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BDS3 CLINICAL Ortho > Aetiology of malocclusion 2 > Flashcards

Aetiology of malocclusion 2 Flashcards

1
Q

What is the etiology of malocclusion split into

A

skeletal
dental
soft tissue
other

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2
Q

What are examples of skeletal issues that cause malocclusion

A 
class III 
high FMPA
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3
Q

What are examples of dental issues that cause malocclusions

A

missing teeth

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4
Q

What are examples if soft tissue issues that cause malocclusions

A

lip trap

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5
Q

What is the definition of local causes of malocclusion

A

localized problem or abnormality within either arch, usually confined to one, two or several teeth producing a malocclusion

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6
Q

What 5 areas can local causes of malocclusion be divided into

A 
variation in tooth NUMBER
variation in tooth size or FORM 
abnormalities of tooth POSITION
local abnormalities of SOFT TISSUES
local PATHOLOGY
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7
Q

What are variations in tooth number

A

supernumerary teeth

hypodontia

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8
Q

What is a supernumerary tooth

A

tooth or tooth like entity which is additional to normal series

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9
Q

Where are supernumerary teeth most common

A

anterior maxilla

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10
Q

Which gender are supernumerary teeth most common

A

males

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11
Q

What is the prevalence of supernumerary teeth

A

1% in primary dentition

2% in permanent

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12
Q

What are the four types of supernumerary teeth

A

conical
tuberculate
supplemental
odontome

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13
Q

What is the shape of conical supernumerary teeth

A

small peg shaped
may erupt so extract
usually 1 or 2
tend not to prevent eruption but may displace adjacent teeth

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14
Q

What are mesiodens conical supernumerary

A

mesiodens

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15
Q

What are the tuberculate supernumerary

A

tend not to erupt
paired
barrel shaped
usually extracted

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16
Q

What are the tuberculate supernumerary teeth

A

failure of eruption of permanent upper incisors

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17
Q

What are supplemental supernumerary teeth

A

extra teeth of normal morphology
most often upper laterals or lower incisors
can eat raid premolars or fourth molars
often extract - decision based on form and position

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18
Q

What are odontome supernumerary teeth

A

command - discreet denticles

complex - disorganized mass of dentine, pulp and enamel

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19
Q

What is hypotonia

A

developmental absence of one or more teeth

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20
Q

Which gender is hypodontia more prevalent with

A

females

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21
Q

What teeth are most commonly effected by hypodontia

A

upper lateral 2s

second premolars

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22
Q

What are retained primary teeth

A

a disruption in the sequence of eruption

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23
Q

When should alarm bells ring about retained primary teeth

A

difference of more than 6 months between the shedding of contra lateral teeth (alarm bells)

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24
Q

Why may primary teeth be retained

A

absent successor
ectopic successor or dilacerated
infra occluded (ankylosed) primary molars
dentally delayed in terms of development
pathology/supernumary

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25
Q

What should you do if there is a retained primary tooth with an absent successor

A

either maintain primary tooth for as long as possible if it has a good prognosis
or
extract deciduous tooth early to encourage spontaneous space closure in crowded cases

early ortho referral for advice is best

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26
Q

What are infra occluded primary molars

A

(was called submerging before)
process where a tooth fails to achieve or maintain its occlusal relationship with adjacent teeth
temporary ankylosis
common in 1-9%

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27
Q

What type of sound do the infra occluded primary molars make

A

percussion sound

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28
Q

What is the management of a retained infra occluded primary molar if there is a permanent successor present

A

usually self corrects so keep under review
consider extraction if
1. contact points are going subgingival
2. root formation of successor is near completion

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29
Q

What is the management of a retained infra occluded primary molar if there is not a permanent successor present

A

depends on potential crowding
retain if in good condition
extract and plan space management

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30
Q

What is early loss of primary teeth due to

A

trauma
periapical pathology
caries
resorption by successor

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31
Q

What can early loss of primary teeth result in

A

crowding

centre line shift

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32
Q

What does the result of early loss of primary teeth depend on

A

which tooth is extracted
when the tooth is extracted
patients inherent crowding

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33
Q

What is a balancing extraction

A

extraction of a tooth from the opposite side of the same arch
designed to minimize midline shift

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34
Q

What is a compensating extraction

A

by extraction of a tooth from the opposing arch of the same side

designed to minimize maintain occlusal relationships

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35
Q

What is the impact of the early loss of primary incisors

A

very little impact

no compensating or balancing extraction needed

36
Q

What is the impact of early loss of primary canines

A

unilateral loss in crowded arch, can give centre-line shift
will et some mesial drift of buccal segments
consider balancing extraction

37
Q

What is the impact of early loss of primary molars

A

more space loss with Es and Ds
more space loss in upper > lower
6’s drift medially and steal 5s spaces
tend not to balance or compensate

38
Q

What is the effect when primary teeth are extracted

A

most effect is when primary teeth are extracted early

little effect is extracted late

39
Q

What is the effect when there is inherent crowding

A

marked space loss in crowded px

minimal or no space loss in spaced dentition

40
Q

When is the routine assessment for the prognosis of 6’s done

A

at age 8-9
seldom ideal tooth of choice for relief of crowding

but planned loss at correct age is better than later enforced loss

41
Q

What are factors that influence the impact on the loss of 6s

A

age at loss
crowding
malocclusion

42
Q

Is age an important factor for the age at loss for 6s

A

no

less important

43
Q

When is the ideal time for extraction of 6’s

A

ideally at time of bifurcation development in 7s

44
Q

If the lower 6 is extracted too late what happens

A

the 7s have erupted already

often poor space closure

45
Q

If the lower 6 is extracted too early what can happen

A

distal drift of 5s

46
Q

If there is crowding in the upper arch and there is loss of 6s what can happen

A

rapid space loss

47
Q

If the lower arch is spaced what is the impact on the loss of 6s

A

will have spaces

48
Q

If the lower arch is aligned what is the impact of the loss of 6s

A

will have spaces

49
Q

If the lower arch is crowded what is the impact of the loss of 6s

A

best results likely

50
Q

If an upper 6 has to go do we compensate

A

no

51
Q

If a lower 6 has to go do we compensate

A

often yes

52
Q

What should we do about the unschedules loss of central incisor

A

in first instance maintain space by reimplanting

then plan how to deal with space

53
Q

What are the 3 variations in tooth size and form

A

too large - macrodontia
too small - microdontia
abnormal form

54
Q

What is macrodontia

A

tooth/teeth larger than average

localized or generalised

55
Q

What are problems that arise from macrodontia

A

crowding
asymmetry
aesthetics

56
Q

What is microdontia

A

tooth/teeth smaller than average
localized or generalised
leads to spacing
linked to hypodontia

57
Q

What are different abnormal forms of teeth

A 
peg shaped laterals
dens in dente
geminated/fused teeth
talon cusps
dilaceration
accessory cusps and ridges
58
Q

What are abnormalities of tooth position called

A

ectopic teeth

59
Q

What teeth are most commonly atopic

A 
third molars
upper canines
first permanent molars
upper centrals 
transpositions
60
Q

What percentage of population have ectopic canines

A

1-3%

61
Q

What percentage of ectopic canines are palatal

A

80%

62
Q

What are ectopic canines associated with

A

small or absent upper laterals

63
Q

How do we check for ectopic canines

A

check for palpable buccal canine bulge from 9 years onward

further investigation or refer if in doubt

64
Q

What is the clinical assessment for ectopic canines

A

visualisation/palpation for any obvious bumps of 3

inclination of 2

mobility of c or 2

color of c or 2

65
Q

How many radiographs are needed for ectopic canines

A

2 - usually OPT and anterior occlusal

can do vertical parallax too

66
Q

What are the 3 Ps we look for in radiography of ectopic canines

A

presence
position
pathology

67
Q

What are the management options for ectopic canines

A

prevention
extraction to encourage improvement in position of 3 (interceptive)
retain 3 and observe (accept its position)
surgical exposure and orthodontic aligmnet
surgical extraction
autoimplantation

68
Q

How can we prevent ectopic canines

A

appropriate to monitor from 9 onwards

clinical assessment - look for symmetry

69
Q

How common are ectopic first molars

A

less than 5%

70
Q

What arch are ectopic first molars most common in

A

upper

71
Q

At what age are ectopic first molars reversible

A

8

72
Q

What are signs of ectopic first molars

A

crowding

mesial path of eruption

73
Q

What is management of ectopic first molars

A

seperator
attempt distalize 6
extract e

74
Q

When looking at ectopic upper central incisors what do we check for

A

sequence

symmetry

75
Q

Why can upper central incisors become ectopic

A

supernumerary

dilacerated (trauma)

76
Q

What is possible tx for ectopic central incisors

A

surgical exposure removal of supernumerary if present and bond a gold chain
make space
above 9 years ortho traction
bonded retainers

77
Q

What is transposition

A

interchange in the position of two teeth

78
Q

What can transposition be classified into

A

true and pseudo

79
Q

What teeth are most commonly transposition

A

upper canine and first premolar

lower canine and incisor

80
Q

What are the tx options for transposition

A

accept
extract
correct

81
Q

What are the 3 local abnormalities of soft tissue

A

digit sucking
frenum
tongue thrust

82
Q

What is the effect of non nutritional digit sucking habits

A

proclined UI
retroclined LI
anterior open bite
unilateral posterior cross bite

83
Q

What can a labial frenum cause

A

median diastema

84
Q

What can tongue thrust cause

A

anterior open bite

85
Q

What are the local pathologies that can cause malocclusion

A

caries
cysts
tumours

BDS3 CLINICAL Ortho (11 decks)

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