6 - Risks and benefits of orthodontics Flashcards
What are the benefits of orthodontics?
- improvement in dental appearance
- improvement in facial appearance
- improvement in function
- improvement in dental health
What are the psychological benefits of orthodontics?
- severe malocclusions affect facial attractiveness which can cause people to be perceived unfavourably
- correction can see improvement in self esteem
Which malocclusions see marked improvement in function after orthodontics?
- large AOB
- severe increased OJ
- reverse OJ
- ortho rarely improvements speech defects
What risks are associated with impacted teeth?
- resorption
- supernumerary teeth can prevent normal eruption
- cyst formation
What risks are associated with increased overjet?
Risk of trauma (especially if lips are incompetent)
What risks are associated with anterior crossbites?
- loss of periodontal support
- tooth wear
What risks are associated with posterior crossbites?
Significant displacement can lead to asymmetry
What risks are associated with crowding?
- caries, as teeth can be harder to clean
- perio, as teeth are harder to clean, more calculus can accumulate
What risks are associated with deep traumatic overbites?
- gingival stripping
- loss of periodontal support
Can orthodontics be used to aid TMD?
- do not offer to patients whose malocclusion does not warrant treatment
- conservative treatment options should be explored first
- orthodontics may exacerbate TMD, weak evidence to suggest any improvement
What are the main risks of orthodontic treatment?
- decalcification
- root resorption
- relapse
- soft tissue trauma
What are more rare risks of orthodontic treatment?
- recession
- loss of periodontal support
- enamel fracture or tooth wear
- loss of vitality
- allergy
- failed treatment
How do you prevent decalcification?
- case selection
- OH
- diet advice
- fluoride
What indicates a good case for selection for orthodontic treatment?
- motivated patient
- good OH prior to treatment
- low caries risk
What are red flags for decalcification?
- caries history
- pre-existing decal
- erosion
What is considered normal root resoorption from orthodontic treatment?
1mm over 2 years fixed appliances
Which teeth are most commonly affect by root resorption?
Upper incisors > lower incisors > 6s
What are risk factors for root resorption during orthodontics?
- type of tooth movement (prolonged high forces, intrusion, torque, large movements)
- root form (blunt or pipette)
- previous trauma
- nail biting
Define relapse.
The return of the features of the original malocclusion following correction
Which features of a malocclusion are most prone to relapse?
- lower incisors
- rotations
- crowding
- diastema
- instanding laterals
- bridgework
- class II div 2
- AOB
How do you prevent relapse?
- case selection
- informed consent
- retainers
What are the different types of removable retainer?
- clear occlusal retainer
- pressure/vacuum formed retainer
- essix
- Hawley
What are the benefits of a removable retainer?
- remove for OH
- part-time wear
- patient control
- easy to spot problem
What are the problems associated with fixed retainers?
- prone to plaque and calculus build up
- can break without patient realising
