1Gingivitis 2Damage to enamel surface 3Mobility and Pain Related to Orthodontic Treatment 4Effects on Pulp 5Effects on root structureRRR 6Moderate Generalized Resorption 7Severe Root Resorption ID: 933617
Download Presentation The PPT/PDF document "Detrimental effects of orthodontic treat..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Detrimental effects of orthodontic treatment
Slide21.Gingivitis
2.Damage to enamel surface
3.Mobility and Pain Related to Orthodontic Treatment
4.Effects on Pulp
5.Effects on root structure(RRR)
6.Moderate Generalized Resorption
7.Severe Root Resorption
8.Effect on Alveolar Bone
Slide3Gingivitis
There is increased marginal gingivitis due to plaque retention
Increased levels of streptococcus
mutans
and lactobacilli in the plaque
Proper oral hygiene measures may reduce the gingivitis
Slide4Slide5Slide6Damage to enamel surface
Incidence of enamel decalcification and formation of white spots due to orthodontic appliances.
Observed with both bending and bonding appliances.
Meticulous oral hygiene and fluoride application can reduce the enamel de-mineralization.
Use of fluoride releasing bonding agents and cements.
Enamel tears and fractures can also occurs during de-bonding.
Slide7Slide8Slide9Mobility and pain Related to Orthodontic treatment
Here is re-modeling of bone adjacent to the teeth and re-organization of the PDL during tooth movement that leads to increased mobility.
With the increase of force more undermining resorption occurs and mobility increases.
In case of increased mobility tooth should be dis-occluded and force should be discontinued.
Pain is due to development of ischemic areas in the PDL.
In the case of heavy force pain develop almost immediately as the PDL is crushed.
In case of lighter forces pain develop two to four hours after.
Pain usually last for two to four days.
Acteaminophen
is the drug of choice for the discomfort with
ortho
treatment since it is a weak PG inhibitor so it doesn’t affect orthodontic movement.
Slide10Slide11Effects on pulp
Ideally the orthodontic force should produce only PDL reaction and no effect on pulp.
But usually a moderate and transient inflammatory response occurs in pulp leading to discomfort
With heavy force the apex blood vessel get severed and blood supply may be compromised leading to loss of vitality.
Removal of bonding cements may cause rise in temperature and pulpal damage
Slide12Slide13Effects on root structure [RRR]
Orthodontic tooth movement is possible because the cementum is more resistant to resorption and repair process is fast as compared to alveolar bone.
Cementum resorption occurs after heavy force application for at least 30 days
Even with most careful force application some areas of PDL hyalinization are observed and some degree of root resorption seen.
Slide14Slide15Root resorption Index
Resorption and repair are the constant features of orthodontic tooth movement.
Permanent Resorption of root is usually seen at the apex.
GRADE1- A regular root, contour
GRADE2- Resorption at Apex less than 2mm
GRADE3- 2mm to 1/3rd of root length.
GRADE4- More than 1/3
rd
root length.
Slide16Slide17Resorption of Tooth root occurs in three distinct forms-
1-Moderate Generalized Resorption
2-Severe Generalized Resorption
3-Severe Localized Resorption
Slide18Moderate generalized resorption
Some loss of root length who have undergone comprehensive orthodontic treatment
Modest shortening is almost imperceptible and clinically insignificant
Root resorption is more when duration of treatment is more.
Maxillary incisors shows greater resorption than other teeth
Slide19Slide20Severe generalized resorption
This is rare
Some individuals are prone to this etiology is unknown.
Conical roots with pointed apices, distorted tooth forms , history of trauma are predisposing factors
Slide21Slide22Severe localized resorption
Probably caused by orthodontic treatment in many instances.
Excessive heavy forces with prolonged duration increases resorption
Maxillary central incisors more prone to resorption
Slide23Slide24Effects on alveolar bone
There may be loss of alveolar bone height
Orthodontic appliance increases the gingival inflammation
Even with good oral hygiene this potential side effects of treatment might seem more likely