Orthodontia , also called orthodontic and dentofacial orthopaedics , is a specialized field of dentistry that deals primarily with malposition and jaw teeth: diagnosis, prevention and correction. An orthodontist is a specialist who has undergone special training in a dental school or college after they graduate in dentistry. The field was founded by the efforts of pioneering orthodontists such as Edward Angle and Norman William Kingsley.
Video Orthodontics
Etimologi
"Orthodontics" comes from the Greek orthos ("true", "straight") and -odont - ("teeth").
Maps Orthodontics
History
The history of orthodontics has been closely linked to the history of dentistry for over 2000 years. Dentistry has its origins as part of medicine. According to the American Association of Orthodontists, archaeologists have discovered elderly mummies with metal bands wrapped around individual teeth. Malocclusion is not a disease, but abnormal tooth alignment and the way the upper and lower teeth come together. The prevalence of malocclusion varies, but using an orthodontic treatment index, which categorizes malocclusion in terms of severity, it can be said that nearly 30% of the population present with malocclusion is severe enough to benefit from orthodontic treatment.
Orthodontic treatment can focus on gearshift only, or handle the control and modification of facial growth. In the latter case it is better defined as "dentofacial orthopedics". In severe malocclusions that may be part of craniofacial abnormalities, management often requires orthodontic combinations with headgear or facemask of inverted tack and/or jaw surgery or orthognathic surgery.
This often requires additional training, in addition to a formal three year formal training. For example, in the United States, orthodontists earn at least another year of training in the form of fellowship, called 'Craniofacial Orthodontics', to receive additional training in orthodontic management of craniofacial anomalies.
Method
Usually treatment for malocclusion can take 1 to 2 years to complete, with slightly changed braces every 4 to 8 weeks by orthodontists. There are several methods to adjust the malocclusion, depending on the needs of each patient. In growing patients there are more options for treating skeletal dis- cussions, either promoting or limiting growth using functional equipment, orthodontic headgear or reverse tensile facemasks. Most orthodontic work begins during the initial permanent tooth growth stage before bone growth is complete. If bone growth has been completed, orthognathic surgery can be an option. Tooth extraction may be necessary in some cases to aid orthodontic treatment. Starting a treatment process for overjets and upper teeth that stand out in children rather than waiting until the child has reached adolescence has been shown to reduce damage to the lateral and central incisors. But the treatment results are no different.
Fixed equipment
Currently, most Orthodontic Device Therapy is delivered using fixed equipment, with the use of removable equipment greatly reduced. Treatment results for equipment remain significantly larger than removable equipment because the fixed type produces biomechanics that have greater control over the teeth being handled: capable of removing the teeth in dimensions so that the next tooth position is more ideal.
Indications for Equipment Equipment
Equipment remains commonly used when orthodontic treatment involves the movement of a tooth through 3 axes of the plane in the mouth. These movements include:
1) Rotation in which the tooth does not fit the curved shape and there is contact movement.
2) Some gear movements where there may be a crowd involved and correction will involve the movement of many teeth in various fields.
3) Body movement may be needed to move the gear aligned with the map into the arch where the long axis of the broad teeth is correct but the teeth need to move back into the arch that maintains the axial position.
4) Gives tipping or altering the longitudinal axis of the teeth in which the teeth can be prepared or retrocelled and dental angulation is changed.
5) Root torquing - where the angle of the long axis of the tooth is altered with the position of the altered root to facilitate the crown and the root of a more naturally positioned advantage.
Contraindication
- Poor oral hygiene: this predisposes to decalcification, caries, gingival hyperplasia, periodontal damage
- Active caries
- Poor motivation: treatment will last at least several months, the patient must commit to maintain the highest level of oral hygiene during this period.
- Malocclusion is mild
Risiko
- Dekalsifikasi
The accumulation of plaque around the periphery of the brackets and the tape may cause the demineralization of the email area. It is important that the patient maintain excellent oral hygiene standards during the treatment.
- Root resorption
This often occurs in orthodontic treatment, although usually in small amounts. This is an unreleased unpredictable result. The equipment keeps causing much more root resorption than removable devices. Resorption is more common in adults and with a greater number of tooth movement. The root resorption stops as soon as the gear movement stops so early detection is important.
- Loss of periodontal support
- Loss of bone support
- Maintenance failed
- soft tissue trauma
Jenis Peralatan Tetap
There are many fixed equipment systems in use today. This varies depending on the mechanical system used and personal preferences. In basic terms, the bracket is attached to the center of the tooth and the cable is placed in the bracket slot to control movement in all 3 dimensions. Each individual bracket has different shapes, functions, and features for each particular tooth. Equipments equipped with seats on the side include Edgewise, Begg, Lingual, self-ligating bracket systems. Laboratory fabrication equipment including Herbst, Quadhelix and MIA, Lingual and Transpalatal arch and RME screw equipment. The most common tool in use today is the customized Edgewise Tool.
Brackets
The main parts of the bracket are:
- Wires
- Bracket base - can be used to see welds into orthodontic bands
- Wings of wings
- The marker orientation - placed on the distal-gingival gear aspect
Brackets can be made of stainless steel or porcelain. Brackets can be crushed into teeth using direct or indirect techniques. Direct techniques involve ethical and chemical acids or conventional light cured composites. The indirect technique involves a bracket that light is healed onto an orthodontic model that works to allow the soft soft splint to blow the tool to be built over the model to help the placement of the bracket into the tooth.
Orthodontic Bands
Most commonly used in molar teeth or premolar teeth. They are the means by which force is applied to the teeth. They are made of stainless steel and have one or more tubes passing through it. Large round tubes for facebow and smaller square tubes for archwire. They can also have a number of customized features built into their design, which will affect the gear position.
Archwires
Archwires are made of different metal alloys, and are supplied either as long straight or as pre-formed archwires. There are different types of archwires including:
- Light to heavy
- Round/rectangle
- Interwoven or multi-strand
Archwires are carefully fitted into each bracket slot ready for ligation. Ligating is done using elastic modules or thin wire ligatures: 'Quick Ties'. The closer the matching of the arch cable is to the slot on the bracket, the greater the gear control. As the treatment progresses, thicker wires are used to control the teeth entirely in three dimensions.
Complement
- Coils or springs - used to generate space by opening a space by pushing a tooth apart or closing the space.
- Elastic - active components that come in the form of bands, threads or chains
- Long ligatures - used to bind several teeth together to produce anchorage
- Blur hook - can have elastic or close rolls attached to it.
Functional device
When there is a maxillary overjet, or Class II occlusion, functional equipment may be used to improve occlusion, it is recommended that professionals become specialists in orofacial orofacial to perform these deceptions and personal preferences. The most commonly used fixed tool today is the Pre-Fatigue Edgewise Tool. treatment, orthodontic therapy initiator that involves the use of oral activators by orophageal orthopedics is Viggo Andresen, Viggo Valdemar Julius Andresen (Copenhagen, May 31, 1870 - October 8, 1950) is a Danish professor at Orthodontics in Oslo who is considered the inventor of the activator. In 1908 Viggo Andresen applied his bracket for the first time. Andresen uses activators to stimulate the development of the lower and lower teeth of an orthodontically grown child. This can be fixed or removed. Fixed dental braces are wires that are inserted into brackets secured to the tooth on the labial or lingual surfaces (lingual braces) of the teeth. Other classes of functional equipment include removable equipment and overhead equipment, and this functional equipment is used to redirect jaw growth. Post-treatment followers are often used to maintain new positions of the teeth.
During fixed orthodontic treatment, metal wires are held in place by elastic bands on the orthodontic bracket (braces) on each tooth and inserted into the band around the molars. Orthodontic archwires can be made of stainless steel, nickel-titanium (Ni-Ti) or a more aesthetic ceramic material. Ni-Ti is used as an initial curved wire because it has good flexibility, allowing it to exert the same power regardless of how much it has been deflected. There is also a heat activated Ni-Ti wire that tightens when heated to body temperature. The curved cable interacts with the brackets to move the gear to the desired position.
Orthodontic equipment still helps the movement of teeth, and is used when 3-D movement of the teeth is required in the mouth and multiple tooth movement is required. Ceramic fixed appliances can be used which more closely mimic the color of the teeth than the metal brackets. Some manufacturers offer fixed appliances with their own lighting where metal wires are held by an inseparable clip on the bracket itself. These can be given as metal or ceramic.
The surface of the tooth is scratched, and the brackets adhere to the teeth with adhesive long enough to withstand the orthodontic force, but are capable of being removed at the end of treatment without damaging the teeth. There is currently insufficient evidence to determine whether a conventional self-etch or etching preparation causes less decalcification around the bonding site and if there is a difference between them in the rate of failure of the bond. The bonding material should also be attached to the tooth surface, easy to use and preferably protecting the tooth surfaces against caries (decomposition) because the orthodontic appliance becomes a trap for plaque. Currently the resin/matrix adhesive which is the light cured command is most commonly used. This is similar to a composite filler material.
Anchorage for the appliance prevents unwanted tooth movement and may come from a used head cover, a palate, or a surgical implant.
For young patients with mild to moderate grade 3 to mild grade angle angle (prognathism), sufficient functional means for correction. Examples of functional equipment are: face lid, chin cup, traction bow tandem or headgear. As the malocclusion increases, orthognathic surgery may be necessary. This treatment comes in three stages. Before surgery there was orthodontic treatment to align the teeth into their postoperative occlusion position. The second stage is surgery such as osteotomy of the mandibular or sagittal/sagittal steps of bilateral sagittal split osteotomy depending on whether one or both sides of the mandible are affected. The bone is damaged during surgery and stabilized with titanium plates and screws, or bioresorbabel plates to allow healing to take place. The third stage of treatment is post surgical orthodontic treatment to move the teeth to their final position to ensure the best occlusion.
Posterior crossbite malocclusion may be corrected using a quad helix or removable apparatus during the initial tooth-mixing stage (eight to 10 years), and further research is needed to determine whether the intervention provides greater results than the others for the next stage of dental development.. These crossbites are when the maxillary or jaw teeth are narrower than the mandible, and may occur unilaterally or bilaterally.. Treatment involves the extension of the maxillary arch to restore functional occlusion, which can be 'rapid' at 0.5 mm per day or 'slow' at 0.5 mm per week. Palatal expansion can be achieved by using fixed tools or removable tools. The woven maxillary expansion involves metal bands attached to individual teeth attached to the braces, and the expansion of the bonded upper jaw is an acrylic splint with a wire frame attached to a screw in the palatal diameter, which can be rotated and opened to expand maxillary.
Removable functional appliances are useful for simple movements and can help change tooth angulation: maxillary retrocler and procreating tooth teeth; help with expansion; and overbite reduction.
The head cover works by applying an external force to the back of the head, moving the molar teeth in the posterior (distalising) to allow room for the anterior teeth and reduce the density or to help with the anchorage problem.
Facial hood aims to pull the maxillary and jaw teeth forward and downward to meet the mandible through a balanced force applied to the upper teeth. The mask rests on the forehead and chin of the wearer, and is connected to the maxilla teeth with elastic bands.
Some removable equipment has a flat acrylic bite field to allow full dislocation between the maxillary and mandibular teeth to assist movement during treatment. An example of this is the Clark Twin Block. This design has two acrylic blocks that leave the tooth and protrudes from the lower jaw. This is used to treat Class II malocclusions.
Vacuum-shaped plates such as Invisalign consist of clear, flexible plastic trays, which move the teeth gradually to reduce mild density and can increase irregularities and light distances. They are not suitable for use in complex orthodontic cases and can not produce body movements. They are used full-time by patients other than when eating and drinking. The great benefit of this type of orthodontic appliance is that they are suitable for use when patients have porcelain veneers: because metal brackets can not be attached to the veneer surface.
Adjunctive Therapy
Additional surgical and non surgical treatment has been studied as an option to help reduce the duration of orthodontic treatment. Surgical interventions such as alveolar decortication, and corticision have been used in conjunction with orthodontic treatment to reduce time spent in functional equipment, but more research is needed for possible surgical effects. Non-surgical therapy involves the use of vibrational strength during treatment, but it has not been proven that this significantly reduces maintenance time, or increases comfort for the patient.
Extensive research has been done to prove the effectiveness of functional equipment, but retain important results after the active care phase has been completed.
Post treatment
After orthodontic treatment is completed, there is a tendency to return, or relapse, to a pre-treatment position. More than 50% of patients have some return to pre-treatment positions within 10 years after treatment. To prevent relapse, the majority of patients will be offered retainers (orthodontics) after treatment is completed, and will benefit from using their followers. Followers can be fixed or removed. The removable retainer will be used for different time periods depending on the patient's need to stabilize the tooth. The fixed regulator is a simple wire attached to the labial surface of the incisor using a tooth adhesive and can be particularly useful to prevent rotation of the incisors. Other types of retainers may still include braces or lingual braces, with a fixed bracket on the teeth.
Removable followers include those known as Hawley retainers, made with acrylic base plate and metal wire covering the canines to the canine area. Another form of retractable retainer is an Essix retainer made of polypropylene or polyvinylchloride in the form of a vacuum and can cover all the teeth.
Diagnosis and care planning
In diagnosis and treatment planning, orthodontists should (1) recognize various characteristics of dococcus malocclusion or deformity; (2) defines the nature of the problem, including etiology where possible; (3) designing treatment strategies based on individual needs and desires; and (4) present a treatment strategy to the patient in such a way that the patient fully understands the consequences of his decision.
Care planning is an important aspect of health care. In orthodontics, it is important to consider the following aspects when it arrives at the patient care plan; (1) aesthetics (considering patient concerns and expectations of care), (2) oral hygiene (consider patient and overall dental motivation All patients undergoing orthodontic treatment need to maintain good oral hygiene), (3) function and (4) stability.
Orthodontic treatment "should not endanger dental health [but] promote good functioning, and should produce stable results".
Before a treatment plan can be made, it is important to make the diagnosis. The patient's orthodontic deep assessment is important.
Based on the patient's concern/expectation and the diagnosis being made, a list of 'problems' can be made. Depending on the problem, there may be more than one treatment for the patient. It is important to have a list of 'problems' where you can make a list of treatment options for each 'problem' and present this information to the patient along with the benefits and risks of each treatment option.
Malocclusion varies in severity and can sometimes be simple to treat or very complex to treat.
There are several options for treating malocclusions with underlying skeletal problems;
(1) Orthodontic camouflage: This means that the difference is acceptable, but the tooth is transferred into a Class I relationship.
(2) Growth Modification: This treatment is only possible in growing patients where orthodontic equipment is used to make small changes to the skeletal pattern.
(3) Surgical orthodontic and orthognathic surgical treatment: surgical correction of jaw differences in combination with orthodontics is performed to produce optimal dental and facial aesthetics. Orthognathic surgery can only be performed in patients who have completed growth.
Dental crowd is also common among residents. Cluster maintenance planning involves spatial analysis needed to defuse the crowd.
The number of present crowd can be classified as: light (& lt; 4mm), medium (4-8mm) or weight (& gt; 8mm).
Space can be created in the following ways:
(1) Extraction
(2) Molar distal movement
(3) Pengupasan Enamel
(4) Expansion
(5) Proklinasi insisif
(6) Combination of any or all of the above
It is very important to take all existing and unexploded teeth into account and consider the prognosis of each tooth to achieve the treatment plan.
Once a care plan has been made, informed consent must be taken from the patient. Informed consent includes providing patient information about malocclusion, proposed treatment/alternatives, required commitment, duration of treatment and cost implications.
Malocclusions
The malocclusions are defined as abnormal deviations either aesthetically, functionally or both from ideal occlusion; anatomically perfect set of teeth. The prevalence of malocclusion varies with the age and ethnicity of a person but not all malocclusions require treatment.
Malocclusion is the result of a combination of genetic and environmental factors. Key factors include:
- Abnormal gear positions
- Delay pending
- Dilaceration (abnormal development of tooth shape)
- Hyper & amp; Hypodontia
- Impact
- Tooth loss
- Patient Habits (ie sucking the thumb)
- Retention of deciduous teeth
- Skeletal development
- Pathology (ie cyst)
Malocclusion classification
Skeletal classification indicates mandible maxilla:
- Class I: the mandible is 2-3mm behind the maxillary.
- Class II: mandible more than 3mm behind the maxillary.
- Class III: mandible more than 3mm in front of maxilla.
Class tooth classification - The British Standard Institution Classification is used to determine incisal relationships:
- Class I: the lower incisors deviate with, or lie just below, the cingulum plateau (the middle third of the palate surface) of the upper incisors.
- Class II division 1: the lower incisor edge is located in the posterior plateau of the cingulum on the upper incisor and there is an increase in overjet and incisor over the resulting or average tendency.
- Class II division 2: the lower incisor edge is located in the posterior plateau of the cingulum on the upper incisor and the central incisor over the retroclined; overjet is usually minimal but can be improved.
- Class III: the lower incisor edge is located anterior to the cingulum plateau of the upper incisors; the overjet is reduced or reversed.
Angle Classification (Molar) is used to describe the first permanent molar relationship from normal to malocclusion:
- Class I: the first permanent upper mesio-buccal cusps occur in the lower lower molar buccal grooves.
- Class II: the first permanent upper mesio-buccal cusps clog anteriorly to the first permanent bottom buccal groove.
- Class III: the cusps of the first permanent upper molars over the posterior clog into the lower lower buccal first bile groove.
Other types of dental malocclusion may include:
Overjet: the horizontal distance between the labial insisivus surface and the upper edge of the insisal; Normal measurement is 2-3mm.
Overbite : the vertical distance between the upper and lower incisal sides. Normal is one third to two thirds of the top teeth overlap to the lower incisors. An incomplete overbite is when the lower incisors do not close with opposing upper incisors or the palatal mucosa when the buccal teeth are in occlusion.
Crossbite: Deviations from normal bucco-lingual relationships. It can be anterior or posterior but also unilateral or bilateral. Crossbites can be further subdivided into
- The cheekbone: the buccal cusp of the lower premolar or the lower molar is congested buccally into the buccal cusp of the upper or upper molars.
- Lingual crossbites: the buccal cusp from the lower molar clogs the lingual to the lingual sac of the upper molar.
An anterior open bite: there is no vertical overlap of the incisors when the buccal gear teeth are in a blockage.
Posterior open bite : when the tooth is in occlusion there is a space between the upper and lower posterior teeth.
Difficulty
Crowds occur when one or more teeth do not have enough space to align in the arch. Crowds can be caused by various factors:
- Pending eruption - A delayed eruption produces adjacent teeth hovering and/or tilting resulting in the loss of the curved space . A similar effect is seen early in the loss of primary teeth.
- Lower dental incisors - Intercannine growth increases until age 12-13 , followed by a gradual decrease throughout adulthood. This reduction in the size of the arch is considered a developmental phenomenon
- Early Tooth Loss - Either due to caries, premature exfoliation or planned extraction - early loss of early teeth results in an increase in pre-existing severity. When crowding any remaining teeth will be floated or tilted to the empty space provided. The younger the patient is when the tooth is gone and the previous one in the adjacent tooth development is more serving the effect.
- Hyperdontia - Hyperdontia is a congenital condition having supernumerary teeth. Hyperdontia can cause a crowd due to an increase in the number of teeth inside the arch.
- Skeletal - Skeletal base, largely controlled to genetics, regulates the overall shape, size and relationship of Maxilla and mandible.
- Soft & amp; patient habits - The strength given by the cheeks, tongue, lips and habits of patients all play a role in tooth alignment.
Orthodontic Index
The orthodontic index is one of the few tools available for orthodontists to assess and assess malocclusions. The orthodontic index may be useful for epidemiologists to analyze the prevalence and severity of malocclusion in any population.
Angle classification
Angle Classification was designed in 1899 by Orthodontic father, Dr. Edward Angle to describe the class of malocclusion, widely accepted and widely used since its publication. The Angle Classification is based on the mesiobukal molar relationship of the maxillary first molars and the mandibular first molar plot of the lower jaw. Angle Classification describes 3 classes of malocclusions:
- Class I : Normal occlusion molar relationships or as described for the maxillary first molar, with malocclusion limited to anterior teeth
- Class II : Retracting the lower jaw with the distal occlusion of the lower teeth (or in other words, the maxillary first molars clog anteriorly into the buccal cavity of the lower mandibular first molar
- Class II div 1 : a class II relationship with a central incisivist over the incidis (overjet)
- Class II div 2 : a class II relationship with the upper central incisive lingual inclination (retrocline) and the upper lateral incisors that overlap with the center
- Class III : The protrusion of the lower jaw with a cusp mesiobukal from the maxillary posterior first molar to the buccal groove of the mandibular first molar, with incisivus and cuspids tend to be lingual
The angular classification only considers anteroposterior deviations in the sagittal plane while malocclusion is a three-dimensional (sagittal, transverse and vertical) problem rather than two dimensions as described in the Angle classification. The angular classification also ignores the relationship of teeth with the face.
Massler and the Frankel index noted the number of displaced teeth
Introduced in 1951 by Massler & amp; Frankel to produce a way to record the prevalence of malocclusion that would meet 3 criteria: simple, accurate and applicable to large groups of individuals; produce quantitative information that can be analyzed statistically; reproduced so that the results are comparable. This index uses individual teeth as an occlusion unit, not a curvilinear segment. Each tooth is examined to determine whether the occlusion is correct or malocclusion.
The total number of malocclusion teeth is calculated and recorded. Each tooth is examined from two different aspects: the occlusal aspect and then the buccal and labial surfaces with the exception of the third molar. Teeth not in perfect occlusion of the two occlusal aspects (in perfect alignment with the contact line) and the buccal aspect (in perfect alignment with the occlusion plane and in true interdigitations with opposing teeth) are considered malocclusions. Each malocclusion tooth is assigned a value of 1 whereas the tooth in perfect occlusion is scored 0. A score of 0 will indicate perfect occlusion; a score of more than 10 would be classified as sufficient severity that would require orthodontic treatment; scores between 1 to 9 will be classified as a normal occlusion where no orthodontic treatment is indicated.
However, while the index is simple, easy and able to provide prevalence and incident data in population groups, there are some major losses with this index: primary teeth, erupted teeth and missing teeth left in the scoring system and difficulty in assessing the suitability of each tooth to an ideal position on all aircraft.
Decrease Index
Introduced in 1959 by Lawrence Vankirk and Elliott Pennell. This index requires the use of small tools such as plastic gauges designed for assessment. Rotation and gearshift are measured.
The mouth is divided into 6 segments, and is examined in the following order: anterior jaws, upper right posterior, upper left posterior, anterior mandibular, right posterior posterior mandible and posterior left mandible. This tool is placed above the teeth for scaling measurements, each tooth is given a score of 0, 1 or 2.
2 types of malalignment being measured, rotation and displacement. Rotation is defined as the angle formed by the projected line through the observed dental plan and the ideal curved line. The displacement is defined as both the gear contact area being shifted in the same direction from the ideal alignment position.
- A score of 0 shows the ideal alignment without clear deviations from the ideal curve.
- Score 1 shows minor malalignment: rotation less than 45Ã,º and displacement less than 1.5mm
- Score 2 shows the main malalignment: a rotation of more than 45Ã,º and a displacement of more than 1.5mm
Handicapping Labiollingual Deviation Index (HLDI)
This index was proposed in 1960 by Harry L. Draker. HLDI is designed for the identification of dento-face defects. This index is designed to generate prevalence data when used in playback. Measurements taken are as follows: cleft palate (all or none), severe traumatic deviation (all or none), overjet (mm), overbite (mm), mandibular protrusion (mm), anterior open bite ), labiolingual spread (measurement of gearshift in mm) The HLD Index is used in several states in the United States, with some modifications to its original form by countries that use it to determine orthodontic treatment needs.
Occlusal Feature Index
The Occlusal Feature Index was introduced by Poulton and Aaronson in 1961. This index is based on four important occlusion features that are important in orthodontic examination. The four main features are as follows:
- Lower anterior crowd (canine to canine area)
- Posterior cuspal interdigitation (right posterior premolar to molar area)
- Vertical overbite (measured by lower incisors covered by top upper incisors in occlusion)
- Horizontal overjet (measured between the upper labial surfaces of the upper incisors to the lower labial surfaces of the lower incisors)
The Occlusal Feature Index recognizes the malocclusion is a combination of the way the teeth close and the position of the teeth relative to the neighboring teeth. However, the scoring system is not sensitive enough for case selection for orthodontic purposes.
Malocclusion Severity Estimate (MSE)
Introduced in 1961 by Grainger. MSE measures 7 weighted and undefined measurements:
- Overjet
- Overrated
- An anteriorly bite
- The missing maxillary tooth bone
- The first permanent molar relationship
- Posterior bar bite
- Gearshift (actual and potential)
MSE defines and describes 6 malocclusion syndrome:
- The bones are open positive and anterior open
- Overjet is positive, positive overbite, distal molar contact and posterior crossbite with maxillary maxillary teeth to mandibular teeth.
- Negative overjets, mesial molar links and posterior crossbites with lingual maxillary teeth against mandibular teeth
- Upper maxillary tooth missing by default
- Teeth transfer
- Potential transfer of teeth
Although the definition is relatively comprehensive, there are some drawbacks to this index: data derived from patients aged 12 years may not apply to mixed and mixed teeth, the scores do not reflect all measurements taken and the accumulation and absence of occlusal disorders are not rated as zero. Grainger then revised the MSE index and published a revised version in 1967 and renamed the index to Treatment Priority Index (TPI).
Occultal Index (OI)
The Occlusal Index was developed by Summers in his doctoral dissertation in 1966, and a final paper was published in 1971. Based on the Malocclusion Severity Estimate (MSE), OI attempted to address the shortcomings of MSE.
Summer sets up a different scoring scheme for deciduous, mixed and permanent teeth with 6 specified dental stages:
- Gear age 0 begins at birth, ending with the eruption of the first tooth.
- Gear age 1 begins when stage 0 ends, ending with all primary teeth in the occlusion.
- Gestational age 2 begins when stage 1 ends, ending with the first permanent dental eruption.
- Teeth age 3 begin when stage 2 ends and ends with all permanent centers, lateral incisors and first permanent molars are in occlusion.
- The age of teeth 4 begins when stage 3 ends and ends with a permanent or premolar canine eruption.
- The age of teeth 5 begins when stage 4 ends and ends with all permanent canine teeth and premolars in blockage.
- The age of teeth 6 begins when all permanent canine and premolar teeth are in occlusion.
Nine weighted and defined measurements are taken:
- Molar relations
- Excessive
- Overjet
- Crossbite posters
- The posterior open bite
- Teeth transfer
- Midline relationship
- Maximum median diastase
- Upper maxillary tooth missing by default
Summers also defined 7 malocclusion syndromes including:
- Overjet and openbite
- The distal, overbite, overjet, posterior crossbite, diameter of the diastema and the midline deviation
- The missing maxillary tooth bone
- Gearshift (actual and potential)
- Posterior open bite
- The mesial molar, overjet, overbite, posterior crossbite, diameter of the diastema and midline deviation
- The mesial molar relationship, mixed dental analysis (tooth-shifting potential) and tooth movement.
Index Scale Grade for Needs Assessment (GISATIN)
The Grade Index Scale for Care Needs Assessment (GISATN) was created by Salonen L in 1966. GISATN assessed the type and severity of malocclusion but the index did not show or describe the damage each type of occlusion may cause.
Priority Maintenance Index (TPI)
Priority Care Index (TPI) was created in 1967 by R.M. Grainger at Washington D.C United stated. Grainger describes the index as "a method for assessing the severity of the most common malocclusion types, defect rate or priority of their care". In the index there are eleven measurements weighed and determined: upper anterior segment overjet, lower anterior segment overjet, anterior upper anterior upper anterior, anterior open bite, congenital incisor, distal molar relationship, mesial molar, cross posterior bite (buccal) posterior crossing (lingual), gearshift, dirty anomaly. It also includes seven maloklussion syndromes: maxillary expansion syndrome, overbite, retrognathism, open bite, prognathism, maxillary collapse syndrome and congenitally missing incisors.
Track Malocclusion Assessment Notes (HMAR)
The handicapping malocclusion assessment record (HMAR) was created by Salzmann JA in 1968. It was created to establish the need for treatment of handicapping malocclusion according to the severity presented by the magnitude of the score when assessing malocclusions. Assessment can be done directly from the oral cavity or from the available molds. To make the assessment more accurate, an additional note form was made for direct mouth assessment allowing the recording and scoring of mandibular function, facial asymmetry, lower lip malposition in relation to maxillary incisors and treatment desires. The index has been accepted as a standard by the Board or Orthodontic Health Care, Board of Directors of the American Association for the ease of using HMAR.
Little Slight Index
The small irregularity index was first written in a paper published The Irregularity Index: the quantitative score of the anterior mandibular frontline. The Irregularity Littles Index is commonly used by the public health sector and insurance companies to determine the need for care and the severity of malocclusions. It is said that this method is "simple, reliable and valid" to measure the linear displacement from the point of contact of the tooth. This index is used by creating five linear lines of adjacent contact points ranging from mesial right canines to mesial left canine teeth and these are recorded. Once this is done, the player model can be ranked on a scale ranging from 0-10.
WHO/FDI - basic method for recording malocclusions
The WHO/FDI index uses the prevalence of malocclusion ions and estimates the treatment needs of the population in various ways. It was developed by the Federation of Dentaire Internationale (FDI) of the Classification and Statistics Commission for Mouth Conditions (COCSTOC). The goal when creating indexes is to allow the system to measure occlusions that can be easily compared. The five major groups recorded are as follows: 1.Gross Anomaly 2.Dentition: missing tooth, supernumerary teeth, incisive malformations and exotic eruptions 3. Terms: Diastheme, Crowding and Spacing 4.Occlusion:
* Incistive segments: maxillary/mandikuler overjet, overbite, open bite and cross bite   * Lateral segment: anteroposterior relationship, open bite, posterior cross bite
5. Orthodontic treatment needs to be assessed subjectively: no need, doubtful and necessary
Dental Esthetic Index (DAI)
The aesthetic index created in 1986 by Cons NC and Jenny J and has been recognized by WHO added to the International Mental Health Interpretation Study. This index links the aesthetic and clinical aspects plus the patient's perception and combines them mathematically to produce a single score. Although DAI is widely recognized in the United States, in Europe as government pressure is more effort is spent on defining patients with malocclusions that can be damaging and who can qualify under government regulation to be paid rather than look at the aesthetic aspect.
Handicapping Labiollingual Deviation (HLD) (CalMOD)
HLD is a suggestion by Dr. Harry L. Draker in 1960 in the American Journal of Orthodontics published in 1960. It was intended to identify the most unfavorable looking malocclusion as a defect but completely failed to recognize a patient with a large maxillary bulge with enough even a tooth, to be looks very flawed by the public. The index ends up being a law-driven modification of the 1960's advice. Harry L. Draker and became the HLD (CalMod) Index of California. In 1994, California was sued once again and the settlement of this allowed for an adjustment. This allows overjets greater than 9mm to qualify as an exception, fixing previous modification failures. To resolve the lawsuit and respond to the plaintiff's wishes, a reverse overate greater than 3.5mm is also included in the qualifying exception. The modifications were then used officially in 1991.
The purpose of the HLD index (CalMod) is to measure the presence or absence, and the degree of defect caused by the index component and not to diagnose malocclusions. Measurements for the index are made with Boley Gauge (or disposable ruler) scaled in millimeters. The absence of a condition should be presented by entering '0'.
These are the conditions you should consider:
- deformity palin defects
- Deeply implies overbite
- Cross bites from individual anterior teeth
- Severe traumatic deviation
- Overjet is larger than 9mm
- Overjet in mm
- Overbite in mm
- mandibular protrusions in mm
- Open bite in mm
- Ectopic eruption
- An anterior crowd
- Labiolingual spread
- Posterior Crossbite unilateral
Once this is done and all checks are completed, the score is added. If patients do not achieve a score of 26 or above, they may still qualify under EPSDT (Early and Periodic Screening, Diagnostic and Treatment) unless medical needs are documented.
Peer Assessment Rating Index
The index was implemented in 1987 by the British Orthodontic Standard Working Party after 10 members of this party formulated this index during a series of 6 meetings
This index is a quick, simple, and powerful way to assess orthodontic treatment standards performed by an orthodontist is achieving or trying to achieve rather than the degree of malocclusion and/or the need for orthodontic treatment. However, it should be concluded that this patient should receive orthodontic treatment before the PAR index. The PAR index has also been used to assess whether physicians correctly determine the need for orthodontic treatment when compared to calibrated malocclusion examiners.
This type of index compares the results of orthodontic treatment because it observes the outcomes of a group of patients, rather than individually to the results they expect. This type of testing occurs because there will always be a small number of individual patients where the index results are not fully representative. Interpretation of results indicates that when there is an PAR score greater than 70% it is a very high standard of care, anything less than 50% indicates poor overall care standards and below 30% means that the malocclusion patient has not been improved with orthodontic treatment
The result should only be compared using a group of patients rather than an individual base as this may show completely different results that would not represent the standard of care performed.
Orthodontic Necessity Index (IOTN)
The Orthodontic Necessity Treatment Index was developed and tested in 1989 by Brook and Shaw in the UK following a government initiative.
The purpose of the IOTN is to assess the likely impact of malocclusion on dental health and psychosocial well-being. Indexes easily identify individuals who would benefit most from orthodontic treatment and assign them priority care. Therefore, in the UK, it is used to determine whether patients under the age of 18 are eligible for orthodontic treatment in the NHS.
It consists of two elements: the dental component and the aesthetic component.
For dental health (DHC) components, malocclusions are categorized into 5 classes based on occlusal characteristics that may affect the function and length of dental growth. Index is not cumulative; one of the worst features of the malocclusion determines the set value.
The aesthetic component (AC) considers the potential psychosocial impact of malocclusion. A scale of 10 standard color photos shows a decrease in the level of attractiveness of teeth used. The images are compared to the patient's teeth, when viewed in the occlusion of the anterior aspect, by an orthodontist who will get an appropriate score. Scores are categorized according to treatment needs:
- Score 1 or 2 - no need
- Score 3 or 4 - little need
- Scores of 5, 6, or 7 - moderate/limit
- Scores of 8, 9, or 10 - exact needs
AC has been criticized for its subjective properties and because of the lack of representation of Class III malocclusions and anterior open bites in the photographs used.
Often, DHC scores alone are used to determine the need for care. However, air conditioning is often used in boundary cases (DHC grade 3). IOTN is used in the following ways:
Memorandum of Orthodontic Screen dan Indikasi untuk Perawatan Ortodontik
The index was implemented in 1990 by the Danish national health council.
In 1990 the Danish system was introduced based on the health risks associated with malocclusions, where it described the possible damage and problems arising from untreated malocclusions that allowed for the identification of treatment needs.
This mandate introduces a more valid descriptive index of biological views, using qualitative rather than quantitative analysis.
Ideal Dental Relations Index
ITRI ​​was founded in 1992 by Haeger utilizing intra-arch and inter-arch relationships to generate index scores to compare all tooth occlusion. This index is used because dividing the arch into segments will produce more accurate results.
This index evaluates the dental relationship from a morphological perspective that has been used when evaluating orthodontic treatment outcomes, post-treatment stability, persistence, relapse and different modalities of orthodontic treatment.
ITRI ​​â €
The index was first described and implemented in 1992 by Espeland LV
This index is used by the Norwegian health insurance system and because it is designed for the allocation of public subsidies from medical expenses, and the amount of reimbursement associated with the category of care needs. It classifies malocclusions into four categories based on the need for care.
Risk Assessment Malocclusion (ROMA)
This is a tool used to assess treatment needs in young patients by evaluating the problem of malocclusions in growing children, assuming that some aspects may change under the positive or negative effects of craniofacial development. It was published for use in 1998 by Russo et al .
This index describes the need for orthodontic intervention and is used to establish a relationship between the registered onset of orthodontic treatment and inhibition of facial and alveolar bone growth, and tooth development along with the IOTN index.
This index can be used in exchange for the IOTN scale as it is fast and easy to apply as a screening test to decide whether and when to refer patients to orthodontist specialists.
Complexity Index, Results and Needs (ICON)
The index was produced in 2000 by Charles Daniels and Stephen Richmond in Cardiff and has been investigated to illustrate that it can be used to replace PAR and IOTN scales as a means of determining the needs and outcomes of orthodontic treatment.
This index measures the following to produce a valuation system:
- Dental aesthetics measured with the aesthetic components of IOTN
- The presence of a cross bite
- The anterior vertical relationship measured by PAR
- Crowd/curvature above on a 5-point scale
- The correlation-rectal segment relationships measured by PAR.
Measurements are added together to produce scores that can be interpreted by a range of scores that provide for maintenance, complexity and level of improvement.
The system claims to be more efficient than the PAR and IOTN indexes because it requires only a single measurement protocol but this should still be validated for use in the UK and unsuitable problems for predicting appearance, function, speech, or treatment. the need for individuals who attend general dental practice for routine dental care, so for this reason it is usually never used.
Baby-ROMA
It was established in 2014 by Grippaudo et al for use in assessing the risks/benefits of early orthodontic therapy in primary dental growth.
This is a pediatric type version of the ROMA scale. It measures the occlusal, skeletal and functional parameters that may represent a negative risk for physiological development of the orofacial region, and indicates the need for preventive or interception orthodontic treatment using a score scale.
This index is designed because it has been observed that some of the signs of malocclusion observed in primary teeth may deteriorate with growth while others remain the same over time and others may even improve. This index is therefore used to classify the observed malocclusion at an early stage on a risk-based scale.
Training
There are several specialized fields in dentistry, but orthodontic specialization is the first recognized in dentistry. In particular, the American Dental Association recognized orthodontics as a specialty in the 1950s. Each country has its own system to train and register orthodontic specialists.
Canada
In Canada, obtaining a dentist's degree, such as a Dentist (DDS) or Dentist (DMD), will be required before admission by the school for orthodontic training. Currently, there are 10 schools in the country that offer orthodontic specialties. Candidates should contact the school directly to get the latest prerequisites before admission. The Canadian Dental Association expects dentists to complete at least two years post-doctoral, specialized orthodontic training in an accredited program, upon graduation from their dentist degree.
United States
Similar to Canada, there are several colleges and universities in the United States that offer orthodontic programs. Each school has a different admission process, but every applicant must graduate with DDS or DMD from an accredited medical school. Admission to highly accredited accredited orthodontic courses, and starting with passing the national or state licensing exam.
The program normally lasts for two to three years, and in the final year, graduates will complete the written American Board of Orthodontics (ABO) exam. The exam is also divided into two components: a written exam and a clinical exam. Written exams are comprehensive exams that test applicants' knowledge of basic science and clinical concepts. Clinical examinations, however, consist of Oral Core Checking (BCOE), Case Reporting (CRE), and Oral Case Reporting (CROE) Examination. Once certified, certification must be updated every ten years. Orthodontics programs can provide a Master of Science degree, a Doctor of Science degree, or a Doctor of Philosophy degree depending on the school and individual research requirements.
Bangladesh
Dhaka Dental College in Bangladesh is one of the many schools recognized by the Bangladesh Medical and Dental Council (BM & amp; DC) offering post-graduate orthodontic programs. Before applying to a post-graduate training program, an applicant must have completed a Bachelor Dental Surgery (BDS) exam from all dental colleges. After the application, applicants must take admission tests organized by a particular college. When successful, the selected candidate undergoes training for six months.
United Kingdom
Throughout the United Kingdom, there are a number of available Orthodontic Orthodox Training Registration posts. The program is full-time for three years, and upon completion, the trainees graduate with degrees at the Master or Doctorate level. Training may take place within the hospital departments associated with recognized dental schools. Obtaining a Special Training Completion Certificate (CCST) allows an orthodontist specialist to be registered under the General Dental Council (GDC). An orthodontic specialist may provide care in primary care settings, but to work in a hospital as an orthodontic consultant, higher level training is required further as a post-CCST training participant. To work in a university setting, as an academic consultant, completing research to obtain a PhD is also required.
Pakistan
In Pakistan to be enrolled as a student or resident in a postgraduate orthodontic course approved by the Pakistani dentist's board of dentistry, the dentist must graduate with a Bachelor of Dental Surgery (BDS) or equivalent degree. Pakistan Medical & amp; The Dental Council (PMDC) has a recognized program in orthodontics as Orthodontic Master in Dental Surgery (MDS) and Orthodontic FCPS as a 4-year postgraduate degree program, most recently undertaken by CPSP Pakistan.
Oral hygiene and orthodontic equipment treatment
Good oral hygiene is essential for successful orthodontic treatment. The presence of orthodontic equipment placed on the teeth makes traditional home-care techniques very difficult to do. It is important that a good oral hygiene regime is established at the start of treatment and adhered to. Hose in this case can cause general complications of orthodontic treatment - tooth decay and periodontal disease.
The early signs of tooth decay that can be detected with the naked eye are white spot lesions. This can happen as early as 4 weeks after treatment with the tool begins. It is therefore important to ensure that all dental surfaces are achieved to ensure effective removal of plaque. Places with the highest plaque accumulation rates for a person with an orthodontic device are around the incisors of the lateral and maxillary canines, the gingival margins, and the tool bracket. The usual toothbrush may be difficult to reach all these places as it provides inadequate cleaning. Toothbrushes are regularly replaced, Interdental brushes and threads are helpful in achieving this.
Orthodontists recommend that those who currently undergo twice-daily orthodontic treatment brush with fluoride toothpaste - containing 2,800 ppm of NaF is indicated for those with orthodontic equipment. It is also recommended that patients also use fluoride mouthwashes at separate times to brush their teeth.
Diet is also an important part in establishing a good oral health regimen. Avoiding crunchy and sticky foods will not only reduce the level of food storage around the tool but also protect fragile wires and brackets against damage and separation. Reducing sugar levels in foods also reduces the risk of caries, which can cause demineralization around the tool. Restricting high sugar foods and drinks at mealtimes is an effective way to do this. On the sidelines eating healthy snack foods such as wheat bread, crackers, bread stick sticks vegetable sticks and cheese. These are all safe foods and will help reduce the risk of caries formation. Beware of eating hard or chewy foods such as apples and carrots can cause wire damage, cut these food first or avoid completely during the treatment period.
When using removable tools, high quality care is equally important. After each meal, the appliance must be removed, and the teeth cleaned as usual. Toothbrush and paste should then be used to brush the food scraps or plaque from the tool, over a bowl of water to prevent damage if dropped. It is ideal for patients to carry a toothbrush with them during the treatment to allow this level of cleaning to take place at school or at work.
See also
- Accelerated orthodontic treatment
- American Orthodontist Association
- Canadian Orthodontist Association
- Indian Orthodontic Society
- Orthodontic technology
- Orthognathic Operation
- List of Orthodontic Functional Equipment
- Molar distillation
References
External links
- What is a Certified Orthodontist Board?
Source of the article : Wikipedia
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