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ortho year 4 > Anterior openbite > Flashcards

Anterior openbite Flashcards

1
Q

Definition of AOB

A

Absence of vertical overlap of
the upper and lower incisors

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2
Q

Incidence of AOB

A

2-4 percent of children
4 percent of adults

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3
Q

Significance of AOB

A
  • Dental appearance
  • Functional difficulties: eating and speech
  • Weak association with TMJ dysfunction
  • Skeletal causes associated with “long face’ and poor facial appearance
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4
Q

Aetiology of AOB

A

Skeletal
Habits
Soft tissues
Iatrogenic

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5
Q

Skeletal

A

Genetic
TMJ (trauma/pathology)

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6
Q

Habits

A

Thumb sucking
Digit sucking

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7
Q

Soft tissues

A

Macroglossia
???endogenous/adaptive tongue thrusting
Muscular dystrophy

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8
Q

Iatrogenic

A

Extrusion/over eruption of molars during treatment or retention

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9
Q

Classification of AOB

A

Dental
Skeletal
Combination of dental/skeletal

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10
Q

Intra-oral features

A
  • Generally no unusual extra-oral features
  • Usually limited to incisor region
  • Features may be related to aetiology (eg. retroclined lower incisors and proclined upper incisors)
  • Upper arch may be narrow
  • Often due to Digit/Dummy
    sucking habits
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11
Q

Due to a digit or dummy sucking habit?

A

Usually limited to an incisor region
Usually asymmetrical
Retroclincation of lower incisors
Proclination of upper incisors class II div 1

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12
Q

Stats for children up to age 7 finger/ thumb sucking? And continue to age?

A

15 percent of children up to the age 7
(And 7.5 percent continue after age 7)

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13
Q

Stats for dummy sucking? And after age 6?

A

50 percent of children
1 percent after age 6

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14
Q

For finger and thumb sucking severity of AOB depends on?

A

Duration and intensity of habit

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15
Q

Thumb/ finger sucking for what amount of time would mean significant effects?

A

More than 6 hours a day

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16
Q

Skeletal AOB intra-oral features?
Occlusion and occlusal plane?

A

In severe cases only 7s may occlude
Upper occlusal plane canted upwards
Lower occlusal plane canted downwards

17
Q

Skeletal AOB intra-oral features
Incisors etc.

A

Incisors usually normal inclinations
Gingival hypertrophy due to mouth breathing

18
Q

Extra oral features of skeletal AOB?

A

Long face
Increased MM angle
Lip incompetence

19
Q

AOB cephalometric features?
Dental AOB

A

May have normal skeletal pattern

20
Q

Ceph features skeletal AOB

A

Reduced ramus height
Increased MM angle
Increased lower facial proportion

21
Q

Treatment of AOB- why?

A

Dental aesthetics
Function
Facial appearance

22
Q

Treatment options

A

Interceptive”: stop digit sucking habits

  • Orthodontics only: mild cases, dental AOB
  • Orthodontics and Orthognathic surgery:
    severe cases, skeletal AOB
  • Cases with a greater skeletal element are more difficult to treat
23
Q

Photo ‘goalpost appearance’

A
24
Q

Transpalatal arch

A
25
Q

Fixed appliance only treatment-
Patients and best treated by?

A

Acceptable facial appearance
Specialist orthodontists only

26
Q

Appliance wise how for fixed only

A
  • Fixed appliances with elastics: extrude incisors
  • High pull headgear to intrude upper molars
  • Temporary anchorage device (TAD) intrusion of buccal segments
27
Q

Treatment with orthodontics and surgery
Patients, when and best treated by?

A
  • For patients with poor facial appearance (usually long lower face)
  • Wait until growth has stopped
  • Orthodontist & Maxillofacial Surgeon
28
Q

Appliance wise how with orthodontics and surgery?

A
  • Fixed appliances to align arches
  • “Le Fort I” maxillary impaction to elevate upper posterior teeth
29
Q

Prognosis- stability and correction of AOB

Prognosis and relapse

A
  • If due to a habit, prognosis is good if habit stops
  • A third of fixed appliance AOB cases relapse
30
Q

Growth and surgical correction AOB?

A
  • Growth is unpredictable and may be unfavourable
  • Surgical correction in adults is usually stable
31
Q

Most common cases of AOB are

A

Skeletal pattern and habits

32
Q

Treatment depends on

A

cause, and whether or not the facial appearance is acceptable

33
Q

Dental AOB and mild skeletal AOB may often be treated with

A

Fixed appliances

34
Q

Moderate and severe skeletal AOB usually needs

A

Surgery for full correction

ortho year 4 (11 decks)

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