Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ortho year 4 > Adverse effects of orthodontic treatment > Flashcards

Adverse effects of orthodontic treatment Flashcards

1
Q

What are the adverse effects of orthodontic treatment

A
  • Enamel damage
    . Periodontal disease
    . Root damage
    . Other
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Informed consent

A
  • Patient and parent should be
    warned of risks
  • Information leaflet
  • Written record of warnings in
    notes
    . Pre-treatment records
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Enamel damage

A
  • Decalcification
  • Enamel wear
    –ceramic brackets
  • Enamel fracture
    –debonding
  • rare
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The white spot lesion

A
  • Precursor of enamel caries
  • Accumulation of plaque adjacent to brackets
  • Deep and rapid demineralisation can occur in
    as little as 4 weeks
  • During treatment there is an increase in
    streptococci, lactobacilli, and anaerobes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe frequency of strep mutants before during and after treatment

A

Before- slightly lower than after
During- significantly higher
After- slightly higher than before

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe prevalence of white spot lesions in orthodontic patients compared to non ortho patients

A

Higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where is most susceptible for plaque build up?

A

Gingival lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What often happens beneath a band?

A

Decalcification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Generally in ortho
How do you prevent decalcification?

A
  • Appliance design
  • Fluoride Mouthrinse
  • Oral Hygiene Instruction
  • Diet Advice
    . Chlorhexadine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do you prevent decalcification in terms of appliance design?

A
  • Keep appliances as simple as possible
  • Check for loose bands at each visit
  • Glass ionomer band cement
  • Fluoride releasing elastomeric modules & chain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does fluoride help decalcification with appliance wear?

A
  • Increases enamel hardness
  • inhibits bacterial glycolysis
  • remineralises early lesions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How to give fluoride to ortho patients to prevent decalcification with appliance wear?

A

0.05 percent daily mouthrinse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What’s the problem with fluoride mouthrinses?

A

studies have shown only 13 % of
orthodontic patients are using fluoride mouthrinses regularly despite being advised to do so

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Negatives of chlorhexadine mouthwashes for decalcification with ortho appliances?

A

12% effective:
* Little additional benefit
* Staining is a problem
* Not routinely used by orthodontists
* N.B. Effectiveness of chlorohexidine is reduced by fluoride mouthwash- do not use at the same time!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How to prevent decalcification with ortho appliances?

A

Toothbrushing+ diet+
Fluoride mouthwash

(Plus TePes, single tufted brushes sand sensodyne)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What to do when decalcification occurs?

A
  • Inform patient
  • Reinforce previous advice
  • Finish treatment as soon as possible and remove
    appliances
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What about the progression of white spot lesions?

A

Progression of white spot lesions will stop once the
cariogenic challenge has ceased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Treatment of white spot lesions- key points?

A

Tends to improve with time
Don’t use fluoride on anterior teeth
Hydroflouric acid and pumice microabrasion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Tends to improve with time …if what is done?
(3)

A

–slow remineralisation from saliva and toothpaste
–1 cm of TP contains 500 micrograms of Fluoride
–maximum improvement achieved in 6 months

20
Q

Don’t use fluoride varnish on anterior teeth-why

A
  • causes rapid surface remineralisation
    –prevents slow remineralisation of subsurface lesions
21
Q
  • Hydrofluoric acid & pumice microabrasion
A

Only suitable for superficial lesions

22
Q

What happens when you apply high fluoride dose to an established white spot lesion?

A

The flouride cannot penetrate the enamel surface and access the subsurface demineralised area
(It just sits on the top of the enamel surface)

23
Q

Why should you therefore apply low flouride dose to the established white spot lesion?

A

Because the flouride can penetrate the enamel surface and cause remineralisation

24
Q

What is another complication of ortho appliances?

A

Periodontal complications ie
Gingivitis
Periodontitis

25
Q

What points about patients and gingivitis?

A

Nearly all patients will get gingivitis
Patients with poor oral hygiene pre treatment are often uncooperative patients during treatment

26
Q

What can you do to determine access to ortho treatment?

A

Use plaque scores

27
Q

What’s important about the patients and gingivitis?

A

Rarely leads to loss of attachment

28
Q

Prevention of gingivitis?

A
  • Oral hygiene instruction
  • Particular attention to gingival areas above brackets
    Single tufted brushes for below arch wires
29
Q

Periodontitis and progression?

A

Progression to periodontitis is rare in children and adults

30
Q

Periodontitis and pre-ortho treatment?

A

Important to assess the periodontal health of adult patients before commencing orthodontic treatment

31
Q

How

A

BPE
–loss of attachment
–plaque indices
–BLEEDING ON PROBING*
- radiographs

32
Q

What could be an red flag from radiographs

A

Low bone levels

33
Q

Orthodontic treatment effect periodontal disease?

A
  • Orthodontic tooth movement in the presence
    of active periodontal breakdown will increase the rapidity of periodontal destruction
34
Q

What should you do therefore?

A

Ensure the control of periodontal inflammation before active treatment ie.
- **no bleeding on probing
- High standard of oral hygiene

35
Q

How to ensure best prognosis with ortho treatment in a patient who has periodontal disease?
(Appliances, Tx, other)

A
  • Keep appliances simple
  • Bond molars rather than place bands
  • Regular professional cleaning and scaling every 3 months
    during treatment
  • Reinforce OHI
  • Warn patient re. Possible LOA and bone loss
    . Permanent retention
36
Q

What do we know about external apical root resorption (EARR)

A

EARR)?
* High prevalence but low morbidity (only 5 % > 5 mm)
* More common in upper incisors
* Resorption ceases when appliances removed
* Aetiology?
. Long term consequences?

37
Q

Aetiology of EARR?

A

Multi factorial- treatment factors and patient factors (dentoskeletal features and individual susceptibility)

38
Q

Treatment factors contributing to external apical root resorption?

A

Class II elastics
Duration of treatment
Duration of incisor retraction
Standard edgewise> SWA

39
Q

Dentoskelatal factors affecting EARR

A

Narrow roots
Crown invagination
Agenisis

40
Q

Patient/other (individual suseptibility)?

A

Age
History of trauma

41
Q

What could a pre-op anterior occlusal show?

A

Abnormal roots pre-treatment

42
Q

How much of the variation is explained?
And what does this show

A

64 percent unexplained and 36 percent explained

Ie if 10mm is lost form an incisor root we explain why 3mm was lost but we do not know why the other 7mm was lost

43
Q

What do we know in terms of the proportion of the root that is lost (resorted)?

A

Apical third is known
Coronal two thirds is unknown

44
Q

Management of root resorption?

A
  • Informed consent
  • Pre-treatment radiographs
  • Radiograph 6-9 months into treatment
    –evidence of resorption indicates high risk of severe root
    resorption
  • Debond early in severe cases
  • Fixed retainers or splinting in severe cases
45
Q

Other adverse effect of ortho treatment?

A

Loss of vitality
Soft tissue trauma and ulceration from appliances
Headgear injuries (extra-oral or intra-oral)
Burns from acid etchant

ortho year 4 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions