Orthodontics: Malocclusions and Treatments

• Module UF3_NF1: Assistance procedure for orthodontic treatment.

Introduction to Orthodontics

• Orthodontics is a branch of dentistry focused on studying and treating malocclusions.
• The term comes from the Greek words "ortho" (straight) and "odontos" (teeth).
• Occlusion refers to the relationship between the upper and lower dental arches.
• Malocclusion is a condition characterized by an abnormal relationship between teeth within the same arch or between opposing arches.
• Normocclusion is a correct dental occlusion.
• The stomatognathic apparatus is the set of organs and tissues that are responsible for functions like eating, speaking, swallowing, smiling, breathing, kissing, and sucking, encompassing the oral cavity, skull, face, and neck.
• Orthodontic devices are mechanical appliances that apply physical forces to teeth, bones, and surrounding tissues to correct deviations.
• Orthodontic treatment aims to correct malocclusion, improve masticatory function, preserve the integrity of the dentition, harmonize with the stomatognathic apparatus, and enhance aesthetics.
• Knowledge of materials and devices is essential for an assistant to correctly perform an operation together with an odontologist
• Fixed and removable devices are used to enhance the patient's scientific and technological advances, offering new treatment options.
• Malocclusion is the fundamental basis for orthodontic treatments, described and classified by Angle.
• Angle's classifications continue, and some maintain, conditions like open bite are not considered.

Angle Classification of bite

• Class I: Individual malpositions of teeth, like rotations or vertical deviations.
• Class II: Maxilla is displaced anteriorly, or the mandible is retruded.
• Class III: Mandible is advanced, or the maxilla is retruded.

Types of Clasification in Orthodontics

• Orthodontic appliances are classified according to several criteria: whether they are removable or fixed, their location (extraoral, intraoral, or mixed), the origin of the forces they apply, and their composition.
• Removable appliances are those that patients can remove themselves, while fixed appliances are not.
• Appliances can be active or passive; active appliances exert force, while passive appliances transmit force from anatomical structures.
• Depending on localization of device it can be Extraoral, intraoral or a mixture.
• Some can be acrylic, metallic or a mixture.
• Active devices exert force, whereas, passive devices transmit force from the parts of the patient.
• Some devices can be orthodontic acting on the dents while others are orthopedic acting on the jaw.

Removable Orthodontic Appliances

• Removable orthodontic appliances are orthodontic devices that can be removed by the patient, unlike fixed appliances, the forces applied are intermittent, and the movement is slower.
• Consist of active and passive parts.

Passive Elements

• Passive elements in removable orthodontic appliances include:
• Acrylic base plates- rests on keratinized mucosa to the lingual surfaces and providing anchorage, retention, support, and stabilization.
• Clasps or retainers- include Adams clasps and ball clasps providing stability.
• Occlusal rests- on the occlusal surface, providing support.
• A lingual screen- prevents the tongue from interacting with anterior teeth and correcting an open bite
• Lip bumpers or paralabial arches- arcs of wire placed inside the mouth covering the teeth, and preventing the jaw from closing
• Lateral screens- acrylic devices placed on either side of the vestibular arch impede the jaw.
• Bite planes - Metallic or acrylic planes are situates on anterior or posterior teeth to separate teeth.
• Inclined planes- An acrylic extension that seeks to bring position to the mandible.

Active Elements

• Arches of wire adapt to the position of the teeth and the original shape to drag it into the position.
• Active vestibular arc (Hawley arc) can activate or deactivate generating intrusion or extrusion.
• Progeny Vestibular Arch is a plate that lowers in a U Shape.
• Handles incorporated are deformated wire in a "U" to produce teeth movement.
• Springs move the teeth in a direction and are made from different materials.
• Screws (jacks) have 2 side of cylindrical parts that each have a base of acrylic, when activated separate parts allowing it to expand.
• Micro-screws are like screws.

Active and Passive Applicances

• Removables that use the generated force by the anatomical structure of the patient is passive with no extra forces.

Retainers or Retention Devices

• Retainers: Contact the teeth to prevent movements.
• Placa de Hawley: removable plate with a vestibular section that contact the lingual side.
• Transparent acrylic splints to impede the aggression.

Removable Appliances

• Removable appliances or functional correct oral habits or positions adding escorts or lip-bumpers.

Functional Appliances:

• Functional appliances use their function of peridentaria to move the teeth.
• They are the transmitters for the function or vehicles that retain it and add it to the teeth.

Bimaxillary Devices

• Consist of a set of plates usually positioned together obligating it to go to a certain position.
• Modulador elastic de Bimler, El activador can be examples.

Herbst Appliance

• Herbst Appliance is positioned between superior molar and inferior canines obligating the mandible to be in certain position.
• Forsus are a modern example.
• Removable has limited appliances but now it is can be fixable.

Classification Based On Muscular Response

• Miodinàmics enhances muscular activation (Bilmer, Klammt)
• Miotònics enhances muscular activity (Andreasen)
• Miofuncional eliminates muscular activities. (Bionator, Frankel)
• Limp Bumpers can also be a functional appliance
• Extraoral appliances are used to be removed outside of the mouth but can be fix
• Purs appliances where the appliance is external.
• Mentonera has a part of acrylic were hooks are connected to the chin to retain the jaw.

Fixed Orthodontic Appliances

• Fixed orthodontic appliances are not removable by the patient and are attached to the teeth using cement or microimplants. The forces applied are continuous, resulting in faster and more controlled movements.
• Parts involved include active and passive components.

Active elements

• Elements of the filferro include - A steel wires.
• Nanses in the arcs - Incorporates in the filferrro.
• Lligadures Elastics and Metallica.
• Lligadures Seperation - To keep the teetch.
• Elastic are for upper and lower teeth.
• Muelle is in the metal an can create or open space with brackets .
• Cadenetes are for the teth a
• Fils Elastoerics are in to draw the teeth and can have carts.

Passive Parts

• Bandes Are the teeth adapted. .
• Brackets.
• Base.
• Aleta the parts to install lligadueres where it is to be collocated
• ASlot ranura is in the center to install the brackets.
• Tubs molars or metallic is in to transfer forces to the dental.
• Cajetines have a lingual function where there can be bows

Class For Molars

• Palometes: A device for the lingual that is attached to the teeth and to move the teeth.
• Bottons a component where protuberancia can contact some of the materials.
• A micro-implant component of titanium or has some issues if you do not colab
• Alignment is a phase where to be placed the bracket in their spot, leveling it vertical and at the clase is where the molar is corrected.
• After the teeth touch each to close and have good teeth

Aparetologia for others teeth.

• Mantenidor: is a is a fixed part in the mouth
• Arcs is another fixed thing
• A translatina is a teeth with a bar that crosses the surface the palate, it is activitie generate the part.
• Button is similar to a part but it protects and maintains is passiving or active.

Appliant Technology.

• A lip bumper helps the distalizalica and is like a bumper to the teeth
• Cuad helix. Is when u are to the top jaw to have a better bite.
• Pindul De Hligers to distizalize the teeth.
• Disjuntor to the upper jaw to improve the part
• Disjuntor Comencionnal is for the jaw or the mouth with a central component
• Disjuntor Of Hyrax like the teeth but it is on the middle.
• Isjuntor with acrylic in their plans
• Contencion fixed which consist in fixing the teeth that have been treated. It asids when you to fix the area.
• It must have an acid that the palatinial area that should applied with resina.

Cirugia Ortoguastica (ORAL SURGERY)

• Some mouths has malicolusion that is altered you may need or recurse into artodedencia to fix the jaw.
• Phase one in orthofencia for 1 to 1.5 years
• Phase 2 surgal procese the jaw is sectioned. And a new fix is applied. They used a model to do and fix the teeth -Phase 3 is to use the orofence a year to assist to make to new jaw to function.