs
W arch
Quad helix
Slow expansion
4-5 mm of buccal expansion in 4-6
wks..left behind for 3 months
Fixed jackscrew expanders
HYRAX, RPE
1-2 turns per day for 4 weeks(1
turn=0.25mm)
INTERCEPTION OF
SKELETAL
MALOCCLUSION
Skeletal class II mal due to max
prognathism
Restricted max growth using
headgears
Skeletal class II mal due to mand
retrognathism
Myofunctional appliance to promote
mand growth
Skeletal class II due to mand
retrognathism & max prognathism
Myofunctional appliances to promote
mand growth & headgear to restrict
max growth
Sk class III due to mand prognathism Chincup therapy to restrict mand
growth
Sk class III due to max retrognathism Myofunctional appliance to promote
max growth & face mask therapy
Sk class III due to max retrognathism
& mand prognathism
Face mask therapy & chin cup to
restrict max growth
FUNCTIONAL APPLIANCES
Myofunctional appliances - harness the muscle
pressure



Functional appliances- elicit certain natural
functions of the orofacial region
Functional appliances are conceptually based
on Moss functional matrix theory

Form follows function
BACKGROUND
These appliances either transmit, eliminate or
guide the natural forces of the masculature.

Are used for growth modification procedures that
are aimed at intercepting and treating jaw
discrepancies
They bring about following changes:
An increase or decrease in jaw size.
A change in spatial relationship of the jaws
Change in direction of growth of the jaws
Acceleration of desirable growth
classifications
I) Tom Graber, when functionals were removable:
Group A- teeth supported appliances eg.
Catalans, inclined planes, etc.

Group b- teeth/tissues supported appliances.
Eg. Activator, bionator, etc.

Group c- vestibular positioned appliances.
With isolated support from tooth / tissue eg. Oral
Screens, frankel, lip bumpers.
classification
II) With the advent of fixed functionals another classification
evolved:
A)Removable functionals eg. Activator, Frankel etc.
B)semi fixed functionals eg. Den holtz, Bass appliances.
C)fixed functionals eg. Herbst, Jasper jumper, MARA, etc.
classification
III) With the awareness & acceptance of the concept of
hybridism by Peter Vig, functionals could be further
classified as
A)classic functional appliances like
Activator, Catalans, Frankel etc.

B)hybrid appliances like Propulsor, Double Oral
screen, Hybrid bionators, bass appliance.
classification
IV)
1) Tooth borne passive appliances- myotonic appliances
Eg. Andresen/Haupl activator, Herren activator, Woodside activator
Balters bionator etc.
2) Tooth borne active appliances- myodynamic appliances
Eg. Elastic open activator (EOA), Bimler appliances, Modified bionator,
Stockfish appliances, Kinetor,etc.
3) Tissue borne passive appliances.
Eg. Oral screens, Lip plumpers
4) Tissue borne active appliances
Eg. Frankels appliances
5) Functional orthopedic magnetic appliances (FOMA)
ORAL SCREEN (NEWELL
1912)
MODE OF ACTION
both the principles of force application n elimination
Indications :
Interception of habits like
Correction of mild disto-occlusion
Muscle exercises for correction of hypotonic lip & cheek
muscles.
Correction of mild anterior proclination.

Fabrication :
Impression
Sealing of cast in occlusion
Covering of labial surfaces of teeth & alveolar process with
wax of 2-3mm thickness.
Fabrication of appliance with self cure or heat cure resin.

Patient is asked to wear the appliance in the night & 2-3 hrs
during the day time.
Seen about once every 3 weeks or a month
Modification of vestibular
screen
1. Hotz modification- metal ring- muscle
exercises
2. Double oral screen- tongue thrust
3. With holes- mouth breathers
LIP BUMPER
Combined removable fixed appliance
Muscular force application or force elimination
Both maxilla and mandible

USES:
o Lip sucking
o Hyperactive mentalis- crowding of lower ant
o Distalization of first molars
Maxillary arch- Denholtz appliance

Appliance design
ACTIVATOR
Kingsley 1879 : Vulcanite palatal plate.

Hotz : Vorbissplate

Perrie Robin- Monoblock

Viggo Andreasen 1908 :Biomechanical working retainer


Along with Karl Haulp - Norwegian appliance

It was named activator because of its ability to activate
muscle forces.

MODE OF ACTION
1. Myotactic reflex- Introduces a new pattern of mandibular
closure
2. Condylar adaptation- Backward & upward growth
3. Force generated while swallowing & sleep
INDICATIONS:
Class II, div 1 malocclusion.
Class II, div 2
Class III malocclusion
Class I, open bite
Class I, deep bite
Post treatment retention.
Children with decreased lower facial height.
Fabrication of appliance
Impression
Bite registration
Articulation of the model
Preparation of wire element- labial bow-0.8 or
0.9mm wire
Fabrication of acrylic portion
o Maxillary part
o Mandibular part
o Interocclusal part
CONSTRUCTION BITE
Mandible is advanced by 4-5 mm and bite opened by
2-3 mm
General considerations-
Trimming of the activator
For vertical control
Intrusion of teeth-




Extrusion of teeth-
For sagittal control
Class II correction




Protrusion & retrusion of incisors






For transverse control - Jack screw is incorporated





Management:
1
st
week: 2-3 hrs during day
2
nd
week: full night + 1-3 hr each day
3
rd
week: appliance is checked to evaluate the trimming
Every 6 weeek: check up appointment

MODIFICATIONS
Bow activator of Schwarz
Wunderers modification
Propulsor
Reduced activator or cybernator of Schmuth
Cutout or palate free activator
Karwetzky modification
Herrens modification
BIONATOR (BALTER 1950)
Philosophy of bionator







Does not activate the muscle
ACTIONS OF THE BIONATOR
Causes sagittal repositioning of mandible thereby increasing
the oro functional space.
Causes anterior positioning of the tongue
prevents the external unfavorable muscle forces by means of
vestibular arch and its buccal extension.
Intrusion and extrusion of teeth
Types of bionator
Standard appliance
Open- bit appliance
Class III or reverse bionator
OPEN BITE APPLIANCE
The interocclusal bite blocks prevent the extrusion of
posterior teeth.
prevents thrusting of tongue
CL III OR REVERSED
BIONATOR
FUNCTIONAL REGULATOR

FRANKELS PHILOSOPHY AND MODE OF
ACTION
1. VESTIBULAR ARENA OF OPERATION
Dentition is influenced by peri-oral muscle function.
Abnormal peri-oral muscle function creates a barrier for
the optimal growth of the dento-alveolar complex.
FRANKELS PHILOSOPHY
2) Sagittal correction via tooth borne anchorage

3) Differential eruption guidance

4) Periosteal pull by buccal shields & lip pads

5) Minimal maxillary basal effect

Frankel-Ia
class I malocclusion, minor to moderate crowding & deep
bite cases.
Frankel-Ib
class II, division 1 malocclusion
overjet < 7mm.
Types of Frankel appliances
Frankel-Ic
Cl - II division 1 malocclusion
overjet >7mm.
Frankel-II
CL-II and division 1 & 2

Is modified by adding a stainless
steel protrusion bow behind the
maxillary incisors.
Types of Frankel appliances
Frankel-III - CL-III malocclusion.
lip pads are situated in the maxillary vestibular labial sulcus.
Labial bow rests against the mandibular teeth
There is a protrusive bow similar to that of Frankel-II
Types of Frankel appliances
FRANKEL-IV
correction of open bite & to a lesser extent in
bimaxillary protrusion.
redirect the mandibular growth from a downward &
backward growth rotation to a upper and forward
rotation.
Frankle V
Used along with headgears
TWIN BLOCK APPLIANCE
Occlusal inclined plane is the fundamental functional
mechanism of the natural dentition.

Class I
Class II
MODE OF ACTION OF TWIN
BLOCK
The unfavourable cuspal contacts of the distal occlusion are
replaced by favourable proprioceptive contact on the inclined
plane of Twin block
Due to the inclined plane effect a mesial component of force
is created
Case Selection
Angles class II div I with good arch form
Arches that uncrowded or decrowded
overjet10-12mm & a deep overbite
VTO positive
Actively growing individual
Angulation of inclined plane
70 degree- more horizontal
component of force- encourage
fwd mand growth
Stages of treatment
Active phase 6-9 months
Support phase- 3-6 months
Retention phase- 9 months
avg- 18 months

8-10 hours a day
2-3 months
Emil Herbst (1900s).
Pancherz 1982 & McNamara 1990 - both skeletal and dental
adaptations
This was previously used in the mixed dentition period but
now primarily used as an appliance in permanent dentition.
HERBST APPLIANCE

holds lower jaw in a forward position
while pushing the upper jaw backward.
INDICATIONS
In class II due to retrognathic mandible
As an anterior repositioning splint in pt
having TMJ disorders
Uncooperative pts
Post adolescent
TREATMENT EFFECTS
Class II to class I molar relation
Increase in mand growth
Distal driving of max molars
Overjet reduction
An inhibitory influence on sagittal max growth
JASPER JUMPER
J.J Jasper 1980
MOA -Similar to that of Herbst
appliance.
A coil spring is used instead of rigid
telescopic unit as in case of Herbst
appliance .

INDICATIONS:
Skeletal class II malocclusion with
maxillary excess & mandibular def.
Acc Sassouni et al- 1972
Orthodontic therapy- aimed at correction of
dentoalveolar malocclusion

Orthopedic therapy- correction skeletal imbalance
with correction of any dentoalveolar malocclusion
being of less importance

Orthopedic forces are heavier (400gm) when
compared to orthodontic forces( 50-100gm)
ORTHOPEDIC APPLIANCES
Basis for orthopedic
appliances
Makes use of teeth as a handle to transmit forces
to the underlying skeletal structures.

1. Amount of force -400-600gm/side
2. Duration of force- 12-14hrs /day
3. Direction of force- posteriorly &superiorly through
the centre of resistance of the maxilla.
4. Age of the patient-
5. Timing of force application-


Orthopedic appliances
Headgear
Facemask
Chin cup
HEAD GEARS
Distalize the maxillary dentition or maxilla it self.


350 -450 gms on each side for 12-14 hrs / day.

COMPONENTS :
Force delivering unit- Face bow, J hook
Force generating unit ( elastic / springs )
Anchorage unit ( head strap/ cervical strap )
Types
1. Cervical headgear-
2. Occipital headgear
3. High pull(parietal )
4. Combination pull
CHIN CUP THERAPY
Objective - to provide growth inhibition or redirection
& posterior positioning of mandible.

A force is usually directed through the condyle or
below the condyle.
Most studies recommend an orthopaedic force of 300 to 600
g per side (AJO 1987).
Patients are instructed to wear the appliance 12-14 hrs/day.


Ideal patient for chin cup-
Acc to T M Graber
A mild skeletal problem with the ability to bring incisors
edge to edge or nearly so
Short vertical facial height
normally positioned or protrusive , but not retrusive lower
incisors
Types of chin cup
1. Occipital pull chin cup-
Classs III with mild to moderate prognathism
pt with short facial height also benefits from yhis type
2. Vetical pull chin cup- high angle cases or long face patients
PROTRACTION FACE MASK
Hickham 1972.. Reverse head gear

Mainly used to pull the max ahead simultaneously pushing
the mandible distally.

250gm per side for 13 months

12-24 hrs/day.
MAXILLARY INTRUSIVE
SPLINT
Indication severe gummy class II div 1
malocclusion
It reduces the visibility & vulnerability of the
maxillary incisors by
Achieving intrusion of max teeth
Restraining the max growth
Forward mandibular rotation
MAXILLARY INTRUSIVE SPLINT
FABRICATION-
PRE ORTHODONTIC
TRAINER
Technical Features
1.Tooth channels

2. Labial bows

3.Tongue tag

4.Tongue guard

5. Lip bumpers

6. Jaw repositioning
Tooth guidance
system
Myofunctional
Training
Jaw positioning /
Functional appliance
118
Phase 1
Soft : maximum compliance & flexibility
Adapts to severe dental alignment
made of Silicone
Recommended use :
Every day for 1 hr plus overnight while
the child sleeps
Duration : 6 8 months
119
Phase 2
Duration : 6 12 months
much stiffer
same principle as orthodontic arch wire
Made of polyurethane

120
The TRAINER System
T4K - The Pre-orthodontic TRAINER.
Improves facial & dental development in the growing
child (mixed dentition).


T4A - Aligns and retains anterior teeth in the
permanent dentition.


INFANT TRAINER - For habit correction.
To assist development of teeth & jaws in the
growing child.


121
The TRAINER System cont.,
T4B - The TRAINER for Braces.
Shields the soft tissue from brackets.


T4CII - The TRAINER for Class II Correction.
Jaw alignment in combination with fixed
orthodontics.

LINGUA - Train the Tongue Day & Night.
tongue retraining.
122
The FARRELL BENT WIRE
System
The BWS allows arch development and anterior dental alignment to be
combined without encroaching on the natural position of the tongue.
Therefore the force of the.. allowing the BWS to use very light forces.

Fabrication:
Uses:
Dental arch alignment
Along with trainer for treatment of habits

Advantages:
Eliminate speech and functional problems
Fixed; no patient compliance
Stability..along with trainer
No lab work..
Cost effective

Management:
Follow Up Visits Every 2 - 3 Weeks
Activation at the loops should be no more than one
millimeter initially then subsequently 12mm every three to four
weeks.
Open the loops bilaterally with Adams pliers at the base of the loop
and place a compensating bend
THE MYOBRACE SYSTEM
Features 2 main elements-
A soft flexible outer , &
Dynamicore- a hard
inner core- produces
positive arch
development & tooth
alignment
Used in late mixed &
early permanent
dentition
Interceptive series- i-3

1: A Frankel cage for maxillary development, with an offset
Class I/II incisor preset.

2: High extended reflex sides to discourage anterior
mandibular posture.

3: Positive tongue position elevator to raise tongue position in
conjunction with the tongue tag used in the Pre-Orthodontic
TRAINER (T4K)..

custom-made series of
aligners .
These aligner trays are made
of smooth, comfortable and
virtually invisible plastic .
Wearing the aligners will
gradually and gently.
You just pop in a new set of
aligners approximately every
two weeks, until your
treatment is complete.
INVISALIGN
Correction of anterior crossbite
Prarthana 7/F.. Tongue blade theray
Chitra 9/F.. Hawleys with expansion screw
Kavana 8/F.. Anterior inclined plane

Management of Class I malocclusion with crowding using
Trainer
Usha 12F

Pre op







Post op
Arch expansion using Bent Wire System for management of crowding

Brunda 11/F
CONCLUSION
The earlier treatment begins, the more the
face will adapt to your standards, the later
treatment begins the more your standards will
have to adapt to the face.
C.Gugino
REFERENCES
Orthodontics current principles: 4
th
edition- T.M.Graber
Hand book of orthodontics : 4
th
edition - Moyers
Contemporary orthodontics : 4
th
edition - Proffit
Dentistry for child and adolescent : 9
th
edition - R.J.
McDonald
Textbook of orthodontics:2
nd
edition- Gurkeerat singh
Orthodontics : 3
rd
edition - SI.Balajhi
Functional appliances in orthodontic treatment- An atlas
of clinical prescription & lab construction. Harry S Orton



Clinical Pedodontics: 4
th
edition Finn

Textbook of pedodontics:2
nd
edition- Tandon

Occlusal guidance in pediatric dentistry Nakata

Pediatric dentistry .infancy through adolescence: 4
th
edition
Pinkham

Google search

Myobrace.com

REFERENCES