 Hello, everyone. Welcome back to another session in dentistry. I'm on today's topic is adult orthodontics So it is a very vast topic. I'll be covering in a brief manner So orthodontic treatment we commonly give for younger age people or adolescents That is maybe age ranging till 20 because the bone cessation happens by then so adult orthodontics is for 25 plus people there is no age restriction to categorize adult Orthodontics So basically these group of people the demand for orthodontics For two things one is looking for comprehensive treatment. I'm talking about adult patient comprehensive treatment or Adjunct treatment So that is a demand from the adult group of patients So why they seek ortho treatment? So basically we seek ortho treatment to improve our dental appearance. So same reason the adult patients also having and Treatment of the relapse cases Sometimes the patient might have done orthodontic treatment in earlier and relapse happened So in order to treat the relapse then to facilitate restorative or Peridontal treatment and for surgical correction of jaw discrepancy And to use intraoral mantibular advancement appliances for obstructive sleep apnea That is OSA So these are the reasons why adult patients seek ortho treatment So what are the basic indications for adult treatment? Actually, there is no age limit for adult orthodontics And as I mentioned it could be aesthetics Then it could be functional Also could be Adjunct to Other treatment. So these are the indications. Okay, so I already explained it Now the contraindications as we all know the medical problems medical problems then poor oral hygiene then short root So all these can be contraindications So what are the problems the adult patients faces? The thing is first one is a lack of growth because the growth Cessation happens. There is no growth. So lack of growth is a main problem Because orthodontics is basically related to the growth of Bones that is mantable and maxilla So it is a remodeling process of bone, but Once a growth cessation happens, there is no remodeling. There is no resorption. So there is no growth and There are many problems with the periodontal structures. That is Periodontal diseases The adult group of people faces a second problem. That is periodontal diseases Then the missing or heavily restorative missing tooth restore tooth another problem Then the physiological factors affecting tooth movement physiological factors Then the adult motivation and attitude Motivation attitude of adult patients So what exactly mean by lack of growth? So as I mentioned the growth changes have occurred by the end of puberty. There is no scope for growth modification And the overbite correction is very difficult after the growth Cessation happens and extruding the molars are prone to relapse So what about the periodontal disease? So these adult people are more likely to be suffering from the periodontal disease and there will be active periodontal disease Which should be treated and stabilized before moving to a orthodontic treatment. Otherwise it will worsen the existing situation Then about the missing tooth or heavily restored teeth There will be tooth loss which might be resulting in drifting and tilting of the adjacent teeth and over eruption of the opposing teeth Then there will be atrophy of the alveolar bone and If there is any heavily restored teeth which are more common in adults and it may complicate the orthodontic treatment because the bonding to restoration material is difficult and About the physiological factors affecting tooth movement. So there is reduced tissue blood supply and decreased cell turnover in adults So initial tooth movement is lower in adults and may be more painful So Basically, it is advisable that light initial forces and Regarding the motivation and attitude. So usually adults are well motivated patients So increased cooperation may compensate for the slower initial tooth movement So these adults tend to be more conscious of their parents and they have more drive towards aesthetic orthodontics But they are more reluctant to wear extra oral appliances According to profit adult orthodontic procedures are classified into three that is adjunctive, comprehensive and surgical adjunctive treatment Adjunctive orthodontic treatment is tooth movement which is carried out to facilitate other dental procedures necessary to control disease and Restore function. So typically this will involve any or all of several procedures So basically it involves uprighting of posterior teeth Or forced erection alignment of anterior teeth and also cross bite correction So this is like operating means repositioning of teeth which are drifted after extraction or bone loss So as to facilitate the placement of RPD or FPD or even implants for that purpose We are changing the position of teeth So along with orthodontic therapy, we have another prosthetic therapy. So it is an adjunctive procedure Next is a forced erection of badly broken Teeth to expose sound to structure on which to place crowns. So that is forced erection. We need to place crowns So we are going to forcefully erupt the Root okay Next is the alignment of anterior teeth to allow more aesthetic restoration or successful splinting and lastly cross bite correction if these compromises jaw function we need to Correct the cross bite. So these are going along with some other procedures or to help the procedures Okay, such as a splinting such as placement of crowns we are using the orthodontic Therapies on the existing teeth that is adjunctive orthodontic treatment in adults And the basic characteristics are it should be completed very fast maybe within six months and Appliances are required only a portion of the dental arch that is partial fixed appliances So if a orthodontic treatment for temporal mandibular disorder, which cannot be considered as adjunctive So the basic goals are to facilitate Restrictly treatment by positioning the teeth so that more ideal and conservative technique can be used or to improve the parodontal health by eliminating black harboring areas and improving the alveolar ridge contour adjacent to the teeth or to establish a favorable crown to root ratio and Position the teeth so that the occlusion forces are transmitted along the long axis of teeth So adjunctive orthodontic treatment are basically to help the person To have a good oral health Next we have the comprehensive orthodontic treatment So comprehensive orthodontic treatment is the same what we perform usually but it can be done on adult patient also So it is to make the patients occlusion as ideal as possible Repositioning all or nearly all the teeth in the process So it is not just like adjunctive. It is a comprehensive treatment, but we are performing In adults that is a difference. So the ideal time is at all sense because The succededness teeth they have just erupted and some vertical and anterior posterior growth of the jaw remains So we can manage it well, but once the growth cessation or growth completion happen. It is quite difficult So the problem we face we already discussed such as the lack of growth and there is involvement of parodontal disease and The level of motivation for such patients. So all process problem for comprehensive ortho treatment in adult time So the first thing is regarding the motivation motivation You know motivation can be internal or external motivation Internal the patient himself feels the need for a treatment Maybe because a psychological reason But if the patient is forced by some others to go for a treatment that becomes external motivation So next one is parodontal disease patients. So to perform a ortho treatment in a parodontally Compromised patient is under very risk. So we need to be very careful. We need to analyze the bond length The pattern of bond loss everything and we need to Alter our treatment depending upon the severity of parodontal disease. So patient can be minimally parodontal involvement moderate level on a parodontal Severe parodontal disease level. So all cases we need to be very careful and we need to Diagnose the patient properly then do procedure accordingly There can be horizontal bond loss. There can be hemiceptal defect. There will be vocation defect all cases we need to be To proper diagnosis and procedure based on the diagnosis So comprehensive ortho roundic treatment is same as the adults and one but we need to be more careful when we are doing Adults because there is no growth. There is lot of parodontal issues and The motivation factor and the last one is surgical ortho roundic treatment So correction of severe skeletal deformity in an adult is achieved by Surgery so around 10 to 20 percentage of adults fall into this category So the surgical treatment basically involves plant fracturing of the facial skeletal parts and repositioning them as desired So this can be performed in both jaws and in all three planes of space So in anterior posterior plane, we have maxillary surgery Then we have mandibular advancement That is in the anterior posterior plane And also we have mandibular setback Whereas the correction of vertical relationships We can perform again maxillary surgery or mandibular surgery and in a transverse relationship such as maxillary expansion for lingual cross-bite and Genioplasty such procedures can be done Now we have some newer techniques in adult ortho roundics Such as Invisalign. Invisalign is a popular one nowadays and lingual ortho roundics is another one Invisalign is a newer introduction to ortho roundic treatment There It offers adult patients who requires full mouth ortho roundic treatment with anesthetically agreeable solutions It was introduced by Alain Technologies in California It is an ortho roundic technique which uses a series of clear plastic aligners. They use clear plastic aligners To move the teeth they want for a minimum of 20 hours per day and it should be changed every two weeks And each aligner moves a tooth for a small group of teeth about point 252.33 M for Invisalign technique there will be a computer aided scanning imaging and manufacturing technology which has completely changed the treatment scenario because The scanning and imaging of high precision cars made from very accurate impression like polyvinyl silicone impression This allows a patient to be replicated on a screen in a 3d model So which can be manipulated and virtually corrected Through a treatment plan developed by the author on this So that is a very newer technology in this line whereas lingual ortho roundics So invisalign can alone be taken as a separate Video so now I am stopping it here. Just a brief idea about Invisalign now Let's move to the lingual ortho roundics So most lingual ortho roundic patients are adults because the aesthetic issue So the advantages are the labial enamel surface is preserved which plays an important aesthetic role and susceptibility of this enamel surface to permanent decalcification following chemical Incell from the etchant and from black accumulation is prevented. So the enamel is prevent enamel is prevented from etchant and black And aesthetic is the main concern For the adult people to seek for lingual ortho roundics So lingual appliances allow easy access for routine oral hygiene procedures and Evaluation of individuals to positions can be easily assessed as a label surfaces free of distracting metal or plastic brackets So basically this is very effective in intrusion of anterior teeth intrusion of anterior teeth and Maxillary arch expansion and Digitalization of maxillary mollus. So Invisalign and lingual ortho roundics. I just mentioned it very briefly It is a very very vast topic Just like adult ortho roundics. So I was giving a very brief introduction about all the three procedures That is the adjunctive comprehensive and surgical and the newer techniques So that was a brief idea about adult ortho roundics So we discussed about the indication contraindication and the basic three procedures and the problem What adult patient faces for the ortho roundic treatment? Hope you understood this small topic I will come up within your topic in the industry and more. Thank you