Clinical Dentistry Handbook

Question 1

impacted upper first permanent molars

Answer 1

2-6%

Question 2

infraoccluded primary molars

Answer 2

8-14%

Question 3

Balancing/Compensating extraction

Answer 3

B: extn of same tooth on the opposite side of arch to preserve symmetry

C: extn of same tooth in opposing arch

Question 4

Lower 2nd premolars extraction of choice in lower

Answer 4

Extn alters the anchorage balance.
Favours the closure by forward movement of molars.

Question 5

Transposition

Answer 5

Maxilla: 3 usually transposed with 4
Mandible: 3 usually transposed with 2

Question 6

Palatally displaced ectopic canine

Answer 6

2%
17-25% bilateral
F>M
Management: interceptive ext of c

Question 7

Increased overbite

Answer 7

Normal o/b is between 1/3 and 1/2 overlap of lower incisors
inter incisal angle is usually 135 degrees
management:
CII D I - Avoid extn excpt in cases of crowding. Moderate/Severe inc ob best treated with FA to close space by forward movement of buccal segments and to correct incisor relationship.

C II D I ob dec before oj dec. functional appliance is indicated for AP correction then ob can be reduced by trimming the appliance to allow eruption of lower molars. if headgear is being used then it may be helpful to commence ob reduction with a URA with a flat anterior biteplane, clipped over the bands on the upper molars.

CIII avoid reducing ob as it will aid retention of the corrected incisor position.

Question 8

AOB

Answer 8

tx - TAD

Question 9

X bites

Answer 9

Post x-bite: skeletal
CII -lingual
CIII - buccal
Uni: greater the no of teeth involved in post crossbite the greater the skeletal contribution.
RME: screw appliance with bands on UR64 and UL46. Object is to expand maxilla by opening midline suture. 0.2mm 2 x a day for 2 wks
Quad helix: slow exp. 1mm SS attached to UR6 and UL6. 1/2 tooth width per side during placement.

Question 10

Anchorage

Answer 10

Source of resistance to reaction from active components.
Amount of forward movement depends on root surface area and force used.
E/O:
Anchorage - 250g for 10h/day
Traction - 500g 14-16h/day
Reinforcement:
CII - LR6 to UR3 and LL6 to UL3
CIII - UR6 to LR3 and UL6 and LL3

TADs: implants used to provide skeletal anchorage

Question 11

Removable appliances

Answer 11

Indications:
buccal xbite
upper incisor xbite
ob red
dist movement upper molars w/headgear
elim occlusal interference

practical components:
active - spring/screws
retention - adam crib 0.7mm, labial bow 0.7mm
baseplate - heat cure more robust than self cure

Question 12

Fixed appliances

Answer 12

Components:
Bands on molar teeth
GI cement
Auxiliaries to hold wires to brackets

Question 13

Functional appliances

Answer 13

utilise, elim, guide forces
indicated for AP correction CII

CTB: posture mandible forward
mandible postured 7-10mm forward
blocks >5mm high

MOA: dec LFH, eruption of lower molars

Herbst: rapid AP correction