30. Orthodontics I Flashcards
Father of MODERN dentistry
Edward angle
Father of ortho
Norman kingsley
MB cusp of Max 1st molar lines up with the buccal groove of the Mn 1st molar
Mx canine lies between the Mn canine and 1PM
Class I / Neutrocclusion
Class I Type 1
Anterior crowding
Class I Type 2
Labioversion
Procline anteriors
Class I Type 3
Anterior crossbite
“Negative overjet”
Crossbite
Horizontal overlap
Overjet
Class I Type 4
Posterior crossbite
Class I Type 5
Mesial drifting
6 months to move
First sign of Drifting
Rotation
Class I Type 6
Bimaxillary protrusion
🔺MB cusp of the Mx 1M falls between the Mn 1M and 2PM
🔺Mx canine is mesial to mn canine
Class II / Distocclusion/ Retrognathism
BQ: “Sunday bite”
Class II Div 1
Mx incisor in extreme labioversion
✅Proclined CI
Class II Div 1
Mx incisor tipped palatally and in retruded position
Mx laterals are tipped labially or mesially
✅ proclined LI
✅retroclined CI
Class II Div 2
Class II Div 1 “subdivision”
Subdivision: ✅ one molar - class I ✅ one molar - class II
🔺MB cusp of 1M falls between the Mn 1M and 2M
🔺 Mx canine is distal to Mn canine
✅ Overjet = 0mm or negative
Class III / mesiocclusion / prognathism
Class III type 1
Edge to edge/ cusp to cusp/ end to end
Class III Type 2
Anterior crowding
Class III Type 3
Anterior crossbite
BQ: What is the most common malocclusion?
Class I malocclusion
BQ: Bimaxillary protrusion is classified under what malocclusion?
Class I Type 6
3 signs of incipient malocclusion:
- Lack of interdental spacing in primary dentition
- Perm ant have greater MD width than primary ant - Crowding of permanent incisors in mixed dentition
- Premature loss of primary canine (mandibular)
- Insufficient arch size in the ant region / lack of space
BQ: Appliance used for premature loss of primary mandibular canine
Boards: “LHA” (with spurs)
BQ: Normal eruption sequence of mx teeth
612(453)78
BQ: Normal eruption sequence of mandibular teeth
612(345)78
BQ: Permanent anterior teeth erupts in what direction?
Lingually-apically
BQ: Primary anterior teeth erupts in what direction?
Occlusally-facially
BQ: Followed by permanent teeth during eruption
Gabernacular cord
BQ: Which surface of the deciduous teeth resorbs first when permanent teeth erupts?
Lingual surface
Sibilants
S, Z
Associated malocc with sibilants (S, Z)
Anterior open bite
Large gap between incisors
Linguodental sounds
T, D
Assoc malocc with linguodental sounds (T, D)
Irregular incisors (li position of mx incisors)
Fricatives
F, V
Assoc malocc with fricatives (F, V)
Skeletal class III
Bilabial sounds
B,P,M
BQ: Closest speaking space
”s”
Best treatment for LONG TERM LOSS of Perm Mn 1M
Case: exo of #6 ~ Px 12y/o ➡️ 25y/o ❌replacement of #6
Molar uprighting
Tipping the crown of 2nd molar distally and opening a space for a pontic to replace 1st molar
Molar uprighting
Time frame for molar uprighting:
6-12months
Stabilization period for simple molar uprighting
2 months
Stabilization period for complicated cases of molar uprighting
6months
Case:
👩🏻: 12y/o
❌ exo of #6
What space maintainer to use? (FPD/RPD?)
RPD
- growth stage of Mn / Mx (❌fpd = ✅18y/o)
BQ: Closed apex of first molars: what age
9 years old
Closed apex = +2-3* yrs to age of eruption
Determines tooth-tooth, bone-bone and tooth-bone relationships
Shows the amount and direction of craniofacial growth
Cephalometrics
BQ: what is the poor man’s cephalometrics?
Facial profile analysis (Glabella/subnasale/tip of chin)
Straight facial profile
Skeletal class I
Convex facial profile
Skelatal class II
Concave facial profile
Skeletal class III
BQ: Facial type is the RATIO OF?
Ratio of glabella-chin and bizygomatic width
Arch: parabola / rounded
What facial type?
Mesofacial / Mesocephalic
Arch: tapering/ narrow/ long ^
What facial type?
Dolichocephalic/ dolichofacial
Arch: square/broad
What facial type?
Brachyfacial/brachycephalic
Used to predict the size of the UNERUPTED 3,4,5 through calculations
MDA
“RATIO/ PROPORTION OF MN AND MX” tooth size
✅ estimate “OVERBITE and OVERJET”
Bolton’s analysis
Determine if crowding is due to inadequate “APICAL BASES” based on measurement on apical base with at premolar
Howe’s analysis
Suggests ideal “MX 4,5,6” arch form based on MD diameter of Mx “22/21”
Ponts index
BQ: if FL > MD = broader “CONTACT AREAS” which will result in more stable and resistant crowding
Peck and peck
Classified teeth into “SMALL, MEDIUM, LARGE”
Sanim-Savarra
highest point in the concavity behind the “occipital condyle”
Bolton (Bo)
The most forward and highest point of the anterior margin of the “FORAMEN MAGNUM”
basion (Ba)
the point of “INTERSECTION” of the contour of the posterior cranial base and the posterior contour of the condylar process
Articulare (Ar)
Bridge of nose
Nasion
Nasion is a junction of what bones?
Frontal bone and nasal bone
Nasal bone is deficient in what disease
Down’s syndrome
Soft tissue counterpart of NASION
Glabella
Most superior margin of the external auditory canal
Porion (Po)
The midpoint of sella turcica
Sella
Gland found in the sella turcica
Pituitary gland
MOST INFERIOR PORTION of the orbit
Orbitale
Innermost point on contour of premaxilla between incisor and ANS
Point A
Other name for POINT A
Subspinale
Soft tissue counterpart of point A
Subnasale
Innermost point on contour of mandible bet incisor and bony chin
Point b
Other term for point B
Supramentale
Soft tissue counterpart of Point B
Tip of the chin
Most ant point of the contour of the chin
Pogonion (pog)
Most inf part of the mn symphysis
Menton (Me)
Lowest most posterior point on the mn with teeth in occlusion
Gonion
Angle of the mn
Gonion
BQ: Most stable landmark in cephalometric radiograph
Sella
BQ: What is the point between Pogonion and Menton?
Gnathion
BQ: Represents the “anterior cranial base”
Sella-Nasion* (pag isa lang)
Frankfurt Horizontal Plane
BQ: Nasion to pogonion forms what plane?
Facial plane
BQ: Menton to gonion forms what plane?
Mandibular plane
Normal range of Frankfurt Mandibular plane angle
- 7 +/- 5.8
22. 9-34.5
STEEP mn plane angle =
Long vertical dimension
Anterior open bite (mouth breather!!) - difficult to pronounce “s”
Class II
FLAT mn plane angle =
Short anterior vertical dimension
Deep bite
Class III
BQ: Normal range of ANB
2.5 +/- 2.5
0-5
> 5 ANB = what is the skeletal relationship?
Skeletal class II
<0 or negative ANB = what is the skeletal relationship?
Skeletal class III
Only movement of any removable appliance
Tipping
Most common orthodontic tooth movt
Tipping
Most common retainers
Hawley appliance
3 indications of Removable appliance
- Tipping movts
- Retention after comprehensive movts
- Growth modification during the mixed dentition (headgears)
BQ: Case: 👩🏻: 8y/o ❌ exo of #6 📌What is the treatment in premature loss of #6 in ages 8-10y/o???
No treatment, observe only
Mixed dentition period is aka
Ugly duckling stage
Mixed dentition period:
✅ starts at what age?
🚫 ends at what age?
Start : 6y/o
Ends : 12y/o
Initial tooth movement (mesial drifting) happens when?
After 6 months
Major components of REMOVABLE APPLIANCE:
Retentive component
Framework or baseplate
Active component or tooth moving component
Anchorage component
Retentive component of Removable appliances that is commonly used in space regainers
Adams clasp
Material used as framework or baseplate in removable appliances in removable appliances
Acrylic (Polymethyl methacrylate)
Initial sign of tooth movement
Rotation
Maximum space a space regainer can regain
<3mm space
Mechanism of action of space regainers
Causes distal tipping of first molars
Space regainers can only be used until
Eruption of 7s
Not useful once erupted na second molar
Most common denture base material (chemical name)
Polymethyl methacrylate (Acrylic)
Consists of springs, jack screws, or elastics
Active component or tooth moving component
Resists force of active component
Anchorage component
Appliance that doesnt move the teeth
Passive appliance
Example of passive appliance:
Space maintainers
Does passive appliance have an anchorage component?
None (✅retentive components only)
Appliance that moves the teeth
Active appliance
Example of an active appliance:
Space regainers
Does active appliance have an anchorage component?
Yes
Appliances used to alter or modify growth
Headgears
BQ: Headgears are usually used in what skeletal relationship?
Developing skeletal class II
Time of the day when headgears are worn? Why?
During dinner: 6pm to 9pm
- Growth hormone is released during this time
Treatment length of headgears:
6-18months
Headgears for DEVELOPING SKELETAL CLASS II
High pull/parietal pull
Cervical pull
Straight pull
Type of headgear: headcap connected to facebow
High pull or parietal pull headgear
BQ: Movement of high pull headgear
“Distal and intrusive” force on Maxillary molars and maxilla
Type of headgear: neck strap connected to facebow
Cervical pull headgear
BQ: Movement of cervical pull headgear
“Distal and EXTRUSIVE” force in mx tth and maxilla
BQ: Movement of straight pull headgear
DISTAL ONLY!!
BQ: Only headgear used for developing skeletal class III to move maxilla-ant and mn-post
Reverse pull headgear/ Facemask
“facemask” headgear
Reverse pull headgear
Type of headgear: inhibits forward growth of mandible
Chin cup
Is it possible to stop the growth of the mandible?
No. Redirect only
Growth displacement of Mandible
Downward and forward
BQ: what is the extraoral headgear used to treat scoliosis?
Milwaukee brace
Appliance designed to modify growth during mixed dentition both dental and skeletal effects
✅Used during GROWTH STAGE!
Functional appliance
Functional appliance is used for what skeletal relationship?
Developing skeletal class II
MOA: advances mn forward and allows condyle to move superiorly and posteriorly towards the fossa
Mech of action of FUNCTIONAL APP
Functional appliance: anchorage on tooth
Tooth borne appliance
Functional appliance: anchorage on soft tissue (lips/cheeks)
Tissue borne appliance
BQ: TOOTH BORNE APPLIANCES
All of the ffg are tooth borne appliances EXCEPT:
Activator
Bionator
Herbst
Twin block
BQ: the ONLY TISSUE BORNE APPLIANCE
Frankel functional appliance
Tooth borne appliance: advances the mandible to an edge to edge position to stimulate mandibular growth for class II
activator
Tooth borne appliance: trimmed down version of activator
Bionator
Tooth borne appliance: Max and Mand framework splinted together via PIN AND TUBE that holds the mn forward
Herbst
Tooth borne appliance: uses two piece acrylic appliance
Twin block
Fixed appliance: what movements?
All movements!
Four basic components of fixed appliance
Band
Brackets
Archwires
Auxillaries
Fixed appliance with HORIZONTALLY positioned slot
✅siamese twin brackets: double wings for inc rotational and tip control of roots
Edgewise appliance
Edgewise appliance is discovered by
Edward angle
2 types of edgewise app
Conventional edgewise tech
Straight wire technique
Wire used in conventional edgewise tech: for controlled force
Ss wires
✅bendable
Wire used in straight wire tech
NiTi wires (memory wires)
Variation of edgewise
Straight wire appliance
Fixed app: VERTICALLY positioned slot
Ribbon-arch appliance
Ss wires are made up of what combination of metals
Cobalt and chromium
Self ligating brackets
Damon brackets
BQ: What is the most commonly used orthodontic app?
Edgewise appliance
BQ: What is the modified ribbon arch appliance
Begg appliance
Uses MOLAR “BANDS”
✅ GIC for cementing: fluoride release
Banding
Where does excess fluoride excreted?
Kidney
BQ: most common etchant used
37% phosphoric acid
Etching is also called
Conditioning
Etchant used for etching before bonding???
35-50% unbuffered phosphoric acid
BQ: Who introduced enamel “ETCHING”?
BQ: What year?
Buonocore (1955)
BQ: Component of bonding agent
bisGMA
BQ: bonding agent was discovered by
BQ: what year?
Bowen (1962)
BQ: Properties of archwires
All of the ffg…EXCEPT
Hugh strength
Low stiffness
High range
High formability
Metal: for rigidity
Cobalt
Metal: corrosion resistance
Chromium
3 Alloy composition:
Stainless and cobalt chromium alloy
NiTi
beta-Ti
Property of nickel (kayang ishape)
Nickel is ductile
BQ: Px = braces ✅ ; had an allergic reaction. What is the cause?
NiTi
aka “titanium molybdenum”
Beta-Ti
In and out bends
First order
BQ: Movts of first order wire bending
facial
Lingual
Rotational
Tip bends
Second order
BQ: Movts of second order wire bending
Mesial and Distal
BQ: Movt of third order wire bending
Torque
“Intra arch elastics” / Horizontal elastics
Class I elastics
BQ: loc and movt of elastics in Class I elastics
Distal of 3
Mesial of 6
BQ: loc and movt of elastics in CLASS II ELASTICS
⬆️3: distal/extrusive
⬇️6: mesial/extrusive
BQ: loc and movt of CLASS III ELASTICS
⬇️3 - distal/extrusive
⬆️6 -mesial/extrusive
Elastics used to treat open bite in adults for up to 2mm
Anterior elastics
Elastics to treat Class II division 1 (SUNDAY BITE)
Zigzag elastics
