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4 - ortho > fixed appliances > Flashcards

fixed appliances Flashcards

1
Q

What is a fixed appliance and what do they consist of?

A

An appliance which is fixed to the teeth and cannot be removed by the patient
Consists of brackets, bands, archwires and auxiliaries and are used for precise tooth movement

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2
Q

What factors affect fixed appliances?

A

3D control
Complex tooth movements
Control of root
Less dependent on compliance
Require excellent OH
Risk of iatrogenic damage
Poor intrinsic anchorage

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3
Q

What factors affect removable appliances?

A

Simple tooth movements such as tipping
No control over root movement
Greater compliance required
Less risk of iatrogenic damage
Good intrinsic anchorage
Can be lost

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4
Q

When can fixed appliances be used?

A

Correction of mild to moderate skeletal discrepancies - camouflage
Alignment of teeth
Correction of rotations
Centreline correction
OB and OJ reduction
Closure of spaces
Creating spaces
Vertical movements of teeth

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5
Q

What are the components of fixed appliances?

A

Bracket/tube
Band
Archwire
Modules
Auxiliaries
Anchorage components
Force generating components

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6
Q

What are the components of brackets?

A

Bracket slot
Tie wings
Bracket base

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7
Q

What materials are used in brackets?

A

Metal - SS, CoCr, Ti, Au
Polymers
Ceramerics

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8
Q

What are bands?

A

SS with pre-welded attachments - can be tubes or cleats
Require space before placement - separator visit

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9
Q

How is bonding to teeth acquired for fixed appliances?

A

Composite via acid etch - brackets
Glass ionomer for molar bands

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10
Q

What materials can be used for archwire?

A

SS
NiTi
CoCr
Beta-titanium (TMA)
Composite/glass

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11
Q

Describe NiTi

A

Flexible
Applies light continuous force
Shape memory - returns to original shape and cannot bend
Higher friction than SS (disadvantage)

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12
Q

Describe SS archwire

A

Low friction
Formable into archwires and loops

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13
Q

Give 4 examples of force generating components

A

Elastic power chain
NiTi coils
Intra-oral elastics
Active ligature

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14
Q

What are NiTi coil springs used for?

A

To keep teeth apart

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15
Q

What are the 5 types of anchorage?

A

Simple
Compound
Reciprocal
Absolute
Cortical

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16
Q

What can be used for absolute anchorage?

A

Temporary anchorage devices (TADS) - non osseo-integrating mini screws

17
Q

How is cortical anchorage achieved?

A

Cortical plates used
Maintains the intermolar width

18
Q

What is needed for headgear use?

A

Appropriate safety mechanisms
Written and verbal instructions needed
Patient compliance

19
Q

Describe post-ortho retention

A

Maintaining the final tooth position with a passive ortho appliance
Can be fixed or removable
Must be stressed at consent stage of tx that lifelong retention is required

20
Q

Give 4 examples of features with a high relapse potential

A

Any from:
- diastema/space closure
- rotations
- palatally ectopic canines
- proclination of lower incisors
- AOB
- instanding upper lateral incisors

21
Q

What is the retainer wear pattern for a removable pressure formed retainer?

A

Varies between clinicians
2 weeks full time wear except for eating and drinking
Night only thereafter
Or straight to nights only

22
Q

Describe a Hawley retainer?

A

Labial bow to control incisors and canines
Not well tolerated in the lower arch

23
Q

Give 4 examples where a fixed ortho retainer should be provided

A

Any from:
- spaced closure
- diastema
- proclination of lower labial segment
- periodontal cases
- ectopic canines
- instanding upper 2s

24
Q

What are the risks of fixed appliances?

A

Decalcification
Root resorption
Relapse

25
Q

How long does the average ortho case tx take?

A

18-24 months

26
Q

How long does the average hypodontia or orthognathic case take to treat?

A

24-30 months

27
Q

How often should routine fixed appliance adjustment take place?

A

Every 4-8 weeks

28
Q

What initial problems may be encountered with fixed appliances?

A

Pain
Mucosal irritation
Ulceration
Appliance breakage

29
Q

What is the role of a GDP in fixed appliances?

A

Continue to see pt for routine care and check ups - reinforce OHI and diet advice
Liaise with orthodontist if concerns
Make appliance safe in case of an orthodontic emergency eg - snipping of wire, removal of loose component

4 - ortho (14 decks)

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