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Malocclusion (Etiology of Malocclusion (Defect in embryonic/dental…

- - - - Prevalence:
        
        Supernumeraries = 2-3%
        
        Ectopic Canines = 2-3%
        
        Transposed teeth = <1%
    - - Prevalence:
        
        Hypodontia = 2-3%
        ex. Missing laterals
        
        Diastema = 7%
  - - - Class III
        Prognathic Mandible/ Retronagthic Maxilla
      - Management:
        
        Mx retrusion = reverse E/O headgear
        
        Alternative = Functional +Fixed appliances
    - - Class II
        Prognathic Maxilla/Retrognathic mandible
        
        maxilla forward relative to mandible
        
        proclined anterior teeth
      - Management:
        
        Max protrusion = E/O Head gear (300-500g/side)
        
        Mdb retrusion = Twinblocks or Activator
        
        Alternative: Functional + fixed appliances
  - - - Eitology
        
        Habits
        
        Prolonged thumb/finger sucking
        
        Tx around habit cessation
        
        Tongue Thrust
        
        Tongue thrust during swallowing produce significant forces
        
        Loss of condylar Ramus Height
        
        Tumor, osteoarthritis, idiopathic resorption
        
        Tx w/ fixed/removable bite planes
      - Prevalence:
        Prevalence in Caucasians (2-4%) vs. Africans (5-10%)
      - Management:
        
        Primary:
        
        Cessation of habits
        
        Permanent:
        
        Cessation support of habits /and or orthodontic appliance ie tongue crib
        
        Fixed ortho appliances w/ age timing, maybe orthognathic surgery
    - - Prevalence:
        Prevalence in Caucasians (7-12%) vs. Africans (0.8-1.5%)
      - Aeitology:
        
        Strong genetic predisposition
      - Management
        
        Removable or fixed bite planes
        
        Other ortho fixed applainces
        
        Cervical headgear (extrude upper posterior teeth)
        
        Orthognathic surgery
  - - - Anterior Crossbite
        Occurs when 1 or more upper labial segment (ULS) teeth occlude palatal to incisal edges to the lower labial segment (LLS)
        
        Aeitology:
        Local – Crowding, retained primary teeth
        Skeletal – Class III base
        Trauma – repositioned, subluxed tooth
        Development – cleft palate (primary fusion misformation)
        Functional – anterior mdb shift
        
        Management:
        
        Removable: URA [z-springs, posterior bite planes]
        
        Fixed: - AP expansion
        
        Surgery: - fixed braces & reset the mandible back
        
        Prevalence = 4-5%
      - Posterior crossbite
        Occurs when palatal cusps of at least one maxillary posterior tooth do not occlude in the central fossa of the opposing mandibular tooth
        
        Aetiology:
        Hereditary
        Sucking/Swallowing habit – Infantile swallowing
        Mdb functional Shift
        Impaired nasal breathing – enlarged adenoids
        Prevalence:
        Most common transverse problem = 20%
        (predominate unilateral)
        
        Classification
        
        Dentoalveolar:
        
        AB=CD (teeth tilt toward midline)
        
        Skeletal:
        
        AB<<CD (teeth tilted away from midline)
        
        Management:
        
        Fixed
        SME = Quad-helix
        RME = Hyrex-Screw
        
        Removable
        SME = Midline expansion w/ posterior capping
        
        Surgical
        Assisted RME
      - Unilateral
        
        Asymmetrical mandible or maxilla
        
        Functional shift (mdb deviation to achieve MI)
        
        Bilateral
        
        Associated w/ skeletal discrepancy (mx or mdb discrepancy)
    - - Etiology:
        Genetic (craniofacial microsomia, unilateral CLP)
        Environmental (pathology, excessive asymmetric condylar growth)
        Functional deviations (premature contacts, constricted mx)
        Local (restrained/missing teeth)
      - Management:
        Minimize mx cant during growth (esp. CF microsomia)
        Orthognathic surgery
        Soft tissue augmentation
        Functional adjustments
        Exodontia
- - - - Class I – Lower incisors edges occludes with above cingulum of upper incisor
      - Class II, division 1 – Upper 1s proclined, lower occludes on/post. to upper cingulum
      - Class II, division 2 – Upper 1s retroclined, lower occludes post to upper cingulum
      - Class III – Lower incisor edges occlude anterior upper incisor
    - - Class I – The distal surface of the L3 is within a premolars width of the mesial surface of the U3
      - Class II, 1/2 Unit – Distal surface of L3 is distal to mesial U3 half the width of the premolar
      - Class II, full unit – Distal surface of L3 is distal to the mesial surface of U3 by a full width of a premolar
      - Class III – Distal surface of the L3 is mesial to the mesial surface of U3 by the width of a premolar
    - - Class I –MB cusp of U6 occludes in the Mb groove of L6
      - Class II – MB cusp of U6 occludes mesial to Mb groove of L6
      - Class II – MB cusp of U6 occludes distal to Mb groove of L6
    - - Class I – Mdb 2-3mm posterior to mx
      - Class II – Mdb retruded rel. To mx
      - Class III – Mdb protruded rel. mx