10. Orthodontics Flashcards by Katie Munro

What are the 4 components of an orthodontic assessment?

History
E/O assessment
I/O assessment
Orthodontic assessment

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What is included in the E/O component of an Ortho assessment?

Skeletal Pattern
TMJ
Lip line

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What is included in the I/O component of an Ortho assessment?

Tooth chart
Periodontal asssessment
Plaque index

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What is included in the orthodontic component of an Ortho assessment?

Tooth inclination
Tooth alignment
Mixed dentition analysis
Tooth relationships
Bite analysis
Centreline assessment

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What are the 3 areas assessed in a skeletal pattern asssesment?

Anteroposterior
Vertical
Transverse

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How is anteroposterior skeletal pattern measured?

Two finger method

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How is vertical skeletal pattern measured?

Using FMPA and LFH

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How is transverse skeletal pattern measured?

Assesses symmetry by splitting face into 5ths

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What is assessed in a lip assessment?

Lip competency and smile line

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What are the two components of an intraoral exam in Ortho?

Gingival assessment: general condition, BPE, plaque index
Dental assessment: dental chart, any additional findings, caries risk assessment

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What are the 4 components of the Ortho stage of assessment?

Tooth inclination
Tooth alignment
Mixed dentition analysis
Occlusal assessment

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Tooth inclinations:

Average
Proclined
Reteroclined

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Tooth alignments:

Aligned
Crowded
Spaced

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What is the mixed dentition analysis?

A measurement if enough space for teeth to erupt
Done by: measuring from distal of 2 to medial of 6
21mm = average for lower arch
22mm = average for upper arch

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List the 8 things assessed in an orthodontic occlusal assessment:

Incisor, canine and molar relationships
Overjet
Overbite
Open bite
Cross bite
Centrelines

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What radiogrpah is commonly used in orthodontics?

Lateral cephalograms

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What is the 4 steps process in manually processing a lateral ceph?

Draw outlines
Locate points
Join dots
Measure angles

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What points are plotted on a lateral ceph?

Sella
Nation
ANS
PNS
A Point
B point
Gonion
Menton

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What dots are joined on a ceph?

S and N (cranial base)
N and A
N and B
Ans and pns (maxilla)
Gonion and menton (mandible)
Upper incisors
Lower incisors

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What 6 angles are measured on a ceph?

SNA, SNB, ANB, MMPA, INCISOR, E PLANE

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SNA angle

Indicates maxilla in relation to cranial base
> 82 degrees = prognathic
< 82 degrees = reterognathic

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SNB angle

Indicates mandible in relation to cranial base
> 80 degrees= prognathic
< 80 degrees = reteroganthic

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ANB angle

Indicates maxilla in relation to mandible
> 4 degrees = class II skeletal pattern
< 2 degrees = class III skeletal pattern

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MMPA angle

Intersection of maxilla and mandible
Increased angle = vertical growth
Decreased angle = horizontal growth

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Incisor inclination angle

110 = maxillary average 90 = Mandibular average Increased angle = proclined Decreased angle = reteroclined

E plane angle

Line drawn from nose tip to chin Should be a distance of: 1-2mm from lower lips 2-3mm from upper lips

what does IOTN stand for and what are the 2 components of it?

Index of orthodontic treatment need Dental component Aesthetics component

How is the dental health component calculated?

MOCDO and IOTN ruler Grade 1 = no Tx needed Grade 5 = very great need for Tx

What does MOCDO stand for?

Missing Overjet Crossbites Displacement Overbite

What is the aesthetic component of the IOTN?

A 10 point photo scale

What are the 4 main roles of the GDP in relation to orthodontics?

Identify, examine and refer using IOTN maintain OH Orthodontic first aid Retain Tx outcomes

What 9 things should be included in an Ortho referral letter?

1. Urgency level 2. Pt details 3. Reason for referral 4. History (HPC, MH, SH, DH) 5. Previous Tx history 6. Summary of malocclusion 7. IOTN grade 8. Radiographs 9. Study models

How is A-P skeletal pattern assessed and what are the grades?

2 point finger test Class I - hand level - maxilla and mandible orthognathic/straight Class II - hand tilts up - maxilla forward and mandible back Class III - hand tilts down - maxilla back and mandible forward

How is VERTICAL skeletal pattern assessed?

FMPA and LFH FMPA: average - intersects at occiput increased - intersects at ear decreased - intersects beyond head LFH: face split into 1/3’s - average/increased/ decreased

How is TRASVERSE skeletal pattern asssed?

Assesses facial symmetry Done by splitting face into vertical fifths

CLASS I MOLAR RELATIONSHIP

MB cusp of U6, sits in buccal groove of L6

CLASS II MOLAR RELATIONSHIP

MB cusp of U6, sits anterior to buccal groove of L6

CLASS III MOLAR RELATIONSHIP:

MB cusp of U6, sits posterior to buccal groove of L6

CLASS I CANINE RELATIONSHIP

L3 sits mesial to U3

CLASS II CANINE REALTIONSHIP

L3 Sits distal to U3

CLASS III CANINE RELATIONSHIP

L3 and U3 do not occlude

Overjet

Horizontal overlap of teeth

Overbite

Vertical overlap of teeth

Openbite

No overlap of teeth

Cross bite

Unilateral or bilateral Buccal or lingual Always relates to buccal cusps of lower teeth

What are the 3 types of orthodontic appliance?

Removable Fixed Functional

What are the 4 components of a removable appliance?

1. Active (springs, biteplabes, screws, bows) 2. Retentive (clasps) 3. Anchorage 4. Baseplate (connector of all components)

What is a fixed appliance?

An appliance made up of brackets attached to teeth and and arch wire

What 3 planes do fixed appliances move teeth?

Tipping Body movements Torque

What 2 materials are used for fixed applaince wires?

Nickel titanium NiTi Stainless steel SS

What is a functional appliance?

A group of appliances used only in the growing patient that aims to redirect masticatory forces and muscles to create tooth movement and modify facial growth

What are the indications for functional appliances?

Mild/moderate skeletal discrepancies Overjet/overbites Pre adolescent growth

List 3 common problems associated with tooth eruption and occlusion:

Eruption cysts Impacted teeth Crossbites

Signs of an eruption cyst:

Blue mucosa overlying an unerupted tooth

List 4 causes of impacted teeth:

Obstructions Eruption failure Insufficient space Ectopic teeth

What teeth are commonly affected by Crossbites?

Molars and incisors

What causes infra-occluded deciduous teeth?

Ankylosis of deciduous teeth No permanent successor

What causes deciduous teeth to be retained?

Missing permanent successors Ankylosis

What 4 teeth are commonly affected by impaction?

E’s 6’s Centrals Canines

How should impacted E’s be managed?

Place separator or Xla

How should impacted 6’s be managed?

Separator or XLA

What causes impacted central’s?

Supernumaries Crown-root dilaceration Trauma Premature loss of decidious teeth

How should impacted centrals be managed?

Remove obstruction Expose URA to align

How should impacted canines be managed?

Should be palpable aged 8-10 and radiographed If impacted, Extract C’s and wait for eruption If this fails, Treat in permeant dentition phase by exposing/extracting/ monitoring