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Ortho Final > 5B > Flashcards

5B Flashcards

1
Q

Adjunctive therapy:

● Goal to

A

reposition teeth to facilitate other dental procedures (restore fxn & control disease)

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2
Q

Adjunctive therapy:

○ Main goal is

A

NOT ideal occlusion/alignment

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3
Q

Adjunctive therapy:

● Generally limited in

A

scope (ie. doesn’t fix overjet, but creates space for implant placement)

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4
Q

Adjunctive therapy:

● Always inter-disciplinary →

A

Prosthodontist, Perio, OMFS, &/or Endo

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5
Q

Adjunctive therapy:

● Patient characteristics:

A

○ Adults with underlying dental disease

○ Sequencing care is critical

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6
Q

Adjunctive therapy:

■ Orthodontics to realign teeth for

A

better restorative treatment

○ Control/eliminate disease process - primary goal

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7
Q

Adjunctive therapy

■ No orthodontics or restorative until

A

underlying perio or caries stopped

○ These pts have very specific biomechanical treatments

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8
Q

Effect of reduced periodontal support

● Many pts requiring adjunctive therapy have

A

reduced periodontal support

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9
Q

● Reduced periodontium (changes C-res) ⇒

A

alters amount of orthodontic force

○ Apical migration of C-res

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10
Q

Common Adjunctive Procedures

1. Uprighting molars ⇒ common scenario where

A

molar/PM extracted & adjacent teeth or abutments drift into unrestrained extraction spac

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11
Q

Common Adjunctive Procedures
Uprighting molars
○ Need to consider

A

of teeth being uprighted & anchorage

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12
Q

Common Adjunctive Procedures
Uprighting molars
■ Uprighting molars can be

A

difficult & requires a lot of anchorage

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13
Q

Common Adjunctive Procedures
Uprighting molars
○ 2 methods of uprighting molars:

A

■ Distal crown tip
■ Mesial root tip
■ Combination of distal crown tip & mesial root tip

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14
Q

■ Distal crown tip ⇒ Maintains

A

space for pontic

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15
Q

Distal crown tip

● If NO antagonist →

A

distal tipping will extrude tooth

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16
Q

Distal crown tip

○ Coil

A

spring mechanism

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17
Q

Distal crown tip

○ ↑ crown ht &

A

↓ mesial pocket

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18
Q

DISTAL CROWN TIP

○ May require

A

crowd reduction to improve crown:root ratio

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19
Q

■ Mesial root tip

● Reduces

A

pontic space (eliminates need for pontic, but more difficult)

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20
Q

Mesial root tip

○ Requires

A

T-loop, spring, or helical mechanics (more complicated)

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21
Q

Mesial root tip

A

● Intrudes tooth

22
Q

■ Combination of distal crown tip & mesial root tip

● Goal is

A

distal crown tip, but want to prevent extrusion

23
Q

Combination of distal crown tip and mesail root tip

○ To prevent extrusion →

A

use T-loops or helical mechanics to intrude tooth &/or move roots mesially

24
Q
  1. Forced eruption:

○ Indications:

A

■ Subgingival tooth fx

25
Q
  1. Forced eruption:
    ○ Indications:
    ● Can’t restore
A

subgingival fx; will either need to extract or extrude tooth to provide tooth structure for restoration

26
Q
  1. Forced eruption:
    ○ Indications:
    ■ Periodontal disease & vertical bony defect
    ○ Treatment options:
A

■ Perio crown lengthening - limitation is crown-root ratio

■ Orthodontic rapid extrusion

27
Q
  1. Forced eruption:
    ○ Indications:
    ■ Orthodontic rapid extrusion
A

● Spring helical mechanism (straight wire would tip adjacent teeth)

28
Q
  1. Forced eruption:

○ Orthodontic extrusion ⇒

A

orthodontic forces used for extrusion

29
Q

Ortho extrusion

■ PDL/alveolar bone follows

A

extruding tooth

30
Q
  1. Forced eruption:

○ Rapid extrusion ⇒

A

heavier forces & more frequent activations

31
Q
  1. Forced eruption:

■ Tooth extruded without

A

periodontium following (partial extraction)

32
Q
  1. Forced eruption:

■ Lengthens

A

clinical crown - to expose sound tooth & root structure

33
Q
  1. Forced eruption:

○ Retention period important -

A

long retention period to prevent re-intrusion

34
Q
  1. Intrusion for supra-erupted teeth

○ Anterior tooth intrusion ⇒

A

possible with conventional orthodontics

35
Q

Intrusion for supra-erupted teeth

○ Posterior tooth intrusion ⇒

A

possibly ONLY with reinforced anchorage - TADs or implants

36
Q

Intrusion for supra-erupted teeth

Intrusion ⇒ one of the most

A

difficult orthodontic movements to accomplish

37
Q

Intrusion for supra-erupted teeth

● Often with extrusion, patients have

A

vertical periodontal defects (bc bone following extruded tooth)

38
Q

Skeletal anchorage ⇒ utilizes

A

osseointegration (implants) or TADs (temporary anchorage devices)

39
Q

● TADs ⇒ allow

A

previously difficult tooth movements possible (ie. posterior tooth intrusion)

40
Q

TADs

○ Simplifies

A

ortho biomechanics & speeds up treatment

41
Q

TADs

■ Allows for

A

symmetric force. (ie. placing TAD’s buccally & lingually to extruded tooth allows intrusion w/o tipping)

42
Q

Tooth Proportions:

● Maxillary incisors: ideally ~

A

10mm tall & 8.5 mm wide

43
Q

Tooth proportions

○ Ideal width to height ratio

A

80-84%
● Golden proportion
● Recurring Esthetic Dental Dimension
○ 70% proportion recommended for average teeth length (lateral width 70% of central)

44
Q

Maxillary & mandibular anterior attrition & supra-eruption
● As teeth undergo attrition →

A

tend to supra-erupt & gingival margins change

45
Q

○ Laterals should have the most

A

cervical gingival margin

46
Q

● Intruding anteriors will create

A

open bite for general dentist to restor

47
Q

Congenitally missing maxillary lateral incisors

● Canines can erupt in place of

A

missing laterals (good bc brings alveolar bone with it; allows for future implant if decide to distalize canines)

48
Q

Congenitally missing maxillary lateral incisors
● Treatment plan depend on pt:
○ Class II with overjet →

A

treat canine as lateral & close space to reduce overjet

49
Q

Congenitally missing maxillary lateral incisors
● Treatment plan depend on pt:
○ Class I →

A

distalize canines to class I position & restore w/ implants

50
Q

Congenitally missing maxillary lateral incisors

■ Adj. roots must be

A

upright to allow for implant placement

Ortho Final (8 decks)

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