Adjunctive orthodontics in multidisciplinary management Flashcards
Loss of lower molar can lead to…
- Tipping and drifting of adjacent teeth
- Poor interproximal contacts
- Poor gingival contour
- Reduced inter-radicular bone
- Supra-eruption of unopposed tooth
What is adjunctive orthodontic treatment
Tooth movement carried out to facilitate other dental procedures necessary to control disease and/or restore function and aesthetics
When and why are orthodontic techniques used
Restorative:
1. Level the occlusal plane (supraerupted teeth, improve interdigitation)
2. normalize occlusion
3. Distribute and close interdental spaces
Periodontics:
4. Alter anatomic conditions to facilitate the improvement in periodontal health
5. Improve gingival aesthetics
How is orthodontics used for restorative dentistry and periodontics?
Restorative:
1. Molar uprighting
2. Space opening and closure
3. Extrusion of teeth
4. Intrusion of teeth
Periodontics:
5. Pocket elimination
6. Prevention of further gingival recession
What are the two ways to upright a tilted molar?
- Mesialising the roots (more mechanically difficult) - presence of teeth distal to and in contact with molar
- Tipping of crown and regaining space for pontic (easier as root does not move as much) - absence of teeth distal to or not in contact with molar
Will molars get extruded during uprighting? How to fix?
Yes
Intrusion force from coil spring to reduce crown extrusion during uprighting
When is an example of when orthodontic extrusion is performed?
Traumatized incisors with subgingival crown-root fractures of the “chisel-type” and horizontal fractures extending below the alveolar crest - bring fractured site above gingival margin
What is rapid orthodontic extrusion?
Rapid extrusion involves stretching and readjusting of periodontal fibres, avoiding marked bone remodeling - change in gingival level observed
“Crown lengthening”
What are the biomechanics of rapid orthodontic extrusion
Force module to produce a vertically directed force along the long axis of the tooth
What is the appliance used for rapid orthodontic extrusion
- heavy base wire (at least 0.020’‘ss)
- elastic traction
- high point of attachment
What is the force applied during rapid orthodontic extrusion
25-40g
How often is the elastic thread changed
Every week
How long should it extrude after 4 weeks
~3-4mm
How long is the duration of rapid orthodontic extrusion
2-4 weeks
Activation stopped when desired extrusion is achieved
What should be removed from the provisional crowns prior to rapid orthodontic extrusion
palatal portion - occlusal interference
