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d b review > 31. Orthodontics II > Flashcards

31. Orthodontics II Flashcards

1
Q

3 classifications of Posterior crossbites based on the cause

✅ What is the treatment?

A

Dental - abnormal eruption
Functional - thumbsucking habit
Skeletal - bone constriction

✅Palatal expansion

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2
Q

Palatal expanders for PRE-ADOLESCENT (<12 y/o)

A

Expansion lingual arch
W arch
Quad helix

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3
Q

Most common / most conservative palatal expander

A

Expansion lingual arch

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4
Q

“Modified W arch”
Indications:
✅thumbsucker
✅needs palatal expansion

A

Quad helix

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5
Q

Palatal expanders for ADOLESCENT (>12 y/o)

A

Jackscrew

Surgery - cleft palate

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6
Q

BQ: Case:
👶🏻: 4y/o
#51 = non vital; rx none; asymptomatic; discolored

A. No tx
B. Exo
C. Pulpo
D. Pulpec

A

A. No tx

- most conservative tx!

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7
Q 
BQ: Case:
#51 = swelling, pain, what initial procedure?

A. Exo
B. Pulpo
C. Pulpec
D. Ask for parents consent

A

D. Ask for parents consent

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8
Q

1 to 2 in anterior crossbite

A

Dental cause

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9
Q

Multiple teeth in anterior crossbite (>=3)

A

Skeletal cause

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10
Q

What is the most common cause of single tooth anterior crossbite?

A

Overly retained primary tooth/incisor

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11
Q

Treatment for single/2 teeth anterior crossbite? (Dental cause)

A

Inclined plane

✅Anchorage on: 4 perm mn incisors

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12
Q

Skeletal cause/>=3 anterior crossbite indicates that:

A 
Developing skeletal class III
*Established skeletal class III
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13
Q

Tx for dev skel class III

A

Reverse pull/ facemask or chincup

SA BOARDS: ✅Refer to orthodontist!!!!

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14
Q

Tx for established skeletal class III

A

Surgery - BSSO

“bilateral sagittal split osteotomy”

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15
Q

Example of Functional anterior crossbite

A 
Pseudoclass III
- Skel class 1 but during fxn = Skeleta class III
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16
Q

Patient adapts a jaw position upon closure which is forward to normal

A

Pseudoclass III

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17
Q

Vertical overlap

A

Overbite

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18
Q

Negative overbite

A

Openbite

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19
Q

Opposite arches cannot be brought into occlusion

A

Openbite

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20
Q

BQ: Most common cause of anterior openbite

A

Thumbsucking

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21
Q

Equilibrium/ balanced forces between muscles determines position of the teeth

A

Buccinator mechanism

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22
Q

Muscles involved in Buccinator mechanism

A

Buccinator
Orbicularis oris
Superior pharyngeal constrictor
(VS) Tongue

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23
Q

BQ: What is the triad of Thumbsucking?

A

Duration - 6hrs; most impt
Frequency - Am/pm
Intensity - 1 room away

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24
Q

BQ: What is the initial treatment for Thumbsucking?

A
  1. Observe!!! - INITIAL ✅
  2. Psychological therapy
  3. Tape thumb
  4. Tape elbow
  5. Palatal crib - last resort
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25
BQ: What is the appliance of choice for Thumbsucking?
Palatal crib
26
BQ: What is the treatment for OPEN BITE?
if caused by habit: ✅ Remove thumbsucking habit If caused eruption pattern: ✅ no tx/ observe
27
Tongue protrudes during swallowing, speech, or even at rest
Tongue thrusting
28
BQ: most common cause of tongue thrusting
Thumbsucking | thumbsuck - openbite - tongue thrust
29
Infantile swallowing: what age
<1 y/o
30
Cranial nerve used during infantile swallowing
CN VII - Facial muscles are used by infants to swallow
31
BQ: Location of tip of tongue in infantile swallowing
Bet U/L lips or Bet gumpads
32
BQ: Loc of tip of tongue during adult swallowing
Premaxilla
33
Cranial nerve used in adult swallowing
CN V
34
BQ: What is the tx for tongue thrusting
If thumbsucker: Remove habit | If eruption pattern or born with open bite: No tx/observe!
35
BQ: Appliance of choice for tongue thrusting
Tongue crib (mx arch)
36
BQ: Appliance of choice to correct swallowing
Blue grass
37
BQ: What is the best space maintainer?
Well restored natural tooth
38
Space maintainer: unilateral; single tooth loss
Band and loop
39
Space maintainer: bilateral;single/multiple tooth loss | ✅unilateral but must have multiple tooth loss
Lingual holding arch
40
What teeth must be present in LHA
2 Mn 6s | 4 Perm mn incisors
41
BQ: Appliance for premature loss of primary mn canine
LHA (w/ spurs)
42
Space maintainer: Early loss of Primary 2nd molar before permanent 1st molar erupts
Distal shoe
43
Disadv of distal shoe
Infection
44
Space maintainer: (MAXILLARY) unilateral;multiple tooth loss
Transpalatal arch
45
Space maintainer: (MAXILLARY) bilateral; single/multiple tooth loss
Nance appliance
46
Disadv of nance
Acrylic button-irritant/allergy
47
BQ: What is the most common space maintainer?
Band and loop
48
Recommended app: Thumbsucking
Palatal crib
49
Recommended app: bruxism
Night guards/ bite plate
50
BQ: Most common cause of Bruxism
Malocclusion
51
Recommended app: Hyperactive mentalis
Lip bumper/ plumber/ Mayne/ Denholtz
52
Recommended app: Cheek or lip biting
Oral screen
53
Recommended app: Tongue thrusting
Tongue crib
54
Recommended app: Mouth breathing
Oral vestibular screen/ shield
55
Determines the future antero-posterior position of perm 1M | Compares distal portion of E
Primary molar relationship
56
normal “CUSP to CUSP” permanent 6; may lead to class I by MESIAL SHIFTING
Flush terminal plane
57
Mesial movement of permanent 1st molar to achieve class I molar relationship
Mesial shifting
58
with immediate AVAILABLE SPACE
Early | - happens in early mixed dent (6-8)
59
without immediate available space | ✅space = because of exfoliation of one tooth
Late (10-12y/o)
60
Molar relationship in Distal step
Distal step ➡️ Class II ➡️ Class II
61
Molar relationship in Mesial step
Mesial step= Class I ➡️ Class I / Class III (mesial shift!)
62
Primate space in maxillary
Mesial of canine | distal of Li
63
Primate space in Mandibular
Distal of Canine | mesial of primary molar
64
BQ: 7 y/o with multiple spaces in teeth
Diastema
65
Causes of diastema
1. Normal part of development 2. Tooth size discrepancy - microdontia 3. Mesiodens 4. Abnormal frenal att
66
Tx for mesiodens
Exo asap
67
What age can you do diastema closure
Once erupted na yung Mx Canine (around 11-12 y/o)
68
Tx for high frenal attachment
1st - ortho 2nd - surgery (pag inuna surgery magrrelapse lang bec of scar formation)
69
Maxillary midline diastema = ? - common during mixed dentition - usually closes after canine erupts
<2mm (normal)
70
Large mx midline diastema = ? | - unlikely to close even after canine erupts!!
Large diastema = >2mm
71
>2mm mx midline diastema usually caused by
Supernumerary teeth (mesiodens)
72
BQ: Remember before treating a DIASTEMA..
Always wait for the canine before treating the diastema!!!
73
BQ: What is the primary determinant of diastema
Canines
74
BQ: What is the treatment for an 8y/o px with a 3mm diastema?
Take a radiograph (to know if there’s supernumerary)
75
BQ: What is the treatment for a 12yr old px with 2mm diastema?
Diastema closure
76
Principle of cephalocaudal growth curve
Structures farther from the brain GROWS MORE but GROWS LATER
77
BQ: Which is first to mature? cranial base Maxilla Mandible
Cranial base (accdg to cephalocaudal growth curve)
78
BQ: Which has the highest growth? Cranial base Maxilla Mandible
Mandible | -bec farthest from the brain
79
Increases in size until puberty then starts to decrease in size
Lymphoid growth curve | Ex. Thymus 10-12y/o: 200% then shrinks
80
Indirect bone formation
Endochondral bone formation | “ESPECOLS”
81
Direct bone formation
Intramembranous bone formation
82
Bone formation in Cranial vault: - frontal - parietal - squamous temporal - squamous occipital
Intramembranous
83
Type of bone formation in CRANIAL BASE - “OSET”
Endochondral
84
Bone lengthening
Interstitial bone growth
85
Bone widening
Appositional (IL-AW)
86
BQ: Tension (+) side = bone ___ | Facing the direction of growth
Deposition
87
BQ: Pressure side (-) | Facing away
Resorption
88
BQ: Deposition + resorption = a gradual movement of the growing area of the bone which is called?
Drift
89
``` BQ: “Piezoelectric Theory” Negative ions (-) = Positive ions (+) = ```
BQ: “Piezoelectric Theory” ✅OPPOSITE!!!!! ``` Negative ions (-) = deposition Positive ions (+) = resorption ```
90
BQ: What is the first thing that happens in orthodontic treatment / when a tooth is moved?
Bone BENDING
91
Principle: Most of the facial bones are “V-shaped” ✨”RODI”✨ Inner side: Outer side:
Enlow’s V principle of growth Inner side: depostion Outer side: resorption
92
Examples of V - shaped bones which follows Enlow’s V principle
Mandible Maxilla Palate Orbit
93
BQ: Palate: Roof of oral cavity= bone ____
Roof of oral cavity = + deposition
94
BQ: Palate: Floor of nasal cavity = bone ____
Floor of nasal cavity = resorption (-)
95
BQ: Growth Theory: “genes/genetic influence”
Genetic theory
96
BQ: Growth Theory: “sutures/ sutural growth”
Sicher’s (sounds like “sutures”)
97
BQ: Growth Theory: “cartilage”
Scott’s (“scott-lage”)
98
BQ: Most accepted craniofacial growth theory: | ➡️ Soft tissue vs Bone = BONE YIELDS/gives way
Moss’ (“Most”)
99
Supports all the theories
Van limborg’s theory
100
Servosystem theory
Petrovic’s theory
101
Area of cellular hyperplasia?
Synchondroses
102
Growth site for cranial base: closes 3-5 y/o
Intraoccipital synchondroses
103
BQ: Growth site for cranial base: until 20 y/o
Spheno-occipital synchondroses
104
Growth site for cranial base: at the age of 6-7
Spheno-ethmoidal synchondroses
105
Growth site for cranial base: during birth
Intersphenoidal synchondroses
106
Growth center of maxilla (nasomax complex)
Nasal septum
107
3 bones of nasal septum “VaPeS”
vomer Perpendicular plate of ethmoid bone Septal cartilage
108
Site of bone deposition; controls growth of adjacent structures
growth center
109
REMEMBER: ALL growth centers are growth sites But NOT ALL growth sites are growth centers
REMEMBER: ALL growth centers are growth sites But NOT ALL growth sites are growth centers
110
Growth direction (deposition) in Maxilla:
Superior-Posterior | Upward-backward
111
Growth displacement (resorption) in maxilla
Downward-forward | Inf - ANTERIOR
112
BQ: Exception~ bone deposition on the ANTERIOR of MAXILLA
Anterior nasal spine
113
Growth center of Mandible
Condylar cartilage
114
Growth direction in Mandible
Sup-Post | Up/back
115
Growth displacement in the Mandible
Downward and forward | Inf-Anterior
116
BQ: Exception~ bone deposition on the ANTERIOR of MANDIBLE
Tip of chin
117
BQ: Sites of bony depostion in Maxilla
1. Condyle 2. Posterior border of ramus 3. Coronoid process 4. Tip of chin / Pog
118
BQ: Sites of bone resorption in the mandible
1. Anterior | 2. Ant border of ramus
119
gives space to erupting 2nd/3rd molars
Resorption of ant border of ramus
120
BQ: What causes the increase length in the mandible
Bone resorption
121
BQ: At the age of 6 the greatest increase in size pf mandible occurs where???
Distal to the first molar
122
BQ: Maxillary arch = how many mm?
Maxillary = 128mm
123
BQ: Mandibular arch = how many mm?
126mm
124
1st growth spurt Female = Male =
1st growth spurt Female = 3 Male = 3
125
2nd growth spurt Female = Male =
2nd growth spurt Female = 6-7 Male = 7-9
126
3rd growth spurt Female = Male =
3rd growth spurt Female = 11-12 Male = 14-15
127
What is the general rule for growth?
The earlier the growth spurt; the lesser the growth; the earlier it will stop
128
Used in predicting the time of the pubertal growth spurt
Hand and wrist radiograph
129
BQ: How many bones are there in the hand and wrist radiograph? Puberty: Adults:
``` Puberty = 28-30* Adults = 27-29* ```

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