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Methods of gaining space

Dr Khaled AboulAzm Orthodontic Course Director OR422 2012

You Never Fail Until You stop trying....

Methods of gaining space

Dr.Khaled AboulAzm 2012

Methods of gaining space


Space is required for Alignment of crowded teeth Retraction of proclincd teeth Correction of molarrelationship Derotation of anterior teeth Leveling the curve of Spee The various methods of gaining space include 1. Proximal stripping 2. Arch expansion 3. Distalization of molars 4. Extraction 5. Uprighting of tilted teeth 6. Proclination of anterior teeth

There is enough enamel Thickness (Broader occlusally)

CONTRAINDICATIONS Patients who are susceptible to caries. Proximal stripping is avoided in young individual as their teeth may possess large pulp chambers

ARCH EXPANSION
Orthodontic Expansion Widens buccal segments (usually by tipping crowns) using fixed appliances Done only in permanent dentition Orthopedic Expansion Palatal expansion with a fixed appliance Can be used in mixed dentition

PROXIMAL STRIPPING
the selective reduction of the mesiodistal width of certain teeth to create space. The teeth that are usually proximally stripped are the mandibular incisors.

INDICATION Done when space requirement is minimal (2.5- 3 mm).

Methods of gaining space

Dr.Khaled AboulAzm 2012

DISTALIZATION OF MOLARS
push the maxillary and/or mandibular terminal molars posteriorly. This increases the arch length by the same length as the amount of distalization achieved.

EXTRACTION
most common methods of gaining space in the arch. If the dentition is too large to fit in the dental arch without irregularity, it may be necessary to reduce the dentition size by the extraction of teeth.

usually undertaken before the eruption of the second permanent molars. Guidelines for extraction The appliances distalization of molars can be Less than 4 mm arch length discrepancy exclassified as: traction rarely indicated. Extraoral distalizing appliances ( Head gear) 5-9 mm arch length discrepancy borderline non-extraction or extraction possible; depends on the details of the therapy 10 mm or more arch length discrepancy extraction almost always required

First premolars extraction


lt is the tooth most commonly extracted as part of orthodontic therapy especially for the relief of crowding because: Intraoral distalizing appliances It is positioned near the center of each quadrant of the arch and is therefore near the site of crowding, i.e. the space gained by their extraction can be utilized for correction both in the anterior and posterior region. The contact between the canine and second premolar is satisfactory. First premolar extraction leaves behind a posterior segment that offers adequate anchorage for retraction of the 6 anterior teeth.

Extraction of lower incisor


In a very limited cases as Incisors with poor prognosis due to trauma, caries, gingival recession Incisor completely out of the arch

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