Space Analysis

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Transcript of Space Analysis

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Proffit, 2007

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JUMLAH DIAMETER MESIO DISTAL TIAP GIGI DI

MESIAL MOLAR PERTAMA PERMANEN

PADA GELIGI BERCAMPUR, UKURAN GIGI YANG

BELUM ERUPSI DIDAPAT DARI :

• PENGUKURAN PERBANDINGAN YG DIAMBIL DARI

FOTO BITE WING ATAU PERIAPIKAL (HUCKABA)

• TABEL PREDIKSI

• KOMBINASI KEDUANYA

Graber, 2005

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NILAI CANINUS DAN PREMOLAR YG BELUM ERUPSI

DIAMBIL DR PENGUKURAN TERBESAR MESIODISTAL

MAHKOTA GIGI TSB PD PERIAPIKAL RADIOGRAPH

Graber, 2005

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Graber, 2005

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Proffit, 2007

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Graber, 2005

X = (Y)X1Y1

X = PERKIRAAN UKURAN DR GIGI PERMANEN

X1= UKURAN GIGI PERMANEN PD RADIOGRAPH

Y = UKURAN GIGI M 2 DECIDUI PD CETAKAN GIGI

Y1 = UKURAN GIGI M 2 DECIDUI PD RADIOGRAPH

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Proffit, 2007

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KE4 INSISIVUS BAWAH DIUKUR PADA BAGIAN

MESIODISTAL YG TEBESAR DNG SLIDING BOLEY

GAUGE YG DILETAKKAN SEJAJAR DNG

PERMUKAAN INSISAL GIGI

Graber, 1994

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Ukuran mesio-distal gigi insisivus bawah dipakai untuk memprediksi ukuran gigi caninus dan premolar atas dan bawah

: Moyers

Tanaka & Johnston

Sitepu

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= ARCH PERIMETER

YANG UMUM DIPAKAI ADALAH RAHANG BAWAH

DNG BRASS WIRE YG DILENGKUNGKAN MELEWATI

TONJOL BUCCAL DAN UJUNG INSISAL GIGI BAWAH

MULAI DARI MOLAR KE MOLAR YG KMD

DILURUSKAN

BRASS WIRE DIBUAT MENGIKUTI LENGKUNG

OKLUSI YAITU : GARIS YG MELEWATI CENTRAL

FOSA GIGI ATAS , ATAU TONJOL BUKAL GIGI BAWAHGraber, 1994

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Graber, 2005

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Brass wire

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Hou HM et al, 2006

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Hou HM et al, 2006

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CARA LAIN YG DIPAKAI ADALAH MENGGUNAKAN

BOW DIVIDER ATAU MEMAKAI HANGING CHAIN

YG PENTING DIPERHATIKAN ADALAH CURVE OF

SPEE; JIKA DATAR TIDAK PERPENGARUH PADA

ANALISA RUANG, TETAPI BILA ADA GIGITAN DALAM

AKAN MEMPENGARUHI PERHITUNGAN

UNTUK MENDATARKAN 1 MM CURVE OF SPEE KIRA

KIRA MEMERLUKAN 1 MM RUANG TAMBAHAN, JIKA

LENGKUNG DIBUAT DATAR MULAI DARI M2Graber, 1994

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Inklinasi dan posisi anteroposterior insisivus

Curve of Spee

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If the incisors flare forward, they can align themselves along the arc of a larger circle,

which provides more space to accommodate the teeth and alleviates crowding.

Conversely,If the incisors move lingually, there is less space, and

crowding becomes worse. For this reason, crowding and protrusion of incisors must

be considered two aspects of the same thing: how crowded and irregular the incisors

are reflects both how much room is available and where the incisors are positioned

relative to supporting bone

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Hou et al, 2006

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Hou et al, 2006

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Untuk meramalkan oklusi gigi setelah perawatan : beberapa gigi dipindahkan dari cetakan gigi sebelum dirawat dan disusun dengan malam sesuai dengan oklusi yang diinginkan setelah perawatan.

Gigi disusun dalam tulang alvoelus pasien dalam kondisi yang kemungkinan dapat dicapai dengan perawatan ortodonti

Staley RN & Reske NT, 2011

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PROFFIT 167

Proffit, 2007

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Hou et al, 2006

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Hou et al, 2006

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DIDAPAT DARI :

•PENCABUTAN

•EKSPANSI

•PENGASAHAN INTERPROKSIMAL

•MEMAJUKAN INSISIVUS

•MENEGAKKAN MOLAR

•KOMBINASI

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Alexander, 2000

Extraction BorderlineNon

Extraction

Soft tissue profile

Mandibular incisor position

Attached periodontal tissue

Growth potential

Skeletal pattern

Arch length discrepancy

Patience compliance

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DIPENGARUHI BANYAK FAKTOR TIDAK HANYA

DITENTUKAN ANALISA RUANG

•JARINGAN PERIODONSIUM

•POLA VERTIKAL DAN HORISONTAL

•POSISI INSISIVUS

•PROFIL & KETEBALAN BIBIR

•LENGKUNG GIGI : BERDESAKAN/ RENGGANG

Bennet & Mc. Laughlin

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Diskrepansi ruang < 5mm tanpa pencabutan (tidak termasuk M3)

Diskrepansi ruang 5 – 9 mm

diusahakan tanpa pencabutan

Diskrepansi ruang > 10 mm

pencabutan (tidak termasuk M3)

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1. Proffit WR : Contemporary orthodontics, 3rd ed, Els : St.Louis, 2007, p. 134

2. Graber TM, Vanarsdall RL : Orthodontics Current Principles and Techniques, 2nd ed, Els : St. Louis, 2005, p.56 – 57, 328 – 335

3. Hou HM, Wong RWK, Hagg U. The uses of orthodontic study models in diagnosis and treatment planning. Hongkong Dental Journal 2006;3:107-15

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Page 254

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Summary of Contemporary Extraction Guidelines. Contemporary guidelines for orthodontic extraction in Class I crowding and/or protrusion can be summarized as follows: • Less than 4 mm arch length discrepancy: extraction rarely indicated (only if there is severe incisor protrusion or in a few instances, a severe vertical discrepancy). • Arch length discrepancy 5 to 9 mm: non-extraction or extraction treatment possible. T h e extraction/nonextraction decision depends on both the hard- and soft-tissue characteristics of the patient and on how the final position of the incisors will be controlled; any of several different teeth could be chosen for extraction. Non-extraction treatment usually requires transverse expansion across the molars and premolars. • Arch length discrepancy 10 mm or more: extraction almost always required to obtain enough space. T h e extraction choice is four first premolars or perhaps upper first premolars and mandibular lateral incisors; second premolar or molar extraction rarely is satisfactory. This aspect of the extraction-non-extraction decision is

Proffit, 2007