Dental Relapse and Adults

Question 1

What are two major causes of orthodontic relapse?

Answer 1

1-Continued Growth

2-Tissue rebound

Question 2

Active retention takes what two forms?

Answer 2

1-extra oral force in conjunction with retainers (head gear)

2-Funcitonal appliance

Question 3

Which fibers keep teeth in contact and do not have an osseous attachment?

Answer 3

Periodontal Trans-septal fibers

Question 4

What are two ways to deal with tissue rebound?

Answer 4

1-Over treatment

2-Adjunctive periodontal surgery

Question 5

How much should you over treat class II, II or crossbite in order to overcome tissue rebound relapse?

Answer 5

1-2 mm

Question 6

What are the 3 most popular types of retainers?

Answer 6

1-Hawley retainer
2-Clear essix
3-Bonded permanent retainer

Question 7

What two types of bone can be identified according to pattern of collagen forming in osteoid?

Answer 7

1-Woven (haphazard organization)
2-Lamellar (parallel alignment)

*12 weeks for woven to mature to lamellar

Question 8

How long does reorganization of the PDL take?

Answer 8

3-4 months

*Full time retainers during this time.

Question 9

Which procedure involves cutting down to the crest of the alveolar bone around the labial and lingual gingival margins to sever periodontal fibers?

Answer 9

Circumferential supracrestal fibrotomy (CSF)

*alternatively, incisions through the papilla can be made

Question 10

Severing periodontal fibers is most effective in reducing relapse of what?

Answer 10

Rotated teeth

Question 11

A frena that is attached too closely to the gingival margin can cause what?

Answer 11

Gingival recession

*Also midline diastema

Question 12

What are 6 benefits for adult orthodontics?

Answer 12

1-Cleansability
2-Correct osseous defects
3-Esthetics
4-Force eruption
5-Gingival embrasure correction
6-Improve spacing for implants

Question 13

What hard to cleanse feature forms as the second molar drifts into the edentulous space where the first molar once was?

Answer 13

A pseudopocket

*ortho can correct this to make it more cleanable and restorable

Question 14

_____ crown movement leads to increase space for implants and bridge while _____ root movement reduces space

Answer 14

Distal

Mesial

Question 15

What is the likely cause of slow progress in the movement of molar uprighting?

Answer 15

Occlusal interference

Question 16

What scenario of uprighting adult teeth will require a different approach and more time?

Answer 16

If both second and third molars need to be uprighted

Question 17

What might need to be done if the patient needs a crown uprighted but has a steep mandibular angle?

Answer 17

Crown reduction to align with occlusal plane

Question 18

Which type of periodontal defects can be improved with orthodontics?

Answer 18

1 wall and sometimes Two wall

*not used for 3 wall defects

Question 19

How long after a bone graft can ortho be started?

Answer 19

6 months if the area is stable

Question 20

Rather than using anatomy, what is used to determine bracket placement in adult patients?

Answer 20

Inter proximal Bone level

Question 21

What bone level related lesion is the most difficult to maintain and can worsen during ortho?

Answer 21

Furcation lesions

*2-3 month recall schedules

Question 22

Crown lengthening surgery should be done prior to orthodontic intrusion to achieve how much ferrule?

Answer 22

at least 1.5 mm

Question 23

What is the typically freeway space?

Answer 23

2-4 mm

Question 24

How does the bone and gingiva typically react to slow extrusion?

Answer 24

it follows the eruption of the tooth

*less likely with rapid extrusion but ankylosis becomes more likely

Question 25

What is the ideal crown to root ratio

Answer 25

At least 1:1

Question 26

If a tooth fractures to the level of the bone, how far must the tooth be erupted?

Answer 26

4 mm

*2.5 mm for biologic width and 1.5 for ferrule

Question 27

The height between the deepest point of the gingival sulcus and the alveolar bone crest is called what?

Answer 27

Biologic width

*violating this causes iatrogenic periodontal disease

Question 28

As a general rule the width of the root canal space should not be more than one third of what?

Answer 28

The overall width of the root

Question 29

What are 6 criteria that determine if a tooth should be forcibly erupted?

Answer 29

1-Root length
2-Root form
3-Level of fracture
4-Importance of tooth
5-Esthetics
6-Endo/perio prognosis

Question 30

If the entire crown is fractured 2 to 3 mm apical to the level of the alveolar bone how likely is it that you can erupt it for a restoration?

Answer 30

Very difficult if not impossible

Question 31

High lip line smiles display how much gingiva?

Answer 31

2-3 mm