BDS3 ortho tx planning

Question 1

what are stages of treatment planning?

Answer 1

1. Plan around the lower arch (angulation of LLS is stable)
2. Decide on treatment in lower (ext/nonext)
3. Build upper arch around lower
   aim for class I incisor and canine relationship (OJ and OB normal*)
4. Decide on molar relationshipClass I or full unit class II molar relationship

(*if upper and lower incisors normal size, shape and number)

Question 2

what do you look to examine in lower arch?

Answer 2

• Crowding / Angulation of incisors Mand plane
• Angulation of the canines / Centrelines
• Curve of Spee

Space required? What are the options?
Extraction or non extraction?

Question 3

what do you look to examine in upper arch?

Answer 3

• Crowding /Angulation of incisors to the Max Plane
• Angulation of the canines / Centrelines

Question 4

what do you examine when teeth in occlusion ICP?

Answer 4

Incisor relationship
OJ
OB (curve of Spee)
Centrelines
Canine relationship
Molar relationship

Question 5

what are the general principles in space required in lower arch?
if mild (0-4mm)

Answer 5

non-ext (stripping)
ext 5’s

Question 6

what are the general principles in space required in lower arch?
if moderate (5-8mm)

Answer 6

ext 5’s
ext 4’s

Question 7

what are the general principles in space required in lower arch?
if severe (8+mm)

Answer 7

ext 4’s

Question 8

what are the general principles to consider when considering lower arch extraction when yes and no?

Answer 8

yes
- extract in upper arch (MR class I)

No
- extract in upper arch (MR class II)
- Distalise UBS using headgear (MR class I)

Question 9

what are treatment options?

Answer 9

1. Accept malocclusion
2. Extractions only
3. URA
4. Functional appliances
5. Fixed appliances
6. Complex treatment involving orthodontics and restorative treatment or orthodontics and orthognathic surgery

Question 10

what are limitations of ortho treatment?

Answer 10

• little effect to skeletal pattern just dento-alveolar
• tooth movement limited by size, shape of alveolar processes
• Teeth will only remain stable in a position where there ise quilibriumbetween the
  -forces of the soft tissues,
  -the occlusion and
  -the periodontal structures.
  All other positions are unstable and will be prone to relapse.

Question 11

what do you asses clinical for anterior cross bites?

Answer 11

 Displacement?
 Mobility of lower incisor
 Tooth wear
 Gingival recession

Question 12

why treat anterior open bite early?

Answer 12

o To maximise potential for spontaneous correction of anterior open bite whilst there is still eruptive potential for incisors (8-10 years/ root formation still incomplete)
o To prevent effects on vertical and transverse skeletal development which could lead to permanent skeletal change if habit persists

Question 13

what are steps of digit habit management?

Answer 13

o 1. Positive reinforcement
o 2. Bitter-tasting nail varnish
o 3. Glove on hand, Elastoplast
o 4. Habit breaker appliance (habit deterrent) – fixed or removable