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PEDO (Spring) > 10. Interceptive Orthodontics > Flashcards

10. Interceptive Orthodontics Flashcards

1
Q

Definition of inceptive orthodontics

A

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
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2
Q

When multiple teeth are in an anterior cross bite what are the two different skeletal occlusal schemes

A
  • Pseudo class III

- True Class III

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3
Q

How can you recognize a pseudo class III clinically

A
  • Occlude in end to end

- Slides into crossbite

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4
Q

Multiple teeth in a crossbite suggests what

A

skeletal component- need ortho referral

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5
Q

Reasons a tooth erupts into a cross bite

A
  • 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
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6
Q

What are the three reasons to treat a single tooth anterior cross bite

A
  • Puts lower incisor at risk of recession
  • If pt occludes end to end can chip/traumatize the incisors
  • Esthetics
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7
Q

Treating a single tooth anterior cross bite becomes difficult when

A

there is not enough room on the maxilla to move the incisor forward (or lingually if we need to move the lower incisor)

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8
Q

What are the options for treatment of an anterior single tooth crossbite (interceptive tx)

A

Fixed
-2x4 (2 molars and 4 incisors)

Removable
-Hawley with Z-spring

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9
Q

Described the fixed 2x 4 appliance

A
  • 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)
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10
Q

Describe the Hawly with Z-spring appliance

A
  • 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
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11
Q

What should you do treatment wise when a posterior cross bite exists in the

  • primary dentition
  • Mixed dentition
A
  • Primary= monitor

- Mixed= if persists in the mixed you should treat

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12
Q

A unilateral crossbite typically represent a (unilateral/bilateral) constriction of the maxilla

A

bilateral

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13
Q

A midline discrepancy is indicative of

A

a functional shift (helps achieve MIP)

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14
Q

Why treat a posterior crossbite in mixed dentition

A
  • 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
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15
Q

Appliances to fix posterior open cross bite

A

Fixed

  • Hyrex/Rapid palatal expander
  • Quad helix

Removable
-Schwartz Plate

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16
Q

Describe the hyrex rapid palatal expander

A
  • 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
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17
Q

Describe the quad helix

A
  • Anchored on the 6 year molars
  • Loops allow you to stretch the appliance
  • Puts gentle pressure causing expansion
  • Can remove to reactivate
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18
Q

Describe the schwartz plate

A
  • 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
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19
Q

What percent of kids have a non-nutritive sucking habit beyond 3 y/o

A

20%

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20
Q

T/F Incisor position will correct itself if habit stops early enough

A

t

21
Q

At what age would we like to see non-nutritive habits stop by 9max age)

A

3 (but critical when the permanent incisors are erupting)

22
Q

Problems with non-nutritive sucking habits

A
  • Anterior open bite
  • Flared incisors
  • Posterior maxillary constriction (can lead to posterior cross bite)
  • High arched palate
  • Asymmetry
  • Tongue thrust on swallow
23
Q

Extent of the issues from non-nutrutuve sucking habits are based on

A

frequency, intensity and duration

24
Q

What are different treatment options to help the child break the habit

A
  • Mavala (bitter taste spray for thumb)
  • Thumb guard
  • Appliance (fixed for removable ) – examples are the rake, bluegrass and crib
25
Q

What is ectopic eruption

A

-When a permanent tooth causes either reposition of primary tooth other than the one it is supposed to replace or resorption of an adjacent permanent tooth

26
Q

Ectopic eruption most commonly occurs with what teeth

A
  • Lateral incisor (both arches)
  • Maxillary 1st molar
  • Maxillary canine
27
Q

Ectopic eruption of the lateral incisor involves

A

premature exfoliation of the primary canine

28
Q

Ectopic eruption of the lateral incisor often indicates what

A

crowding

29
Q

Treatment for lateral incisor ectopic eruption

A

Unilateral

  • Extract the other primary canine (prevent midline shif)t and LLHA with a spur
  • Refer to orthodontists
30
Q

Ectopic eruption of the maxillary first molar involves

A

mesioangular eruption position of the maxillary 1st molar

-Resorbs the distal portion of the primary 2nd molar

31
Q

What percentage of ectopically erupted maxillary 1st molars self-correct

A

66%

32
Q

Prevalence of ectopically erupted maxillary 1st molars

A

3-4%

33
Q

What are the tx options for ectopic eruption of maxillary 1st molar

A
  • Orthodontic separators
  • Brass wire
  • Ortho appliance
  • Estraction of send molar with pace maintenance or future distalization of the molar
  • Severe cases result in loss of primary 2nd molars and space loss
34
Q

T/F once the ectopically erupted maxillary 1st moalr is corrected, the second primary molar often requires extraction due to abcess formation

A

F- most of the time it is fine- although it is a possibility

35
Q

What is a Halterman appliance

A
  • Used to correct ectopically erupting maxillary 1st molars
  • Band on primary 2nd molar
  • Button on ectopic molar
  • Ortho chain to force the ectopic molar distally
36
Q

What is a Shammy appliance

A

-Meant to distalize or derotate a maxillary 1st molar

37
Q

Ectopically erupting maxillary canines are positioned in what direction

A

mesioangular

38
Q

How many ectopic maxillary canines are positioned palatally? Labially?

A

Palatally= 2/3 labially= 1/3

39
Q

Incidence of ectopic maxillary canine impaction is

A

1,5-2%

40
Q

Palatal impaction of maxillary canine is suspected when

A

canine buldge is not palpable

41
Q

Having and ectopic maxillary canine is more common when

A

lateral incisor is missing or small

42
Q

How can you improve the eruption path of an ectopic maxillary canine

A

extract the primary canine

  • Overlapping less than half the lateral incisor root (91% success)
  • More than half of overlap with the lateral root (64% success)
  • If unsuccessful the canine will remain impacted
43
Q

Maxillary incisor is ectopic or impacted in _% of the population

A

2%

44
Q

Causes of maxillary incisor impaction or ectopic are

A
  • Supernumerary tooth
  • Trauma
  • Pulpal treatment of primary incisor
45
Q

Treament of ectopic/impacted maxillary incisor

A

Impacted
-Extract supernumerary tooth or overretained primary tooth

Ectopic

  • Extract overretained primary tooth
  • Supernumerary tooth (consider root development of permanent incisors)
46
Q

Mandibular incisors tend to erupt (labially/lingually)

A

lingually

47
Q

Lingually erupted mandibular incisors are called

A

shark teeth

48
Q

treatment for lingually erupted mandibular incisors

A
  • Evaluate O and P for mobility
  • Pressure from tongue typically moves 24 and 25 labially
  • Extract O and P is 24 and 25 are mostly erupted and O and P aren’t mobile.

PEDO (Spring) (9 decks)

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