Indications and Contraindications of Serial Extractions in Pediatric Dentistry: Updated Clinical Guide

Serial extractions are a preventive orthodontic procedure used to manage severe crowding by sequentially removing selected primary and permanent teeth. Correct case selection is essential to ensure long-term success and avoid complications.

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This article reviews the clinical importance, key indications and contraindications, and current recommendations based on recent scientific evidence.

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✅ Clinical Importance of Serial Extractions
Serial extractions help manage space deficiencies during mixed dentition, guiding permanent teeth into more favorable positions. When indicated appropriately, they can:

° Reduce the need for complex orthodontic treatments in adolescence.
° Minimize treatment duration and need for permanent extractions later.
° Maintain balanced facial growth and dental function.

As Proffit et al. (2019) highlight, interceptive orthodontics, including serial extractions, plays a crucial role in guiding proper occlusal development in growing patients.

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✅ Indications for Serial Extractions
Serial extractions are recommended when the following conditions are met:

1. Severe Crowding (>4–5 mm per quadrant)
The primary indication is significant space deficiency that prevents proper eruption of permanent teeth.

2. Negative Tooth–Arch Size Discrepancy
When the total mesiodistal width of permanent teeth exceeds the basal arch length, serial extractions help achieve alignment.

3. Altered or Asynchronous Eruption Patterns
When the eruption sequence is delayed or misaligned, especially in anterior segments, creating space can improve outcomes.

4. Skeletal Class I Pattern
Serial extractions are most effective in patients with normal skeletal growth and no vertical or sagittal disharmonies.

5. Ideal Age: 8–11 Years (Early Mixed Dentition)
The ideal timing is when the first permanent molars and incisors are present, and canines and premolars are developing.

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✅ Contraindications for Serial Extractions
This procedure is not recommended in the following situations:

1. Skeletal Malocclusions (Class II or III)
Patients with significant jaw discrepancies, open bites, deep bites, or crossbites may require orthopedic intervention instead.

2. Presence of Harmful Oral Habits
Thumb sucking, tongue thrust, or mouth breathing must be addressed first, as they can compromise treatment outcomes.

3. Hypodontia or Congenitally Missing Teeth
Teeth should not be extracted if others are absent, as this may worsen spacing or occlusal issues.

4. Mild Crowding or Adequate Arch Space
Unnecessary extractions may cause undesirable gaps or misalignment in otherwise manageable dentitions.

5. Eruption Anomalies or Tooth Impactions
Ectopic eruptions or impacted teeth may require surgical exposure or space creation through other orthodontic means.

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✅ Updated Clinical Recommendations

° Comprehensive diagnostic workup is essential: panoramic and cephalometric X-rays, dental cast analysis, and space evaluation.
° Collaborate with an orthodontist early in treatment planning.
° Educate parents and caregivers about the rationale, timeline, and phases of serial extraction.
° Ensure long-term follow-up to monitor permanent tooth eruption and intervene if deviations occur.

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💬 Discussion
When applied correctly, serial extractions can greatly reduce future treatment complexity. However, inappropriate indication—such as in skeletal malocclusion cases—may lead to unwanted effects, such as arch collapse or residual spacing. The procedure does not replace orthodontic treatment but is rather a preventive adjunct to simplify it (Jarjoura et al., 2020).
Current research supports the effectiveness of serial extractions in well-selected Class I cases. Multidisciplinary coordination and long-term monitoring are key to avoiding complications and ensuring occlusal harmony.

💡 Conclusion
Serial extractions remain a valuable strategy in pediatric orthodontics, but only when properly indicated. Understanding both indications and contraindications allows clinicians to plan treatment safely and predictably. When combined with accurate diagnosis and follow-up, this preventive approach can optimize dental development and reduce the need for future interventions.

📚 References

✔ Jarjoura, K., Goonewardene, M., & Fleming, P. S. (2020). Serial extraction in orthodontics: A systematic review of effectiveness and efficiency. Orthodontics & Craniofacial Research, 23(2), 122–131. https://doi.org/10.1111/ocr.12338

✔ Proffit, W. R., Fields, H. W., Larson, B., & Sarver, D. M. (2019). Contemporary Orthodontics (6th ed.). Elsevier.

✔ Singh, G., & Clark, W. (2018). Interceptive orthodontics: Key concepts and clinical applications. Dental Clinics of North America, 62(3), 457–471. https://doi.org/10.1016/j.cden.2018.03.002

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Serial Extractions in Pediatric Dentistry: Clinical Phases, Benefits, and Updated Guidelines

Serial extractions are a preventive orthodontic technique used to manage severe crowding in mixed dentition. By removing selected primary and permanent teeth in a planned sequence, clinicians can guide the eruption and alignment of permanent teeth.

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This article provides an evidence-based review of the clinical phases of serial extractions, their benefits, indications, and current recommendations.

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✅ What Are Serial Extractions?
Serial extractions refer to the planned and sequential removal of selected primary and permanent teeth to address space discrepancies and facilitate proper eruption of permanent teeth (Proffit et al., 2019). This interceptive orthodontic approach is typically used in children aged 8 to 11 with moderate to severe crowding, where early intervention may reduce the need for complex orthodontic treatment in adolescence.

✅ Why Are Serial Extractions Important?
Properly timed serial extractions can provide several key benefits:

° Prevent severe malocclusions.
° Reduce treatment time and complexity in future orthodontic therapy.
° Support balanced facial aesthetics and functional occlusion.
° Minimize the need for extraction of permanent teeth later in adolescence.

Long-term studies show that patients who undergo serial extractions have more stable outcomes compared to those treated with orthodontic appliances alone (Valentine & Howitt, 2019).

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✅ Phases of the Serial Extraction Protocol

1. Diagnostic Phase
An accurate diagnosis is critical for success. The initial assessment should include:
° Clinical evaluation and dental history.
° Panoramic and cephalometric X-rays.
° Dental model analysis and space assessment.
° Measuring tooth–arch discrepancies.
Candidates for serial extraction typically present more than 4 mm of crowding per quadrant, without skeletal anomalies (Jarjoura et al., 2020).

2. Phase I: Extraction of Primary Teeth
° Common teeth removed: Primary canines and first molars.
° Goal: Facilitate the eruption and alignment of permanent incisors and canines.
° Best timing: Around ages 8–9, with radiographic confirmation of permanent tooth development.

3. Phase II: Extraction of Permanent Premolars (If Needed)
° Indicated in cases of persistent crowding after incisors and canines have erupted.
° Typically performed between ages 10–11, once two-thirds of premolar root formation is complete.
° Must consider periodontal health and adjacent tooth position.

4. Phase III: Orthodontic Guidance and Monitoring
° Use of fixed or removable appliances to guide final alignment.
° Monitoring eruption and alignment every 4–6 months.
° Making necessary adjustments to the treatment plan based on eruption patterns.

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✅ Updated Clinical Recommendations

° Serial extraction should always follow thorough orthodontic planning.
° Multidisciplinary collaboration between pediatric dentists and orthodontists is crucial.
° Families should be fully informed of the steps, benefits, and timeline of treatment.
° Continued monitoring is essential until eruption of all permanent teeth.

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💬 Discussion
While highly effective in selected cases, serial extractions are not suitable for all patients. They do not correct skeletal discrepancies, and thus are not indicated in patients with Class II or Class III malocclusions, open bites, or significant jaw misalignments.
When properly implemented, serial extractions can simplify future orthodontic treatment and improve long-term stability. Clinical evidence supports their use in cases of severe crowding with favorable growth patterns (Proffit et al., 2019; Jarjoura et al., 2020).

💡 Conclusion
Serial extractions are a valuable early intervention technique in pediatric dentistry and orthodontics. With careful diagnosis, proper case selection, and phase-specific monitoring, this protocol offers a predictable and efficient way to manage space discrepancies and support ideal dental development. Incorporating this approach can lead to improved long-term functional and aesthetic outcomes.

📚 References

✔ Jarjoura, K., Goonewardene, M., & Fleming, P. S. (2020). Serial extraction in orthodontics: A systematic review of effectiveness and efficiency. Orthodontics & Craniofacial Research, 23(2), 122–131. https://doi.org/10.1111/ocr.12338

✔ Proffit, W. R., Fields, H. W., Larson, B., & Sarver, D. M. (2019). Contemporary Orthodontics (6th ed.). Elsevier.

✔ Valentine, F., & Howitt, J. W. (2019). Long-term outcomes of serial extraction: A 20-year follow-up. American Journal of Orthodontics and Dentofacial Orthopedics, 155(3), 411–419. https://doi.org/10.1016/j.ajodo.2018.06.015

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White Spot Lesions in Orthodontics: Causes, Prevention, and Treatment Options

White spot lesions (WSLs) are a common clinical challenge during and after orthodontic treatment with fixed appliances. They are early indicators of enamel demineralization and can significantly affect the esthetic outcomes of orthodontic care.

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This article explores the definition, characteristics, etiology, prevention, and treatment options for WSLs based on the most recent scientific literature.

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✅ Definition and Characteristics
White spot lesions are defined as subsurface enamel porosities caused by the demineralization of hydroxyapatite crystals, which appear as opaque, chalky white areas on the smooth surfaces of teeth (Gorelick et al., 1982). Unlike caries cavities, WSLs represent a non-cavitated stage of enamel decay that is often reversible with timely intervention (Featherstone, 2004).
These lesions are typically seen on the buccal surfaces of anterior teeth, especially around orthodontic brackets, and can become permanent esthetic defects if left untreated.

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✅ Etiology and Risk Factors
WSLs develop when dental plaque accumulates around orthodontic brackets and is not effectively removed. The cariogenic bacteria, particularly Streptococcus mutans and Lactobacillus, metabolize dietary sugars and produce acids that lower the pH in the biofilm, leading to enamel demineralization (ten Cate, 2001).

➤ Risk factors include:
° Poor oral hygiene during orthodontic treatment
° High carbohydrate/sugar diet
° Salivary flow or composition abnormalities
° Prolonged treatment time
° Lack of fluoride exposure

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✅ Prevention Strategies
Effective prevention is crucial since early WSLs are reversible but can rapidly progress without intervention. Strategies include:

1. Oral Hygiene Education
Patient education remains the cornerstone. Brushing twice daily with fluoride toothpaste, interdental brushes, and electric toothbrushes has shown significant benefit (Derks et al., 2004).
2. Fluoride Use
Fluoride varnishes, mouth rinses, and high-fluoride toothpaste strengthen enamel and reduce WSL incidence. A randomized controlled trial found that 5% sodium fluoride varnish applied every 6 weeks significantly lowered WSL formation (Øgaard, 1994).
3. Sealants and Coatings
Resin sealants and glass ionomer coatings applied to tooth surfaces or brackets can form a physical barrier against plaque accumulation (Julien et al., 2006).
4. Diet Counseling
Minimizing acidic and sugary food intake is essential. Xylitol gum may also reduce bacterial load and stimulate salivary flow.

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✅ Treatment Approaches
Once WSLs appear, timely and appropriate treatment can improve esthetics and prevent progression.

1. Remineralization Agents
° Fluoride therapies: High-fluoride toothpaste, varnishes, and gels promote remineralization.
° CPP-ACP (casein phosphopeptide–amorphous calcium phosphate): Enhances calcium and phosphate delivery to enamel (Bailey et al., 2009).
° Nano-hydroxyapatite: Biomimetic agent that integrates into enamel matrix (Huang et al., 2011).
2. Microabrasion
A minimally invasive technique using acidic and abrasive compounds to remove superficial enamel and improve lesion appearance (Croll, 1990).
3. Resin Infiltration (Icon®)
A novel approach using low-viscosity resin to infiltrate and mask lesions, improving esthetics and halting progression. Clinical studies report high patient satisfaction and long-term effectiveness (Paris et al., 2010).
4. Restorative Techniques
In advanced cases, composite resin restoration or veneers may be required to restore function and esthetics.

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💬 Discussion
WSLs are a frequent but preventable side effect of fixed orthodontic appliances. The use of preventive strategies, such as patient education, fluoride application, and professional monitoring, is essential in reducing incidence. Emerging technologies like resin infiltration provide minimally invasive alternatives with promising results.
Current research focuses on biomimetic remineralizing agents and nanotechnology to enhance enamel repair. However, long-term studies are needed to validate their effectiveness in different populations and orthodontic conditions.

💡 Conclusion
White spot lesions represent a significant clinical concern in orthodontics. Through early diagnosis, preventive strategies, and minimally invasive treatments, dental professionals can mitigate their impact. Collaboration between orthodontists, general dentists, and patients is key to preserving enamel integrity and esthetic outcomes.

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✅ Recommendations

° Reinforce oral hygiene at every orthodontic visit.
° Prescribe fluoride varnishes or high-fluoride toothpaste for at-risk patients.
° Consider applying sealants on high-risk teeth before bracket bonding.
° Introduce resin infiltration early for cosmetic management.
° Promote regular follow-up appointments post-debonding to monitor lesion progression.

📚 References

✔ Bailey, D. L., Adams, G. G., Tsao, C. E., Hyslop, A., Escobar, K., Manton, D. J., ... & Reynolds, E. C. (2009). Regression of post-orthodontic lesions by a remineralizing cream. Journal of Dental Research, 88(12), 1148-1153. https://doi.org/10.1177/0022034509347163

✔ Croll, T. P. (1990). Enamel microabrasion: observations after 10 years. Journal of the American Dental Association, 121(5), 548-550. https://doi.org/10.14219/jada.archive.1990.0172

✔ Derks, A., Katsaros, C., Frencken, J. E., van't Hof, M. A., Kuijpers-Jagtman, A. M. (2004). Caries-inhibiting effect of preventive measures during orthodontic treatment with fixed appliances: a systematic review. Caries Research, 38(5), 413-420. https://doi.org/10.1159/000079623

✔ Featherstone, J. D. B. (2004). The continuum of dental caries—evidence for a dynamic disease process. Journal of Dental Research, 83(Spec No C), C39-C42. https://doi.org/10.1177/154405910408301s08

✔ Gorelick, L., Geiger, A. M., & Gwinnett, A. J. (1982). Incidence of white spot formation after bonding and banding. American Journal of Orthodontics, 81(2), 93–98. https://doi.org/10.1016/0002-9416(82)90032-X

✔ Huang, S. B., Gao, S. S., Yu, H. Y. (2011). Effect of nano-hydroxyapatite concentration on remineralization of initial enamel lesion in vitro. Biomedical Materials, 4(3), 034104. https://doi.org/10.1088/1748-6041/4/3/034104

✔ Julien, K. C., Buschang, P. H., & Campbell, P. M. (2006). Prevalence of white spot lesion formation during orthodontic treatment. The Angle Orthodontist, 76(6), 1045–1050. https://doi.org/10.1043/0003-3219(2006)076[1045:POWSLF]2.0.CO;2

✔ Øgaard, B. (1994). Effectiveness of a fluoride-releasing orthodontic bonding material in the prevention of white spot lesions: a 9-month clinical study. American Journal of Orthodontics and Dentofacial Orthopedics, 106(6), 583–591. https://doi.org/10.1016/S0889-5406(94)70002-5

✔ Paris, S., Meyer-Lueckel, H., Mueller, J., Hummel, M., Kielbassa, A. M. (2010). Progression of sealed initial caries lesions: a randomized controlled clinical trial. Caries Research, 44(1), 67–71. https://doi.org/10.1159/000279324

✔ ten Cate, J. M. (2001). Review on fluoride, with special emphasis on calcium fluoride mechanisms in caries prevention. European Journal of Oral Sciences, 109(2), 207-212. https://doi.org/10.1034/j.1600-0722.2001.00006.x

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How to Correct Harmful Oral Habits in Children That Affect Facial and Dental Development

Early childhood is a critical period for craniofacial and dental development. Certain harmful oral habits, such as thumb sucking, mouth breathing, or nail biting, can interfere with proper facial growth and tooth alignment.

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✅ Common Harmful Oral Habits in Children: Definitions and Treatments

1. Thumb Sucking
➤ Definition:
° A repetitive behavior in which the child inserts one or more fingers into the mouth, usually for comfort or stress relief.
➤ Potential Effects:
° Anterior open bite
° Protrusion of upper front teeth
° Underdeveloped lower jaw
° Improper lip seal
➤ Treatment Options:
° Positive reinforcement techniques (e.g., reward charts)
° Behavior tracking with family support
° Intraoral appliances (e.g., palatal crib or tongue rake) in persistent cases
° Psychological support for anxiety-linked cases (Barbería et al., 2021)

2. Prolonged Pacifier or Bottle Use
➤ Definition:
° Using a pacifier or bottle beyond age 2–3, leading to non-nutritive sucking behavior.
➤ Potential Effects:
° Anterior open bite
° Posterior crossbite
° High, narrow palate
➤ Treatment Options:
° Parent education on weaning by age 2
° Gradual transition to cups and comfort objects
° Orthodontic intervention if malocclusion persists
° Oral muscle training to improve lip seal and tongue posture

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3. Tongue Thrust (Atypical Swallowing)
➤ Definition:
° Pushing the tongue against or between the teeth when swallowing or speaking, instead of placing it against the palate.
➤ Potential Effects:
° Anterior open bite
° Gaps between front teeth
° Weak orofacial muscles
➤ Treatment Options:
° Orofacial myofunctional therapy (OMT)
° Palatal cribs or tongue spurs if habit continues past age 6
° Collaboration with a speech-language pathologist
° Long-term monitoring by pediatric dentist or orthodontist

4. Mouth Breathing
➤ Definition:
° Breathing through the mouth instead of the nose, often due to nasal obstruction or habit.
➤ Potential Effects:
° Long face syndrome
° Incompetent lips (open mouth posture)
° Narrow upper jaw and posterior crossbite
° High-arched palate
➤ Treatment Options:
° ENT evaluation for nasal or adenoid obstruction
° Palatal expansion in cases of narrow maxilla
° Orofacial therapy to re-establish nasal breathing
° Nasal hygiene and breathing retraining exercises

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5. Nail Biting (Onychophagia)
➤ Definition:
° A compulsive habit of biting or chewing nails, often triggered by stress or anxiety.
➤ Potential Effects:
° Tooth wear or misalignment
° Microfractures in front teeth
° Risk of infections around the mouth
° Jaw tension or muscle strain
➤ Treatment Options:
° Behavioral strategies (e.g., bitter nail polish, habit reversal training)
° Psychological support if anxiety-related
° Orofacial therapy to manage perioral muscle tension
° Parental coaching and support at home and school (Maia et al., 2019)

✅ Diagnosis
A thorough diagnosis involves both physical and behavioral evaluation:
Comprehensive dental and facial exam
History of the habit (age of onset, frequency, triggers)
Functional assessment of breathing, swallowing, and oral posture
Referral to ENT, speech therapist, or child psychologist if needed

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💬 Discussion
Persistent oral habits beyond ages 3–4 can significantly impact a child's bite, facial symmetry, and speech development. Studies have shown that early intervention is key, ideally before age 6, when craniofacial structures are still adaptable (Grippaudo et al., 2020; Souki et al., 2019).
Most habits can be addressed successfully through behavioral therapy and parent involvement. In more severe cases, interceptive orthodontics or interdisciplinary care may be required. Educating caregivers is essential for consistent support at home.

💡 Conclusion
Harmful oral habits can disrupt normal facial and dental development if not treated in time. Each habit presents specific risks and requires a tailored treatment approach. Early identification, behavioral guidance, and, when necessary, interdisciplinary therapy, offer the best outcomes. Prevention and early parental education remain the most effective tools in managing these behaviors.

📚 References

✔ Barbería, E., Lucavechi, T., & Suárez-Clúa, M. C. (2021). Clinical Pediatric Dentistry. Elsevier España.

✔ Grippaudo, C., Paolantonio, E. G., Antonini, G., Saulle, R., La Torre, G., & Deli, R. (2020). Association between oral habits, mouth breathing and malocclusion. Acta Otorhinolaryngologica Italica, 40(5), 282–289. https://doi.org/10.14639/0392-100X-N0616

✔ Souki, B. Q., Pimenta, G. B., Souki, M. Q., Franco, L. P., Becker, H. M. G., & Pinto, J. A. (2019). Prevalence of malocclusion among mouth breathing children: do expectations meet reality? International Journal of Pediatric Otorhinolaryngology, 119, 146–150. https://doi.org/10.1016/j.ijporl.2019.01.032

✔ Viggiano, D., Fasano, D., Monaco, G., & Strohmenger, L. (2020). Oral habits and orthodontic anomalies in preschool children. International Journal of Paediatric Dentistry, 30(3), 326–333. https://doi.org/10.1111/ipd.12594

✔ Maia, B. R., Marques, D. R., & Barbosa, F. (2019). Nail biting in children: an integrative review. Psicologia: Reflexão e Crítica, 32(1), 1–9. https://doi.org/10.1186/s41155-019-0116-1

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How Long Should Orthodontic Treatment Last? Procedures, Duration, and Scientific Justification

Orthodontic treatment is a complex but highly effective dental intervention that corrects malocclusion, dental crowding, spacing, and skeletal discrepancies.

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Although many patients expect fast results, the duration of orthodontic treatment is determined by biological, mechanical, and individual patient factors—all of which are backed by current clinical research.

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✅ How Is Orthodontic Treatment Carried Out?
Orthodontic therapy is delivered in four main phases:

1. Diagnosis and Treatment Planning
The orthodontist collects diagnostic data including panoramic X-rays, lateral cephalograms, intraoral scans, and facial photographs. These are analyzed to formulate an individualized treatment plan.
2. Active Phase (Tooth Movement)
Brackets, archwires, or aligners (e.g., Invisalign) are applied to exert controlled forces on the teeth. This phase typically lasts between 6 and 24 months depending on the severity of malocclusion and patient cooperation.
3. Space Closure and Bite Correction
During this phase, spaces from extractions (if any) are closed and bite alignment is refined using interarch elastics or bite correctors.
4. Retention Phase
After the desired tooth positions are achieved, retainers are used to stabilize the teeth and prevent relapse, often for a lifelong period.

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✅ What Is the Recommended Duration?
The average orthodontic treatment duration is 18 to 30 months, depending on case complexity, appliance type, and biological response. Some mild cases may be completed in as little as 12 months, while more complicated malocclusions—such as skeletal Class II or III discrepancies—may require over 36 months, sometimes in combination with orthognathic surgery.

✅ Scientific Justification for Treatment Duration
Tooth movement is mediated by bone remodeling, a physiological process involving osteoclastic and osteoblastic activity in response to controlled mechanical forces.
Rapid orthodontic movement risks:

° Root resorption
° Periodontal breakdown
° Bone dehiscence

Clinical guidelines support the use of light, continuous forces rather than aggressive force applications. According to Papageorgiou et al. (2022), the efficacy and safety of orthodontic treatment are optimized when aligned with biomechanical principles that respect tissue physiology.

Additionally, the pace of treatment is influenced by:
° Age: Adolescents show faster remodeling than adults.
° Type of appliance: Self-ligating brackets and clear aligners may reduce friction and duration in select cases.
° Patient compliance: Missed appointments or broken appliances delay progress.
° Oral hygiene: Poor hygiene may result in gingival inflammation or caries, which can temporarily suspend treatment.

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✅ Conclusion
Orthodontic treatment requires a minimum of 18 to 30 months for safe, stable, and functional results. Each phase of treatment plays a critical role, and shortening the process unnecessarily can compromise long-term outcomes. Duration should always be tailored to individual clinical needs and grounded in evidence-based protocols.

📚 References

✔ Papageorgiou, S. N., Cobourne, M. T., & Eliades, T. (2022). Clinical effectiveness of orthodontic treatment: A systematic review and meta-analysis. Progress in Orthodontics, 23(1), 1–15. https://doi.org/10.1186/s40510-022-00420-3

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Parafunctional oral habits. Which are? Diagnosis and treatment

Parafunctional oral habits are repetitive actions that hinder the harmonious growth of the jaws and orofacial development. Parafunctional habits are highly prevalent and can be acquired and compulsive.

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Early evaluation and diagnosis is essential in these cases, and treatment can be multifactorial through the intervention of the pediatrician and speech therapist. Some parafunctional habits are: tongue interposition, digital sucking and mouth breathing.

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Let's know what the most common parafunctional habits are and their etiology, clinical manifestations, diagnosis, treatment and their relationship with malocclusions.

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📌 Read and download the article in PDF 1:

👉 "Management of Oral Parafunctional Habits: A Case Report" 👈

P.S, Murali & Achalli, Sonika & Chandragiri, Sandeep & Shetty, Sameep. (2023). Management of Oral Parafunctional Habits: A Case Report. Journal of Health and Allied Sciences NU. 10.1055/s-0043-1764358.

📌 Read and download the article in PDF 2:

👉 "Oral Habits and its Relationship to Malocclusion: A Review " 👈

Kharat S. Oral Habits and its Relationship to Malocclusion: A Review. J Adv Med Dent Scie Res 2014;2(4):123-126.

📌 Watch video "Parafunctional oral habits. Which are? Diagnosis and treatment"

Youtube/ Youtube PIDC

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What are impacted canines? - Treatment

The canines are characterized by having a long, single and robust root. They play an important role in facial contour and occlusal harmony.

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Impacted canines is a common anomaly, and is especially seen in the maxilla. The cause of the retention of the canine should be evaluated clinically and radiographically.

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We share a video that defines us and explains the causes and treatment of impacted canines.

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Anterior crossbite - Diagnosis and orthopedic treatment

The anterior crossbite is a malocclusion that has several etiologies and is characterized when the upper incisors are behind the lower incisors, it develops in the primary and mixed dentition.

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Treatment must be early to avoid complications in the permanent dentition and in the aesthetics of the patient. It begins with treatment with orthopedic devices.

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The case, diagnosis and progression of treatment (orthopedic phase and orthodontic phase) of a pediatric patient with anterior open bite are presented.

📌 Read and download the article in PDF : Orthopaedic correction of an anterior cross-bite



Ruiz LCC, Sáez EG. Orthopaedic correction of an anterior cross-bite. Rev Mex Ortodon. 2015;3(4):239-248.

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Tooth extractions in orthodontics? - Why Do Orthodontists Extract Teeth?

Before carrying out an orthodontic treatment, a correct diagnosis is essential, and for this, radiographs (cephalometric and panoramic), clinical examination, photographs, and study models are used.

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Once the analysis is finished, the type of treatment that the patient will receive is determined, and sometimes it is recommended to perform dental extractions. The patient must be informed about the importance of dental extractions.

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Tooth extractions are part of the orthodontic procedure, and it is important that the patient knows the reasons and the importance of this procedure.

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Bionator Appliance: Objectives, Indications, Advantages and Disadvantages

The Bionator is a functional appliance created by Balters, and is used to treat Class II Division 1, Class III malocclusions and open bites. It is also used in patients with temporomandibular disorders.

The Bionator must be used for a long time by the patient, in this way we can observe satisfactory results. One of the advantages is that it is a comfortable functional device for the patient.

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We share a video that details the advantages, disadvantages, indications and contraindications of the Bionator.

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Clear Aligners for Early Treatment of Anterior Crossbite - Indications and Benefits

Anterior crossbite is a sagittal plane malocclusion, and is characterized when one or more upper incisors have a lingual position with respect to the lower incisors.

The detection and treatment of the anterior crossbite must be at an early age, in this way we stop the factors that trigger this malocclusion and avoid abnormal growth of the jaws.

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We share an article that presents the advantages and benefits of transparent aligners in the correction of anterior crossbite in patients with mixed dentition, regarding two reported cases.

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👉 READ AND DOWNLOAD "Esthetic options for anterior primary teeth - Characteristics" IN FULL IN PDF👈

Staderini E, Patini R, Meuli S, Camodeca A, Guglielmi F, Gallenzi P. Indication of clear aligners in the early treatment of anterior crossbite: a case series. Dental Press J Orthod. 2020 Jul-Aug;25(4):33-43

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Space Maintainer in Pediatric Dentistry: How do they work? Benefits and indications

The primary teeth fulfill several functions, one of them is to save and maintain the space that corresponds to the permanent tooth until its exfoliation.

The premature loss of primary teeth puts the correct position and occlusion of the permanent teeth at risk. Preventive orthodontics makes use of space maintainers to prevent unwanted tooth movements.

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We share a complete study and review on the importance, indications, types and effectiveness of space maintainers in pediatric dentistry.

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What is the role of space maintainers? Types of maintainers

👉 READ AND DOWNLOAD "The Use of Space Maintainer in Pediatric Dentistry: A Systematic Review " IN FULL IN PDF👈

(2021). The Use of Space Maintainer in Pediatric Dentistry: A Systematic Review. European Journal of Molecular & Clinical Medicine, 8(2), 1532-1545.

👉 READ AND DOWNLOAD "Dental Space Maintainers: A Brief Review" IN FULL IN PDF👈

[Nayara Silva de Oliveira Morais1, Fabiana Barbosa Faustino1, Talysson Silva de Oliveira Morais, Elias NaimKassis, Fábio Pereira Linhares de Castro, Andreia Borges Scriboni, Simone Andreia Gubolin, Leandro Moreira Tempest and Idiberto José Zotarelli Filho. (2016); DENTAL SPACE MAINTAINERS: A BRIEF REVIEW. Int. J. of Adv. Res. 4 (Oct). 2086-2092] (ISSN 2320-5407). www.journalijar.com


👉 ALSO WATCH THE VIDEO: What is a Space Maintainer and How Does It Work?

Fuente: Youtube / Denovo Dental

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Space Maintainers: Types, indications and complications

Dental trauma and extensive caries are the most common reasons for premature loss of primary teeth. In these cases it is necessary to place a space maintainer whose objective is to preserve the space destined for the successor permanent tooth.

Space maintainers can be fixed or removable, unilateral or bilateral, and have different designs. The specialist will decide which type of maintainer is suitable for the patient after a clinical and radiographic evaluation.

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We share complete information on the importance of space maintainers in the prevention of dental malocclusions, reviewing their applications, indications and complications.

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Albati, M., Showlag, R., Akili, A., Hanafiyyah, H., AlNashri, H., Aladwani, W., Alfarsi, G., Alharbi, M., & Almutairi, A. (2018). Space maintainers application, indication and complications. International Journal Of Community Medicine And Public Health, 5(11), 4970-4974. doi:http://dx.doi.org/10.18203/2394-6040.ijcmph20184251

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Nolla's Stages of Tooth Development - Video

Dr. Nolla in 1960 conducted a study to determine the development and maturation of permanent teeth. To perform this classification, the use of an X-ray is necessary.

The Nolla classification establishes values for tooth formation and development from the presence of the crypt to apical closure.

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Knowing the stages of dental development of Nolla is important for diagnosis in orthodontics, pediatric dentistry and forensic dentistry. Learn the details of each phase of Nolla in the following video.

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How Does Myobrace Work? - Video

The evaluation, diagnosis and treatment of malocclusions from a very early age is recommended. Thanks to functional orthopedics, malocclusions can be corrected and prevented from getting worse.

The Myobrace system through different intraoral devices corrects and prevents malocclusions as well as the consequences of bad oral habits. The use of these devices decreases the time of treatment with braces


We share a video that explains how the Myobrace system works to correct malocclusions and bad oral habits.

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Early Treatment of Anterior Crossbite with Eruption Guidance Appliance: A Case Report

The anterior crossbite is a type of malocclusion in the anteroposterior plane, characterized by having the lower teeth in front of the upper ones. Early evaluation is important to diagnose malocclusion and through interceptive orthodontics to correct it.

During this clinical case, an eruption guidance appliance (EGA) was used in a 05-year-old patient (mixed dentition) for 07 months with satisfactory results.

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We share the case of a 05-year-old boy with anterior crossbite, and an eruption guidance appliance (EGA) was used.

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Marianna Pellegrino, Silvia Caruso, Tiziana Cantile, Gioacchino Pellegrino, Gianmaria Fabrizio Ferrazzano Int J Environ Res Public Health. 2020 May; 17(10): 3587. Published online 2020 May 20. doi: 10.3390/ijerph17103587 PMCID: PMC7277547

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