Appliance Design (Labs) Flashcards
What are the main components of stainless steel and their %s?
- Iron -72%
- Carbon 0.3%
- Chromium - 18%
- Nickel - 8%
- Titanium - 1.7%
What are the properties of stainless steel that makes it good for use in ortho?
- non-corrosive
- can bend without fracturing
- cheap
- flexible
- non-toxic
- strong
- biocompatible
- ductile
What are the advantages of study casts?
- Good for record keeping
- Good to see the improvements/progress
- Good motivation for patients (can cut teeth off and put wax in place (don’t make too realistic)
- Can look when patient isnt there
- design appliances on it
- more information for a more informed decision
- teaching purposes
- retrospective studies
What are the 3 main aims of ortho treatment?
- good aesthetic outcome
- functional
- stable occlusion
What type of action/movement can removable ortho appliances do? (how do they move teeth?)
they can tip/tilt teeth
Where is the fulcrum in terms of the tooth when using a removable appliance?
at the midpoint of the tooth (between the crown and root)
[we dont bend teeth]
What are the advantages of removable appliances?
- Tipping of teeth (able to move teeth)
- fundamental change. In restorative and dentures we are stabilising teeth
- Give excellent anchorage
- Generally cheaper than fixed orthodontics. Fixed involves attaching brackets on every tooth. URA’s are better tolerated than lowers as tongue
- Shorter chairside time required
- Oral hygiene is easier to maintain (can take them out and clean)
- Non-destructive to tooth surface and no tooth prep required (Composite is used to bond to the teeth - need to etch which is destructive - fixed)
- Less specialised training required to manage
- Can be easily adapted for overbite reduction
- Can achieve block movements (segment and entire section of teeth and move it in one - bit of a problem but will be discussed later)
What are the disadvantages of removable appliances?
- Less precise control movement of teeth (aka limited to just tipping/tilting)
- Can be easily removed by patient (can forget to put back in or not compliant)
- Generally only 1-2 teeth can be moved at one time (fixed can move multiple)
- Specialist technical staff required to construct the appliances
- Rotations very difficult to correct (aka tooth rotated mesially or distally)
What is the acronym used for appliance design?
ARAB:
- Active component
- Retentive
- Anchorage
- Baseplate
What is the active component of a removable appliance?
Any component that will move the teeth through the application of force
When writing the active component on a design sheet, what do you need to state?
- The teeth
- The component
- The wire thickness
What kind of stainless steel wire is used in ortho?
Hard stainless steel wire (soft is never used)
What is the thickness of stainless steel wire used for active components?
0.5mm
What is the thickness of stainless steel wire used for retentive components?
0.7mm
What is the definition of anchorage?
the resistance to unwanted tooth movement (Making sure the teeth we want to move do move and the ones we don’t want to move stay in the same place)
Anchorage is resisting displacement forces. What are 5 examples of the displacement forces that will be experienced in the mouth?
- forces from the tongue (click it on and off)
- mastication
- speaking
- gravity
- the active component - is applying forces to the teeth which will bounce out and can cause the appliance to pop out
Newton’s 3rd law makes anchorage hard. What is Newton’s 3rd law?
for every action, there is an opposite and equal action
What are the 3 functions of the baseplate?
- hold all the components together
- assists with retention (adhesion and cohesion)
- Gives a lot of anchorage
What material is the baseplate made from?
Self-cure PMMA
What thickness of HSSW would be used for an Adam’s clasp on a deciduous tooth?
0.6mm HSSW
What baseplate modification is used to help correct overbites? How does it work?
Flat anterior bite plane
- props open mouth and creates posterior open bite
- Lower teeth continue to erupt and new bone is formed around them
- When FABP is removed the overbite will be reduced
Note: cant be done in older patients as teeth would just over-erupt
What is the size of the FABP and why do we make it this size?
OJ + 3mm
If didnt add extra 3mm then patient would change bite and bite behind the plane - result in the lower anterior teeth proclining and increasing the overjet
How do you resolve an anterior crossbite?
Z-spring and a posterior bite plane to give anterior open bite to allow movement of the tooth in crossbite