INTERCEPTIVE

ORTHODONTICS
Defined as that phase of the
science and art of orthodontics
employed to recognize and
eliminate potential irregularities
and malpositions of the
developing dento-facial complex.
 PROCEDURES UNDERTAKEN
IN INTERCEPTIVE
ORTHODONTICS
• Serial extraction
• Correction of developing crossbite
• Control of abnormal habits
• Space regaining
• Muscle exercises
• Interception of skeletal malrelation
• Removal of soft tissue or bony barrier to
enable eruption of teeth
 SERIAL EXTRACTION
Planned and sequential removal of the primary and
permanent teeth to intercept and reduce dental
crowding problems.
-- Tweed

Term given by Kjellgren {1929}

Popularized by Nance {1940}
• Indications –
1) Arch length tooth size discrepancy with one
of the following features :
a) Absence of physiologic spacing.
b) Ectopically erupted teeth.
c) Mesial migration of buccal segment.

2) Skeletal class I malocclusion, straight profile.

3) Growth is not enough to overcome

discrepancy.
 CONTRAINDICATIONS

1) Spaced dentition.

2) Class II or III skeletal malocclusion.

3) Anodontia/ oligodontia.

4) Open bite / deep bite cases.

5) Mild arch length discrepancy.

 RATIONALE

• Arch length tooth material discrepancy

• Physiologic tooth movement
 PROCEDURE

• Dewel’s method c d 4
• Tweed’s method d{4c}
• Nance method d4c
 PROCEDURE
A) Dewel’s Method –
1st step - extract deciduous canine to create space for
alignment of incisors.

2nd step – extract deciduous first molars.

3rd step – extract 1st premolars to permit permanent

canines to erupt.
B) Tweed’s method – Extraction of deciduous 1st
molars followed by extraction of 1st premolars &
deciduous canine.
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CROSS BITE
Definition
An abnormal relationship of one or more teeth to one
or more teeth of the opposing arch in the bucco-lingual
or labio-lingual direction

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CLASSIFICATION OF
CROSS BITE
• Cross bite can be :
1.Anterior / posterior cross bite
2.Buccal / lingual cross bite
3.Dental / skeletal / functional in etiology

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SCISSOR BITE
• Situation in which posterior teeth overlap vertically in
habitual occlusion with their antagonists without
contact of their occlusal surfaces
• The deviation of the affected teeth from their ideal
positions could occur either in a buccal or a lingual
direction.

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DENTAL CROSS BITE

• An abnormal relationship between antagonist teeth,
that is due to deviations in the position or inclination of
one or few teeth.
• The relationship between the maxilla and the mandible
is harmonious.
• Such cross bites are treated by tooth movement alone.

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SKELETAL CROSS BITE

• Anterior or posterior (unilateral or bilateral) cross bite
that is due to a sagittal or transverse in coordination in
the size or shape of the maxilla and or mandible.
• Treatment usually requires a skeletal expansion by
means of rapid maxillary expansion or orthognathic
surgery.

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FUNCTIONAL CROSS BITE

PSEUDO CROSS BITE
• A cross bite that is due to a shift of mandible into faulty
habitual occlusion because of premature occlusal
interference.
• This shift may occur in an anterior and or lateral
direction.

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 CORRECTION OF CROSSBITE
• Tongue blade therapy
• Inclined planes
• Composite inclines
• Hawleys appliance with Z
spring
• Quad helix
 INTERCEPTION OF HABITS

• Thumb sucking
• Tongue thrusting
• Mouth breathing

Fixed tongue
rake
Habit:
• Habit in the orthodontic sense refer to certain actions
involving the teeth & other oral or perioral structures .
• Which are repeated often enough by some patients to have
profound & deleterious effect on position of teeth & occlusion.
• Habit that can affect the oral structures are, thumb sucking,
tongue thrusting , mouth breathing, etc.
Thumb sucking:
• Presence of this habit upto 2.5 - 3years is consider quite
normal.
• Beyond 3.5 - 4years of age can have a damaging
influence on the dentoalveolar structure.
Tongue thrust:
• Is defined as a condition in which the tongue makes
contact with any teeth anterior to the molar during
swallowing.
• Present with open bite & anterior proclination.
• Intercepted by using habit breaker.
• Trained & educated on the correct technique of
swallowing.
Mouth breathing :
• Can be obstructive or
habitual in nature.
• Nasal obstructive such as
nasal polyps ,nasal tumors,
chronic nasal inflammatory
conditions & deviated nasal
septum.
• Persistence of habitual oral
breathing is an indication to
use a vestibular screen to
intercept the habit.
 MUSCLE EXERCISES

• Exercises for masseter muscle

• Exercises for circum-oral muscle
• Exercises for tongue
 MUSCLE EXERCISE

a. Exercise for the masseter muscle:

• To strengthen the masseter muscle .
• Clenching of teeth by the patient while
counting to ten.
• Repeat the exercise for some duration of
time.
b. Exercise for the lip [circum oral muscles]
I. Upper lip is stretched in the posteroinferior direction by
overlapping the lower lip .such muscular lip allow the
hypotonic lips to form oral seal labially.
II. Hypotonic lips can also be exercised by holding a piece
of paper between the lips.
III. Parent can stretch the lips of the child in the
posteroinferior direction at regular interval.
IV. Swashing of water between the lips until they get tired .
V. Massaging of the lips.
VI. Use of oral screen with a holder-to exercise the lips.
VII. Button pull exercise.
VIII. Tug of war exercise.
c. Exercise for the tongue:
i. One elastic swallow.
ii. Two elastic swallow.
iii. Tongue hold exercise.
iv. The hold pull exercise.
 SPACE REGAINING

Fixed appliances Removable appliances

• Herbst space regainer • Hawley’s appliance with

helical spring
• Jackscrew space • Hawley’s with split
regainer acrylic dumb-bell spring
• Hawley’s with sling shot
elastics
• Gerber space regainer • Hawley’s with palatal
spring
• Hawley’s with expansion
screws
 INTERCEPTION OF SKELETAL
MALRELATION
• Interception of class II
malocclusion

Maxillary excess- face bow with

headgear

Mandibular deficiency -
myofunctional appliances

Twin-block
• Interception of class III
malocclusion

Maxillary deficiency - face mask

therapy or Frankel III

Mandibular excess - chin cup

therapy with headgear
 REMOVAL OF SOFT TISSUE
AND BONY BARRIERS
• Removal of retained deciduous tooth /teeth

• Supernumerary teeth

• Fibrous/bony obstruction of the

erupting tooth bud mesiodens
THANK YOU