https://www.spreaker.com/podcast/ortho-pedo--4547638enCoursesCopyright Dr.Mayakha Mariamhttps://d3wo5wojvuv7l.cloudfront.net/t_rss_itunes_square_1400/images.spreaker.com/original/0e3fb5bbb02cd54643c198c0e57b883c.jpghttps://www.spreaker.com/podcast/ortho-pedo--4547638Sat, 27 Sep 2025 11:13:25 +0000Dr.Mayakha MariamDr.Mayakha Mariamthegulfiedentist@gmail.comThese are lectures of The Gulfie Dentist Online Coachingfalseepisodichttps://www.spreaker.com/episode/1-orthopedo-intro--40400119https://api.spreaker.com/episode/40400119Wed, 19 Aug 2020 06:47:37 +0000Dr.Mayakha Mariam29falsefullhttps://www.spreaker.com/episode/2-ossification--40400118
INTRAMEMBRANEOUS- within membrane
 Ossification takes place in the membranes of connective tissue.
 Cells in the membrane differentiate into osteoblasts,
 A collagen matrix is formed, which undergoes ossification
 So basically, these bone is formed from collagen matrix.
 Mostly flat Bones: maxilla, majority of mandible & cranial vault*

ENDOCHONDRAL – within cartilage
 Bone formation takes place From within a hyaline cartilage
 Cartilage cells are replaced by bone cells,ie. osteocytes replace chondrocytes.
 short and long bones are formed this way
 ethmoid, sphenoid, occipital (synchondrosis of bones of cranial base*)
 Some part of mandible (condylar head region)
 MANDIBLE BONE FORMATION IS BY BOTH endochondral + intramembraneous]]>https://api.spreaker.com/episode/40400118Wed, 19 Aug 2020 06:47:31 +0000Dr.Mayakha MariamBONE FORMATION / OSSIFICATION :- INTRAMEMBRANEOUS- within membrane  Ossification takes place in the membranes of connective tissue.  Cells in the membrane differentiate into osteoblasts,  A collagen matrix is formed, which undergoes ossification ...
INTRAMEMBRANEOUS- within membrane
 Ossification takes place in the membranes of connective tissue.
 Cells in the membrane differentiate into osteoblasts,
 A collagen matrix is formed, which undergoes ossification
 So basically, these bone is formed from collagen matrix.
 Mostly flat Bones: maxilla, majority of mandible & cranial vault*

ENDOCHONDRAL – within cartilage
 Bone formation takes place From within a hyaline cartilage
 Cartilage cells are replaced by bone cells,ie. osteocytes replace chondrocytes.
 short and long bones are formed this way
 ethmoid, sphenoid, occipital (synchondrosis of bones of cranial base*)
 Some part of mandible (condylar head region)
 MANDIBLE BONE FORMATION IS BY BOTH endochondral + intramembraneous]]>140falsefullhttps://www.spreaker.com/episode/3-bone-growth--40400137 Don’t confuse bone growth with bone formation above
 Growth of bone is by apposition — layer by layer deposition
 Whereas cartilage growth is by two ways one is appositional and other is interstitial method, which is how mandibular condyle grows.
 Mandible growth starts at 6th wk of IUL & completes at 12-13 years
 Individual — 1st bone to ossify — clavicle— entire body
 1st bone to ossify in head — mandible -2nd bone to ossify overall
 Maxilla growth starts after mandible but completes earlier than mandible

Start (6th wk of IUL)----- (MANDIBLE) --------------finish (12-13 years)

-----------------START -------------------FINISH-------------------------

-------------------------------MAXILLA-----------------------------------


MANDIBLE
 Primary cartilage of mandible — Meckel’s cartilage
but it does not individually induce or contribute to
mandibles growth
 Secondary cartilage — condylar cartilage
 This cartilage contributes to its growth*
 Direction of growth — anterior and inferiorly
 Direction of apposition @ condylar — posteriorly and superiorly
 V shape principle- is shown by the mandibular growth

MAXILLA
 Formed entirely by intramembranous ossification
 Growth is by apposition at sutures and surface remodelling
 Direction of growth/migration – downward and forward
 Direction of apposition – downward at alveolar area and at tuberosity area

 MAXILLA IN A NUTSHELL:
o Increases in height by continuous growth at alveolar bone
o Increases in width by mid-palatine suture
o Increases in depth by apposition at anterior region and tuberosity]]>https://api.spreaker.com/episode/40400137Wed, 19 Aug 2020 06:47:25 +0000Dr.Mayakha MariamBONE GROWTH  Don’t confuse bone growth with bone formation above  Growth of bone is by apposition — layer by layer deposition  Whereas cartilage growth is by two ways one is appositional and other is interstitial method, which is how mandibular... Don’t confuse bone growth with bone formation above
 Growth of bone is by apposition — layer by layer deposition
 Whereas cartilage growth is by two ways one is appositional and other is interstitial method, which is how mandibular condyle grows.
 Mandible growth starts at 6th wk of IUL & completes at 12-13 years
 Individual — 1st bone to ossify — clavicle— entire body
 1st bone to ossify in head — mandible -2nd bone to ossify overall
 Maxilla growth starts after mandible but completes earlier than mandible

Start (6th wk of IUL)----- (MANDIBLE) --------------finish (12-13 years)

-----------------START -------------------FINISH-------------------------

-------------------------------MAXILLA-----------------------------------


MANDIBLE
 Primary cartilage of mandible — Meckel’s cartilage
but it does not individually induce or contribute to
mandibles growth
 Secondary cartilage — condylar cartilage
 This cartilage contributes to its growth*
 Direction of growth — anterior and inferiorly
 Direction of apposition @ condylar — posteriorly and superiorly
 V shape principle- is shown by the mandibular growth

MAXILLA
 Formed entirely by intramembranous ossification
 Growth is by apposition at sutures and surface remodelling
 Direction of growth/migration – downward and forward
 Direction of apposition – downward at alveolar area and at tuberosity area

 MAXILLA IN A NUTSHELL:
o Increases in height by continuous growth at alveolar bone
o Increases in width by mid-palatine suture
o Increases in depth by apposition at anterior region and tuberosity]]>322falsefullhttps://www.spreaker.com/episode/4-sacammon-s-growth-curve--40400132
4 GROWTH SPURTS
1. JUST BEFORE OR AT BIRTH - Most rapid growth in human occur during pre-natal period
2. 1 YEAR AFTER BIRTH
3. PRE-PUBERTAL [GIRLS 5-6YEARS., BOYS 6-8 YEARS]
4. PUBERTY [GIRLS 10-12, BOYS 12-14]
Mandibular growth coincides with 4th growth sprout ie; pubertal
growth


A. Neural — Brain
a. At birth 50%
b. At 4-6 years — 95%
c. So below this age, ie around 3 yrs child will not be able to differentiate colours, tell his name and so.
d. Complete at 15 years age — 100%

B. Genital
a. Begins at 12 years
b. Complete at 18 years

C. Lymphoid / immunity
a. At peak — 200% — 12 years
b. Complete — 100% — 18 years
∴ immunity is highest in children]]>https://api.spreaker.com/episode/40400132Wed, 19 Aug 2020 06:47:19 +0000Dr.Mayakha MariamSCAMMON’S GROWTH CURVE — GROWTH SPURTS 4 GROWTH SPURTS 1. JUST BEFORE OR AT BIRTH - Most rapid growth in human occur during pre-natal period 2. 1 YEAR AFTER BIRTH 3. PRE-PUBERTAL [GIRLS 5-6YEARS., BOYS 6-8 YEARS] 4. PUBERTY [GIRLS 10-12, BOYS 12-14]...
4 GROWTH SPURTS
1. JUST BEFORE OR AT BIRTH - Most rapid growth in human occur during pre-natal period
2. 1 YEAR AFTER BIRTH
3. PRE-PUBERTAL [GIRLS 5-6YEARS., BOYS 6-8 YEARS]
4. PUBERTY [GIRLS 10-12, BOYS 12-14]
Mandibular growth coincides with 4th growth sprout ie; pubertal
growth


A. Neural — Brain
a. At birth 50%
b. At 4-6 years — 95%
c. So below this age, ie around 3 yrs child will not be able to differentiate colours, tell his name and so.
d. Complete at 15 years age — 100%

B. Genital
a. Begins at 12 years
b. Complete at 18 years

C. Lymphoid / immunity
a. At peak — 200% — 12 years
b. Complete — 100% — 18 years
∴ immunity is highest in children]]>285falsefullhttps://www.spreaker.com/episode/5-bone-joints--40400115
 SYNOSTOSIS
Bone formed b/w two bone junction

 SYNCHONDROSIS
Cartilage formed at the junction of two bones
Eg. Spheno-occipital synchondrosis

 SYNDESMOSIS
Ligament formed at the junction of two bones
Eg: stylohyoid


PAIRED & UNPAIRED BONES
Total no. of bones in skull :-
 At birth — 45 bones
 Later — 22 bones *

Unpaired bones in skull :-
A. Frontal [FACE OF SUHAIRA EPPO VIDARUM MACHA?]
B. Occipital
C. Sphenoid
D. Ethmoid
E. Vomer
F. mandible
REST ALL ARE PAIRED]]>https://api.spreaker.com/episode/40400115Wed, 19 Aug 2020 06:47:13 +0000Dr.Mayakha MariamBONE JOINTS  SYNOSTOSIS Bone formed b/w two bone junction  SYNCHONDROSIS Cartilage formed at the junction of two bones Eg. Spheno-occipital synchondrosis  SYNDESMOSIS Ligament formed at the junction of two bones Eg: stylohyoid PAIRED &...
 SYNOSTOSIS
Bone formed b/w two bone junction

 SYNCHONDROSIS
Cartilage formed at the junction of two bones
Eg. Spheno-occipital synchondrosis

 SYNDESMOSIS
Ligament formed at the junction of two bones
Eg: stylohyoid


PAIRED & UNPAIRED BONES
Total no. of bones in skull :-
 At birth — 45 bones
 Later — 22 bones *

Unpaired bones in skull :-
A. Frontal [FACE OF SUHAIRA EPPO VIDARUM MACHA?]
B. Occipital
C. Sphenoid
D. Ethmoid
E. Vomer
F. mandible
REST ALL ARE PAIRED]]>109falsefullhttps://www.spreaker.com/episode/6-development-of-occlusion--40400133
 GUM PADS
 0-6 months of age
 Anterior open bite
 So such complaint of open mouth by mother at this age
o Rx — self correcting anomaly ! (SCA)

 NATAL TOOTH – tooth present at birth

 NEONATAL TOOTH — tooth formed within 15 –
30 days.
 Most common — mandibular (anterior) central incisor
 Syndrome — Rege fede syndrome
 Inability to suck milk —
 Nutritional deficiency
 Lower part of tongue irritation.

 ALVEOLAR RIDGE
Transverse grooves — it divides the gum pad into 10
segments for future eruption of the teeth.

CALCIFICATION DATES

 1st calcification seen at 14 weeks of IUL, max sinus develops
 12th week – mandible
 6-10weeks- palate
 4-6 weeks- lip
 In pedo root formation completes 1year after eruption

 As a general rule,
o four teeth erupt for every six months of life,
o mandibular teeth erupt before maxillary teeth,
o teeth erupt sooner in females than males.
o During primary dentition, the tooth buds of permanent teeth develop below the primary
teeth, close to the palate or tongue. Tooth bud is always — lingual / palatal and inferiorly
placed.]]>https://api.spreaker.com/episode/40400133Wed, 19 Aug 2020 06:47:02 +0000Dr.Mayakha MariamDEVELOPMENT OF OCCLUSION  GUM PADS  0-6 months of age  Anterior open bite  So such complaint of open mouth by mother at this age o Rx — self correcting anomaly ! (SCA)  NATAL TOOTH – tooth present at birth  NEONATAL TOOTH — tooth formed...
 GUM PADS
 0-6 months of age
 Anterior open bite
 So such complaint of open mouth by mother at this age
o Rx — self correcting anomaly ! (SCA)

 NATAL TOOTH – tooth present at birth

 NEONATAL TOOTH — tooth formed within 15 –
30 days.
 Most common — mandibular (anterior) central incisor
 Syndrome — Rege fede syndrome
 Inability to suck milk —
 Nutritional deficiency
 Lower part of tongue irritation.

 ALVEOLAR RIDGE
Transverse grooves — it divides the gum pad into 10
segments for future eruption of the teeth.

CALCIFICATION DATES

 1st calcification seen at 14 weeks of IUL, max sinus develops
 12th week – mandible
 6-10weeks- palate
 4-6 weeks- lip
 In pedo root formation completes 1year after eruption

 As a general rule,
o four teeth erupt for every six months of life,
o mandibular teeth erupt before maxillary teeth,
o teeth erupt sooner in females than males.
o During primary dentition, the tooth buds of permanent teeth develop below the primary
teeth, close to the palate or tongue. Tooth bud is always — lingual / palatal and inferiorly
placed.]]>401falsefullhttps://www.spreaker.com/episode/7-special-teeth-spaces--40400126 Smallest — mandibular L1
 First erupting — mandibular C1
 Largest tooth — mandibular 2nd M

PERMANENT TEETH
 Smallest — mandibular CI
 Largest — maxillary 1st M
 First erupting — mandibular CI

SPACES
 In primary teeth — physiologic space
 It is self correcting anomaly
 Midline Diastema
 Maxillary 1.7mm — mesial to C
 Mandibular 1.5mm — distal to C
 They are known as Primate space or Anthropoid space or Simmian space.

SELF CORRECTING ANOMALIES
o Anterior deep bite — 6 months age anomaly
o (SCA) — Self correcting as posterior teeth erupts
o (self – correcting anomaly)]]>https://api.spreaker.com/episode/40400126Wed, 19 Aug 2020 06:46:57 +0000Dr.Mayakha MariamPEDO TEETH  Smallest — mandibular L1  First erupting — mandibular C1  Largest tooth — mandibular 2nd M PERMANENT TEETH  Smallest — mandibular CI  Largest — maxillary 1st M  First erupting — mandibular CI SPACES  In primary teeth — physiologic... Smallest — mandibular L1
 First erupting — mandibular C1
 Largest tooth — mandibular 2nd M

PERMANENT TEETH
 Smallest — mandibular CI
 Largest — maxillary 1st M
 First erupting — mandibular CI

SPACES
 In primary teeth — physiologic space
 It is self correcting anomaly
 Midline Diastema
 Maxillary 1.7mm — mesial to C
 Mandibular 1.5mm — distal to C
 They are known as Primate space or Anthropoid space or Simmian space.

SELF CORRECTING ANOMALIES
o Anterior deep bite — 6 months age anomaly
o (SCA) — Self correcting as posterior teeth erupts
o (self – correcting anomaly)]]>216falsefullhttps://www.spreaker.com/episode/8-deciduous-occlusion--40400143
FLUSH TERMINAL PLANE (SCA)
 Most Commonly seen occlusion*
 Straight line occlusion
EDGE TO EDGE OR END ON
Crowded , Improper jaw growth

CLASS I OCCLUSION
Mesiobuccal cusp of maxillary 1st M in the mandibular mesiobuccal groove
Usually a flush terminal will end up in class 1 itself
Self – correcting anomaly

MESIAL STEP OCCLUSION
 Ideal Occlusion
CLASS III – When space is utilized
CLASS I – If space not utilized

DISTAL STEP OCCLUSION
CLASS I – If space is utilized
CLASS II- if space is not utilized

 MIXED DENTITION :-
o Started #6 eruption of mandibular 1st Molars
o Finishes #3 eruption of maxillary C or #5 eruption of mandibular 2nd PM]]>https://api.spreaker.com/episode/40400143Wed, 19 Aug 2020 06:46:51 +0000Dr.Mayakha MariamDECIDUOUS OCCLUSIONS :- PRIMARY 2ND MOLARS FLUSH TERMINAL PLANE (SCA)  Most Commonly seen occlusion*  Straight line occlusion EDGE TO EDGE OR END ON Crowded , Improper jaw growth CLASS I OCCLUSION Mesiobuccal cusp of maxillary 1st M in the...
FLUSH TERMINAL PLANE (SCA)
 Most Commonly seen occlusion*
 Straight line occlusion
EDGE TO EDGE OR END ON
Crowded , Improper jaw growth

CLASS I OCCLUSION
Mesiobuccal cusp of maxillary 1st M in the mandibular mesiobuccal groove
Usually a flush terminal will end up in class 1 itself
Self – correcting anomaly

MESIAL STEP OCCLUSION
 Ideal Occlusion
CLASS III – When space is utilized
CLASS I – If space not utilized

DISTAL STEP OCCLUSION
CLASS I – If space is utilized
CLASS II- if space is not utilized

 MIXED DENTITION :-
o Started #6 eruption of mandibular 1st Molars
o Finishes #3 eruption of maxillary C or #5 eruption of mandibular 2nd PM]]>258falsefullhttps://www.spreaker.com/episode/9-eruption-sequance--40400139
MAXILLA
6 1 2 4 5 3 7
MANDIBLE
6 1 2 3 4 5 7

 1st permanent tooth — mandibular 1st M
 1st successor tooth — mandibular CI
 Last successor tooth — max C *** OR mandibular 2nd PM]]>https://api.spreaker.com/episode/40400139Wed, 19 Aug 2020 06:46:45 +0000Dr.Mayakha MariamPERMANENT SEQUENCE OF ERUPTION MAXILLA 6 1 2 4 5 3 7 MANDIBLE 6 1 2 3 4 5 7  1st permanent tooth — mandibular 1st M  1st successor tooth — mandibular CI  Last successor tooth — max C *** OR mandibular 2nd PM
MAXILLA
6 1 2 4 5 3 7
MANDIBLE
6 1 2 3 4 5 7

 1st permanent tooth — mandibular 1st M
 1st successor tooth — mandibular CI
 Last successor tooth — max C *** OR mandibular 2nd PM]]>137falsefullhttps://www.spreaker.com/episode/10-mixed-dentition-1st-stage--40400144
FIRST TRANSITION STAGE [ 6 – 8 ]

 Erupting — C1, L1, 1st Molars
 Anomaly — anterior open bite
o — retrognathic mandible (12-14)
o — ∴ transient class 2
 At 8.5yrs old, there will be equal no of primary and permanent teeth in the mouth,
 Centrals, laterals and 1st molars-permanent
 Canines, 1st molar, 2nd molar-primary
 Incisal Liability
o Maxilla — 7mm
o Mandible — 5mm
 ∴ avg I L = 6 mm
 How is I L Obtained:
o utilising the physiologic spaces
o proclination of anterior
o increase in the inter – canine width]]>https://api.spreaker.com/episode/40400144Wed, 19 Aug 2020 06:46:39 +0000Dr.Mayakha MariamSTAGES OF MIXED DENTITION :- FIRST TRANSITION STAGE [ 6 – 8 ]  Erupting — C1, L1, 1st Molars  Anomaly — anterior open bite o — retrognathic mandible (12-14) o — ∴ transient class 2  At 8.5yrs old, there will be equal no of primary and permanent...
FIRST TRANSITION STAGE [ 6 – 8 ]

 Erupting — C1, L1, 1st Molars
 Anomaly — anterior open bite
o — retrognathic mandible (12-14)
o — ∴ transient class 2
 At 8.5yrs old, there will be equal no of primary and permanent teeth in the mouth,
 Centrals, laterals and 1st molars-permanent
 Canines, 1st molar, 2nd molar-primary
 Incisal Liability
o Maxilla — 7mm
o Mandible — 5mm
 ∴ avg I L = 6 mm
 How is I L Obtained:
o utilising the physiologic spaces
o proclination of anterior
o increase in the inter – canine width]]>181falsefullhttps://www.spreaker.com/episode/11-inter-transition-and-2nd-transition-stage--40400130 Anomaly — ugly duckiling stage (9 – 11 years) *** v.imp
o — midline diastema (SCA)
 Erupting — canines
 Distoangular axial inclination of maxillary incisors!
 Rx – wait till canines erupt completely – 11 years
 After that — ortho Rx.

SECOND TRANSITION STAGE
 Erupting — C, 1st PM and 2nd PM
 3, 4, 5, 7
 Anomaly — anterior deep bite

 LEEWAY SPACE — primary Molars > permanent Molars
 it is the space deference between the combined mesiodistal width of the C,D & E teeth and that of their successors ( 3 ,4 and 5 ) which is
 1.9 mm in maxilla & 3.4 mm in mandible.
 — This space is utilized for primary occlusion to
permanent occlusion
 — late mesial shift
o Maxilla — 0.9 mm
o Mandible — 1.7 mm]]>https://api.spreaker.com/episode/40400130Wed, 19 Aug 2020 06:46:33 +0000Dr.Mayakha MariamINTER – TRANSITION STAGE [ 9 – 11 ]  Anomaly — ugly duckiling stage (9 – 11 years) *** v.imp o — midline diastema (SCA)  Erupting — canines  Distoangular axial inclination of maxillary incisors!  Rx – wait till canines erupt completely – 11 years... Anomaly — ugly duckiling stage (9 – 11 years) *** v.imp
o — midline diastema (SCA)
 Erupting — canines
 Distoangular axial inclination of maxillary incisors!
 Rx – wait till canines erupt completely – 11 years
 After that — ortho Rx.

SECOND TRANSITION STAGE
 Erupting — C, 1st PM and 2nd PM
 3, 4, 5, 7
 Anomaly — anterior deep bite

 LEEWAY SPACE — primary Molars > permanent Molars
 it is the space deference between the combined mesiodistal width of the C,D & E teeth and that of their successors ( 3 ,4 and 5 ) which is
 1.9 mm in maxilla & 3.4 mm in mandible.
 — This space is utilized for primary occlusion to
permanent occlusion
 — late mesial shift
o Maxilla — 0.9 mm
o Mandible — 1.7 mm]]>243falsefullhttps://www.spreaker.com/episode/12-non-self-correcting-anomaly--40400129
SKELETAL
1. Skeletal Class III
2. Skeletal class II

MIDLINE DIASTEMA * after 11 years or C eruption
a] Hgh frenal attachment
 Blanch test — to detect high frenum attachement
 Frenectomy
 Wait for eruption of remaining teeth
 Ortho
b] unerupted mesiodense
 Rx
o Occlusal radiograph
o If before C eruption — extraction of mesiodens might close the gap as C
erupts completely
o If after C eruption — extraction of mesiodens + fixed ortho]]>https://api.spreaker.com/episode/40400129Wed, 19 Aug 2020 06:46:25 +0000Dr.Mayakha MariamNON – SELF CORRECTING ANOMALIES :- SKELETAL 1. Skeletal Class III 2. Skeletal class II MIDLINE DIASTEMA * after 11 years or C eruption a] Hgh frenal attachment  Blanch test — to detect high frenum attachement  Frenectomy  Wait for eruption of...
SKELETAL
1. Skeletal Class III
2. Skeletal class II

MIDLINE DIASTEMA * after 11 years or C eruption
a] Hgh frenal attachment
 Blanch test — to detect high frenum attachement
 Frenectomy
 Wait for eruption of remaining teeth
 Ortho
b] unerupted mesiodense
 Rx
o Occlusal radiograph
o If before C eruption — extraction of mesiodens might close the gap as C
erupts completely
o If after C eruption — extraction of mesiodens + fixed ortho]]>202falsefullhttps://www.spreaker.com/episode/13-crossbite--40400117a. 1st seen at 7 – 8 years
b. ∴ 1st ortho visits @ 7 – 8 years **
c. 1st dental visit @ 6 months **
d. 𝑎𝑛𝑦 𝑚𝑎𝑙𝑜𝑐𝑐𝑙𝑢𝑠𝑖𝑜𝑛 — due to early lossof primary teeth
e. 𝑎𝑛𝑡𝑒𝑟𝑖𝑜𝑟 𝑐𝑟𝑜𝑠𝑠𝑏𝑖𝑡𝑒 — retained primary teeth


ANTERIOR CROSSBITE
DEVELOPING Rx – icecream stick pushes
DEVELOPED Rx – orthodontic

1) Catalans appliance
a. 6 weeks
b. Lower teeth
c. 45° angulation
d. If Catalans appliance used more than 6 weeks
e. Then — separation of occlusion in posterior

2) Z – Spring with posterior bite plane
a. For developed crossbite]]>https://api.spreaker.com/episode/40400117Wed, 19 Aug 2020 06:46:16 +0000Dr.Mayakha MariamCROSSBITE a. 1st seen at 7 – 8 years b. ∴ 1st ortho visits @ 7 – 8 years ** c. 1st dental visit @ 6 months ** d. 𝑎𝑛𝑦 𝑚𝑎𝑙𝑜𝑐𝑐𝑙𝑢𝑠𝑖𝑜𝑛 — due to early lossof primary teeth e. 𝑎𝑛𝑡𝑒𝑟𝑖𝑜𝑟 𝑐𝑟𝑜𝑠𝑠𝑏𝑖𝑡𝑒 — retained primary teeth ANTERIOR CROSSBITE DEVELOPING Rx –...a. 1st seen at 7 – 8 years
b. ∴ 1st ortho visits @ 7 – 8 years **
c. 1st dental visit @ 6 months **
d. 𝑎𝑛𝑦 𝑚𝑎𝑙𝑜𝑐𝑐𝑙𝑢𝑠𝑖𝑜𝑛 — due to early lossof primary teeth
e. 𝑎𝑛𝑡𝑒𝑟𝑖𝑜𝑟 𝑐𝑟𝑜𝑠𝑠𝑏𝑖𝑡𝑒 — retained primary teeth


ANTERIOR CROSSBITE
DEVELOPING Rx – icecream stick pushes
DEVELOPED Rx – orthodontic

1) Catalans appliance
a. 6 weeks
b. Lower teeth
c. 45° angulation
d. If Catalans appliance used more than 6 weeks
e. Then — separation of occlusion in posterior

2) Z – Spring with posterior bite plane
a. For developed crossbite]]>258falsefullhttps://www.spreaker.com/episode/14-crossbite-2--40400113a. For developed crossbite

POSTERIOR CROSSBITE
 Reasons — narrow maxillary jaw
 Rx plan
o Expansion of maxillary arch
o Maxillary expansion device
o At or above 7 years of age
o Max suture growth ends at 15 years
o Both unilateral and bilateral posterior crossbite
 Function of expansion device —bilateral expansion
 Effect seen when midline diastema appears
 This diastema closes as a result of relapse
 No Rx required for midline diastema

UNILATERAL CROSSBITE
1. LAERTOGNATHY / TRUE CROSSBITE
The center of the mandible and the facial midline does not coincide in both rest and in occlusion
2. LATEROCCLUSION
The center of the mandible and the facial midline coincide in rest position butttt in occlusion the]]>https://api.spreaker.com/episode/40400113Wed, 19 Aug 2020 06:46:07 +0000Dr.Mayakha Mariam2) Z – Spring with posterior bite plane a. For developed crossbite POSTERIOR CROSSBITE  Reasons — narrow maxillary jaw  Rx plan o Expansion of maxillary arch o Maxillary expansion device o At or above 7 years of age o Max suture growth ends at 15...a. For developed crossbite

POSTERIOR CROSSBITE
 Reasons — narrow maxillary jaw
 Rx plan
o Expansion of maxillary arch
o Maxillary expansion device
o At or above 7 years of age
o Max suture growth ends at 15 years
o Both unilateral and bilateral posterior crossbite
 Function of expansion device —bilateral expansion
 Effect seen when midline diastema appears
 This diastema closes as a result of relapse
 No Rx required for midline diastema

UNILATERAL CROSSBITE
1. LAERTOGNATHY / TRUE CROSSBITE
The center of the mandible and the facial midline does not coincide in both rest and in occlusion
2. LATEROCCLUSION
The center of the mandible and the facial midline coincide in rest position butttt in occlusion the]]>298falsefullhttps://www.spreaker.com/episode/15-maxillary-expansion-device--40400145RAPID MAXILLARY EXPANSION (RME)
a) Per day 0.5 mm*
b) Key turn/ activation :-
- ¼ turn twice daily* or
- Quarter turn twice daily or,
- 0.25 mm twice daily
c) Eg: Hyrax
- Ratio =𝑑𝑒𝑛𝑡𝑎𝑙/𝑏𝑜𝑛𝑒= 1: 1
- The ratio of dental & skeletal expansion obtained after RME is 1 : 1

SLOW MAXILLARY EXPANSION (SME)
a) 0.5 mm per week*
b) eg: quad helix
c) unwind the coil(no key system)]]>https://api.spreaker.com/episode/40400145Wed, 19 Aug 2020 06:45:58 +0000Dr.Mayakha MariamMAXILLARY EXPANSION DEVICE RAPID MAXILLARY EXPANSION (RME) a) Per day 0.5 mm* b) Key turn/ activation :- - ¼ turn twice daily* or - Quarter turn twice daily or, - 0.25 mm twice daily c) Eg: Hyrax - Ratio =𝑑𝑒𝑛𝑡𝑎𝑙/𝑏𝑜𝑛𝑒= 1: 1 - The ratio of dental &...RAPID MAXILLARY EXPANSION (RME)
a) Per day 0.5 mm*
b) Key turn/ activation :-
- ¼ turn twice daily* or
- Quarter turn twice daily or,
- 0.25 mm twice daily
c) Eg: Hyrax
- Ratio =𝑑𝑒𝑛𝑡𝑎𝑙/𝑏𝑜𝑛𝑒= 1: 1
- The ratio of dental & skeletal expansion obtained after RME is 1 : 1

SLOW MAXILLARY EXPANSION (SME)
a) 0.5 mm per week*
b) eg: quad helix
c) unwind the coil(no key system)]]>187falsefullhttps://www.spreaker.com/episode/16-habits-thumb-sucking--40400131
THUMB/DIGIT SUCKING, PACIFIER
 Normal upto 3 years according to
— Psychosexual theory
— Learning theory
— Oral drive theory
— Routine reflex theory
— These theories support that up to 3 years its normal
 Side effects if continued after 3 years
- Increased overjet – owing to Maxillary anterior teeth proclination & Retruded and crowded mandibular incisors
- Posterior crossbite (due to action of buccinator muscle During the sucking action – buccinator mechanism)
- Anterior open bite, flaring max incisors
- Anteriorly displaced maxilla, Retruded mandible
- ie. Class II occlusion
- Dish pan thumb
- Deep palatal vault
 Treatment phase
- Counselling phase (all age group)
- If dental damage not happened, Pychological treatment to withdraw from habit
- But- if already dental dame caused- Definitive management

Definitive management
1. 4 – 5 years age —1st phase : reward therapy
2. 5-6 years age and above : 2nd phase : reminder therapy
 Tongue crib
- Fixed
- Removable
 Blue grass appliance(also given in tongue thrusting)
- Fixed appliance with six sided plastic roller on the anterior surface of
palate region.
3. 3rd phase : corrective therapy
 Quad helix — habit breaker + arch expansion
(Dip finger — pepper solvent, asefoitida solvent - it is an adjacent therapy)]]>https://api.spreaker.com/episode/40400131Wed, 19 Aug 2020 06:45:41 +0000Dr.Mayakha MariamHABITS THUMB/DIGIT SUCKING, PACIFIER  Normal upto 3 years according to — Psychosexual theory — Learning theory — Oral drive theory — Routine reflex theory — These theories support that up to 3 years its normal  Side effects if continued after 3...
THUMB/DIGIT SUCKING, PACIFIER
 Normal upto 3 years according to
— Psychosexual theory
— Learning theory
— Oral drive theory
— Routine reflex theory
— These theories support that up to 3 years its normal
 Side effects if continued after 3 years
- Increased overjet – owing to Maxillary anterior teeth proclination & Retruded and crowded mandibular incisors
- Posterior crossbite (due to action of buccinator muscle During the sucking action – buccinator mechanism)
- Anterior open bite, flaring max incisors
- Anteriorly displaced maxilla, Retruded mandible
- ie. Class II occlusion
- Dish pan thumb
- Deep palatal vault
 Treatment phase
- Counselling phase (all age group)
- If dental damage not happened, Pychological treatment to withdraw from habit
- But- if already dental dame caused- Definitive management

Definitive management
1. 4 – 5 years age —1st phase : reward therapy
2. 5-6 years age and above : 2nd phase : reminder therapy
 Tongue crib
- Fixed
- Removable
 Blue grass appliance(also given in tongue thrusting)
- Fixed appliance with six sided plastic roller on the anterior surface of
palate region.
3. 3rd phase : corrective therapy
 Quad helix — habit breaker + arch expansion
(Dip finger — pepper solvent, asefoitida solvent - it is an adjacent therapy)]]>468falsefullhttps://www.spreaker.com/episode/17-tongue-thrusting-mouth-breathing--40400120 Proclination of anterior both maxillary and mandibular
 Rx
- Tongue crib / blue grass appliance – must be used as soon as the habit is noticed
- Atleast 6 months (Rx) + 3 months (retention purpose)
- Total about 9 – 10 months
‘Duration of habit force — determines the degree of malocclusion’
– not the frequency


MOUTH BREATHING

Reasons:
- Obstructive problem
Eg: adenoids
Rx: refer to ENT surgeon for removal of adenoids
- Habitual problem
Patients who show this habit even after surgical correction, this is habitual now, ie despite no obstruction now, they are breathing due to th habit they developed before.
Rx : oral screen / mouth screen (only in cases no obstructive causes or
H/O removal of cause)

Clinical features
 Anterior proclination
 Incompetent lip seal

LEPTOPROSOPIC
 Long face syndrome
 They have posterior cross bite
 Said to have a classic adenoid face
 Poor lip seal

Tests used for investigation of mouth breathing
 Mirror test * * *
 Butterfly test
 Waterbath test]]>https://api.spreaker.com/episode/40400120Wed, 19 Aug 2020 06:45:32 +0000Dr.Mayakha MariamTONGUE THRUSTING  Proclination of anterior both maxillary and mandibular  Rx - Tongue crib / blue grass appliance – must be used as soon as the habit is noticed - Atleast 6 months (Rx) + 3 months (retention purpose) - Total about 9 – 10 months... Proclination of anterior both maxillary and mandibular
 Rx
- Tongue crib / blue grass appliance – must be used as soon as the habit is noticed
- Atleast 6 months (Rx) + 3 months (retention purpose)
- Total about 9 – 10 months
‘Duration of habit force — determines the degree of malocclusion’
– not the frequency


MOUTH BREATHING

Reasons:
- Obstructive problem
Eg: adenoids
Rx: refer to ENT surgeon for removal of adenoids
- Habitual problem
Patients who show this habit even after surgical correction, this is habitual now, ie despite no obstruction now, they are breathing due to th habit they developed before.
Rx : oral screen / mouth screen (only in cases no obstructive causes or
H/O removal of cause)

Clinical features
 Anterior proclination
 Incompetent lip seal

LEPTOPROSOPIC
 Long face syndrome
 They have posterior cross bite
 Said to have a classic adenoid face
 Poor lip seal

Tests used for investigation of mouth breathing
 Mirror test * * *
 Butterfly test
 Waterbath test]]>350falsefullhttps://www.spreaker.com/episode/18-model-analysis--40400127
 Why – to determine the arch length and tooth material discrepancy
o If the discrepancy less than 2.5 mm - proximal stripping prior to ortho
o If the discrepancy more than 2.5mm – 5 mm - extraction of 2nd PM, usually after starting ortho
o If the discrepancy more than 5 mm – 10 mm - extraction of 1st PM
 Proximal stripping remove only 50% enamel, otherwise there will be severe sensitivity.
 Normal occlusion — Andrew’s six keys
 7th key added — Bolton ratio = 91.3%]]>https://api.spreaker.com/episode/40400127Wed, 19 Aug 2020 06:45:19 +0000Dr.Mayakha MariamMODEL ANALYSIS  Why – to determine the arch length and tooth material discrepancy o If the discrepancy less than 2.5 mm - proximal stripping prior to ortho o If the discrepancy more than 2.5mm – 5 mm - extraction of 2nd PM, usually after starting...
 Why – to determine the arch length and tooth material discrepancy
o If the discrepancy less than 2.5 mm - proximal stripping prior to ortho
o If the discrepancy more than 2.5mm – 5 mm - extraction of 2nd PM, usually after starting ortho
o If the discrepancy more than 5 mm – 10 mm - extraction of 1st PM
 Proximal stripping remove only 50% enamel, otherwise there will be severe sensitivity.
 Normal occlusion — Andrew’s six keys
 7th key added — Bolton ratio = 91.3%]]>159falsefullhttps://www.spreaker.com/episode/19-mixed-dentition-analysis--40400136
 WHY — to predict the crowding of maxillary or mandibular arch
 Determines the space available vs the space required
 It is the best investigatory method for serial extarcation
 HOW (Moyer’s analysis) —𝒔𝒖𝒎 𝒐𝒇 𝒎𝒂𝒏𝒅𝒊𝒃𝒖𝒍𝒂𝒓 𝒊𝒏𝒄𝒊𝒐𝒓 𝒘𝒊𝒅𝒕𝒉 (𝒄𝒊+𝒍𝒊) / 𝟐
 The size of unerupted permanent canines and PMs are predicted from the knowledge of
the size of M-D width of mand incisors.
 Mxillary incisors are never measeared coz of high chance of variability. Mandibular is taken even to predict maxillary space discrepancy.
 Best analysis done = Stanley kaber analysis*
 Tooth cause crowding in lower anterior region if early extracted: Primary mandibular first molar lower ie. D*
 Most teeth responsible for crowding is: Lower E & upper D

SERIAL EXTRACTION:-
C D 4 — order * if discrepancy > 10mm
 Preferred — Dewel procedure
 Done at 8-9 years only if there is crowding!
 Anything before that extract ad give space maintainer.
 Go for double extraction if age 8-9 and crowding not present
 Advantages :
o Interceptive orthodontics
Easy ortho movement in future due to breakage of transseptal fibres — no relapse
o Helps eruption of permanent canine ?]]>https://api.spreaker.com/episode/40400136Wed, 19 Aug 2020 06:45:09 +0000Dr.Mayakha MariamMIXED DENTITION ANALYSIS  WHY — to predict the crowding of maxillary or mandibular arch  Determines the space available vs the space required  It is the best investigatory method for serial extarcation  HOW (Moyer’s analysis) —𝒔𝒖𝒎 𝒐𝒇 𝒎𝒂𝒏𝒅𝒊𝒃𝒖𝒍𝒂𝒓...
 WHY — to predict the crowding of maxillary or mandibular arch
 Determines the space available vs the space required
 It is the best investigatory method for serial extarcation
 HOW (Moyer’s analysis) —𝒔𝒖𝒎 𝒐𝒇 𝒎𝒂𝒏𝒅𝒊𝒃𝒖𝒍𝒂𝒓 𝒊𝒏𝒄𝒊𝒐𝒓 𝒘𝒊𝒅𝒕𝒉 (𝒄𝒊+𝒍𝒊) / 𝟐
 The size of unerupted permanent canines and PMs are predicted from the knowledge of
the size of M-D width of mand incisors.
 Mxillary incisors are never measeared coz of high chance of variability. Mandibular is taken even to predict maxillary space discrepancy.
 Best analysis done = Stanley kaber analysis*
 Tooth cause crowding in lower anterior region if early extracted: Primary mandibular first molar lower ie. D*
 Most teeth responsible for crowding is: Lower E & upper D

SERIAL EXTRACTION:-
C D 4 — order * if discrepancy > 10mm
 Preferred — Dewel procedure
 Done at 8-9 years only if there is crowding!
 Anything before that extract ad give space maintainer.
 Go for double extraction if age 8-9 and crowding not present
 Advantages :
o Interceptive orthodontics
Easy ortho movement in future due to breakage of transseptal fibres — no relapse
o Helps eruption of permanent canine ?]]>340falsefullhttps://www.spreaker.com/episode/20-space-maintainer--40400146
 Function — to maintain space
 Space closure is least likely to occur in primary maxillary 2nd molar
 Anterior SM function —
o To maintain phonetics
o Aesthetics
o Space maintenance
 Fixed SP is better
 Removable space maintainer used when SM required at multiple location
Eg: RPD]]>https://api.spreaker.com/episode/40400146Wed, 19 Aug 2020 06:44:59 +0000Dr.Mayakha MariamSPACE MAINTAINERS:-  Function — to maintain space  Space closure is least likely to occur in primary maxillary 2nd molar  Anterior SM function — o To maintain phonetics o Aesthetics o Space maintenance  Fixed SP is better  Removable space...
 Function — to maintain space
 Space closure is least likely to occur in primary maxillary 2nd molar
 Anterior SM function —
o To maintain phonetics
o Aesthetics
o Space maintenance
 Fixed SP is better
 Removable space maintainer used when SM required at multiple location
Eg: RPD]]>158falsefullhttps://www.spreaker.com/episode/21-band-or-crown-loop-distal-shoe--40400134 Single tooth missing
 Both maxillary and mandibular
 Missing D (at any age)
 Missing E at or above 6 years when 6 tooth available

CROWN & LOOP SM
 If abutment tooth has pulpectomy or large caries
 Both maxillary and mandibular

DISTAL SHOE SM
 If E is missing both maxillary and mandibular
 Age group of 5 years or below
 Shoe into the extraction socket of E
 Contra – indicated in bleeding disorders and infective endocarditis]]>https://api.spreaker.com/episode/40400134Wed, 19 Aug 2020 06:44:53 +0000Dr.Mayakha MariamBAND & LOOP SM  Single tooth missing  Both maxillary and mandibular  Missing D (at any age)  Missing E at or above 6 years when 6 tooth available CROWN & LOOP SM  If abutment tooth has pulpectomy or large caries  Both maxillary and mandibular... Single tooth missing
 Both maxillary and mandibular
 Missing D (at any age)
 Missing E at or above 6 years when 6 tooth available

CROWN & LOOP SM
 If abutment tooth has pulpectomy or large caries
 Both maxillary and mandibular

DISTAL SHOE SM
 If E is missing both maxillary and mandibular
 Age group of 5 years or below
 Shoe into the extraction socket of E
 Contra – indicated in bleeding disorders and infective endocarditis]]>242falsefullhttps://www.spreaker.com/episode/22-remaining-space-maintainers--40400138 Unilateral loss of E&D * in maxillary only
 Connect 6 of opposite arches *at or above 6 years old
 Acts as space maintainer + arch expansion + anchorage — function of TPA SM

NANCE PALATAL ARCH (NPA)
 Can use for both unilateral and bilateral
o E missing and D missing
 Only in maxillary
 At or above 6 years age’support from palate – not teeth

LINGUAL ARCH
 Above 7 years
 Because support from anterior teeth
 Both unilateral and bilateral and multiple missing

Anterior Space maintainer

 REMOVABLE DENTURE, with adams / c clasp / ball clasp
 RPD is advisable only if child is 3yrs above
 FIXED SPACE MAINTAINER, orthodontic bands on primary 2nd molars
 Wire extents anteriorly on the ridge and teeth are fixed on to the wire.
 Mostly for children less than 3yrs, to compensate for speech improvements

PS: If teeth will erupt in 6 months, ---- No need of space maintainer!]]>https://api.spreaker.com/episode/40400138Wed, 19 Aug 2020 06:44:42 +0000Dr.Mayakha MariamMAX – TRANSPALATAL SM  Unilateral loss of E&D * in maxillary only  Connect 6 of opposite arches *at or above 6 years old  Acts as space maintainer + arch expansion + anchorage — function of TPA SM NANCE PALATAL ARCH (NPA)  Can use for both... Unilateral loss of E&D * in maxillary only
 Connect 6 of opposite arches *at or above 6 years old
 Acts as space maintainer + arch expansion + anchorage — function of TPA SM

NANCE PALATAL ARCH (NPA)
 Can use for both unilateral and bilateral
o E missing and D missing
 Only in maxillary
 At or above 6 years age’support from palate – not teeth

LINGUAL ARCH
 Above 7 years
 Because support from anterior teeth
 Both unilateral and bilateral and multiple missing

Anterior Space maintainer

 REMOVABLE DENTURE, with adams / c clasp / ball clasp
 RPD is advisable only if child is 3yrs above
 FIXED SPACE MAINTAINER, orthodontic bands on primary 2nd molars
 Wire extents anteriorly on the ridge and teeth are fixed on to the wire.
 Mostly for children less than 3yrs, to compensate for speech improvements

PS: If teeth will erupt in 6 months, ---- No need of space maintainer!]]>343falsefullhttps://www.spreaker.com/episode/23-canine-exfoliation--40400114 Mandibular – 9 years
 Maxillary – 11 years
 If unilateral extraction required then intentionally extract other C also — to prevent
midline shift — in mandibular only — at 9 years
 Maxillary causes — only extract diseases and give space maintainer — 9 – 10 years

PREMATURE EXFOLIATION OF C
After effects seen
 Lingual collapse of mandibular anterior
 Midline deviation of mandibular
anterior towards C
 Increased overbite
 Loss of arch length or its deficiency
 Increased overjet
 Max canine is most impacted
 Embedded teeth due to lack of eruptive force,
 While impacted teeth is due to lack of space.]]>https://api.spreaker.com/episode/40400114Wed, 19 Aug 2020 06:44:14 +0000Dr.Mayakha MariamCANINE EXFOLIATION  Mandibular – 9 years  Maxillary – 11 years  If unilateral extraction required then intentionally extract other C also — to prevent midline shift — in mandibular only — at 9 years  Maxillary causes — only extract diseases and... Mandibular – 9 years
 Maxillary – 11 years
 If unilateral extraction required then intentionally extract other C also — to prevent
midline shift — in mandibular only — at 9 years
 Maxillary causes — only extract diseases and give space maintainer — 9 – 10 years

PREMATURE EXFOLIATION OF C
After effects seen
 Lingual collapse of mandibular anterior
 Midline deviation of mandibular
anterior towards C
 Increased overbite
 Loss of arch length or its deficiency
 Increased overjet
 Max canine is most impacted
 Embedded teeth due to lack of eruptive force,
 While impacted teeth is due to lack of space.]]>172falsefullhttps://www.spreaker.com/episode/24-malocclusion-in-permanent--40400128
CLASS I
 The buccal groove of mandibular 1st permanent molar must occlude with the mesiobuccal cusp of maxillary 1st molar

CLASS II div I
 Buccal groove of mandibular molar occludes posterior to the mesiobuccal cusp of maxillary 1st molar

CLASS II div I
 Maxillary anterior proclination
 Cause — growth discrepancy
 Soft tissue protrusion in: Class II mod I.

CLASS II div 2
 Maxillary anterior proclined, where laterals proclined and C I’s retroclined
 Cause — growth discrepancy

TRUE CLASS III
 Buccal groove of mandibular molar occludes anterior to the mesiobuccal cusp of maxillary 1st molar
 Skeletal malocclusion
 Cause – hereditary

PSEUDO CLASS III
 Habitual

CANINE RELATIONSHIP
The canine relationship can be used as another method of classifying the AP occlusal relationship.
The classification is outlined below:
 Class I – the maxillary permanent canine occludes in the embrasure between the lower canine and 1st premolar
 Class II – the maxillary canine occludes anterior to the embrasure between the lower canine and 1st premolar.
 Class III – the maxillary canine occludes posterior to the embrasure between the lower canine and 1st premolar]]>https://api.spreaker.com/episode/40400128Wed, 19 Aug 2020 06:44:06 +0000Dr.Mayakha MariamMALOCCLUSION IN PERMANENT DENTITION CLASS I  The buccal groove of mandibular 1st permanent molar must occlude with the mesiobuccal cusp of maxillary 1st molar CLASS II div I  Buccal groove of mandibular molar occludes posterior to the mesiobuccal...
CLASS I
 The buccal groove of mandibular 1st permanent molar must occlude with the mesiobuccal cusp of maxillary 1st molar

CLASS II div I
 Buccal groove of mandibular molar occludes posterior to the mesiobuccal cusp of maxillary 1st molar

CLASS II div I
 Maxillary anterior proclination
 Cause — growth discrepancy
 Soft tissue protrusion in: Class II mod I.

CLASS II div 2
 Maxillary anterior proclined, where laterals proclined and C I’s retroclined
 Cause — growth discrepancy

TRUE CLASS III
 Buccal groove of mandibular molar occludes anterior to the mesiobuccal cusp of maxillary 1st molar
 Skeletal malocclusion
 Cause – hereditary

PSEUDO CLASS III
 Habitual

CANINE RELATIONSHIP
The canine relationship can be used as another method of classifying the AP occlusal relationship.
The classification is outlined below:
 Class I – the maxillary permanent canine occludes in the embrasure between the lower canine and 1st premolar
 Class II – the maxillary canine occludes anterior to the embrasure between the lower canine and 1st premolar.
 Class III – the maxillary canine occludes posterior to the embrasure between the lower canine and 1st premolar]]>227falsefullhttps://www.spreaker.com/episode/25-orthodontic-tooth-movement--40400123
 According to force
o Light continuous force
o Heavy continuous force
o Heavy Interrupted force

 Direction
o Tipping
o Intrusion
o Extrusion
o Bodily movement
o Torque
o Coupled form

LIGHT CONTINUOUS – ORTHODONTIC* ORCE:-
 Frontal resorption is the result
 Osteoclasts and osteoblasts DEPOSITION + RESORPTION
 PDL is compressed at resorption side
 PDL is tensed at deposition zone

HEAVY INTERUPTED – ORTHOPEDIC* FORCE
 Hyalinization & undermined resorption is the result here
 In head gear cases – its principle
 Light continuous is acceptable, so is heavy interrupted, but heavy continuous should be avoided.
 Headgear appliance used for anchorage & traction.
 Chin cup apply to class 3 with long lower face.

Levering the curve of spee for correct deep bite.

Minimal Space needed between primary and permanent dentition
IS : 6 mm in mandible and 7 mm in maxilla.]]>https://api.spreaker.com/episode/40400123Wed, 19 Aug 2020 06:43:58 +0000Dr.Mayakha MariamORTHODONTIC TOOTH MOVEMENT:  According to force o Light continuous force o Heavy continuous force o Heavy Interrupted force  Direction o Tipping o Intrusion o Extrusion o Bodily movement o Torque o Coupled form LIGHT CONTINUOUS – ORTHODONTIC*...
 According to force
o Light continuous force
o Heavy continuous force
o Heavy Interrupted force

 Direction
o Tipping
o Intrusion
o Extrusion
o Bodily movement
o Torque
o Coupled form

LIGHT CONTINUOUS – ORTHODONTIC* ORCE:-
 Frontal resorption is the result
 Osteoclasts and osteoblasts DEPOSITION + RESORPTION
 PDL is compressed at resorption side
 PDL is tensed at deposition zone

HEAVY INTERUPTED – ORTHOPEDIC* FORCE
 Hyalinization & undermined resorption is the result here
 In head gear cases – its principle
 Light continuous is acceptable, so is heavy interrupted, but heavy continuous should be avoided.
 Headgear appliance used for anchorage & traction.
 Chin cup apply to class 3 with long lower face.

Levering the curve of spee for correct deep bite.

Minimal Space needed between primary and permanent dentition
IS : 6 mm in mandible and 7 mm in maxilla.]]>190falsefullhttps://www.spreaker.com/episode/26-types-of-ortho-movements--40400122
TIPPING
 Force — 20 – 50 gram force*
 Most commonly used in ortho Rx
 Removable appliance*
 Centre of rotation at apex
 Root apex at same point and
 Controlled tipping

BODILY MOVEMENT/ TRANSLATION
 Moves the tooth entirely from one position to another.
 Single force is applied at the center of resistence (varies from tooth to tooth)
 Possible only with fixed ortho appliances
 Not possible with removable appliances

INTRUSION
 Minimal force
 Very difficult to attain this movement
 Only resorption, no deposition
 Contra – indicated in gingivitis
 Causes : periodontitis

TORQUE
 Opposite of tipping
 Change in Labiolingual /axial inclination of tooth

EXTRUSION
 Only bone deposition
 Very simple to attain
 Mostly done to create Ferule effect*-orthodontic extrusion
 The fibers that prevent extrusion and lateral tooth movement is the alveolar crestal fibers.

COUPLED FORCE
 Correction of rotation
 Two equal parallel forces acting in opposite direction
 Retention of PMs.
 Transpalatal fibres may need to be cut, - PERICISION is usually indicated after correction of rotation – also call it as CIRCUMFERENCIAL FIBROTOMY]]>https://api.spreaker.com/episode/40400122Wed, 19 Aug 2020 06:43:50 +0000Dr.Mayakha MariamORTHO MOVEMENT DEPENDS ON THE MAGNITUDE OF THE ORTHODONTIC FORCE* TIPPING  Force — 20 – 50 gram force*  Most commonly used in ortho Rx  Removable appliance*  Centre of rotation at apex  Root apex at same point and  Controlled tipping BODILY...
TIPPING
 Force — 20 – 50 gram force*
 Most commonly used in ortho Rx
 Removable appliance*
 Centre of rotation at apex
 Root apex at same point and
 Controlled tipping

BODILY MOVEMENT/ TRANSLATION
 Moves the tooth entirely from one position to another.
 Single force is applied at the center of resistence (varies from tooth to tooth)
 Possible only with fixed ortho appliances
 Not possible with removable appliances

INTRUSION
 Minimal force
 Very difficult to attain this movement
 Only resorption, no deposition
 Contra – indicated in gingivitis
 Causes : periodontitis

TORQUE
 Opposite of tipping
 Change in Labiolingual /axial inclination of tooth

EXTRUSION
 Only bone deposition
 Very simple to attain
 Mostly done to create Ferule effect*-orthodontic extrusion
 The fibers that prevent extrusion and lateral tooth movement is the alveolar crestal fibers.

COUPLED FORCE
 Correction of rotation
 Two equal parallel forces acting in opposite direction
 Retention of PMs.
 Transpalatal fibres may need to be cut, - PERICISION is usually indicated after correction of rotation – also call it as CIRCUMFERENCIAL FIBROTOMY]]>445falsefullhttps://www.spreaker.com/episode/27-finishing-movements--40400125 Wires used here — beta titanium wires*
 Torqueing & uprighting
 LABIOLINGUAL MOVEMENT OF ROOT * CORRECTION OF MESIODISTAL ANGULATION
 CROWN IS STABLE HERE
 Centre of rotation at bracket bonded region on crown

TYPES OF BONES
A) WOVEN BONE* – 1st bone formed in response to orthodontic loading force. It is weak, disorganized, poorly mineralized. It si compacted later to form the COMPOSITE bone, then remodelled to form LAMELLAR bone, if not rapidly resorbed if too much load is given.
B) LAMELLAR BONE - Strong, highly organised well-mineralized tissue
C) BUNDLE BONE - PDL]]>https://api.spreaker.com/episode/40400125Wed, 19 Aug 2020 06:43:39 +0000Dr.Mayakha MariamFINISHING MOVEMENTS  Wires used here — beta titanium wires*  Torqueing & uprighting  LABIOLINGUAL MOVEMENT OF ROOT * CORRECTION OF MESIODISTAL ANGULATION  CROWN IS STABLE HERE  Centre of rotation at bracket bonded region on crown TYPES OF BONES... Wires used here — beta titanium wires*
 Torqueing & uprighting
 LABIOLINGUAL MOVEMENT OF ROOT * CORRECTION OF MESIODISTAL ANGULATION
 CROWN IS STABLE HERE
 Centre of rotation at bracket bonded region on crown

TYPES OF BONES
A) WOVEN BONE* – 1st bone formed in response to orthodontic loading force. It is weak, disorganized, poorly mineralized. It si compacted later to form the COMPOSITE bone, then remodelled to form LAMELLAR bone, if not rapidly resorbed if too much load is given.
B) LAMELLAR BONE - Strong, highly organised well-mineralized tissue
C) BUNDLE BONE - PDL]]>142falsefullhttps://www.spreaker.com/episode/28-anchorage--40400124
STATIONARY ANCHORAGE
I. Class I
a. Intra arch / class I elastic
b. Canine to Molar cases (to close extraction space)
c. They are called buccal canine retractors.
II. Class II and c) Class III
a. Inter – arch elastics or Baker’s anchorage
b. Or class II/III elastic anchorage
c. Upper to lower jaw
d. Class II upper C to lower M
e. Class III upper M to lower C

RECIPROCRAL ANCHORAGE
a) Equal and opposite movement
b) Midline diastema cases closure
c) Posterior crossbite — RME principle

NB: When placing orthodontic bands, theoretically, it is said that we
need prophylactic antibiotic coverage, this is also to prevent
subacte bacterial endocarditis (omr)]]>https://api.spreaker.com/episode/40400124Wed, 19 Aug 2020 06:43:30 +0000Dr.Mayakha MariamANCHORAGE STATIONARY ANCHORAGE I. Class I a. Intra arch / class I elastic b. Canine to Molar cases (to close extraction space) c. They are called buccal canine retractors. II. Class II and c) Class III a. Inter – arch elastics or Baker’s anchorage b....
STATIONARY ANCHORAGE
I. Class I
a. Intra arch / class I elastic
b. Canine to Molar cases (to close extraction space)
c. They are called buccal canine retractors.
II. Class II and c) Class III
a. Inter – arch elastics or Baker’s anchorage
b. Or class II/III elastic anchorage
c. Upper to lower jaw
d. Class II upper C to lower M
e. Class III upper M to lower C

RECIPROCRAL ANCHORAGE
a) Equal and opposite movement
b) Midline diastema cases closure
c) Posterior crossbite — RME principle

NB: When placing orthodontic bands, theoretically, it is said that we
need prophylactic antibiotic coverage, this is also to prevent
subacte bacterial endocarditis (omr)]]>158falsefullhttps://www.spreaker.com/episode/29-fixed-ortho-contraindications--40400155
1. Gingivitis, periodontitis, poor oral hygiene
2. NSAID taking patients
a. Because its anti-inflammatory, but ortho needs inflammation action for osteoclasts and osteoblasts. Eg: ibuprofen, aceclofenac, meftal, paracetamol etc
3. Females above years (menopause)
a. Chances of osteoporosis for which bisphosphonates (same contraindicated in IMPLANT) are given — no resorption action
4. Marfans Syndrome
a. Abraham Lincoln
b. Spider web fingers and toes]]>https://api.spreaker.com/episode/40400155Wed, 19 Aug 2020 06:43:21 +0000Dr.Mayakha MariamCONTRA INDICATIONS FOR ORTHO:- 1. Gingivitis, periodontitis, poor oral hygiene 2. NSAID taking patients a. Because its anti-inflammatory, but ortho needs inflammation action for osteoclasts and osteoblasts. Eg: ibuprofen, aceclofenac, meftal,...
1. Gingivitis, periodontitis, poor oral hygiene
2. NSAID taking patients
a. Because its anti-inflammatory, but ortho needs inflammation action for osteoclasts and osteoblasts. Eg: ibuprofen, aceclofenac, meftal, paracetamol etc
3. Females above years (menopause)
a. Chances of osteoporosis for which bisphosphonates (same contraindicated in IMPLANT) are given — no resorption action
4. Marfans Syndrome
a. Abraham Lincoln
b. Spider web fingers and toes]]>167falsefullhttps://www.spreaker.com/episode/30-myofunctional-appliances--40400121
 Skeletal class II
o Class II retrognathic mandible
o Myofunctional appliance best given in late mixed dentition period to promote
mandible, (not maxilla)

o FRANKEL APPLIANCE 2
 Passive type myofunctional appliance
 Mandibular affect
 Cause mandibular prognathism

o ACTIVATOR
 Common myofunctional appliance

o LIP BUMPER
 Semi-fixed appliance
 Space regainer + myofunctional action
 For molar distalisation.

o ORAL SCREEN
 Habit breaker for mouth breathing + myofunctional

Q. Functional appliances: if asked about functional appliances in the exam just mention posterior bite block: D even if he said active functional: D and do not worry you will get the mark: D no idea how.

but let's explain some notes about functional appliances :
Tooth borne appliances: a) bionator B) herbest(pins and tube device) Tissue borne
appliances: Frankel is the only tissue borne functional appliance

NOTE: all below 18 years at late mixed dentition

12 YEARS AGE
 Growth spurt is minimum, myofunctional wont work
 So need faster acting appliance like
o Herbst — rigid , fixed
o JASPER JUMPER
 Fixed but
 Semi – rigid
o TWIN BLOCK
 70° angulation
 Removable , 12 hours per day]]>https://api.spreaker.com/episode/40400121Wed, 19 Aug 2020 06:42:59 +0000Dr.Mayakha MariamSKELETAL ABNORMALITIES MYOFUNCTIONAL APPLIANCES:- IF SEEN BELOW 18 YEARS  Skeletal class II o Class II retrognathic mandible o Myofunctional appliance best given in late mixed dentition period to promote mandible, (not maxilla) o FRANKEL APPLIANCE...
 Skeletal class II
o Class II retrognathic mandible
o Myofunctional appliance best given in late mixed dentition period to promote
mandible, (not maxilla)

o FRANKEL APPLIANCE 2
 Passive type myofunctional appliance
 Mandibular affect
 Cause mandibular prognathism

o ACTIVATOR
 Common myofunctional appliance

o LIP BUMPER
 Semi-fixed appliance
 Space regainer + myofunctional action
 For molar distalisation.

o ORAL SCREEN
 Habit breaker for mouth breathing + myofunctional

Q. Functional appliances: if asked about functional appliances in the exam just mention posterior bite block: D even if he said active functional: D and do not worry you will get the mark: D no idea how.

but let's explain some notes about functional appliances :
Tooth borne appliances: a) bionator B) herbest(pins and tube device) Tissue borne
appliances: Frankel is the only tissue borne functional appliance

NOTE: all below 18 years at late mixed dentition

12 YEARS AGE
 Growth spurt is minimum, myofunctional wont work
 So need faster acting appliance like
o Herbst — rigid , fixed
o JASPER JUMPER
 Fixed but
 Semi – rigid
o TWIN BLOCK
 70° angulation
 Removable , 12 hours per day]]>283falsefullhttps://www.spreaker.com/episode/31-orthopedic-appliances--40400116
SKELETAL CLASS II - MAXILLA (PROGNATHIC)----headgears

HEAD GEARS : -
 8 YEARS
 High pull, normal pull, cervical pull

 HIGH PULL
o Vertical growth pattern
o Corrects gummy smile
o Corrects overbite

 CERVICAL PULL
o Horizontal growth pattern
o Increase lower facial growth by
Extrusion of molars
o Corrects deep bite

 NORMAL PULL
o Normal growth pattern
 Must wear 12-14 hours
 The force applied here is intermittent (not heave, continuous, light,etc)
 One side force = 450grams (300-500 gm)
 Principle — hyalinization + undermined resorption — heavy force

Q. Active appliances employ force to the teeth to change their position -Most active appliances are fixed. Examples of active appliances include: Rapid maxillary expansion appliance (palatal expander)twice per day 0.5 – 1mm/ day) o Helix o Bite plate o Pin and tube o Ribbon arch o Edgewise o Beg light wire

SKELETAL CLASS III – PROGNATHIC MANDIBLE’
 CHIN CUP
 DAILY 12-14 HOURS
 8 YEARS AGE
 Force = 900 – 1000 grams
 Backwards and superior force direction

SKELETAL CLASS III – RETROGNATHIC MAXILLA
 Face mask / Face frame
 Or reverse head gear
 Daily 12 – 14 hours
 Force 450 grams per side
 Force direction – downwards and forward pull]]>https://api.spreaker.com/episode/40400116Wed, 19 Aug 2020 06:42:46 +0000Dr.Mayakha MariamORTHOPEDIC APPLIANCE SKELETAL CLASS II - MAXILLA (PROGNATHIC)----headgears HEAD GEARS : -  8 YEARS  High pull, normal pull, cervical pull  HIGH PULL o Vertical growth pattern o Corrects gummy smile o Corrects overbite  CERVICAL PULL o...
SKELETAL CLASS II - MAXILLA (PROGNATHIC)----headgears

HEAD GEARS : -
 8 YEARS
 High pull, normal pull, cervical pull

 HIGH PULL
o Vertical growth pattern
o Corrects gummy smile
o Corrects overbite

 CERVICAL PULL
o Horizontal growth pattern
o Increase lower facial growth by
Extrusion of molars
o Corrects deep bite

 NORMAL PULL
o Normal growth pattern
 Must wear 12-14 hours
 The force applied here is intermittent (not heave, continuous, light,etc)
 One side force = 450grams (300-500 gm)
 Principle — hyalinization + undermined resorption — heavy force

Q. Active appliances employ force to the teeth to change their position -Most active appliances are fixed. Examples of active appliances include: Rapid maxillary expansion appliance (palatal expander)twice per day 0.5 – 1mm/ day) o Helix o Bite plate o Pin and tube o Ribbon arch o Edgewise o Beg light wire

SKELETAL CLASS III – PROGNATHIC MANDIBLE’
 CHIN CUP
 DAILY 12-14 HOURS
 8 YEARS AGE
 Force = 900 – 1000 grams
 Backwards and superior force direction

SKELETAL CLASS III – RETROGNATHIC MAXILLA
 Face mask / Face frame
 Or reverse head gear
 Daily 12 – 14 hours
 Force 450 grams per side
 Force direction – downwards and forward pull]]>282falsefullhttps://www.spreaker.com/episode/32-above-18yrs--40400135 ORTHOGNATHIC SURGERY
 Only above 18years age
 If done below 18 years — chances of growth

HIGHER FORCE (head gear)
 Decreases blood supply — cell death
 Avascular area — hyalinized area
 No teeth movement — instead bone changes occur

ORTHOGNATHIC SURGERIES
a) Mandible retrognathism (CLASS II) — bilateral sagittal split osteotomy (BSSO)
b) Maxilla prognathism (CLASS II) — anterior segment osteotomy
c) Class III mandibular prognathic — BSSO set back
d) Maxillary retrognathic — le FORT I Osteotomy

BSSO
 Take care of inferior alveolar nerve
 Saggital plane
 Bilateraly

 For prognathism / retrognathism

QUAD ANGULAR LE FORTE 2 SURGERY
 For midface deformity or deficiency

Q. Orthognathic surgery, you plan to use 2 mm screw the drill
size:1.5 mm.]]>https://api.spreaker.com/episode/40400135Wed, 19 Aug 2020 06:42:37 +0000Dr.Mayakha Mariam18 YEARS AGE  ORTHOGNATHIC SURGERY  Only above 18years age  If done below 18 years — chances of growth HIGHER FORCE (head gear)  Decreases blood supply — cell death  Avascular area — hyalinized area  No teeth movement — instead bone changes... ORTHOGNATHIC SURGERY
 Only above 18years age
 If done below 18 years — chances of growth

HIGHER FORCE (head gear)
 Decreases blood supply — cell death
 Avascular area — hyalinized area
 No teeth movement — instead bone changes occur

ORTHOGNATHIC SURGERIES
a) Mandible retrognathism (CLASS II) — bilateral sagittal split osteotomy (BSSO)
b) Maxilla prognathism (CLASS II) — anterior segment osteotomy
c) Class III mandibular prognathic — BSSO set back
d) Maxillary retrognathic — le FORT I Osteotomy

BSSO
 Take care of inferior alveolar nerve
 Saggital plane
 Bilateraly

 For prognathism / retrognathism

QUAD ANGULAR LE FORTE 2 SURGERY
 For midface deformity or deficiency

Q. Orthognathic surgery, you plan to use 2 mm screw the drill
size:1.5 mm.]]>213falsefullhttps://www.spreaker.com/episode/33-ortho-wires--40400149
NICKEL TITANIUM WIRE
 Super elasticity
 Shape memory —
 Changes from austetic  martentic (A M)
 No plastic deformation
 Disadvantage — high friction
 If NITI wires fractures, it is because of axial fatigue / dynamic & cyclic fatigue.

𝜷 TITANIUM
 Used when patient has allergy to nickel in
 Highest friction
 Finishing wires – ie. Used for making final tooth movements
 Torqueing and uprighting

ROTARY NiTi FILES:-
 Usable in curved canal
 Can use only 3 teeth due to dynamic cyclic fatigue torsion — causing fracture

18 – 8 STAINLESS STEEL
 18% chromium — passivation (function)
 8% nickel
 Very low friction

DIAGNOSTICS
 Cephalometry]]>https://api.spreaker.com/episode/40400149Wed, 19 Aug 2020 06:42:24 +0000Dr.Mayakha MariamORTHO WIRES NICKEL TITANIUM WIRE  Super elasticity  Shape memory —  Changes from austetic  martentic (A M)  No plastic deformation  Disadvantage — high friction  If NITI wires fractures, it is because of axial fatigue / dynamic & cyclic...
NICKEL TITANIUM WIRE
 Super elasticity
 Shape memory —
 Changes from austetic  martentic (A M)
 No plastic deformation
 Disadvantage — high friction
 If NITI wires fractures, it is because of axial fatigue / dynamic & cyclic fatigue.

𝜷 TITANIUM
 Used when patient has allergy to nickel in
 Highest friction
 Finishing wires – ie. Used for making final tooth movements
 Torqueing and uprighting

ROTARY NiTi FILES:-
 Usable in curved canal
 Can use only 3 teeth due to dynamic cyclic fatigue torsion — causing fracture

18 – 8 STAINLESS STEEL
 18% chromium — passivation (function)
 8% nickel
 Very low friction

DIAGNOSTICS
 Cephalometry]]>201falsefull