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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
Q

BQ: What is the appliance of choice for Thumbsucking?

A

Palatal crib

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26
Q

BQ: What is the treatment for OPEN BITE?

A

if caused by habit: ✅ Remove thumbsucking habit

If caused eruption pattern: ✅ no tx/ observe

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27
Q

Tongue protrudes during swallowing, speech, or even at rest

A

Tongue thrusting

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28
Q

BQ: most common cause of tongue thrusting

A

Thumbsucking

thumbsuck - openbite - tongue thrust

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29
Q

Infantile swallowing: what age

A

<1 y/o

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30
Q

Cranial nerve used during infantile swallowing

A

CN VII - Facial muscles are used by infants to swallow

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31
Q

BQ: Location of tip of tongue in infantile swallowing

A

Bet U/L lips or Bet gumpads

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32
Q

BQ: Loc of tip of tongue during adult swallowing

A

Premaxilla

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33
Q

Cranial nerve used in adult swallowing

A

CN V

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34
Q

BQ: What is the tx for tongue thrusting

A

If thumbsucker: Remove habit

If eruption pattern or born with open bite: No tx/observe!

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35
Q

BQ: Appliance of choice for tongue thrusting

A

Tongue crib (mx arch)

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36
Q

BQ: Appliance of choice to correct swallowing

A

Blue grass

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37
Q

BQ: What is the best space maintainer?

A

Well restored natural tooth

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38
Q

Space maintainer: unilateral; single tooth loss

A

Band and loop

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39
Q

Space maintainer: bilateral;single/multiple tooth loss

✅unilateral but must have multiple tooth loss

A

Lingual holding arch

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40
Q

What teeth must be present in LHA

A

2 Mn 6s

4 Perm mn incisors

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41
Q

BQ: Appliance for premature loss of primary mn canine

A

LHA (w/ spurs)

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42
Q

Space maintainer: Early loss of Primary 2nd molar before permanent 1st molar erupts

A

Distal shoe

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43
Q

Disadv of distal shoe

A

Infection

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44
Q

Space maintainer: (MAXILLARY) unilateral;multiple tooth loss

A

Transpalatal arch

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45
Q

Space maintainer: (MAXILLARY) bilateral; single/multiple tooth loss

A

Nance appliance

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46
Q

Disadv of nance

A

Acrylic button-irritant/allergy

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47
Q

BQ: What is the most common space maintainer?

A

Band and loop

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48
Q

Recommended app: Thumbsucking

A

Palatal crib

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49
Q

Recommended app: bruxism

A

Night guards/ bite plate

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50
Q

BQ: Most common cause of Bruxism

A

Malocclusion

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51
Q

Recommended app: Hyperactive mentalis

A

Lip bumper/ plumber/ Mayne/ Denholtz

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52
Q

Recommended app: Cheek or lip biting

A

Oral screen

53
Q

Recommended app: Tongue thrusting

A

Tongue crib

54
Q

Recommended app: Mouth breathing

A

Oral vestibular screen/ shield

55
Q

Determines the future antero-posterior position of perm 1M

Compares distal portion of E

A

Primary molar relationship

56
Q

normal “CUSP to CUSP” permanent 6; may lead to class I by MESIAL SHIFTING

A

Flush terminal plane

57
Q

Mesial movement of permanent 1st molar to achieve class I molar relationship

A

Mesial shifting

58
Q

with immediate AVAILABLE SPACE

A

Early

- happens in early mixed dent (6-8)

59
Q

without immediate available space

✅space = because of exfoliation of one tooth

A

Late (10-12y/o)

60
Q

Molar relationship in Distal step

A

Distal step ➡️ Class II ➡️ Class II

61
Q

Molar relationship in Mesial step

A

Mesial step= Class I ➡️ Class I / Class III (mesial shift!)

62
Q

Primate space in maxillary

A

Mesial of canine

distal of Li

63
Q

Primate space in Mandibular

A

Distal of Canine

mesial of primary molar

64
Q

BQ: 7 y/o with multiple spaces in teeth

A

Diastema

65
Q

Causes of diastema

A
  1. Normal part of development
  2. Tooth size discrepancy - microdontia
  3. Mesiodens
  4. Abnormal frenal att
66
Q

Tx for mesiodens

A

Exo asap

67
Q

What age can you do diastema closure

A

Once erupted na yung Mx Canine (around 11-12 y/o)

68
Q

Tx for high frenal attachment

A

1st - ortho
2nd - surgery
(pag inuna surgery magrrelapse lang bec of scar formation)

69
Q

Maxillary midline diastema = ?

  • common during mixed dentition
  • usually closes after canine erupts
A

<2mm (normal)

70
Q

Large mx midline diastema = ?

- unlikely to close even after canine erupts!!

A

Large diastema = >2mm

71
Q

> 2mm mx midline diastema usually caused by

A

Supernumerary teeth (mesiodens)

72
Q

BQ: Remember before treating a DIASTEMA..

A

Always wait for the canine before treating the diastema!!!

73
Q

BQ: What is the primary determinant of diastema

A

Canines

74
Q

BQ: What is the treatment for an 8y/o px with a 3mm diastema?

A

Take a radiograph (to know if there’s supernumerary)

75
Q

BQ: What is the treatment for a 12yr old px with 2mm diastema?

A

Diastema closure

76
Q

Principle of cephalocaudal growth curve

A

Structures farther from the brain GROWS MORE but GROWS LATER

77
Q

BQ: Which is first to mature?

cranial base
Maxilla
Mandible

A

Cranial base (accdg to cephalocaudal growth curve)

78
Q

BQ: Which has the highest growth?

Cranial base
Maxilla
Mandible

A

Mandible

-bec farthest from the brain

79
Q

Increases in size until puberty then starts to decrease in size

A

Lymphoid growth curve

Ex. Thymus 10-12y/o: 200% then shrinks

80
Q

Indirect bone formation

A

Endochondral bone formation

“ESPECOLS”

81
Q

Direct bone formation

A

Intramembranous bone formation

82
Q

Bone formation in Cranial vault:

  • frontal
  • parietal
  • squamous temporal
  • squamous occipital
A

Intramembranous

83
Q

Type of bone formation in CRANIAL BASE - “OSET”

A

Endochondral

84
Q

Bone lengthening

A

Interstitial bone growth

85
Q

Bone widening

A

Appositional (IL-AW)

86
Q

BQ: Tension (+) side = bone ___

Facing the direction of growth

A

Deposition

87
Q

BQ: Pressure side (-)

Facing away

A

Resorption

88
Q

BQ: Deposition + resorption = a gradual movement of the growing area of the bone which is called?

A

Drift

89
Q 
BQ: “Piezoelectric Theory”
Negative ions (-) = 
Positive ions (+) =
A

BQ: “Piezoelectric Theory”
✅OPPOSITE!!!!!

Negative ions (-) = deposition
Positive ions (+) = resorption
90
Q

BQ: What is the first thing that happens in orthodontic treatment / when a tooth is moved?

A

Bone BENDING

91
Q

Principle: Most of the facial bones are “V-shaped”

✨”RODI”✨
Inner side:
Outer side:

A

Enlow’s V principle of growth
Inner side: depostion
Outer side: resorption

92
Q

Examples of V - shaped bones which follows Enlow’s V principle

A

Mandible
Maxilla
Palate
Orbit

93
Q

BQ: Palate: Roof of oral cavity= bone ____

A

Roof of oral cavity = + deposition

94
Q

BQ: Palate: Floor of nasal cavity = bone ____

A

Floor of nasal cavity = resorption (-)

95
Q

BQ: Growth Theory: “genes/genetic influence”

A

Genetic theory

96
Q

BQ: Growth Theory: “sutures/ sutural growth”

A

Sicher’s (sounds like “sutures”)

97
Q

BQ: Growth Theory: “cartilage”

A

Scott’s (“scott-lage”)

98
Q

BQ: Most accepted craniofacial growth theory:

➡️ Soft tissue vs Bone = BONE YIELDS/gives way

A

Moss’ (“Most”)

99
Q

Supports all the theories

A

Van limborg’s theory

100
Q

Servosystem theory

A

Petrovic’s theory

101
Q

Area of cellular hyperplasia?

A

Synchondroses

102
Q

Growth site for cranial base: closes 3-5 y/o

A

Intraoccipital synchondroses

103
Q

BQ: Growth site for cranial base: until 20 y/o

A

Spheno-occipital synchondroses

104
Q

Growth site for cranial base: at the age of 6-7

A

Spheno-ethmoidal synchondroses

105
Q

Growth site for cranial base: during birth

A

Intersphenoidal synchondroses

106
Q

Growth center of maxilla (nasomax complex)

A

Nasal septum

107
Q

3 bones of nasal septum “VaPeS”

A

vomer
Perpendicular plate of ethmoid bone
Septal cartilage

108
Q

Site of bone deposition; controls growth of adjacent structures

A

growth center

109
Q

REMEMBER:
ALL growth centers are growth sites
But NOT ALL growth sites are growth centers

A

REMEMBER:
ALL growth centers are growth sites
But NOT ALL growth sites are growth centers

110
Q

Growth direction (deposition) in Maxilla:

A

Superior-Posterior

Upward-backward

111
Q

Growth displacement (resorption) in maxilla

A

Downward-forward

Inf - ANTERIOR

112
Q

BQ: Exception~ bone deposition on the ANTERIOR of MAXILLA

A

Anterior nasal spine

113
Q

Growth center of Mandible

A

Condylar cartilage

114
Q

Growth direction in Mandible

A

Sup-Post

Up/back

115
Q

Growth displacement in the Mandible

A

Downward and forward

Inf-Anterior

116
Q

BQ: Exception~ bone deposition on the ANTERIOR of MANDIBLE

A

Tip of chin

117
Q

BQ: Sites of bony depostion in Maxilla

A
  1. Condyle
  2. Posterior border of ramus
  3. Coronoid process
  4. Tip of chin / Pog
118
Q

BQ: Sites of bone resorption in the mandible

A
  1. Anterior

2. Ant border of ramus

119
Q

gives space to erupting 2nd/3rd molars

A

Resorption of ant border of ramus

120
Q

BQ: What causes the increase length in the mandible

A

Bone resorption

121
Q

BQ: At the age of 6 the greatest increase in size pf mandible occurs where???

A

Distal to the first molar

122
Q

BQ: Maxillary arch = how many mm?

A

Maxillary = 128mm

123
Q

BQ: Mandibular arch = how many mm?

A

126mm

124
Q

1st growth spurt
Female =
Male =

A

1st growth spurt
Female = 3
Male = 3

125
Q

2nd growth spurt
Female =
Male =

A

2nd growth spurt
Female = 6-7
Male = 7-9

126
Q

3rd growth spurt
Female =
Male =

A

3rd growth spurt
Female = 11-12
Male = 14-15

127
Q

What is the general rule for growth?

A

The earlier the growth spurt; the lesser the growth; the earlier it will stop

128
Q

Used in predicting the time of the pubertal growth spurt

A

Hand and wrist radiograph

129
Q

BQ: How many bones are there in the hand and wrist radiograph?

Puberty:
Adults:

A 
Puberty = 28-30*
Adults = 27-29*

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