Dental crowding – Space Creation

Dental crowding – Space Creation

We’ll be writing about dental crowding now. Crowding affects approximately 60% of Caucasians both jaw size and tooth size are mainly genetically determined and appear to be reduced in size however environmental factors, for example, premature deciduous tooth loss can also increase crowding. In evolutionary terms both jaw size, and tooth size appear to be reducing however crowding is more prevalent in the modern population than it was in prehistoric times this may be due to that the introduction of a less abrasive diet so that there’s less interproximal tooth wear occurring during the life of an individual. This is supported by the fact that the change from a rural lifestyle to an urban lifestyle has been shown to increase the amount of crowding after two generations.

Dental crowding
Dental crowding

Classification of crowding considering the amount of crowding. Crowding can be classified as mild when this soup zero to four millimeter need moderate when it’s five to eight-millimeter need and severe where there are more than eight millimeters of crowding from an ideological point of view.

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Classification of Crowding

We can classify it as primary secondary and tertiary now primary crowding is a hereditary type of crowding and it’s determined genetically and is caused by disproportionate size teeth and jaws meaning larger teeth than the jaws. The malalignment of the anterior teeth is characteristic of this type of crowding now certainly crowding it’s an acquired anomaly caused by mutual drift of the molars as a cause of premature loss of the city was teeth virtually crowding. On the other hand occurs between the ages of eighteen to twenty primarily in the lower anterior segment it may be attributed to several factors like medial migration incisor a brightening soft tissue and entertaining width regarding Mitchell migration of the posterior teeth owing to forces from the eruption of the third molars this has a weak relation with the development of late lower anterior crowding furthermore crowding can still develop in patients with congenital missing third molars therefore the prophylactic removal of these third molars if it’s asymptomatic cannot be justified up lightening of the lower incisors as a result of forward growth of the mandible when maxillary growth has slowed it may be a contributing factor soft tissue pressure being stronger from the lips and cheeks and from the tongue at this age also can contribute the development of crowding reduction in lower entertaining width in most individuals canine width increases to around 12 to 13 years of age and this is followed by a very gradual reduction of this size until they to adulthood this decrease is mostly seen in the mid and late teens.

Space Creation Methods

There are several space creation methods. The amount of space that will be created during treatment can be assessed the aim is to balance the space required with the space created space can be created by one of the following methods the rotating teeth the rotating incisors do not contribute to space creation because d rotating in period teeth need space because rotated incisors take up less space than aligned ones while on the other hand d rotating molars and premolars contributes to space because rotated molars take up more space than aligned ones so you frequently see appliances to redo rotate molars early in treatment up writing incisors create space because miserly tipped or distally tipped up incisors they take up more space than upright ones distal movement of the molars in the upper arch can be achieved with headgear extraoral traction using headgear will produce up to two to three millimetres per side meaning a total of four to six millimetres for total arch length and this can be useful when there’s a mild case of crowding where extractions are not indicated or in severe cases of crowding. In addition to extractions, there are a variety of intraoral appliances that make use of screws or Springs and acrylic buttons to distil eyes molars as well however nowadays temporary Anchorage devices offer an alternative to headgear appliances attached to these Anchorage devices can be used to distil eyes the upper molars distal movement of the lower molars however are very difficult and this, in reality, the best that can be achieved is to just upright the molar and bring the roots forward rather than the crown distally. 

Dental crowding

Jaw Expansion Methods

Expansion space can be created by expanding the upper arch laterally expansion should ideally only be undertaken when there’s a crossbite expansion without a crossbite may increase the risk of instability or perforation of the buccal plate several designs of appliances can be used for expansion and approximately 0.5 millimetres of space is gained for each one millimetre of posterior art expansion. Expansion on the lower arch may be indicated if there is a lingual Crosswhite or a scissor bite of the lower premolars and molars however any significant expansion in the lower arch particularly the lower inter cleaner in width is unstable now proclamation of in sizes space can be created by proclaiming in sizes but this will be dictated by the aims of the treatment soap reclining upper in sizes in class 3 malocclusion and lower in sizes in costume at occlusion can help correct the incisor relationship and relief crowding at the same time. For each millimetre of incisor advancement, you get 2 millimetres of space created within the dental arch. For enamel stripping enamel interproximal reduction or stripping is the removal of a small amount of enamel on the medial and distal aspects of the teeth in addition to creating the space the process can improve the shape of the teeth the contact points of the teeth and possibly enhance the stability at the end of treatment on the interior teeth approximately half a millimetre can be removed on each tooth. Being a quarter of a millimetre on the middle and a quarter on of the millimetre on the distal side without compromising the health of the teeth enamel can be carefully removed with an abrasive strip then treated topically with fluoride in a high-speed air turbine. The handpiece can be used to remove enamel from the posterior teeth however both teeth and peritoneum can be damaged unless care is taken removal of filling material is preferred over sound enamel when applicable it is important to realize that reduction of enamel should be done after aligning these teeth because it’s very difficult to reduce the enamel in these crowded areas unless some areas are already aligned. You can reduce these areas, and as alignment progresses then you reduce the other areas. The final method of space creation is extraction and before planning extraction of any permanent teeth, it is essential to ensure that all the remaining teeth are present and developing appropriately.

Two groups of orthodontic treatments

A normal upper arch should look like this. It forms that way because the tongue rests in the area between the upper teeth, there, it counteracts the pressure of the cheeks which would otherwise push the upper arch, the jaw in. But, if a child sucks his thumb or breaths through his or her mouth for any reason then the tongue drops from the top of the mouth and the upper arch can get pushed in. A narrowed upper arch has a knock-on effect on the lower jaw forcing it further back and down.

Dental crowding

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