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BDS4 Orthodontics > Fixed Orthodontic Appliances > Flashcards

Fixed Orthodontic Appliances Flashcards

1
Q

What components make up fixed appliances?

A
  • brackets/tube
  • bands
  • arch wires
  • modules
  • auxiliaries
  • anchorage components
  • force generating components
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2
Q

What are fixed orthodontic appliances?

A
  • an appliance which is fixed to the teeth and cannot be removed by a patient
    • precision tooth movers
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3
Q

Compare fixed appliances with removable appliances

A
  • fixed appliances
    • 3D control
    • complex tooth movement
    • control of roots
    • less dependent on compliance
    • requires excellent oral hygiene
    • risk of iatrogenic damage
    • poor intrinsic anchorage
  • removable appliances
    • simple tooth movements
      • tipping
    • no control over tooth movements
    • greater compliance required
    • less risk of iatrogenic damage
    • good intrinsic anchorage
    • can be lost
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4
Q

When are fixed appliances used?

A
  • correction of mild to moderate skeletal discrepancies
    • camouflage
  • alignment of teeth
  • correction of rotations
  • centreline correction
  • overbite and overjet reduction
  • closure of spaces/creating spaces
  • vertical tooth movements
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5
Q

What components make up brackets?

A
  • bracket slot
  • tie wings
  • bracket base
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6
Q

What materials can brackets be made of?

A
  • metal
    • stainless steel
    • CoCr
    • titanium
    • gold
  • polymers
  • ceramics
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7
Q

What are orthodontic bands and how are they placed?

A
  • stainless steel with pre-welded attachments
    • tubes
    • cleats
  • require space before placement
    • separator visit
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8
Q

What is bracket prescription?

A
  • the shape and angulation of the bracket
    • determines tip, torque and in/out
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9
Q

How are orthodontic components bonded to teeth?

A
  • brackets and tubes
    • composite via acid etch technique
      • photo-initiation (440-480nm)
      • micro mechanical retention
  • molar bands
    • glass ionomer
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10
Q

What are the different materials arch wires can be made of?

A
  • stainless steel
  • nickel titanium
  • cobalt chromium
  • beta-titanium
  • composite/glass
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11
Q

What are the properties of NiTi archwire?

A
  • flexible
  • light continuous force
  • shape memory
    • return to original shape
    • cannot bend
  • higher friction than stainless steel
    • better at small diameters
  • good when large deflections are present
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12
Q

What are the properties of stainless steel archwire?

A
  • low friction
    • working archwires
  • formable
    • arch wire bends
    • loops
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13
Q

Provide examples of force generating components and how they work

A
  • elastic power chain
  • NiTi coils
  • intra-oral elastics
  • active ligature
  • sliding mechanics
    • utilise energy stored in component
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14
Q

What problems can present with elastic power chain?

A
  • degrades very quickly
    • significant loss of force
      • 24-48 hours
  • patient return with snapped power chain
    • inactive
    • regular appointments required
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15
Q

What is the function of NiTi coils?

A

push teeth apart

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16
Q

What is the function of intraoral elastics and what two ways can they be placed?

A
  • use the force of one arch against the other
  1. Class II elastics
    • more anterior on the upper
    • more posterior on the lower
  2. Class III elastics
    • more posterior on the upper
    • more anterior on the lower
17
Q

What are active ligatures?

A
  • elastomeric separating module
  • long ligature
18
Q

What anchorage considerations must be made for fixed orthodontic appliances?

A
  • resistance to unwanted tooth movement
    • Newtons 3rd law
19
Q

What is absolute anchorage?

A
  • high anchorange
  • temporary anchorage device (TADs)
    • non-osseointegrating mini screw
    • anchorage control
    • tooth movement mechanics
  • pre-op radiograph required to determine location of adjacent roots
20
Q

Where can temporary anchorage devices be placed?

A
  • inter-radicular
  • palatal
20
Q

What increases anchorage for a tooth?

A

increased root surface area

21
Q

What is compound anchorage?

A

grouping teeth together to reduce unwanted tooth movement and increasing desired tooth movement

22
Q

What is reciprocal anchorage?

A

two similar teeth with equal root surface area resulting in equal movement

23
Q

What is cortical anchorage?

A
  • cortical plates utilised
    • increased resistance to tooth movement
  • maintains intermolar width
    • transpalatal arch
    • nance button
      • utilises palatal vault
      • anchorage reinforcement
24
Q

What is used to provide intermaxillary anchorage?

A
  • inter maxillary elastics
    • class II elastics
      • upper canine to lower molar
    • class III elastics
      - lower canine to upper molar
25
Q

What are retainers?

A

passive orthodontic appliances to maintain the final tooth position after completion of orthodontic treatment

26
Q

When must retention be discussed with patients?

A
  • at the consent stage
    • must consent to lifelong retention
27
Q

Which malocclosion features have a high relapse potential?

A
  • diastema
  • rotations
  • palatally ectopic canines
  • proclination of lower incisors
  • anterior open bite
  • instanding upper lateral incisors
28
Q

What are pressure formed retainers?

A
  • clear overlay dentures
    • variety of materials and thickness
    • can contain prosthetic tooth
  • well tolerated
29
Q

What is the recommended wear pattern for removable pressure formed retainers?

A
  • varies between clinicians
  • 2 weeks full time wear
    • except eating and drinking
    • only nights after 2 weeks
  • only night time wear
  • for entire life or as long as would like retention
30
Q

What is a Hawley removable retainer?

A
  • removable appliance
    • labial bow to control incisors and canines
    • usually URA
      • not well tolerated in the lower arch
31
Q

When are fixed orthodontic retainers recommended

A
  • space closure
  • diastema
  • proclination of lower labial segment
  • periodontal cases
  • ectopic canines
  • instaning upper laterals
32
Q

Describe bonded wire retainers

A
  • requires careful monitoring
  • ID cleaning vital
  • ensure composite attachments are intact
  • refer back to orthodontist if problems
  • must have occlusal clearance, avoid debond
33
Q

What are the three main risks of orthodontics with fixed appliances?

A
  • decalcification
  • root resorption
  • relapse
34
Q

Describe the patient journey for fixed orthodontic appliances

A
  • assessment and diagnosis
    • treatment aims
  • treatment plan
  • commence treatment
  • routine adjustments
    • every 4-8 weeks
  • initial problems encountered
    • pain
    • mucosal irritation
    • ulceration
    • appliance breakage
35
Q

What is the duration of an average orthodontic case?

A

18-24 months

36
Q

What is the duration of a hypodontia case?

A

24-30 months

37
Q

What is the duration of an orthognathic case?

A

24-30 months

38
Q

What is the role of the GDP in regards to fixed orthodontic appliances?

A
  • see patient for routine care and checkups
    • reinforce OHI and diet advice
  • liaise with orthodontist is concerned
  • make appliances safe in case of emergency
    • snipping of jaggy wire
    • removal of loose component

BDS4 Orthodontics (8 decks)

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