43. Generalized spacing and arch expansion. Clinical manifestation, diagnosis, prevention, treatment

Question 1

Teeth spacing, and how it is classified

Answer 1

• Interdental spaces and a lack of contact points between teeth
• Generalized=>anterior and posterior teeth
• Localized=>only two or four teeth

Question 2

Why spacing in anterior region of primary dentition important

Answer 2

• Providing sufficient space for permanent dentition to erupt properly

Question 3

Etiological factors of generalized spacing

Answer 3

• Natural development=>spaced teeth after eruption
• Microdontia
• Missing teeth
• Oral habits=>thumb sucking and tongue thrusting
• Supernumerary teeth=>Extra teeth causing midline displacement and diastema
• Alveolar size=>A larger alveolar bone
• Ugly duckling stage
• Primate space
• Periodontal disease

-Primate space-Natural spacing in primary dentition between lateral incisors and canines in the maxillary arch, and between canines and first molars in the mandibular arch.

Question 4

Clinical manifestations of generalized spacing and arch expansion

Answer 4

• Gaps between teeth in anterior and posterior segments
• Arch larger than tooth material, or tooth material smaller than expected

Question 5

How diagnosis of generalized spacing and arch expansion performed

Answer 5

• Permanent spacing dentition analysis
• Arch length analysis
• Tooth size discrepancy analysis

Question 6

Permanent spacing dentition analysis types

Answer 6

• Pont’s Index=>determines ideal arch width based on maxillary incisors’ MDW
• Linderharth Index=>Modifies Pont’s formula for anterior and posterior arch width
• Schwarz Analysis=>analyzes ideal interpremolar and intermolar widths based on facial type (narrow, normal, broad)

Question 7

Arch length analysis types

Answer 7

• Korkhaus Analysis=>measures anterior arch length to reveal sagittal malpositioning of incisors
• Gerlach Analysis=>studies proportions of dental arch segments and their discrepancies

Question 8

Tooth size discrepancy analysis types

Answer 8

• Bolton’s Analysis=>Assesses ratios between MDWs of mandibular and maxillary teeth=>
• Detect interarch tooth size discrepancies

Question 9

Preventive measures for generalized spacing

Answer 9

• Addressing bad oral habits before generalized spacing becomes established

Question 10

Treatment options for generalized spacing

Answer 10

• Space closure
• Methods to eliminate space
• Handling missing teeth

Question 11

Types of space closure

Answer 11

• Retraction of protruded maxillary anterior teeth=>tipping or bodily movement
• Fixed appliances=>
• Large spaces, rotations, and bodily displacement

Question 12

Methods to eliminate space

Answer 12

• Contraction of dental arches
• Replacement of missing teeth=>
• Bridges transplants, or implants after space redistribution
• Building up individual teeth=>
• Composite or crowns

Question 13

Methods of Handling missing teeth

Answer 13

• Autotransplantation for missing teeth w/ crowding in other areas
• Retaining primary teeth as long as possible=>
• Congenitally missing teeth are present
• Prosthetic restorations
• Mesialization of posterior teeth to close space
• Crown or composite build-ups for microdontia and peg-shaped laterals