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Orthodontics > Expansion And Quad Helix > Flashcards

Expansion And Quad Helix Flashcards

1
Q

Method of expansions?

A
  • Upper removable appliance with midline screw
  • Expanded stainless steel arch wire
  • Cross elastics
  • Expansion arch
  • Rapid Maxillary Expansion (RME)
  • Quadhelix
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2
Q

Upper removable appliance with midline screw

A
  • Patient or parent turns screw once/ week (0.25mm expansion)
  • Not suitable if maxillary Teeth are buccally tipped.
  • Problem - compliance , should be avoided poorly controlled epileptic patients ( Risk to airway from displacement during seizure)
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3
Q

Expanded Stainless steel archwire

A
  • Ideally large dimension 0.019x 0.025ss
  • Expanded extra orally and tied into brackets.
  • Useful - Co ordinate upper and lower arch
  • only possible once in stainless steel wire.
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4
Q

Cross elastics

A
  • Patient places elastics daily
  • From Upper palatal button to buccal hook
  • Careful monitoring needed - can cause molar extrusion which can be reduced with rigid SS archwire.
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5
Q

Expansion arch

A
  • Large dimension auxiliary archwire 1mm around SS.
    -Placed in HG Tubes, cinched and ligated anteriorly.
  • Bulky/ patient discomfort (rarely used)
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6
Q

Rapid Maxillary Expansion (RME)

A
  • Dental and skeletal expansion 2:1 (sk 40% expansion)
  • Patient less than 15yrs old
  • Screw turned -Hyrax once a day (0.2-0.5/day) for 1-3 weeks (midline diastema develops quickly).
  • Evidence that mid- palatal suture does split producing maxillary expansion.
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7
Q

What is Quadhelix?

A
  • Fixed expansion appliance
  • 4 x helices
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8
Q

Quadhelix - why used in ortho tx?

A
  • Anterior posterior expansion
  • Does not rely on compliance
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9
Q

Quadhelix appliance- Mode of action:

A
  • Expansion primarily buccal tipping of maxillary posterior teeth
  • Some skeletal expansion may be achieved depending on age of patient but mainly dental.
  • Prepubertal childer 6:1 ratio of molar tipping : Skeletal expansion .
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10
Q

Advantages of Quadhelix

A
  • Provide some differential expansion
  • Can derotate molars
  • No need of pt compliance like URA
  • Good retention
  • Can be used with Fixed appliance
  • More cost effective than URA
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11
Q

Disadvantage of Quadhelix

A
  • Molar tipping and buccal flaring of molars
  • Limited skeletal change
  • Patient discomfort
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12
Q

Indications for Quadhelix

A
  • Posterior crossbite correction
  • Expansion for upper narrow arch
  • improvment of upper arch crowding
  • Habit breaker
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13
Q

Contraindications for Quadhelix

A
  • Active periodontal disease
  • Patient non- compliance or lack of co-operation
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14
Q

Types of Quadhelix

A
  • Fixed & removable
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15
Q

Removable Quadhelix advantages .

A
  • Easily removed and reinserted , avoiding debanding & recementation
  • Extra oral activation is simple and precise
    -Can be left in place during tx or it can be removed without the need for new molar bands
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16
Q

Removable Quadhelix - Disadvantages

A
  • During fitting, important to avoid distortion of retention loops.
  • Retention loops sometimes require adaption before they lie passively in the sheaths.
17
Q

Types of Quadhelix- Different designs

A
  • Bilateral expansion of molars only
  • Bilateral rotation of molars
  • Unilateral rotation of molar
  • Asymmetrical expansion.
18
Q

Appointment steps and constructing Quadhelix

A

Visit 1 - Place separators upper 6s’

Visit 2- Band upper 6s’ / Upper impression with bands in situ for Quadhelix construction. Replace seps/ bands to maintain space for Quadhelix fit.

Visit 3- Fit Quadhelix with GIC

19
Q

Quadhelix insertion and activation step 1

A
  • Clean and sterilise appliance
  • Ensure all necessary component are present.
20
Q

Quadhelix insertion and activation
Step 2

A
  • insertion process and pre expansion measurment
  • Position the Quadhelix at the desired location in the mouth
  • Gently guide it into place
  • Ensure proper fit and comfort for patient
  • Record pre- expansion measurements (ruler and caliper )
21
Q

Quadhelix insertion and activation
Step 3

A
  • Activation by orthodontist and activated measurement
22
Q

Quadhelix insertion and activation
step 4
Insertion of activated appliance

A
  • Place GIC on inner surface of bands to cement Quadhelix
  • Compress the appliance to fit bands onto upper molars
  • Remove excess GIC.
23
Q

Aftercare instructions

A
  • OHI cleaning
  • Speech
  • Eating
  • Discomfort and pain relief
  • Wax
24
Q

Monitoring Expansion

A
  • 6 weeks review appointments

-Record measurement of inter molar width and compare to pre- treatment measurements and expansion measurement

  • We are expecting 2mm expansion / month (1mm each side).
  • Record buccal segment relationship: x-bite /edge-edge/ Scissorbite
  • Intra-oral photos are urself
25
Q

Re- Activation of the Quadhelix

A
  • Re- activation Methods:
  • Removal of appliance and replacement with increased expansion
  • Quadhelix in situ with triple beak pliers
26
Q

Cases Can be

A
  • Unlateral x bite and mandibular displacement correction
  • Quadhelix use in orthodontic with fixed appliance
  • Quadhelix use for therapeutic diagnose w/o fixed appliance
27
Q

Complications and challenges

A
  • Tissues irritation
  • Breakages of appliance
  • Unwanted tooth movement e.g overexpansion = scissor bite
  • Reduction in overbite
  • Communication with orthodontist for complex issues.
28
Q

Removal of Quadhelix and maintenance of expansion

A
  • Aim to over expand to reduce relapse potential.
  • Maintenance of expansion with stainless steel.
29
Q

Summary of OT responsibilities

A

1- Appliance Maintenance
2- Monitoring progress
3- Communication within orthdontic team

30
Q

1- Appliance Maintenance

A
  • Instructing patient on proper oral hygiene practices while wearing the appliance
  • Emphasising the importance of regular check ups and follow up appointments
31
Q

2-Monitoring progress

A
  • Regualr evaluation of patient’s dental changes during treatment
  • Documenting any adjustments made to the Quadhelix appliance
  • Tracking patient compliance and addressing any issue may arise.
32
Q

3- Communication within orthodontic team

A
  • Effective collaboration with orthodontists , dentist, and other healthcare professionals involved in patient care
  • Sharing relevant information regarding treatment progress , challenges, or modifications needed.

Orthodontics (53 decks)

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