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Orthodontics > Aetiology of Malocclusion II > Flashcards

Aetiology of Malocclusion II Flashcards

1
Q

Definition of local causes of malocclusion

A
  • A localised problem or abnormality within either arch, usually confined to 1,2 of several teeth producing a malocclusion
  • Tends to get worse with time
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2
Q

List some local causes of malocclusion (5)

A
  1. Variation in tooth number
  2. Variation in tooth size or form
  3. Abnormalities of tooth position
  4. Local abnormalities of soft tissues
  5. Local pathology
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3
Q

What 4 ways can the aetiology of malocclusion be classified?

A

SKELETAL

  • Class III
  • High FMPA

DENTAL
- Missing teeth

SOFT TISSUE
- Lip trap

OTHER
- Habits

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4
Q

What does variation in tooth number include (5)

A
  1. Supernumerary teeth
  2. Hypodontia (developmentally absent teeth)

Variation of timing:

  1. Retained primary teeth
  2. Early loss of primary teeth
  3. Unscheduled loss of permanent teeth
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5
Q

In what arch are supernumerary teeth more common?

A

Anterior maxilla

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6
Q

In what gender are supernumerary teeth more common

A

Males

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7
Q

What are the 4 types of supernumerary teeth

A
  1. Conical
    - May erupt
  2. Tuberculate
    - Tend not to erupt
  3. Supplemental
    - Often extracted
  4. Odontome
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8
Q

What are mesiodens?

A

Supernumerary teeth that are close to midline

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9
Q

Do conicals affect eruption?

A

Tend not to prevent eruption, but may displace adjacent teeth

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10
Q

Do tuberculates affect eruption?

A

One of the main causes of failure of eruption of permanent upper incisors

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11
Q

What are supplemental teeth?

A

Extra teeth of normal morphology

  • Most often upper laterals/lower incisors
  • Often extract
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12
Q

Indications for extraction of supplementary teeth (3)

A
  • If stopping eruption of permanent teeth
  • Can cause crowding
  • Causing central line shifts
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13
Q

What are the 2 types of odontome?

A
  1. Compound
    - Discreet denticles
  2. Complex
    - Disorganised mass of dentine, pulp + enamel
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14
Q

Define hypodontia

A

Developmental absence of 1 or more teeth

  • Mild/moderate/severe hypodontia
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15
Q

What teeth are normally affected by hypodontia?

A

Upper laterals

Second premolars

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16
Q

Do retained primary teeth affect eruption?

A

Yes

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17
Q

What malocclusions affect eruption?

A
  1. Tuberculates

2. Retained primary teeth

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18
Q

List some reasons why primary teeth do not exfoliate (remain retained) (5)

A
  1. Absent successor
  2. Ectopic successor/dilacerated
  3. Infra-occluded (ankylosed) primary molars
  4. Dentally delayed in terms of development
  5. Pathology
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19
Q

Tx for a retained primary tooth with an absent successor (2)

A
  1. Either maintain primary tooth as long as possible (if good prognosis) to keep space

OR

  1. Extract deciduous tooth early to encourage spontaneous space closure in crowded cases

EARLY ORTHO REFERRAL FOR ADVICE

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20
Q

Retained deciduous teeth:

Definition of infa-occluded primary molars

A
  • Process where a tooth fails to achieve or maintain its occlusal relationship with adjacent teeth
  • Causes temporary ankylosis
  • Percussion sound
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21
Q

Grading system for infra-occluded primary molars (3)

A
  1. Slight
    - Marginal ridge not level either side but above the contact point
  2. Moderate
    - Just at the contact point
  3. Severe
    - Lower deciduous molar falling well below the contact points
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22
Q

Management of a retained deciduous incisor - if the permanent successor is present (3)

A

> Usually self correct so keep under review

> Consider extraction if:

  1. Contact points are going subgingival
  2. Root formation of the successor is near completion
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23
Q

Management of a retained deciduous incisor - if permanent successor is absent (2)

A

Depends on potential of crowding:

  1. Retain if in good condition (onlay)
  2. Or extract and plan space management (ortho) or prosthetic tooth
24
Q

List some causes for early loss of primary teeth (4)

A
  1. Trauma
  2. Periapical pathology
  3. Caries
  4. Resorption by successor
25
Q

What can early loss of primary teeth lead to? (2)

A
  1. Crowding of adult teeth

2. Central line shifts

26
Q

What does crowding depend on? (3)

A
  1. Which tooth is extracted
  2. When the tooth is extracted
  3. Patients inherent crowding
27
Q

Define balancing extraction

A

Extracting a tooth from the opposite side of the same arch

28
Q

Define compensating extraction

A

Extracting a tooth form the opposing arch of the same side

29
Q

Do you have to balance/compensate primary incisors?

A

No

Very little impact

30
Q

Do you have to balance/compensate primary canines? (2)

A
  • Balancing extraction
  • Can give centre-line shifts
    Will get some mesial drift of buccal segments
31
Q

Do you have to balance/compensate primary molars?

A

Space maintaining

As 6s drift mesially and steal 5s space

32
Q

What teeth causes more space loss in molars

A
  1. With E’s > D’s

2. In upper> lower

33
Q

List some factors that influence the impact on the loss of 6s (3)

A
  1. Age at loss
  2. Crowding
  3. Malocclusion
34
Q

Ideal time for loss of lower 6

A

Ideally at the time of the bi-furcation development in 7s

35
Q

What happens if loss of 6 after 7s have erupted?

A

Often poor space closure

36
Q

What happens if loss of 6 too early?

A

Distal drift of 5’s

37
Q

Protocol if U6 has to go

A

No compensation

38
Q

Protocol if L6 has to go

A

Often compensation

39
Q

When is balancing considered?

A

Not if spaced or well aligned

Consider if premolar crowding

40
Q

Protocol for unscheduled loss of central incisor (2)

A
  1. Maintain space = reimplant
  2. Plan how to deal with space
    - prosthesis
41
Q

Examples of variation in tooth size/form

A
  1. Macrodontia
    - Too large
  2. Microdontia
    - Too small
  3. Abnormal form
42
Q

Associated issues with macrodontia (3)

A
  1. Crowding
  2. Asymmetry
  3. Aesthetics
43
Q

Associated issues with microdontia

A
  1. Leads to spacing

2. Linked to hypodontia

44
Q

When should we check for a palpable buccal canine bulge?

A

From 9 years onwards

45
Q

What does the clinical assessment for ectopic canines entail? (3)

A
  1. Visualisation/palpation
  2. Inclination of 2
  3. Mobility/colour of C or 2
    - Mobility may indicate root resorption
46
Q

3 P’s when looking at radiographs?

A
  1. Presence of teeth
  2. Position of teeth
  3. Pathology
47
Q

What radiographs are needed for ectopic canine assessments? (2)

A
  1. OPT
  2. Anterior occlusal
    Parallax technique
48
Q

Management options for ectopic canines (3)

A
  1. Prevention
    - Appropriate monitoring from 9 onwards
    - Cinical assessment for symmetry
  2. Extraction of C to encourage improvement in position of 3 (interceptive)
  3. Retain 3 and observe
49
Q

Management for an ectopic first molar (3)

A
  1. Separator
  2. Attempt to distalise 6
  3. Extract E
50
Q

Define transposition

A

Interchange in the positions of 2 teeth

Can be true/false

51
Q

True transposition

A

Roots + crowns both switched too

52
Q

False transposition

A

Crowns have switched but the root apices are in the correct place

53
Q

Tx options for transposition (3)

A
  1. Accept
  2. Extract
  3. Correct
54
Q

List some causes for local abnormalities of soft tissues (3)

A
  1. Digit sucking
  2. Frenum
  3. Tongue thrust
55
Q

What can a labial frenum potentially cause?

A

Median diastema

56
Q

List some examples of local pathology that can cause malocclusion (3)

A
  1. Caries
  2. Cysts
  3. Tumours

Orthodontics (8 decks)

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