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Orthodontics > Fixed Appliances > Flashcards

Fixed Appliances Flashcards

1
Q

What kind of tooth movements are fixed appliances capable of?

A

Bodily movement, rotation, intrusion/extrusion, root control

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2
Q

What force is needed for bodily movements on teeth?

A

50-120g

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3
Q

What force is needed for torquing movements on teeth?

A

50-100g

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4
Q

What force is needed for rotational movements on teeth?

A

35-60g

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5
Q

What force is needed for extrusion movement on teeth?

A

35-60g

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6
Q

What force is needed for tipping movement on teeth?

A

25-60g

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7
Q

What force is needed for intrusion movements on teeth?

A

10-20g

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8
Q

What are some advantages of fixed appliances?

A 
All types of tooth movement is possible 
Allow bodily movement 
Groups of teeth can be moved
Detailed movement possible 
Essential for dealing with complex cases- ectopic canines, hypodontia, severe crowding
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9
Q

What are the components of fixed appliances?

A 
Brackets
Bands/bonded buccal tubes 
Archwires
Ligatures (eslastomeric or stainless steel)
Auxiliaries
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10
Q

Where are bands usually placed?

A

Usually on molars or premolars

Stronger than bonded attachments- headgear, quad helix, occlusal forces, orthognathic surgery

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11
Q

What are the features of bands?

A

Preformed stainless steel
Buccal attachment welded to band- lower 1 or 2 tubes, upper 2 or 3 tubes
Range of sizes
Lingual cleat sometimes

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12
Q

How do you select a band size?

A

Separators for one week or less- warn patient re slight discomfort and advise re care/removal
Select correct band (U/L, L/R)
Try in and select a size which is a good fit
It should seat fully but be a neat fit

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13
Q

How are bands placed?

A

Select band
Dry tooth
Cement using GIC (releases fluoride) and bite stick
Check position- parallel to cusps, fully seated but not over seated

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14
Q

How do you place brackets?

A

Acid etching- 37%/40% phosphoric acid for 20-30 seconds
Wash and dry- enamel should look frosted, maintain dry field
Bonded with composite and light cured

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15
Q

What is the arch wire sequence of fixed appliances?

A 
Progress from flexible to stiff wire 
Progress from NiTi to SS wire 
Initial alignment 0.012”/0.014” NiTi 
Intermediate archwire 0.020” x 0.020” CuNiTi/0.017” x 0.025” CuNiTi
Working archwire 0.019” x 0.025” SS
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16
Q

What are the advantages of the Begg appliance system?

A

It had 3 stages
It relies on extension
It has good speed of movement

17
Q

What are the disadvantages of the Begg appliance system?

A

Lack of precision

18
Q

What are the advantages of the Edgewise (Angle) appliance system?

A

Mechanically simple
Precise
Versatile

19
Q

What are the disadvantages of the Edgewise appliance system?

A

Slower speed of movement

20
Q

What are the current fixed appliance systems?

A

The Tip-Edge appliance- derived from the Begg appliance system
The Straight-wire appliance (SWA)- derived from Edgewise appliance

21
Q

What are some advantages of the tip-edge appliance?

A

Permits tooth tipping in early stages
Anchorage saving
Versatile
More precise than Begg

22
Q

What are some disadvantages of tip-edge appliance?

A

Narrow bracket with poor control
Requires intermaxillary elastics
Complex in stage 3
Based on extension philosophy

23
Q

What the stages of treatment with straight wire appliances?

A 
Anchorage management 
Levelling and alignment 
Overbite correction/control 
Overjet correction 
Space closure 
Finishing and detailing
Initially- round flexible archwires 
Later in treatment- rectangular archwires
24
Q

What are some advantages of SWA?

A 
Reduced wire bending- pre adjusted design 
Use of sliding mechanisms 
Precision and finishing 
Flexibility and biomechanics 
Multiple bracket design
25
Q

What are some disadvantages of SWA?

A

Friction
Perceived anchorage demands
Adjustments still required for individual patients
Deceptive simplicity

26
Q

What is the difference between the original edgewise appliance and the SWA?

A

Original edgewise appliance required a lot of wire bending- 1st order bends (in/out), 2nd order bends (canine tip), 3rd order bend (incisor torque)
SWA incorporates much of the wire bending into the bracket design

27
Q

What are the features of SWA brackets?

A

Stainless steel brackets
Sometimes ceramic
Rectangular horizontal slot
0.018” or 0.022” slot size

28
Q

As as GDP what can you do if a patient comes in with a missing bracket?

A

Enquire with the patient about what happened
Risk inhaled- consult A&E for possible chest x-ray
Risk ingested- seek advice from A&E

29
Q

As a GDP what can you do if the patient complains of acute gingival inflammation close to the attachment or band?

A 
Intensive OHI 
Disclosing tablets 
Chlorhexidine gel/mouth rinse 
Localised scale and polish 
Contact orthodontist
30
Q

As a GDP what do you do if a patient comes complaining that their teeth feel loose from their braces?

A

Reassure
Check for traumatic occlusion
Check vitality/colour/TTP/perio issue
Attend orthodontist

31
Q

As a GDP what do you do if your patient attends complaining that their teeth feel painful from their braces?

A 
Reassure 
Analgesia 
Check there’s no damage to the appliance 
Check for traumatic occlusion 
Contact orthodontist
32
Q

As a GDP what do you do if your patient attends with a broken URA?

A

If broken clasp remove
If broken acrylic, smooth rough edge
Get patient to attend orthodontist

33
Q

As a GDP is a patient attends with a loose URA what do you do?

A

Adjust claps with spring formers
Advise patient not to clock appliance in/out of mouth
Advise to return to orthodontist

34
Q

As a GDP if a patient attends with a inflamed palate caused by their URA what do you do?

A

Query Candida infection
OHI and diet advice
Prescribe miconazole oromucosal gel

Orthodontics (11 decks)

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