BDS4 Risk and benefits to ortho Flashcards
what are needs to iotn dhc?
1 & 2 No Need/Low Need
(min benefit)
3 Borderline Need
(some benefit)
4 & 5 Need/High Need
(significant benefit)
what does MOCDO mean?
- MISSING TEETH
- OVERJET
- CROSSBITES
- DISPLACEMENT of contact points
- OVERBITES
effects of impacted teeth?
- cause resorption
- supernumerary prevent normal eruption
- can be associated with cyst formation
what size is big risk with overjet and why and when is it worse?
- Overjet >6mm
- risk of trauma to upper incisors
- worse with incompetent lips
what is associated with anterior crossbites?
- loss of perio support
- tooth wear
what may posterior crossbites lead to?
- significant - lead to
*asymmetry
*requiring early correction
what does deep traumatic overbites lead to?
- gingival stripping
- loss of perio support
what are 5 big risks to ortho? and couple others
- decalcification
- root resorption
- relapse
- soft tissue trauma
- recession
others
*loss perio support
*FTA
what is decalcification
- loss of calcium and weakens enamel to caries
how to prevent decal?
- Case selection
- Oral Hygiene
- Diet advice
- Fluoride
what is a good case selection?
- motivated pt
- good OH pre tx
- low caries risk
- if low or borderline need - best avoid tx
what is fluoride of mw?
225ppm - 0.05% f mw
what is percentage of sevre root resorption
1-5%
how much do teeth get resorbed in ortho?
average approx 1mm over 2 years fixed applianced
inevitable consequence
what teeth are most affected to root resorption?
any teeth but
UI > LI >6s
what are risk factors to root resorption?
– Type of tooth movement
*Prolonged, high force
*Intrusion
*Large movements
*Torque (root movement)
– Root form - blunt, pipette, resorbed already – Previous trauma
– Nail biting ?
what are features most prone to relapse?
– Lower incisor crowding
– Rotations
– Instanding 2’s
– Spaces & diastemas
– Class II div 2
– Anterior open bites
– Reduced perio support/short roots
how to manage relapse?
- case selection
- informed consent
- retainers - fixed and removable
how to prevent relapse after tx?
- Removable retainers
–Clear Occlusal retainer (COR)
–Pressure or vacuum formed (PFRs/VFRs)
– Essix
– Hawley type - good for occlusion - Remove for OH
- Can wear part time
- Patient control
- Easy to spot problem
what is important to know about fixed retainers?
- prone to plaque and calculus buildup
- Need excellent OH
- Tend to leave in situ for life
- Require more care/ long-term maintenance
what do you tend to for fixed retainers
- place vacuum formed retainer on top
what are types of soft tissue trauma for ortho?
- pain/discomfort
- ulceration
what is management of recession?
- Correct tx planning - teeth within bone avoid over expansion
- Thin biotype
- Warn Pt
- Gingival graft
what must you do with active perio disease and ortho tx?
– Must be treated, stabilised, maintained before ortho tx starts
– During ortho Tx – accelerates alveolar bone loss and perio
destruction
– Treated as priority over continuing Tx
what is prevention of headgear trauma?
Safety mechanisms - 2 minimum
* Snap away traction spring
* Nitom facebow
* Masel strap
what are allergies related to ortho tx
- Latex
- Nickel
- Adhesive - colophony
what is sucess of tx dependent on?
– severity of malocclusion
– motivation of patient
– operator expertise
why is fta/poor tx a risk?
clinician
*poor diagnosis
*poor tx planning
*operative technique error
patient
*unfavourable growth
*poor co-op
