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Orthodontics > ALL ORTHO Qs > Flashcards

ALL ORTHO Qs Flashcards

1
Q

aetiology of malocclusion (general)

A

skeletal - size/shape
muscle - form/function of muscles
dental - size of teeth in relation to jaw size

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2
Q 
AP jaw discrepancy -class 1 definition
-class 1 features and ceph
A

maxilla 2-3mm in front of mandible

-ceph - SNA - 81+_3/SNB - 78+_3/ANB - 3+_2

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3
Q 
AP jaw discepancy  - class 2 def
-ceph features
A

-maxilla >2-3mm in front of mandible
ceph -SNA averege or increased/SNB - decreased
ANB>5mm

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4
Q

what is the eastmen correction

A

For every >1 degree than average, subtract 0.5mm of ANB/vice versa

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5
Q 
AP jaw discrepancy - class 3 def
-ceph features
A

mandible placed in front of maxilla
-SNA - decreased/SNB - average or increased/
ANB - <1 or negative

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6
Q

what is dento-alv compensation

A

the inclination of the teeth that compensates for the underlying skeletal pattern

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7
Q

how to determine AP jaw relationship

A

visual/palpate/ceph

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8
Q

what are the measurement points of:

  • frankfort plane
  • mandibular plane
A
  • frankfort - orbitale/porion

- mandibular - menton to gonion

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9
Q

how to measure the vertical jaw relationship

A

FMPA - 27 degrees

LAFH - 50/50 clin 55% ceph

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10
Q

what does a backward mandibular growth rotation produce, values:

  • FMPA
  • LAFH
A

steeply inclined mand plane, AOB tendency

  • FMPA >31 degrees
  • LAFH ->55%
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11
Q

what does a forward mandibular growth rotation produce

  • FMPA
  • LAFH
A

Parallelism of jaws
deep OB
-FMPA - <23
-LAFH - <55%

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12
Q

what are the two transverse discrepancies

A

arch width

mandibular displacement

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13
Q

aetiology of malocclusion

A 
skeletal
dental 
ST
BAD HABITS
genetics and enviro
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14
Q

local causes of malocclusion

variation in: (5)

A 
variation in tooth number
" in tooth size/form
abnormality of tooth position
local ST abnormality
local pathology
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15
Q

name 4 types of supernumerary and brief descriptions

A
  1. Conical - small peg shaped, mesiodens in midline
  2. Tuberculate - most likely cause of an unerupted central, paired/barrel shaped
  3. supplemental - extra teeth of normal morphology
  4. odontome - compound - many little teeth/complex - disorganised mass of dentine/pulp/enamel
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16
Q

when should alarm bells be ringing in terms of delayed eruption.
-why would a tooth not erupt

A

6mth after contralateral tooth

-no perm successor/ankylosed/ectopic sucessor/pathology

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17
Q

treatment for retained primary successor

A

if good prognosis, retain as long as poss.

Early ortho referral best

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18
Q

management of an infra occluded primary molar

  • perm succesor
  • no perm successor
A

• Management:
– Permanent successor? Obs. 1 yr
– No successor? Extract, keep if good prog

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19
Q

why would a tooth be lost early

  • what is a balanced XLA
  • what is a compensating XLA
A

trauma/caries/resorptio/early dental development

  • balanced - tooth from opposite side of same arch
  • compensating - tooth from opposing quadrant, minimise interference and maintain occ relationship
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20
Q

what teeth should be balanced/compensated

A 
A/B's - no comp/balance
C's - balanced to prevent midline shift
D’s
– small CL. shift,
balance under GA?
• E’s
– not to balance
– major space loss
– upper>lower
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21
Q

when should children ideally be referred to an orthodontist

A

age 7-9yr

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22
Q

what is the definition of interceptive ortho

A

‘Any procedure that will reduce or
eliminate the severity of a developing
malocclusion’

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23
Q 
spacing percentages in primary dention that translate to crowning in perm dentition
-no spacing
-<3mm
-3-6mm
>6mm
A
  • No spacing 66% crowding
  • < 3mm 50% crowding
  • 3-6mm 20% crowding
  • > 6mm No crowding
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24
Q

when should first perm molars be assessed, what should then happen

A

• Assessment 9 years
• Any doubts re long-term prognosis
refer for advice.

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25
Q

XLA rules of up/low 6’s

A

If extracting lower XLA upper
• Don’t balance with sound tooth.
• If extracting upper don’t necessarily
take lower

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26
Q

what features display the best time to XLA 1st perm molars

A 
Ideally:
• 7’s furcation forming
• 8’s present
• Class 1 av/reduced OB
• Moderate lower crowding
• Mild/moderate upper crowding
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27
Q

on average, when are roots completed in a tooth

A

3yr post eruption

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28
Q

define leeway space and the measurements for max/mand

A

Leeway Space: difference between
e,d,c and 3,4,5.
– Mx 1.5mm
– Md 2.5mm

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29
Q

when should upper canines be assessed

A 
10yrs
Assess position of upper canines from
10 years onwards
• Should palpate by 11 years
• Mobile C’s, symmetry
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30
Q

cause of deformity needing orthognathic surgery

A

family trait/race/congenital/deformity/trauma

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31
Q

Clinical exam prior to orthognathic surgery

A

E/O - AP relationship
front - vertical asymmetry/lip and nose morphology/horizontal asymmetry/ smile line

I/O - dental assessment/occlusal relationship/cetre lines/OJ/OB/incisor inclination/crowding/cleft

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32
Q

who’s part of the multidisciplinary team of an orthognathic surgery team

A

psychologist/OMFS/restorative dentist/orthodontist/speech and language therapy/oral hygiene/technologist

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33
Q

How can combined ortho/surgical treament work

A

-tooth alignment/eliminate crowding/alteration or co-ordination of arches/correct incisor inclination/flatten occlusal plane/surgical fixation/post surgical ortho

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34
Q

diagnosis terms for:
maxilla
mand
chin

A

max - retrognathic/prognathic(anterognathic)/vertical excess/vertical deficiencey

mand-prognathic/retrognathic

chin - prognecia/retrognecia/vertical excess/vertical deficiency

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35
Q

name some surgical procedures in orthognathic surgery

A

max - le fort 1 osteotomy/anterior maxillary osteotomy

mand - andvancement (sagittal split osteotomy)/VSSO

chin - advancement, set back, rotation/augmentation/reduction

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36
Q

variation of tooth form

A

macrodontia
microdontia
abnormal

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37
Q

how many people are affected by ectopic canines (%)

A

1-2%

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38
Q

clinical assessment of ectopic canines

A

visualisation and palpation
colour /mobility of 2/c
inclination of 2
Rg - OPT and anterior occlusal for parallax

39
Q

ectopic canine management

A
  • leave and observe = prevention
  • surgical exposure and ortho alignment
  • XLA of c - encourage movement
  • retain c and observe
  • XLA
  • Transplant
40
Q

ectopic central incisor management

A
  • surgical exposure
  • XLA supernumerary
  • bond gold chain
  • ortho traction
  • fixed appliance
  • bonded retainer
41
Q

class 2 div 1 definition

  • what percetage of malocclusions
  • main concerns
A

the lower incisor edges lie posterior to the cingulum plateau of the upper incisors. Incisors are often proclined/aaverage inclination and theres an increased OJ

  • 15-20%
  • aesthetics/trauma
42
Q 
class 2 div 1 features
-AP
-ST
Dental findings
-Habit
A 
AP - class 1/2
ST - incompetent lips, try to achieve anterior oral seal
-through pushing lower lip up behind up incisors, use of circum-oral musculature, posture mandible forward
-dental features = >OJ, varied OB, good alignment and spacing, class 2 molar relationship
DRYING OF GINGIVAE - gingivitis risk
43
Q

occlusal features of a sucking habit

A

proclined upper inc
retroclined low inc
narrow arch +_ unilateral post crossbite
AOB

44
Q

management options of class 2 div 1

A
  • accept
  • growth mod - headgear/twinblock (functional app), 10yrs
  • URA - robert’s retractor
  • fixed appliances
  • Orthognathic surgery - pre and post ortho
45
Q

mode of effet of functional appliance in class 2 div 1

A

DENTO-ALV CHANGE
distal movement of up dent/mesial movement of low dent/retroclination of up inc/proclination of lower inc
minor skeletal change

46
Q

what features would encourage the use of a URA in class 2 div 1

A

favourable OB/mild class 1 or 2/OJ due to incisor proclination

47
Q 
class 2 div 2 definition
-% of all malocclusions
A

The lower incisor edges lie posterior to the cingulum plateau of the upper incisors. The upper incisors are often retroclined and there is a minimal OJ/slight increase
-10%

48
Q

features of class 2 div 2

  • AP
  • Vertical
  • ST
  • Dental
A

AP-mild/mod skeletal class 2
Vertical - REDUCED FMPA, forward rotational mandible growth patttern
ST - high lip line/marked labiomental fold/high masseteric forces

-dental- retroclination of up incisors, reduced IIA/reduced OJ/2’s crowded/mesio-labially rotated 2’s
reduced arch length
>OB

49
Q

treatment options for class 2 div 2

A

-accept and monitor
-Growth mod - mild/mod skel 2 = modified twin block
-Camouflage
Orthognathic surgery

50
Q

what would occur during the camouflage stage of the tretament of a class 2 div 2

A 
accept the underlying skel base and aim for class 1 incisor relationship = reduce OB 
correct inter-incisal angle = palatal root torque - p incisors/procline lower incisors
51
Q 
class 3 definition
% of all malocclusion
A

the lower incisor edges lie anterior to the cingulum plateau of the upper incisors. There is a reversed or reduced OJ
-3-8%

52
Q

features of class 3

  • AP
  • vertical
  • transverse
  • dental
A

-AP - class 3
-Vertical - May be associated with average, increased or
reduced vertical proportions
– Frankfort Mandibular Plane Angle
– Anterior Facial Height proportions
– Lateral cephalometry
• ↑FMPA and anterior open bite more complex
to treat
-Transverse- bilateral posterior crossbites

-Dental - Class III incisor relationship
• Class III molar relationship (not always)
• Tendency to reverse overjet
• Overbite will vary
• Crossbites
– Anterior and Posterior (buccal)
Alignment
– Maxilla often crowded
– Mandible often aligned or spaced
• Dentoalveolar compensation
– Proclined upper incisors
– Retroclined lower incisors
• Tendency for displacements on closing
53
Q

treatment options for class 3

A
  • Accept and Monitor
  • Interceptive with URA - procline up inc over bite
  • Growth Modification - reverse twin block/frankel III/chin cup/protraction heagear+RME
  • Orthodontic Camouflage
  • Orthognathic surgery
54
Q

features of a frankel III appliance

A 
Pellotes (Shields) labial
to upper incisors to
hold lip away
• Palatal arch to procline
the upper incisors
• Lower labial bow to
retrocline the lower
incisors
55
Q

correct age and features for protraction headgear

A 
Correct age (young age 9/10)
• Co-operative patient
• 14 hour/day protraction facemask wear
• 400g/side
• ± Rapid maxillary Expansion
56
Q

favourable features for use of camouflage in class 3

A

Growth stopped
– Mild to moderate Class III Skeletal base ANB >0˚
– Average or increased overbite
– Able to reach edge to edge incisor relationship
– Little or no dento-alveolar compensation

57
Q

order of ST exam

A 
lip competent
lip trap
nasolabial angle
smile line
tongue
58
Q

overview of intra-oral exam in patient assessment

A
  • chart teeth
  • poor prog
  • OH
  • tooth condition
  • perio
  • wear
59
Q

Crowded measurements

-methods of measuring crowding

A 
<4mm - mild
4-8mm - mod
>8mm - severe
-space available/space required
-mixed dentition analysis
-overlap technique
60
Q

Order of assessment IN OCCLUSION

A
  • incisor class
  • OJ
  • OB
  • centre lines
  • molar relationship
  • canine relationship
  • crossbite
  • mand displacement
61
Q

definition of OJ

A

Horizontal distance between labial surface of tips of upper incisors and the surface of lower inc

62
Q

definition of OB

A

vertical overlap of incisor teeth

63
Q

special inv for ortho

A

Rg -OPT
study models
Planning models - Kesling (cut teeth off and move), Diagnostic - fixed pros

64
Q

Problem list - MOCDOO meaning

A 
Missing
OJ
Crossbite
Displacement of CP
OB
Other
65
Q

CLP - how many

  • % sporadic
  • ratio of M:F
A

1:700 live births
70% sporadic
3M:1F

66
Q

aetiology of CLP

A

genetic - fam H/syndrome/sex ratio/ethnic

enviro - alcohol/drugs (antiep)/Low SES/smoking/multivitamins

67
Q

CLP patient journey

A

3mth - lip closure
6-12mth - palate closure
8-10yr - alv bone graft
12-15yr - definitive ortho
18-20yr - orthognathic surgery

68
Q

members of cleft care team

A 
surgeon
cleft nurse
geneticist
ENT respiratory
psychologist
dental team
speech therapist
69
Q

dental issues with CLP

A 
hypodontia - missing teeth
caries
impacted teeth
crowding
growth
70
Q

member of dental team for CLP

A 
orthodontist
oral surgeon
paediatric dentist
restorative dentist
orthodontic therapist
dental therapist
71
Q

basic order of orthopaedics

A

presurgical orthopaedics
expansion/bone graft
definitive ortho
orthognathic surgery

72
Q

definitions:

  • hypodontia
  • anodontia
  • severe hypodontia
A 
Hypodontia
– Congenital absence of one or more teeth
• Anodontia
– Complete absence of teeth
• Severe hypodontia
– 6 or more congenitally absent teeth
73
Q

prevalence of hypodontia, M:F

  • most likely teeth
  • prmary teeth occurence
A

Prevalence approx. 6% (excl. 8’s)
• 6.3% F, 4.6% M in European population
-lower 5’s, upper 2’s, up 5’s
• 0.9% primary dentition

74
Q

what are the clinical signs of hypodontia

A 
Delayed or asymmetric
eruption
• Retained or infraoccluded deciduous
teeth
• Absent deciduous tooth
• Tooth form
75
Q

what is the occurence % of missing laterals

A

1-2%

76
Q

associated issues with hypodontia

A

microdontia !!!!!!
cleft lip and/or palate
malformation of other teeth
short root anomaly
impaction
delayed formation and/or delayed eruption other teeth
crowding and/or malposition of other teeth
maxillary canine/first premolar transposition
taurodontism
enamel hypoplasia
altered craniofacial growth

77
Q

name 2 conditions associated with hypodontia

A

ectodermal dysplasia

down’s syndrome

78
Q

Hypodontia care pathway

A

GDP recognition
• Referral to Specialist Orthodontist
• If GDH&S: Initial assessment in Orthodontics
and allocate when appropriate to Hypodontia
clinic (Orthodontic & Restorative input)

79
Q

assessment and planning components for hypodontia

A 
History
• Extra-oral examination
• Intra-oral examination
– Orthodontic aspects
– Restorative aspects
• Investigations
• Problem list
• Definitive Plan
• Retention / maintenanc
80
Q

special inv for hypodontia

A 
Study Models
• Planning models
– Kesling, diagnostic
• Radiographs
• Photographs
• Conebeam CT
81
Q

missing upper laterals - treatment options (general)

-detailed

A 
Accept
• Restorative alone
• Orthodontics alone
• Combined orthodontic &amp; restorative
treatment
-Open space  /  Close space
RBB
Implant
Autotransplantation
Conventional bridgework
Partial denture

CLOSE - Space closure plus
Simple

82
Q

ADV and DIS of RRB

A 
• Advantages
• Relatively simple
• Do when young
(complete treatment)
• Non-destructive
• Can look good
• Place on semipermanent basis
• Disadvantages
• Fail rate
• Appearance sometimes
not good, (try again,
new materials)
• Orthodontic retention
needs are high
83
Q

fixed appliance ADV

DIS

A
  • move multiple teeth at once
  • bodily movement
  • no need for patient compliance
  • control of root movement
  • more complex tooth movement

dis
OH needs to be excellent
risk of iatrogenic damage
Poor intrinsic anchorage

84
Q

components of a fixed appliance

A 
brackets
modules
arch wire
band
anchorage components
force generating components
auxilliaries
85
Q

what is torque

what is tip

A

bucco-lingual angulation of tooth
-determined by angle between bracket base and slot
tip - mesio-distal angulation of tooth

86
Q

Properties of nickel titanium

A

shape memory
flexible
-light continuous force
>friction than SS

87
Q

name 3 force generating components

A

elastic power chain/intraoral elastics/active ligatures

88
Q 
where do class 2 elastics fit onto
where do class 3 elastics fit onto
A

class II - low 6 to upper canine

class III - upper 6 to lower canine

89
Q

name some forms of retention

A
  • pressure formed retainer - cover all teeth, removable, easy to clear, can get lost/broken, easily replaced, can have prosthetic tooth for aesthetics
  • hawley’s retainer - labial bow
  • resin bonded retainer - for rotation/diatema/space/ectopic canines
90
Q

types of movement achieved using a quadhelix appliance

A 
unilateral contraction
fan expansion
bilateral expansion of post teeth and canines
molar rotation
CLP expansion
asymmetrical expansion
91
Q

what is the purpose of anance button and transpalatal arch

-how much space between arch wire and GM

A

provide anchorage of molar teeth

-4-6mm between arch wire and GM

92
Q

risks of ortho treatment

A 
relapse
gingival recession
decalcification
root resorption
loss of vitality
periodontal bone loss
failure of treatment
93
Q

difference in adult treatment to children

- issues

A
  • lack of growth = growth mod not an option, OB treatment more difficult/can only expand max arch with surgery
  • periodontal disease -

Orthodontics (3 decks)

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