Concepts of Growth and Dev. Pt 2 Flashcards

1
Q

what is the most common reason to remove mand. 3rd molars?

A

To prevent incisor crowding

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2
Q

In class we covered 2 studies regarding 3rd molars as the cause of mandibular incisor arch crowding. What did each conclude?

A

1-the removal of third molars to reduce or prevent late incisor crowding cannot be justified
2- there was not enough evidence to incriminate third molars as being the only or even a major etiologic factor in the late lower dental arch crowding

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3
Q

One theory is that crowding develops as the mandibular incisors, and perhaps the entire mandibular dentition moves in what direction?

A

distally relative to the body of the mandible.

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4
Q

what other factors may be responsible for mandibular crowding?

A

1-posterior wear
2- stress, clenching, grinding
3-changes in muscular forces

**ultimately the cause is unknown

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5
Q

based on a study, who is more likely to recommend prophylactic removal of 3rd molars, surgeons or orthodontists?

A

Surgeons

*orthos are increasingly under the thought that 3rd molars do not cause incisal crowding

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6
Q

what is intrauterine molding?

A

distortions on the face or body due to pressure against the baby while in utero.

*baby’s arm pressed against his face can result in a facial depression because there is a decrease in amniotic fluid to that area

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7
Q

Pierre Robin Sequnce

A
-small jaw
     tongue falls back in throat
difficulty breathing
-cleft palate
-acid reflux
-sox 9 gene
-AD
-Repeated ear infections
-Teeththat appearwhen the baby is born (natal teeth)
- congestive heart failure
-hypertension
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8
Q

Pierre robin sequence TX

A
  • break the jaw and use a device to move the jaw forward
  • lip-tongue adhesion to tether tongue anteriorly

*fix cleft palate, may beed tracheotomy, tympanostomy tubes, monitor

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9
Q

what evidence is there that the mandibular condyle is not a growth center?

A

if the lateral pterygoid muscle rips the head of the condyle off, there is no growth impairment

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10
Q

if the condyle breaks off and resorbs what happens?

A

80% chance it will regenerate from the periosteum

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11
Q

5 late causes of TMJ injuries

A

1-Facial asymmetry,
2-Malocclusion,
3-Growth disturbance, 4- Osteoarthritis,
5- ankylosis (fusion across the joint so that motion is impaired

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12
Q

if TMJ trauma occurs, the px can experience what 5 things?

A

1-Limited opening and excursive movements
2-Deviation of opening
3-Malocclusion manifesting in cross-bites
4-Short ramus height
5-Hyper-eruption of the teeth on the opposite side, infra-eruption on the ankylosised side

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13
Q

what is the most common cause of facial asymmetry in regards to the condyle?

A

trauma–the condyle may fail to grow vertically

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14
Q

Cleft lip results from failure of what to fuse?

A

maxillary swelling to fuse with the intermaxillary process

*can be unilateral or bilateral

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15
Q

cleft palate results from what failing to fuse?

A

two palatine shelves

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16
Q

In patients with bilateral cleft lip, the _________ is situated too far forward beyond the tip of the nasal septum

A

primary palate

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17
Q

cleft lip may be caused by what 3 drugs?

A

1-phenytoin
2- vitamin A
3-Methotrexate

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18
Q

what 4 drugs can cause cleft palate

A

1- phenytoin
2- Vit. A
3- corticosteroids
4-cigarette smoke

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19
Q

How common is cleft lip

A

1 or 2 out of 1000

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20
Q

clefts are more common in ?

A

Asian, Latino, or Native American descent

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21
Q

what state has highest cleft incidence?

A

Utah at 2.2/1000

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22
Q

babies born with a cleft lip or palate will have trouble eating. what do you do?

A

make a good seal in oral cavity, make sure baby doesn’t choke, use obturator

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23
Q

Muscular derangments in cleft lip and palate patients cause the malformation of what muscles to worsen?

A

1-The superior pharyngeal constrictor muscle attaches to the posterior aspect of the maxillary palatal shelves.
2-orbicularis oris

24
Q

before surgery what device is used as a orthopedic tx?

A

1-The nasoalveolar molding device or NAM is a very elaborate passive or active device

**made of acrylic and later in tx wires are added for protracting forces of nares and coumella

25
Q

what is a Latham device

A

intraoral device to bring palate loser together

*will require an extra surgery

26
Q

when should surgery for lip closure be done?

A

3-6 months of age and baby weighs at least 10 lbs

27
Q

beyond lip repair, what 4 things will need to be improved?

A

1-hearing
2-speech
3-dental work
4-psychosocial integration issues

28
Q

. Cleft lip surgery is usually done before age ___ months, and cleft palate surgery is done before ___months

A

12, 18

29
Q

what is the goal of surgical tx for cleft palate?

A

to create a palate that works well for speech.

30
Q

As kids grow older, they might need additional surgeries, such as an ____ ____ ___ which is used to close the gap in the bone or gums near the front teeth.

A

alveolar bone graft,

31
Q

TX of Diagnostic examination, general counseling of parents, feeding instructions, palatal obturator (if necessary); genetic evaluation and specification of diagnosis; recommendation of a protocol for the prevention of a cleft recurrence in the family
is done when?

A

newborn

32
Q

when is repair of cleft lip done?

A

3 months

33
Q

at what age is Presurgical orthodontics (if necessary) part of tx; first speech evaluation

A

6 months

34
Q

at what age does speech therapy begin?

A

9 months

35
Q

at what age does repair of cleft palate happen?

A

9-12 months

36
Q

at what age does ortho tx really begin?

A

1-7 yrs

37
Q

at what age is a alveolar bone graft considered?

A

7-8 years

**used to close the gap in the bone or gums near the front teeth to provide stability for perm. teeth

38
Q

at what age does ortho tx continue?

A

older than 8 yrs

39
Q

what cause central sleep apnea?

A

your brain doesn’t send proper signals to the muscles that control your breathing.

40
Q

what causes obstructive sleep apnea?

A

you can’t breathe normally because of upper airway obstruction

41
Q

3 risk factors for sleep apnea

A

1- large tonsils
2- obesity
3-syndromic kids (Crouzon, Down Syndrome, Pierre Robins, etc)

42
Q

besides sleep apnea, what other thing can cause kids to lose sleep?

A

food, exercise or emotions, electronics, bad night routine

43
Q

sleep for 0-12?

A

14-15 h/day

44
Q

sleep for 1-3yrs?

A

12-14 h

45
Q

sleep for 3-6yrs?

A

10-12 h

46
Q

sleep for 7-12 yrs?

A

10-11 h

47
Q

sleep for 12-18 yrs

A

8-9 hs

48
Q

what are physical signs of a px at risk for obstructive sleep apnea?

A
1-Small triangular chin
2-Retruded mandible
3-Flat alar cartilages of nose
4-Steep mandibular plane angle
5-High palatal vault
6-Long, oval-shaped face (adenoid facies)
7-Long soft palate
8-Large tonsils (3 or 4)
9-Anterior openbite
10-Posterior crossbite
11-Mouth breather
49
Q

definition of sleep apnea

A

stoppage of breathing for 10+ seconds

50
Q

what 2 imaging technologies may be used to evaluate airway obstruction?

A

cone beam and radiographs

51
Q

should a dentist diagnose sleep apnea?

A

no

52
Q

should dentists be aware of a px with sleep apnea?

A

yes, include in health history

53
Q

If you think you px is at risk for sleep apnea, what do you do?

A

refer to ENT

54
Q

what device can a dentist make to help with snoring?

A

class 2 correctors

55
Q

what help can a maxillary expander offer for sleep apnea?

A

Increases the size of the maxilla and decreases nasal airway resistance.

56
Q

how could an extraction for ortho purposes cause sleep apnea?

A

1-smaller arch forms
2-less space for tongue
3-tongue is forced posteriorly
4-sleep apnea

*extraction doens’t mean that apnea will occur