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IN THE NAME OF GOD Force eruption Dr:Nahvi Force eruption • Unerupted tooth • Fractured tooth Tooth eruption A permanent tooth should erupt: 6 months after natural exfoliation of its predecessor Eruption delayed : if the interval extends to more than 1 year. Eruption of a tooth is considered to be delayed : • The normal time for eruption has been exceeded. • The tooth is not present in the dental arch and shows no potential for eruption. • The root of the unerupted tooth is completely formed. • The homologous tooth has been erupted for at least 6 months. J Can Dent Assoc 2010 Most commonly become impacted • • • • third molars maxillary canines maxillary central incisors mandibular second premolars Causes of Delayed Eruption • Localized • Generalized Localized • • • • • • • the presence of supernumerary teeth(most common ) Odontoma dilaceration malpositioning of the tooth germ Crowding calcifying odontogenic cyst trauma to the corresponding deciduous tooth systemic conditions • cleidocranial dysostosis • hypothyroidism • Gardner syndrome • Down syndrome Criteria for Treatment • chief complaint • At least 3 mm of bone • The tooth is mature J Can Dent Assoc 2010;76:a147 Alignment of an impacted tooth • • • • position and direction degree of root completion degree of dilacerations presence of space Treatment planning: 1-surgical exposure 2-Attachment to the tooth 3-Orthodontic mechanics surgical exposure • (1) exposure of the entire labial aspect (the window approach) • (2) a technique which exposes only 4–5 mm of the labial aspect Attachment • • • • • • Gold chain Band Cast gold crown,onlay Threated pin Wire loop Direct bond attachment(the best) General characteristics of orthodontic Forces • Optimal:light,continuous -Ideal material Maintains elasticity Maintains force over a range of tooth movement Force • Continuous • Interrupted • Intermittent • Extrusion 35-60gr Continuous Interrupted Intermittent Contemporary orthodontics Direction of force parallel to the long axis avoid torquing forces Oral Maxillofacial Surg Clin N Am 16 (2004) 75-89 Force eruption Fixed appliances Removable appliances • Fixed appliances Do not require special patient cooperation precise coronal and root movements • Removable appliances less chairtime better oral hygiene More esthetic Removable appliances • • • • retention clasps labial bow Hook(for attachment of elastics) Finger spring,Zspring,Canine retractor Removable appliances • at least 10 hours per day. • Rest intervals,not to exceed five hours per day. • wear the appliance 24 hours a day, removing it only for meals • the elastics should be changed every two or three days. • Lingual tipping will be minimized when the labial bow is used for the extrusive force JCO/JULY 2002 Fixed appliances coil : • maintains the space • anchorage and balancing resistance J Can Dent Assoc 2010 • Anchorage support for the extrusion—a minimum of one tooth on either side of a single-rooted tooth (2 anchors) or two teeth on either side of a multi-rooted tooth (4 anchors) Use a heavy square or rectangular NiTi wire to minimize tipping J Can Dent Assoc 2010;76:a147 Magnetic force • For a patient with other missing teeth Contemporary orthodontics • Elastics -light -medium(1/8 =3.18mm -heavy 127.58gr) Orthodontic Elastics (3/8", 5/16", 1/4", 3/16", 1/8") Shiraz Univ Dent J 2009; 10(1):7-15 clinical problems (canine) 1) Lateral root resorption 2) External cervical resorption 3) Dentoalveolar ankylosis 4) Calcific metamorphosis of the pulp and aseptic pulp necrosis. Dental Press J Orthod. 2010 Nov-Dec;15(6):18-24 Thank You