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Ortho II > Antero-posterior discrepancies > Flashcards

Antero-posterior discrepancies Flashcards

1
Q

what is the prevalence of class II malocclusion in the general population

A

30%

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2
Q

what is the prevalence of class II malocclusion in all orthodontic patients in the US

A

33%

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3
Q

what are the categories of class II malocclusion

A
  • maxillary excess
  • mandibular deficiency
  • combination
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4
Q

what is the etiology of a class II malocclusion

A

skeletal or dental

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5
Q

what is the most frequent problem presenting in the ortho practice

A

class II malocclusion

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6
Q

what factors are involved in the etiology of class II malocclusion

A

hereditary and environmental

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7
Q

class II malocclusion may reflect:

A
  • maxilla- mandible disharmony with underdevelopment of mandibular growth
  • dental disharmony (angle classification)
  • combination
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8
Q

what are the clinical features in the diagnosis of the maxillary first molar and what is another name for it

A

the maxillary first molar in a mesial position in relation to the mandibular first molar (distoocclusion)

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9
Q

what are the two different types of class II malocclusion

A
  • class II division 1
  • class II division 2
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10
Q

describe class II division 1

A

convex profile
- mandibular retrognathism
- variable facial height
- increased overjet
-proclined maxillary incisors
- narrow and tapered upper maxillary arch

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11
Q

describe class II division 2

A

straight to convex profile
- decreased lower facial height
- normal overjet
- deep overbite
- retroclined maxillary central incisors
- labially inclined maxillary lateral incisors

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12
Q

in severe skeletal class II division 1 the lips are:

A

usually incompetent

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13
Q

vertical dimension is usually decreased in class II division 1 or 2?

A

class II division 1

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14
Q

dental crowding in class II division 2 is created by:

A

retroclination of the maxillary central incisors

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15
Q

deep overbite in class 2 division II is caused by:

A

over eruption of the maxillary central incisors and lower incisors

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16
Q

skeletal class II malocclusion components may be classified by:

A
  • maxillomandibular relationship: mandibular retrognathism, midface protrusion or both
  • vertical discrepancy: anterior upper face height often greater than normal and steep occlusal plane
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17
Q

treatment strategies of class II malocclusion are categorized based on:

A

growing and non growing status of patients

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18
Q

what is the treatment of class II malocclusion in growing patients

A

ideally tx should focus first on improving the skeletal discrepancy
- use functional appliances while the individual is still growing - growth modification

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19
Q

what is the tx of choice of class II maloclussion in adults/non growing individuals

A
  • orthognathic surgery: adjusting the position of both in relation to the cranial base in the three dimensions and improving overall facial esthetics
  • dentoalveolar compensation alone: camoflage dental treatment
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20
Q

what is the flow chart for treating dental class II malocclusion

A

-growing -> dentoalveolar correction
- non growing -> camouflage

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21
Q

what is the flow chart for treating skeletal class II maloclussion

A
  • growing -> growth modification and functional appliances
  • non growing -> orthognathic surgery or camouflage
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22
Q

removable functional appliances and headgear therapy depend on:

A

the cooperation of the patient

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23
Q

which removable appliance is used more often

A

twin block

24
Q

what does the twin block do

A
  • promote mandibular growth
  • restrict further forward growth of the maxilla
  • improve skeletal relationships in growing skeletal class II individuals with mandibular retrusion
25
Q

what are the key differences between removable and fixed appliances

A

different working hours (intermittent vs continuous) and optimal treatment timing (before puberty growth vs at or after puberty spurt) and direction of further growth

26
Q

dental changes with fixed appliances including mesial movement of lower molars and proclination of lower incisors were _____ than skeletal changes when compared to removable appliances

A

more significant

27
Q

limited range of treatment for class II skeletal and dental malocclusions in non growing or growing individuals

A

non growing/adults

28
Q

depending on the severity of the malocclusion you can also use

A

class II elastics, compensatory extractions
- maxillary premolars and/or mandibular premolars

29
Q

orthognathic surgical modalities may be used to:

A

alleviate the functional and esthetic problems associated with this type of malocclusion

30
Q

what is done in orthognathic surgery for severe class II malocclusions

A
  • mandibular advancement with or without maxillary impaction (class II openbite)
31
Q

what should be done before orthognathic surgery for severe class II malocclusion

A

proper presurgical orthodontic tooth movements and alignment of arches are essential to maximize the amount of discrepancy correction during surgery

32
Q

what might prevent patients from choosing orthognathic surgery in severe class II patients

A

cost of the surgery and fear of undergoing surgery

33
Q

what malocclusion is the most difficult and complex orthodontic problem to treat

A

class III

34
Q

skeletal class III malocclusion is characterized by:

A
  • mandibular prognathism
  • maxillary deficiency
  • some combination of these two
35
Q

what is the prevalence of class III malocclusions in caucasians

A

1-4%

36
Q

what is the prevalence of class III malocclusion in asians

A

20% of japanese

37
Q

what are the factors for the etiology of class III malocclusions

A

hereditary and environmental

38
Q

more than half of all skeletal class III malocclusions are reported from:

A

maxillary deficiency

39
Q

what is the incidence of class III malocclusions suffering from maxillary deficiency

A

65-67%

40
Q

what are the extraoral features of a class III malocclusion

A
  • concave profile
  • anterior facial divergence
  • prominent lower third of face/chin
41
Q

what are the intraoral features of class III malocclusion

A
  • class III molar and canine relationship
  • narrow upper arch
  • decreased or reverse overjet
  • crowding in upper arch
42
Q

what are the 3 groups of class III malocclusions and describe each

A
  • skeletal: hypoplastic maxilla, hyperplastic mandible or combo
  • dental: anterior crossbite of functional origin
  • pseudo class III: anterior crossbite due to a forward functional displacement of the mandible, CR-CO shift
43
Q

a pseudo class III is not a true class III malocclusion if:

A

corrected early

44
Q

what is the main etiological factor in most cases of a pseudo class III malocclusion

A

retroclined maxillary incisors

45
Q

when and why must an anterior crossbite be corrected

A

as soon as it is deteched to increase the orthopedic effects thereby increasing the long term stability of the treatment results

46
Q

when would you know that a crossbite is functional

A

manipulate the condyles in their physiologic rest position. if the occlusion is end to end then it is probably functional

47
Q

what is the flow chart for treating a skeletal class III malocclusion

A
  • growing -> growth modification
  • non growing -> orthognathic surgery or camouflage
48
Q

what is the flow chart for dental class III malocclusion

A
  • growing -> removable appliance
  • non growing -> orthodontic treatment- elastics
49
Q

what is the treatment of choice for class III malocclusion in growing patients and what is its goal

A
  • maxillary expansion protraction face mask
  • expand upper jaw to accommodate the lower dentition. apply traction to the maxilla to reposition it more anteriorly. slow down growth of mandible
50
Q

a facemask attached to a maxillary expansion appliance to promote anterior maxilla repositioning by:

A

inducing growth at the maxillary sutures

51
Q

the chance of true skeletal change in class III malocclusion appears to decline when?

A

beyond age of 8

52
Q

the chance of clinical success in treating class III malocclusion declines at:

A

ages 10 to 11

53
Q

the principles involved in the comprehensive treatment of class III dentoalveolar malocclusions are:

A
  • relief of crowding
  • level and align arches
  • increase overbite and overjet
  • compensation by over proclination of upper incisors and retroclination of lower incisors
54
Q

what is involved in the late manageemnt of class III malocclusions

A
  • moderate or severe class III anteroposterior skeletal discrepancies, a combo of orthodontic tx and orthognathic surgery at the completion of skeletal growth (earlier in females than males) will be required to create an acceptable and stable class I occlusion
  • usually an anterior and vertical maxillary repositioning is done
  • more rarely a mandibular set back is done
55
Q

what does presurgical orthodontic treatment involve in the late management of class III malocclusion

A
  • align the maxillary and mandibular arches in order that they will coordinate when their respective skeletal bases have been surgically repositioned (decompensation)
56
Q

a short period of orthodontic treatment is often required after surgery in late management of class III malocclusions to finish and detail the occlusion. how long?

A

ideally less than 6 months

57
Q
A

Ortho II (11 decks)

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