An Introduction To Orthodontic

An introduction to
orthodontic
DR. S ALMA IZELDIN
What is orthodontics
What is orthodontics?
The term "orthodontics" can be broken down into two

Greek words - "orthos" meaning straight or correct and
"dontics" meaning teeth.
Orthodontics is the branch of dentistry concerned with
facial growth, development of the dentition and occlusion,
and the diagnosis, interception, and treatment of occlusal
anomalies.
‘Ideal occlusion’
Is the term given to a dentition where the teeth are in the optimum
anatomical position, both within the mandibular and maxillary arches
(intramaxillary) and between the arches when the teeth are in
occlusion (intermaxillary).
In reality, it is rare to have a truly perfect occlusion and malocclusion is a spectrum, reflecting
variation around the norm.
Need and demand of orthodontic treatment
Benefits of orthodontic treatment
Risk of orthodontic treatment
Benefits of orthodontic treatment:
To determine whether orthodontic treatment is likely to carry a

dental health benefit, it is necessary to consider first whether the
malocclusion is likely to cause problems to dental health and
secondly, whether orthodontic treatment is likely to address the
problem.
Potential benefits to dental health
Potential benefits for oral health-related quality of life
Potential benefits to dental health
Localized periodontal problems

Dental trauma
Tooth impaction
Caries
Plaque-induced periodontal disease
Temporomandibular joint dysfunction syndrome
Localized periodontal problems
Certain occlusal anomalies may predispose individuals to periodontal

problems such as:
• Crowding causing tooth/teeth to be pushed out of the bony trough,
resulting in recession
• Periodontal damage related to traumatic overbites
• Anterior crossbites with evidence of compromised buccal
periodontal support on affected lower incisors
Crowding causing tooth/teeth to be pushed out Periodontal damage related to traumatic
of the bony trough, resulting in recession overbites
Dental trauma:
There is evidence that increased overjet is associated with

trauma to the upper incisors.
Orthodontic intervention may be indicated where
assessment and history indicate the young person is at
increased risk of dental trauma.
Dental trauma:
Tooth impaction:
Tooth impaction occurs when normal tooth eruption is impeded by

another tooth, bone, soft tissues, or other pathology.
Unerupted impacted teeth may cause localized pathology, most
commonly resorption of adjacent roots or cystic change (This is most
frequently seen in relation to ectopic maxillary canine teeth).
Orthodontic management of impacted teeth may be indicated to
reduce the risk of pathology
Tooth impaction
Caries:
Caries experience is directly influenced by oral hygiene, fluoride

exposure, and diet; however, research has failed to demonstrate a
significant association between malocclusion and caries. Caries
reduction is therefore rarely an appropriate justification for
orthodontic treatment. The disease process can be
controlled with good diet and oral hygiene and is
unrelated to the presence or absence of a malocclusion.
Plaque-induced periodontal disease
The association between malocclusion and plaque-induced periodontal

disease is weak. the research indicating that individual motivation has more
impact than tooth alignment on effective tooth brushing. For people with
reduced dexterity or restricted access for cleaning, it is possible that
irregular teeth may delay effective brushing. In these cases, orthodontic
alignment may aid plaque control but appliance treatment must be
approached carefully to minimize the risk of periodontal damage during
treatment.
Crowding:
Temporomandibular joint dysfunction syndrome
TMD comprises a group of related disorders with multifactorial etiology including

psychological, hormonal, genetic, traumatic, and occlusal factors. Some authors
maintain that minor occlusal imperfections can lead to abnormal paths of closure
and/or bruxism, which then result in the development of TMD.
From cross-sectional observational population studies there appears to be a weak
association with some traits of malocclusion, including untreated crossbites with
functional shifts and large overjets, and a slightly higher prevalence of TMD
The role of orthodontics in TMD has been extensively debated, with some authors
claiming that orthodontic treatment can cause TMD.
Potential benefits for oral health-related quality
of life
Appearance
Masticatory function
Speech
Psychosocial well-being
Appearance
Dissatisfaction with dental appearance is often the

principal reason people seek orthodontic treatment
and, in most cases, treatment is able to deliver a
positive change.
Appearance
Patients with significant inter-arch discrepancy

including anterior open bites (AOB) and markedly
increased or reverse overjet often report difficulty
with eating, particularly when incising food.
Speech
Speech is a complex neuromuscular process involving respiration, phonation,

articulation, and resonance. Articulation is the formation of different sounds
through variable contact of the tongue with surrounding structures, including
the palate, lips, alveolar ridge, and dentition. However, where patients cannot
attain contact between the incisors anteriorly, this may contribute to the
production of a lisp (interdental sigmatism). In these cases correcting the
incisor relationship and reducing interdental spacing may reduce lisping and
improve confidence to talk in public.
Psychosocial well-being
Malocclusion has been linked to reduced self-confidence

and self-esteem, with more severe malocclusion and
dentofacial deformities causing higher levels of oral impacts.
Potential risk of orthodontic treatment
Root resorption
Loss of alveolar bone and periodontal support
Enamel damage
Demineralization
Intra-oral soft tissue damage
Intra-oral soft tissue damage
Pulpal injury
Relapse
Relapse is the partial or full return of traits of the original

malocclusion following orthodontic treatment.
There are some cases have a high potential for relapse following
the correction of certain occlusal traits, which include:
• Rotated teeth;
• Lower incisor crowding;
• Changes in the labiolingual position of the lower incisors;
• Expansion of the lower intercanine width; and
• Spacing.
Failure to achieve treatment objectives
Extra-oral damage:
Contact dermatitis is reported in approximately 1% of the population

and allergic reactions may be seen on facial skin in response to
components of appliances, usually nickel.
Recoil injury from the elastic components of headgear poses a rare but potentially severe
risk of damage to the eyes, these include serious ocular injuries, reportedly
resulting in blindness, which was as a result of the ends of the face-bow
coming out of the mouth and causing direct trauma to the eyes .

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An introduction to

The term "orthodontics" can be broken down into two

To determine whether orthodontic treatment is likely to carry a

Localized periodontal problems

Certain occlusal anomalies may predispose individuals to periodontal

There is evidence that increased overjet is associated with

Tooth impaction occurs when normal tooth eruption is impeded by

Caries experience is directly influenced by oral hygiene, fluoride

The association between malocclusion and plaque-induced periodontal

TMD comprises a group of related disorders with multifactorial etiology including

Dissatisfaction with dental appearance is often the

Patients with significant inter-arch discrepancy

Speech is a complex neuromuscular process involving respiration, phonation,

Malocclusion has been linked to reduced self-confidence

Relapse is the partial or full return of traits of the original

Contact dermatitis is reported in approximately 1% of the population

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