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1. Preventive
Orthodontics
INDIAN DENTAL ACADEMY
Leader in continuing dental education
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2. Introduction:
Prevention is not only better than cure but more
stable and cheaper as well.
Preventive orthodontics is that part of orthodontics
which is concerned with
1.Patients & parents education.
2.Supervision of the growth & development
of the dentition & the craniofacial structures.
3.The diagnosis procedures undertaken to predict
the appearance of malocclusion.
4.The treatment procedures instituted to prevent
the onset of malocclusion.
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3. 
Preventive measures undertaken:
Parent counselling.
Caries control.
Exfoliation of deciduous teeth.
Abnormal frenal attachment.
Treatment of locked permanent first molars.
Abnormal oral musculature & related habits.
Space maintenance.
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4.  Parent
counselling
-prenatal counselling
-postnatal counselling
Caries controlEspecially proximal caries detection.
can be prevented by diet counselling, topical
fluoride application, pit & fissure sealants,
educating the parents about caries detection.
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5. Exfoliation of deciduous teeth includes
Extraction of over-retained deciduous/root
stumps.
Extraction of supernumerary teeth.
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Abnormal frenal attachment
may cause the development of
diastemas/spacing between the teeth,which
in turn may not allow the eruption of
succedaneous teeth.
This should be surgically corrected.
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6. Treatment of locked permanent first molars.
Slight distal stripping of deciduous second
molars allows the permanent first molar to
erupt in their right place.
Abnormal oral musculature & habits.
-tongue thrusting.
-thumb/digit/lip sucking.
-mouth breathing.
-hypermentalis action.
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7.  Space
Maintainers:-
 Definition
:- Space maintainers are defined as
the appliances that prevent loss of arch length
and which in turn guide the permanent tooth into
a correct position, in the dental arch.
 Factors to be considered for space
maintainance:1.Time elapsed since loss of tooth:-within 2weeks
to of extraction.
2.Dental age of the patient
3.Amount of bone covering the developing
permanent teeth
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8. 4.Stage of root formation
5.Sequence of teeth eruption
6.Congenital missing teeth
7.Eruption of permanent teeth in opposite arch
Classification of space maintainers:According to Hitchcock:1.Removable or fixed or semifixed.
2.With bands or without bands.
3.Functional or Nonfunctional.
4.Active or Passive.
5.Certain combinations of the above.
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9. According to Raymond C.Thurow:1.Removable
2.Complete arch
Lingual arch
Extra-oral anchorage
3.Individual tooth
According to Hinrichsen:1.Fixed space maintainers
class I a} Non functional types- Bar type
-Loop type
b} Functional types- Pontic type
- Lingual arch type
class II cantilever type (distal shoe, band and loop)
2.Removable space maintainer:- Acrylic partial denture
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10. 
Requirements of space maintainers:-
-Maintain mesio-distal width.
-Must restore the Function.
-Simple in construction.
-Strong enough to withstand functional forces.
-Should not exert excessive stress on adjoining
teeth.
-Must permit maintenance of oral hygiene.
-Must not restrict normal growth & development.
-Should not come in way of other functions.
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11.  Advantages
of Removable space
maintainers:-easy to clean.
-serve important function like mastication,
esthetics & phonetics
-can be worn part time allowing circulation to soft
tissues.
-maintain or restore vertical dimension.
-dental check up can be done for caries
detection.
-stimulate eruption of teeth.
-help in preventing development of tongue thrust
in extraction space.
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12.  Disadvantages
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of removable space
maintainer
May be lost or broken by the patient.
Uncooperative patient may not wear the
appliance.
Lateral jaw growth may be restricted, if clasps
are incorporated.
May cause irritation to the underlying soft
tissue.
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13.  Advantages
of fixed space maintainer
-Bands & crowns are used which require
minimum or no tooth preparation
-Do not interfere with passive eruption of
abutment teeth
-Jaw growth is not hampered
-The succedaneous permanent teeth are free
to erupt in the oral cavity
-They can be used in unco-operative patients.
-Masticatory function is restored if pontics are
placed.
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14.  Disadvantages
of fixed space maintainer
-Elaborate instrumentation with expert skill.
-May result in decalcification of tooth material
under the bands.
-Supra eruption of opposing teeth can take
place if pontics are not used.
-If pontics are used it can interfere with vertical
eruption of abutment of tooth.
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15. Thank you
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