Problem-oriented approach
ORTHODONTIC TRIAGE
Facial asymmetry
Antero posterior or vertical problems
Excessive Dental Protrusion or
Retrusion
Bimaxillary Protrusion
Problems involving dental
development
Asymmetric permanent teeth
Missing permanent teeth
Supernumerary teeth
Other eruption problems
Space problems
Other Occlusal discrepancies
Timing of treatment
TREATMENT PLANNING FOR
PRESCHOOL CHILDREN
(Primary Dentition)
Alignment problems
Incisor Protrusion Retrusion
Posterior cross bite
Antero Posterior discrepancies
Vertical problems
TREATMENT PLANNING FOR
PREADOLESCENTS (EARLY
MIXED DENTITION)
MODERATE PROBLEMS
I Space problems
a. Missing primary teeth with adequate
space maintenance
b. Localized space loss (3mm or less) space
regaining
c. Generalized moderate crowding
II Irregular / Malpositioned incisors
a. Spaced & flared maxillary incisors
b. Maxillary midline diastema
c. Anterior crossbite
d. Posterior crossbite
e. Anterior openbite
Retained primary teeth & Ectopic eruption
SEVERE PROBLEMS
a. Skeletal problems
b. Dentofacial problems related to incisors
protrusion
c. Space discrepancies of 5mm or more
Space discrepancies upto 4mm Non
extraction
Space discrepancies 5-9mm without
extraction or in same cases extraction of
some teeth other than third molar
Space discrepancies of 10mm or more
Require premolar extraction regardless of
III molar eruption
SERIAL EXTRACTION
Indicated in the following cases
1. No skeletal disproportions
2. Class I molar relationship
3. Normal overbite
4. Large perimeter deficiency (10mm / more)
The procedure consists of four
steps
Extraction of primary lateral incisors-
permanent central erupt
Extraction of primary canines - permanent
laterals erupt
Extraction of primary I molar
Extraction of the permanent first premolar
TREATMENT PLANNING FOR
ADOLESCENTS (LATE
MIXED & EARLY
PERMANENT DENTITION)
ALIGNMENT PROBLEMS
Crowding & Protrusion