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SX #2 > dental deformaties > Flashcards

dental deformaties Flashcards

1
Q

causes of skeletal malocclusion (4 main)

A

trauma
pathology
congenital
developmental

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2
Q

ex of skeletal malocclusion due to trauma

A

condylar fracture

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3
Q

ex of skeletal malocclusion due to pathology

A

radiation when young (anodontica, hypoplasia of mandible)

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4
Q

ex of skeletal malocclusion due to congenital defects

A

clefts (class III due to mx deficiency)

syndromes (treacher collins causes mn deficiency)

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5
Q

ex of skeletal malocclusion due to developmental problems

A

condylar hyperplasia

most malocclusions

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6
Q

most malocclusions are due to …

A

developmental problems

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7
Q

Tec 99 radioactive =

A

condylar hyperplasia?

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8
Q

acromegaly causes…

A

class III

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9
Q

goldenhar’s syndrome =

A

hemifacial microsomia

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10
Q

tx of skeletal malocclusions (broad)

A

growth redirection
ortho camo
orthgnathics

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11
Q

in order for growth redirection to work..

A

the patient needs to still be growing

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12
Q

why do you need to decide if you want to do ortho camo or orthognathics before beginning treatment

A

the ortho movements are opposite for the two treatment options

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13
Q

problems with growth redirection

A

pt must still be growing

TMJ considerations

limited correction possible

compliance and burnout (especially cleft pts)

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14
Q

advantages of orthognathic surgery

A

increased stability
decreased treatment time
improved occlusion
improved esthetics

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15
Q

TADS can do what

A

move the envelope of discrepancy for orthodontic movement

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16
Q

envelope of discrepancy shows a visual of..

A

how far you can move teeth with ortho, growth redirection and surgery

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17
Q

phases of treatment for orthognathics and how long for each

A

pre-sx ortho (12-18 mos)

surgery

post-sx ortho (6 mos)

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18
Q

general dentists role in orthognathic sx

A

will they need veneers, crown lengthening etc

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19
Q

general facial form is defined by what ceph measurement

A

N-A-Pg

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20
Q

Pg (on ceph)

A

tip of chin

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21
Q

t/f: you can identify specific skeletal problems using N-A-Pg

A

false

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22
Q

convex profile indicates:

A

protrusive maxilla
retrusive mandible
combo of both

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23
Q

a convex profile is skeletal/dental class

A

II

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24
Q

concave profile indicates:

A

retrusive maxilla
protrusive mandible
combo of both

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25
Q

concave profile is dental/skeletal class

A

class III

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26
Q

vertical maxillary hyperplasia causes class ___ relationship

A

II

causes mandible to rotate DOWN…chin goes down too…looks class II

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27
Q

vertical maxillary deficiency causes ___ relationsihp

A

class III

28
Q

an open bite is indicative of..

A

class III

29
Q

% occurrence for class II, how many need surgery?

A

10% occurrence

2% need surgery

30
Q

which is harder to correct surgically: class II or III

A

class II

31
Q

% occurrence for class III, how many need surgery?

A

2.5% occurrence

40% need surgery

32
Q

which is more likely to need surgical correction: class II or III

A

class III (good thing is its easier to correct)

33
Q

t/f: patients often look worse during pre-sx ortho phase

A

true

34
Q

can you get accurate occlusion from a CT scan

A

no, fillings cause scatter

35
Q

when is a female’s mandible done growing

A

13-14 yo

36
Q

“my incisors stick out” why?

A

retrognathic mn

37
Q

why do you place a k-wire on the nasion during surgery

A

to determine vertical position

38
Q

what dimension does the stent determine during sx

A

AP and transverse

39
Q

with a BSSO forward advancement, do you get a gap in the space you advanced?

A

no, you slide the segments (you dont need a bone graft)

40
Q

anterior horizontal osteotomy =

A

genioplasty

41
Q

can a BSSO go forward or backward

A

yes

42
Q

when would a BSSO be unstable

A

correcting anterior open bite (counterclockwise rotation)

43
Q

major risk of BSSO

A

damage to IAN

avoid if you correctly split around the nerve, but this is harder to do the older the patient

44
Q

t/f: direct damage to IAN is rare during BSSO

A

true

45
Q

what is most important to do before removing teeth or doing BSSO

A

CONSENT–make sure they know about paresthesia

46
Q

at least ____% of BSSO pts will have some IAN, damage, but ___% are satisfied with the procedure

A

50% will have numbness but 90% are happy

47
Q

t/f: damage to IAN during BSSO procedure will induce lingual paresthesia

A

FALSE, lip and chin only

48
Q

t/f: any damage to IAN during BSSO will result in profound/complete numbess

A

nope just parasthesia. disathesia is UNCOMMON

49
Q

which is more stable: maxillary advancement or setback

A

advancement

50
Q

t/f: with a le fort sx you can move the maxilla in all planes

A

true

51
Q

a le fort surgery is a good, stable option for correction of anterior open bite

A

true

BSSO to correct anterior open bite is NOT stable

52
Q

t/f: internal rigid fixation is possible for both BSSO and le fort procedures

A

true

53
Q

what condition would cause a skeletal deficiency due to oligodontia and what treatment might be appropriate?

A

ectodermal dysplasia, le fort 1, pack sinus with hip graft

54
Q

why are cleft patients different/more difficult?

A

scar tissue makes it harder to move, they have BIG A-P problems (large moves)

VP incompetence, vascular compromise, palatal/nasiolabial fistulas

55
Q

is the envelope of discrepancy larger or smaller for cleft patients

A

smaller (scar tissue)

56
Q

t/f: MMA (OSA surgery) has been shown to remove need for CPAP in 100% of patients in one study

A

true

57
Q

who would be a good candidate for OSA surgery (max/mn advancement)

A

non-obese patients

unable to tolerate CPAP

no evidence of redundant pharyngeal soft tissue

58
Q

what is the morbidity for orthognathic surgery

A

very low (unless obese OSA pt)

59
Q

do patients stay overnight for orthognathics

A

usually overnight, you can do it in outpatient in OMFS clinic though

60
Q

do you usually need to do IMF for orthgnathics

A

no

61
Q

incisions are intra/extra oral for orthognathics

A

intraoral

62
Q

satisfaction rate for orthognathics

A

98%

63
Q

how long do you keep rubber bands on after orthognathics

A

3 days

64
Q

how long are pts on liquid diet after orthognathics

A

3 days (when rubber bands are on)

65
Q

how long should an orthognathic pt stick to soft diet

A

6 weeks

66
Q

how to fix open bite without moving mandible?

A

take interference out of mx posterior

67
Q

what muscles will pull and reopen an open bite after correction surgically

A

masseter, temporalis

SX #2 (6 decks)

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