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141-Relapse in Orthodontics
la récidive en Orthodontie
Awatef SHAAR (BAU-LB), Orthodontist.
Mohamad ABOULNASER- Orthodonti...
Intoduction
1-Definition
2-Orthodontic relapse causes
• a-Periodontal ligament traction
• b-Relapse due to growth related ...
Newton’s third law
‘’for every action there is an equal and oppositereaction’’
Any treatment is a failure unless the treat...
• It has been defined as the loss of any correction achieved by orthodontic
treatment.
• Is the return, following correcti...
A-Periodontal ligament traction.
B-Relapse due to growth related changes.
C-Failure to eliminate the original cause.
D-Rol...
Whenever teeth are moved orthodontically through braces, the periodontal and
gingival fibres that encircle the tooth are s...
Growth is a process that continues throughout life. Patients with skeletalproblems
may exhibit relapse due to continuation...
Mandibular height very slowly increases after puberty throughout life, excessive forward
growth and rotation of the mandib...
Excessive backwards growth and rotation of the mandible (matrix rotation with fulcrum
around the condyle), can reduce the ...
The cause of the malocclusion should be determined at the time of diagnosis and adequate
treatment steps should be planned...
D-Causes of Relapse in orthodontics
Role of Occlusion
Good intercuspation of upper and lower teeth is important factor in
...
• uu
D-Causes of Relapse in orthodontics
Role of Occlusion
Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
The third molars erupt very late in the development of dentition. They erupt inmost
cases between the ages of 18-21 years....
Orthodontists can control or correct to help prevent relapse. But what about the
following muscular interferences?
Tongue ...
Posture of tongue and orthodontic relapse
F- Causes of Relapse in orthodontics
Muscular Factors
Oussama SANDID- Mohamad AB...
• oMoacroglossiaor largetongue
Lateral tongue posture
Anterior tongue posture
F- Causes of Relapse in orthodontics
Muscula...
If the bonded wire comes loose or breaks, the orthodontist must replace it
immediately.
Meanwhile, the patient must wear t...
• a- Percision- Circumferential Supracrestal-Fiberotomy
• b- Prolonged Retention
• c- Placement of Teeth in Orofacial Soft...
a- Percision- Circumferential Supracrestal-Fiberotomy
• Relapse of severely rotated teeth due to rebound of elastic fibres...
Fixed and removable retention
b- Prolonged Retention
Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
Musculatures
Proper meshing of the teeth so that they function in harmony with the jaw
joints and muscles will allow teeth...
Obtaining proper occlusion is an important factor in maintaining corrected positions
It has been suggested that good inter...
Overcorrection is especially likely to be needed for these types of movement:
1- Rotations (particularly single-rooted tee...
More stable results are obtainediwhen the mandibular incisors
are either upright or slightly retroclined over the basalbon...
Relapse due to growtthrelatedchanges
Between the ages of 13
and 20 years, the upper
arch length and
intercanine width show...
Bone and adjacent tissues must be allowed to reorganize around newlypositioned
teeth
h- Adaptation of Bone and Adjacent So...
Stability of rotated teeth is enhanced by means of early correction.
i- Treatment of Rotated Teeth at an Early Age
Oussama...
Late incisor crowding (post-adolescent crowding) is widely regarded as a
normal maturation
Current Controversies in Late I...
• Singh, Gurkeerat. Textbook of orthodontics. JP Medical Ltd, 2015.
• Florman, Michael, L. Jerrold, and M. Partovi. "Indef...
141 relapse in orthodontics-recidives en orthodontie-oussama sandid-mohamad aboualnaser-awatef shaar-dentiste orthodontist...
141 relapse in orthodontics-recidives en orthodontie-oussama sandid-mohamad aboualnaser-awatef shaar-dentiste orthodontist...
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141 relapse in orthodontics-recidives en orthodontie-oussama sandid-mohamad aboualnaser-awatef shaar-dentiste orthodontiste-dentist-orthodontist


mohamad aboualnaser-awatef shaar-oussama sandid- orthodontist-orthodontist paris france-Seminars in Orthodontics-Orthodontic & Dental Continuing Education, Seminars & Courses-orthodontist Kingdom of Saudi Arabia ksa-orthodontist qatar-orthodontist koweit-orthodontist emirats- lebanon beirut, dentist beirut lebanon-pediatric dentsitry beirut lebanon-dentiste orthodontiste beyrouth lebanon-pediatrique dentistrie beyrouth liban- periodontics lebanon-orthodontic lebanon-lebanese university dentistry-american university of beirut dentistry orthodontics-beirut arab university dentistry- universite saint joseph beirut dentistry-pediatre beyrouth liban-pediatrics beirut lebanon-makassed hsopital beirut lebanon-ORTHODONTIST BEIRUT LEBANON-PEDIATRIC DENTISTRY BEIRUT LEBANON-DENTISTRY BEIRUT LEBANON -DENTISTS BEIRUT LEBANON

141 relapse in orthodontics-recidives en orthodontie-oussama sandid-mohamad aboualnaser-awatef shaar-dentiste orthodontiste-dentist-orthodontist

  1. 1. 141-Relapse in Orthodontics la récidive en Orthodontie Awatef SHAAR (BAU-LB), Orthodontist. Mohamad ABOULNASER- Orthodontist, BAU, Connecticut, USA. Oussama SANDID- Orthodontist, D.C.D., D.U.O, C.E.S.B.B, C.E.S.O.D.F , S.Q.O.D.F, Paris. France. Contact: dr.aboualnaser@hotmail.com www.orthofree.com
  2. 2. Intoduction 1-Definition 2-Orthodontic relapse causes • a-Periodontal ligament traction • b-Relapse due to growth related changes • c-Muscular factors • d-Role of occlusion • e-Failure to eliminate the original cause • f-Role of third molars • g-Bone adaptation 3-Preventing relapse • a- Percision- Circumferential Supracrestal-Fiberotomy • b- Prolonged Retention • c- Placement of Teeth in Orofacial Soft Tissue Balance • d- Placement of Teeth in Occlusal Equilibrium e-Orthodontic Overcorrection 6 • f- Importance of Lower Incisor Position in Stability g- Maintain Inter-canine & Inter-molar Distances • h- Adaptation of Bone and Adjacent Soft Tissues • i- Treatment of Rotated Teeth at an Early Age Conclusions Bibliography RELAPSE IN ORTHODONTICS Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  3. 3. Newton’s third law ‘’for every action there is an equal and oppositereaction’’ Any treatment is a failure unless the treatment results can be maintained. Relapse is one of the most challenging problems that encounter the orthodontists during and after finishing orthodontic treatment. Relapse after orthodontic treatment without permanent retention Introduction Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  4. 4. • It has been defined as the loss of any correction achieved by orthodontic treatment. • Is the return, following correction, of the features of the original malocclusion J LEMAY www.orthodontisteenligne.com 1- Definition Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  5. 5. A-Periodontal ligament traction. B-Relapse due to growth related changes. C-Failure to eliminate the original cause. D-Role of occlusion. E-Role of third molars. F-Muscular factors. G-Poor cooperation patient. 2- Causes of Relapse Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  6. 6. Whenever teeth are moved orthodontically through braces, the periodontal and gingival fibres that encircle the tooth are stretched. These stretched fibres can contract and can cause the teeth to come back to their original untreatedposition causing the relapse. A- Causes of RelapsePeriodontal Ligament Traction Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  7. 7. Growth is a process that continues throughout life. Patients with skeletalproblems may exhibit relapse due to continuation of the abnormal growth pattern after orthodontic therapy. Hence prolonged retention is indicated until active growth is completed. http://pocketdentistry.com/1-craniofacial-growth/ B- Causes of Relapse Relapse Due to Growth Related Changes Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  8. 8. Mandibular height very slowly increases after puberty throughout life, excessive forward growth and rotation of the mandible can result in an increase in overbite, and anterior crowding B- Causes of Relapse Relapse Due to Growth Related Changes Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  9. 9. Excessive backwards growth and rotation of the mandible (matrix rotation with fulcrum around the condyle), can reduce the overbite with possible development of a skeletal anterior open bite, and the patient may also become more classIII B- Causes of Relapse Relapse Due to Growth Related Changes Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  10. 10. The cause of the malocclusion should be determined at the time of diagnosis and adequate treatment steps should be planned to eliminate them. Failure to remove the etiology can result in relapse e.g. some times the orthodontic problem is because of some habit like thumb sucking, mouth breathing or Tongue thrust. If the habit is not treated at the beginning of the treatment, then relapse will occur after removing the braces. Presence of certain habits such as clenching, grinding, nail biting, lip biting are important causes of relapse C-Causes of Relapse in orthodontics Failure to Eliminate the Original Cause Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  11. 11. D-Causes of Relapse in orthodontics Role of Occlusion Good intercuspation of upper and lower teeth is important factor in maintaining the stability of treated cases. Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  12. 12. • uu D-Causes of Relapse in orthodontics Role of Occlusion Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  13. 13. The third molars erupt very late in the development of dentition. They erupt inmost cases between the ages of 18-21 years. By this time most of the patients have completed their orthodontic treatment. The pressure exerted by the erupting third molars is believed to cause the late anterior crowding causingrelapse http://www.orthodls.com/blog/do-wisdom-teeth-make-your-teeth-crowded E-Causes of Relapse in orthodontics Role of Third Molars Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  14. 14. Orthodontists can control or correct to help prevent relapse. But what about the following muscular interferences? Tongue thrust when swallowing, Mouth breathing, Thumb sucking Lip and tongue pressure F- Causes of Relapse in orthodontics Muscular Factors Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  15. 15. Posture of tongue and orthodontic relapse F- Causes of Relapse in orthodontics Muscular Factors Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  16. 16. • oMoacroglossiaor largetongue Lateral tongue posture Anterior tongue posture F- Causes of Relapse in orthodontics Muscular Factors Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  17. 17. If the bonded wire comes loose or breaks, the orthodontist must replace it immediately. Meanwhile, the patient must wear the clear aligner 24hours. If the patient did not commend to take an appointment for replacement of the fixed retainer then relapse willoccur. G- Causes of Relapse in orthodontics Poor Patient Co-operation Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  18. 18. • a- Percision- Circumferential Supracrestal-Fiberotomy • b- Prolonged Retention • c- Placement of Teeth in Orofacial Soft Tissue Balance • d- Placement of Teeth in Occlusal Equilibrium • e-Orthodontic Overcorrection • f- Importance of Lower Incisor Position in Stability • g- Maintain Inter-canine & Inter-molar Distance • h- Adaptation of Bone and Adjacent Soft Tissues • i- Treatment of Rotated Teeth at an Early Age 3-Prevention of Relapse Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  19. 19. a- Percision- Circumferential Supracrestal-Fiberotomy • Relapse of severely rotated teeth due to rebound of elastic fibres in the Supera-crestal tissues can be reduced by percision. • Fibrectomy (CSF) Prevents Orthodontic Relapse CSF is performed immediately after removal of the orthodontic appliance. By releasing the soft-tissue tension and allowing the reattachment of periodontal fibers.. Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  20. 20. Fixed and removable retention b- Prolonged Retention Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  21. 21. Musculatures Proper meshing of the teeth so that they function in harmony with the jaw joints and muscles will allow teeth to wear and function evenly, be stable, and decrease trauma to the surrounding supporting bone. c- Placement of Teeth in Orofacial Soft Tissue Balance Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  22. 22. Obtaining proper occlusion is an important factor in maintaining corrected positions It has been suggested that good interdigitation of teeth post-treatment may reduce the likelihood of relapse and improve the stability of the final result of orthodontic treatment Malocclusion should be overcorrected as a safety factor Normal occlusion The mesiobuccal cusp of the maxillary first molar is aligned with the buccal groove of the mandibular first molar. There is alignment of the teeth, normal overbite and overjet and coincident maxillary and mandibularmidlines.. d- Placement of Teeth in Occlusal Equilibrium Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  23. 23. Overcorrection is especially likely to be needed for these types of movement: 1- Rotations (particularly single-rooted teeth whose roots have a circular cross-section) 2- Labial-lingual alignment (particularly of incisors) 3- Expansion 4- Extrusion (because the PDL tends to pull the tooth back into the socket) J LEMAY- www.orthodontisteenligne.com e-Orthodontic Overcorrection Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  24. 24. More stable results are obtainediwhen the mandibular incisors are either upright or slightly retroclined over the basalbone. Obtaining proper occlusion is an important factor in maintaining corrected positions f- Importance of Lower Incisor Position in Stability Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  25. 25. Relapse due to growtthrelatedchanges Between the ages of 13 and 20 years, the upper arch length and intercanine width show significant reduction, and can produce anterior crowding In the lower arch, the intercanine width and arch length peak at the age of approximately 8 years old, and also show significant reduction from then omwards g- Maintain Inter-canine & Inter-molar Distance Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  26. 26. Bone and adjacent tissues must be allowed to reorganize around newlypositioned teeth h- Adaptation of Bone and Adjacent Soft Tissues Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  27. 27. Stability of rotated teeth is enhanced by means of early correction. i- Treatment of Rotated Teeth at an Early Age Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  28. 28. Late incisor crowding (post-adolescent crowding) is widely regarded as a normal maturation Current Controversies in Late Incisor Crowding Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR
  29. 29. • Singh, Gurkeerat. Textbook of orthodontics. JP Medical Ltd, 2015. • Florman, Michael, L. Jerrold, and M. Partovi. "Indefinite Orthodontic Retention." Continuing Education Digest (2005): 35-41. • Normando, David. A method to re-treat the relapse of dental misalignment, Dental Press J Orthod 48 2011 Sept-Oct;16(5):48-53 • Khursheed Alam, Mohammad, A to Z ORTHODONTICS, PPSP Publication, August 2012, volume 21, 978-967-0486-10-9 References Oussama SANDID- Mohamad ABOUALNASER- AwatefSHAAR

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