10. Interceptive Orthodontics Flashcards
(48 cards)
Definition of inceptive orthodontics
An extension of preventive ortho
- Occurs in primary or transitional dentition
- Used to reduce the severity of the malformation and mitigate its cause
- Doesn’t eliminate the possibility for future comprehensive therapy
When multiple teeth are in an anterior cross bite what are the two different skeletal occlusal schemes
- Pseudo class III
- True Class III
How can you recognize a pseudo class III clinically
- Occlude in end to end
- Slides into crossbite
Multiple teeth in a crossbite suggests what
skeletal component- need ortho referral
Reasons a tooth erupts into a cross bite
- Trauma to primary tooth(can cause ankylosis making exfoliation more difficult)
- Pulpectomy on primary tooth (more difficult for erupting tooth to resorb the root)
- Mesiodens/supernumerary
- Crowding
- Tooth erupts end to end with lower incisor and deflects into crossbite
- Class III skeletal relationship
What are the three reasons to treat a single tooth anterior cross bite
- Puts lower incisor at risk of recession
- If pt occludes end to end can chip/traumatize the incisors
- Esthetics
Treating a single tooth anterior cross bite becomes difficult when
there is not enough room on the maxilla to move the incisor forward (or lingually if we need to move the lower incisor)
What are the options for treatment of an anterior single tooth crossbite (interceptive tx)
Fixed
-2x4 (2 molars and 4 incisors)
Removable
-Hawley with Z-spring
Described the fixed 2x 4 appliance
- Brackets on four anterior teeth
- Molars are anchors and have occlusal stops (this opens the bite to help move the upper incisor forward without interference from lower teeth)
Describe the Hawly with Z-spring appliance
- Coild on the Z-spring move the incosor forward
- Should wear 24/7
- Wraps over the occlusal surface to open the bite
- Labial bow ensures the teeth aren’t pushed too far outside the arch
What should you do treatment wise when a posterior cross bite exists in the
- primary dentition
- Mixed dentition
- Primary= monitor
- Mixed= if persists in the mixed you should treat
A unilateral crossbite typically represent a (unilateral/bilateral) constriction of the maxilla
bilateral
A midline discrepancy is indicative of
a functional shift (helps achieve MIP)
Why treat a posterior crossbite in mixed dentition
- Allow room for eruption of permanent teeth
- Early tx takes advantage of less complex interdigitation of the maxillary suture
- If a shift is present want early correction to prevent possible skeletal asymmetry
Appliances to fix posterior open cross bite
Fixed
- Hyrex/Rapid palatal expander
- Quad helix
Removable
-Schwartz Plate
Describe the hyrex rapid palatal expander
- Screw mechanism allows for gradual palatal expansion
- Fixed
- Turn screw 1 turn a day (opens 1/4 mm per turn)
- Suture will fill in with bone
Describe the quad helix
- Anchored on the 6 year molars
- Loops allow you to stretch the appliance
- Puts gentle pressure causing expansion
- Can remove to reactivate
Describe the schwartz plate
- Allows gradual palatal expansion (like the RPE)
- Easier to turn the screw because it is removable
- Compliance not as good as RPE because it is removabel
What percent of kids have a non-nutritive sucking habit beyond 3 y/o
20%
T/F Incisor position will correct itself if habit stops early enough
t
At what age would we like to see non-nutritive habits stop by 9max age)
3 (but critical when the permanent incisors are erupting)
Problems with non-nutritive sucking habits
- Anterior open bite
- Flared incisors
- Posterior maxillary constriction (can lead to posterior cross bite)
- High arched palate
- Asymmetry
- Tongue thrust on swallow
Extent of the issues from non-nutrutuve sucking habits are based on
frequency, intensity and duration
What are different treatment options to help the child break the habit
- Mavala (bitter taste spray for thumb)
- Thumb guard
- Appliance (fixed for removable ) – examples are the rake, bluegrass and crib
