ORTHODONTIC
TREATMENT IN MIXED
DENTITION
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INTRODUCTION
The goal of early treatment is to correct
existing or developing skeletal,
dentoalveolar and muscular
imbalances to improve the orofacial
environment before the eruption of
the permanent dentition is complete.
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PRINCIPLES
To eliminate primary etiologic factors if
possible
To eliminate occlusal discrepancies such
as unilateral, bilateral posterior
crossbites, anterior crossbite
To correct skeletal dysplasia
To manage arch length discrepancies to
avoid the future extraction of teeth
(premolars) to resolve crowding .
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TIMING OF EARLY
INTERVENTION
Initiation of early treatment
protocols varies according to
the type of malocclusion.
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UTILITY OF EARLY TREATMENT
PROTOCOLS
Angle classification I II III
Deciduous + -- ++
Early mixed +++
(RME)
+++
Late mixed ++ +++ +
Early permanent + +++ --
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MALOCCLUSION
• Sagittal –Dental,skeletal
• Vertical-Dental,skeletal
• Transverse-Dental,skeletal
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Dental component in the sagittal
dimension
• class1-(crowding).
• Class2-(increased overjet).
• Class3-(reverse overjet).
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Skeletal component in the sagittal
dimension
• Mandible-excess(prognathism)
deficiency(retrognathism) .
• Maxilla- excess(prognathism)
deficiency(retrognathism).
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Dental component in the vertical
dimension
• Maxillary or mandibular arches-excess or
deficiency(over or undereruption).
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skeletal component in the vertical
dimension
• Maxillary or mandibular arches-excess or
deficiency.
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Skeletal & dental consideration in
the transverse dimension
• Unilateral or bilateral posterior crossbite.
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Treatment of nonskeletal problems
• Treatment of tooth size/arch length discrepancy problems— serial
extraction.
• Correction of crowding .
Serial extraction-nance method
tweed method
dewel method.
• Correction of spacing .
• Correction of crossbites of dental origin-posterior crossbite
anterior
crossbite .
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Treatment of skeletal problems
• Treatment of mandibular
deficiency(vertical&anteroposterior)
Functional Appliance
Removable Appliance
frankel11
twinblock
Fixed Appliance
herbst
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FRANKEL II
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FRANKEL II
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TWINBLOCK
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HERBST
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TREATMENT OF MAXILLARY
EXCESS(vertical&anteroposterior)
Headgearwww.indiandentalacademy.com
Treatment of maxiilary
deficiency(anteroposterior&vertical)
• Facemask
• Frankel III
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FRANKEL III
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FACEMASK
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TREATMENT OF MANDIBULAR
EXCESS
• Chincup
• Functional appliance
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Treatment of maxiilary
deficiency(transverse)
• Transverse maxillary constriction
palatal expansion
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HABIT BREAKING APPLIANCE
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Orthodontic treament in mixed dentition