Fixed Orthodontic Appliances Flashcards

1
Q

What is fixed appliances?

A
  • an appliances which is fixed to teeth and cannot be removed by patient
  • consists of brackets, bands, archwires and auxillaries
  • precision tooth movers
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2
Q

FA vs Removable

A
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3
Q

When do we use fixed appliances?

A
  • correction of mild to moderate skeletal discrepancies (camouflage)
  • alignment of teeth
  • correction of rotations
  • centreline correction
  • OB and OJ reduction
  • closure of spaces
  • vertical movements of teeth
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4
Q

Andrew 6 Keys

A
  • tight approximal contacts with no rotations
  • class 1 molars
  • class 1 incisors
  • flat occlusal plane/ slight curve of spee
  • long axis of teeth have a slight mesial inclination except lower incisors
  • crowns od canines back to molars have a lingual inclination
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5
Q

Components of Fixed Appliances

A
  • bracket/ tube
  • archwires
  • band
  • modules
  • auxillaries
  • anchorage components
  • force generating components
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6
Q

Brackets

A

Components
- bracket slot
- tie wings
- bracket base

Materials
- Metal SS, CoCr, Ti, Au
- Polymers
- Ceramics

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7
Q

Bands

A
  • SS with pre-welded attachments
  • require space before placement -> seperator visit
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8
Q

What does bracket prescription mean?

A

determines tip, torque, and in/out control

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9
Q

Bonding to teeth

A
  • Comp via acid etch technique
  • used for brackets
  • photo- initiation reaction using light cure 440-480nm wavelength of light
  • micromechanical retention
  • GI for molar bands
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10
Q

Archwires

A
  • SS**
  • Nickel Titanium**
  • CoCr
  • Beta Titanium (TMA)
  • composite/ glass
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11
Q

Why Nickel titanium arch wires?

A
  • flexible
  • light continuous force
  • shape memory, can return to original shape, cannot bend
  • higher friction than SS
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12
Q

SS

A
  • working archwires
  • slide teeth as low friction
  • formable for archwire bends and loops
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13
Q

Force generating components

A

Sliding mechanism
- elastic power chain
- NiTi coils
- Intra- oral elastics
- active ligature

  • teeth move by utilising energy stored in elastic/ spring
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14
Q

What is anchorage?

A
  • resistance to unwanted teeth movement
  • Newton 3rd law: every force has an equal but opp reactionary force
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15
Q

Simple anchorage

A
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16
Q

Compound anchorage

A
17
Q

Reciprocal anchorage

A
18
Q

Absolute anchorage

A
  1. Temporary anchorage devices (TADS)
    - non- osseointegrating mini screws
  2. Major development in orthodontics
    - anchorage control
    - tooth movement mechanics
19
Q

Cortical anchorage

A
  • cortical plates provide resistance to tooth movement
  • maintains intermolar width
  • nance palatal arch utilises palatal vault for anchorage reinforcement
20
Q

Intermaxillary anchorage

A
21
Q

Retainers

A
  • for retention: maintaining final tooth position with passive orthodontic appliances
  • prevent relapse; fixed/ removable
  • must be stressed to pt at consent stage of tx lifelong retention
22
Q

Features with high relapse potential

A
  • diastema
  • rotations
  • palatally ectopic canines
  • proclination of lower incisors
  • anterior OB
  • instanding upper lateral incisors
23
Q

Removable retainers

A
  • Pressure formed retainers
  • 2 weeks full time wear except for eating and drinking
  • and then night only after
  • some clinicians will say straight to nights only
24
Q

Hawley removable retainer

A
  • labial bow to control incisors and canines
  • not well tolerated in lower arch
25
Q

Bonded wire retainer

A
  • requires careful monitoring and ID cleaning
  • ensure composite attachments intact and sound
  • refer back to orthodontist if problems
26
Q

Main risks of fixed appliances

A
  • decalcification and caries
  • relapse
  • root resorption
27
Q

Tx plan Pt Journey

A
  • average case 18-24 months
  • hypodontia 24-30 months
  • orthognathic 24-30 months
28
Q

Initial Problems encountered by pt

A
  • pain
  • mucosal irritation
  • ulceration
  • appliance breakage
29
Q

Your role as GDP

A
  • continue to see patient for routine and checkups
  • reinforce OHI and diet advice
  • liaise with orthodontist if concerns
  • make appliances safe in case of orthodontic emergency
    1. snipping of jaggy wire
    2. removal of loose component