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F - SCR > BDS3 interceptive ortho important > Flashcards

BDS3 interceptive ortho important Flashcards

1
Q

what is definition of interceptive ortho?

A

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

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2
Q

how is space gained to accomomadate larger anterior teeth of the permanent dentition?

A
  • increase in the intercanine width through lateral growht of jaws
  • upper incisors erupting onto a wider arc
  • leeway space
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3
Q

what is leeway space of upper arch?

A

primary canine + first molar + second molar

minus

permanent canine + first premolar + second premolar

=

1 to 1.5mm

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4
Q

what is leeway space of lower arch?

A

primary canine + 1st molar + 2nd molar

minus

permanent canine + 1st premolar + 2nd premolar

=

2 to 2.5mm

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5
Q

what is diastema?

A

gap in between teeth

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6
Q

what are the management options if a first permanent molar gets stuck between the ‘e’ and fails to fully erupt?

A
    1. If patient <7years wait 6 months (90% self correct)
    1. Orthodontic Separator
    1. Attempt to distalise the first molar
    1. Extract E
    1. Distal disking of ‘e’
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7
Q

what is case assessment of unerupted central incisors?

A
  • Case history –esp. regarding trauma
  • palpate labially and palatally
  • if retained Primary tooth present, Is primary mobile? Is it discoloured ?
  • Radiograph (AOM/ Periapical)
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8
Q

how to deal with unerupted central incisor?

A
    1. Remove primary teeth & Supernumeraries
    1. Create space/maintain space
    1. Monitor for 12 months
      If patient < 9 years (immature root apex)
      Still fails to erupt? OR patient >9 years (mature root apex)
    1. Expose/bond gold chain and apply orthodontic traction
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9
Q

what does early loss of decidous teeth cause?

A

localised crowding

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10
Q

how does the effect of localised crowding from early loss of deciduous teeth vry?

A
  • Degree of crowding already present
  • Age
  • Which arch? Which tooth?
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11
Q

what is a balancing extraction and why?

A

o Balancing Extraction = removal of a tooth from the opposite side of the same arch
Why?
 To maintain the position of the dental centreline (preserve symmetry)

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12
Q

what is a compensating extraction and why?

A

o Compensating Extraction = removal of a tooth from the opposing quadrant
Why?
 To maintain the buccal occlusion.

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13
Q

what is management of early loss of A’s and B’s?

A

 little impact
 don’t balance or compensate

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14
Q

what is management of early loss of C’s

A

balance

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15
Q

what is management of early loss of D’s?

A

small CL. shift, balance under GA?

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16
Q

what is management of early loss of E’s

A

 tend not to balance
 major space loss
 upper>lower
 Consider space maintainer- this main one

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17
Q

describe compensating for a C?

A

if you remove an upper C you gotta remove a lower C

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18
Q

what is a type of removable space maintainer?

A

passive URA

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19
Q

what are typical components of passive URA?

A

o Retention e.g. clasp UR6,UL6 (0.7mmHSSW) Labial bow UR3 to UL3 (0.7mmHSSW) OR Southend clasp (0.7mmHSSW)
o Baseplate – extend acrylic around teeth to prevent unwanted mesial drift
o +/-Mesial Stop (0.6mm HSSW) on individual teeth if required

20
Q

what would factors of extracting carious 6’s be?

A

o Age of patient / stage of dental development
o Degree of crowding
o Malocclusion type

21
Q

when would the most ideal result of extracting carious 6’s?

A

o 7’s bifurcation calcifying
o 8’s present
o Class 1 av/reduced OB
o Moderate lower crowding
o Mild/moderate upper crowding

22
Q

what are general rules for extracting class 1 6’s?

A

o If extracting lower take upper
o Don’t balance with sound tooth. Don’t balance if well aligned or spaced.
o If extracting upper don’tneed to take lower.

23
Q

what are general rules for extracting class 1 6’s?

A

o If extracting lower take upper
o Don’t balance with sound tooth. Don’t balance if well aligned or spaced.
o If extracting upper don’tneed to take lower.

24
Q

how to clinically assess anterior cross-bites?

A
  • displacement
  • mobility of lower incisor
  • tooth wear
  • gingival recession
25
Q

what are types of cross bite?

A
  • Posterior Unilateral Crossbites
  • posterior cross-bites
  • anterior cross-bites
26
Q

when is treatment of posterior unilateral cross bite needed?

A

only if it shifts midline by >2mm. so if pt bites down and between the motion to RCP he laterally shifts >2mm then thats treatment needed

27
Q

what is digit habit management?

A
  1. positive reinforcement
  2. bitter-tasting nail varnish
  3. glove on hand, elastoplast
  4. habit breaker appliance (habit deterrent) - fixed or removable
28
Q

breakdown interceptive ortho and what you do and for what?

A

-unerupted incisors - remove ob/space/obs
- impacted 6’s - observe 6/12 or intercept
- balance c’s - but not critical
- carious lower 6’s - take upper
- uni cross bites - IOTN displacement?
- habits - stop before 9

29
Q

what can be used to help fix habits?

A

detterents apliance

30
Q

what is the aetiology of infra occluding teeth?

A

ankylosis of primary tooth. surrounding alveolar bone continues to grow. primary tooth gets left behind?

31
Q

what is the diagnosis of infra occluding teeth?

A
  • perucssion
  • check for mobility
  • radiographs
32
Q

what do you assess radiograph for with infra occlusion?

A
  • presence /absence of successor
  • Ankylosis of primary tooth (no PDL space/no clear lamina dura)
  • Root resorption of primary
33
Q

what do you do if permanent successor is present when dealing with infra occlusion?

A
  • Monitor 6-12 months
  • Extract if primary tooth is below the interproximal contact point
  • Consider extraction if root formation of successor near completion
  • If extract …..maintain space
  • Be more vigilant in upper arch
34
Q

how long do you monitor permanent successor present for infra occlusion?

A

6- 12months

35
Q

when do you extract if permanent successor is present when dealing with infra occlusion? and what do you do after if you extract?

A
  • Extract if primary tooth is below the interproximal contact point
  • Consider extraction if root formation of successor near completion
  • If extract …..maintain space
36
Q

what are risks of doing nothing if permanent successor is present when dealing with infra occlusion?

A
  • Permanent successor can become more ectopic
  • Infra-occlusion worsens with tipping of adjacent teeth - primary tooth becomes inaccessible for extraction
  • Caries and periodontal disease
37
Q

when does infra occlusion worsen?

A
  • Infra-occlusion worsens with tipping of adjacent teeth - primary tooth becomes inaccessible for extraction
38
Q

when dealing with infra occlusion what does treatment plan depend on if permanent successor is absent?

A

o degree of crowding
o degree of infra-occlusion
o any other features of malocclusion ?

39
Q

when dealing with infra occlusion what do you do if you extract when permanent successor is absent?

A

plan space mangement
o Either maintain space for prosthetic tooth
o Reduce space to one premolar unit ( requires fixed appliance)
o Close space ( fixed appliance)

40
Q

in delayed eruption when should you assess position of upper canines?

A
  • Assess position of upper canines from (9 to) 10 years onwards
  • Should palpate by 11 years
  • Mobile C’s, symmetry
  • Angulation of lateral incisors
41
Q

when is extraction fo the c’s likely to be successful?

A

o Patient is age between 10-13 years
o The canine is distal to the midline of the upper lateral incisor
o There is sufficient space available
o The canine is less than 55 degrees to mid-sagittal plane

42
Q

what are the risks of doing nothing when dealing with ectopic primary maxillary canines?

A

o Permanent successor can become more ectopic
o Permanent canine then fails to erupt (Impacted Canine)
o Risk of root resorption of adjacent teeth
o Risk of root resorption of canine crown (lower risk)
o Risk of cyst formation around canine (rare)

o Permanent canine can become ankylosed (incidence tends to increase with age)

43
Q

what are the options for growth modification for interceptive treatment of class III?

A
  • Protraction headgear +/- RME (rapid maxillary expansion)
  • Functional appliances e.g.Reverse Twin Block / Frankel III
44
Q

when is growth modification in class III most successful?

A
  • skeletal I or only mild class III
  • maxillary retrusion
  • anterior displacement on closing
  • avergae or reduced lower face height
  • patient age 8-10 years
45
Q

what are possible environmental factors of malocclusion?

A

 masticatory muscles
 mouth breathing
 head posture

46
Q

why tx increased overjet early?

A
  • Risk of trauma - incompetent lips
  • Appearance – bullying/ patient self- esteem
  • More difficult to achieve correction once patient stopped growing
47
Q
A

F - SCR (32 decks)

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