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3 views

Space Analysis

Uploaded by

x2xzv95qf9
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Forming an orthodontic problem list

Diagnostic records
Space Analysis
The process of determining the amount of
space required is called “Space Analysis”
• Space analysis is the process that allows an
estimation of the space required in each arch to fulfil
the treatment aims .

• It allows good approach to diagnosis & treatment


planning, also helps to determine whether the
treatment aims are feasible, as well as assisting with
the planning of mechanics & anchorage.
Space analysis is carried out in 2
phases

A B

Space Space
required available
A Space required

• Space is usually required to correct the


following:

1. Crowding.
2. Incisors Anteroposterior position.
3. Leveling the occlusal curve.
• The amount of crowding present can be calculated by
measuring the mesial-distal width of any misaligned
teeth in relation to the available space in the arch
A Space required

• Space is usually required to correct the


following:

1. Crowding.
2. Incisors Anteroposterior position.
3. Leveling the occlusal curve.
• It is often necessary to alter the antero-posterior position of the
upper incisors, particularly when reducing an overjet.
• If the incisors are retracted , this requires space.
• The aim is always to get an ideal overjet which is (2mm).
• Every millimeter of incisors retraction requires 2mm space in the
dental arch.

• Ex: Increased Overjet Normal Overjet 2mm


10mm

16mm
A Space required

• Space is usually required to correct the


following:

1. Crowding.
2. Incisors Anteroposterior position.
3. Leveling the occlusal curve.
Space is also required to level curve of spee.
• The amount of space required to level
the curve of spee is controversial coz its
affected by the shape of the arch & the
shape of the teeth.

Depth of cure of spee (mm) Space required (mm)


3 or less 1

4 1.5

5 or more 2
B Space available
How to create space ??
• Our aim as orthodontist is to balance the space required with the space
available

Space Space
required available
• Space can be created by any of the following methods:

1. Extractions

2. Distal movement of the molars

3. Enamel stripping

4. Expansion

5. Proclination of incisors

6. Combination of any of the above methods.


1- Extraction:
• Before planning extraction of any permanent teeth, it is essential to
ensure that all remaining teeth are present and developing appropriately.
• Choosing the appropriate tooth to be extracted is a complex decision &
requires understanding of all aspects of orthodontic treatment.

• Factors that affect the choice of teeth to be extracted:


1. Prognosis
2. Position
3. Amount of space required
4. Where exactly on the arch the space is required
5. Patient’s profile.
Incisors
• Incisors are rarely the first choice for extraction due to the risk of
compromising aesthetics.
• It can also be difficult to fit 3 incisors in one arch against 4 incisors in the
opposing arch.

• Indications for lower incisor extraction


1. Incisor with poor prognosis.
2. Incisor with compromised periodontal support.
3. Buccal segment class I, with lower incisors crowding.
4. Mild class III skeletal pattern
Canines
• Canines are important tooth aesthetically & functionally.
( Cornerstone )

• Its extracted if severely displaced or ectopic.


First premolars
• Teeth of choice to extract when the space requirement is moderate to
severe.

• It gives the best chance for spontaneous alignment.

• 40-60% of extraction space will be available without anchorage


reinforcement.
Second premolars
• Indications for extracting second premolars:

1. Space closure by forward movement of molars


rather than anterior segment retraction.

2. Mild to moderate space requirement


(25-50% of extraction space will be available).

3. Severe displacement of 2nd premolar.

4. Early loss of 2nd deciduous molar , resulting


crowding of the 2nd premolar palatally or
lingually.
First permanent molars

• Extraction of 1st permanent molar


makes the orthodontic treatment
more difficult & prolonged as this
tooth is functionally important.

• Their extraction is considered due to


their limited prognosis.
Second permanent molars
• Its suggested in the following
cases:

1. To facilitate distal movement of


buccal segment.

2. To relief mild premolar crowding.

3. To provide additional space for


3rd molar eruption, thus avoiding
their impaction.
Third permanent molars
• In the past, early extraction of the 3rd molar has been advocated to prevent
lower labial segment crowding.
However, it is much more likely that the late lower incisor crowding is caused
by residual growth & soft tissue changes.

• It is now, not acceptable to extract 3rd molars purely to prevent crowding of


the lower labial segment.
• Space can be created by any of the following methods:

1. Extractions

2. Distal movement of the molars

3. Enamel stripping

4. Expansion

5. Proclination of incisors

6. Combination of any of the above methods.


2- Distal movement of the
molars
• Distal movement of the upper molars can be achieved by
Head Gear or mini-implants.
• This Extra-oral traction by the Head Gear can produce 2-
3mm per side.
• Distal movement of lower molars is very difficult.

• Ex:
1. Class I incisors with mild upper crowding
2. Class II div.1 with minimally increased overjet.
3. Class II molars, less than half unit.
4. When extraction of first premolars does not give sufficient
space for complete alignment.
5. If there is unilateral class II, due to unilateral loss of deciduous
molar.
3- Enamel stripping:
• Interproximal stripping is the removal of small amount of the
mesial & distal aspects of teeth.

• Can be done by an abrasive strip or a high speed hand


piece(mainly in the buccal segment).

• Almost 0.5mm can be removed from each tooth(0.25mm


from each side).
• This approach can creates 3-6mm of space in each arch.

• Teeth are treated topically by fluoride following enamel


stripping.

• Creates space,
Improve the shape & contact point,
4- Expansion:
• Space can be created by expanding
the upper arch laterally
1mm of posterior expansion creates
0.5mm on the arch.

• Expansion should only be undertaken


when there is posterior cross bite.

• Expansion without a cross bite


increases the risk for relapse.
5-Proclination of incisors:
• Space can be created by proclining the incisors

• Each millimeter of incisors proclination creates 2mm on the arch.


• The amount of crowding present is classified
into:
Space Space
Mild Crowding required
available < -4 mm
Moderate Cr. = -4 to -8 mm
Severe Crowding > -8mm

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