Growth and Development Final Flashcards
The tongue pushes from the ________________; cheek pushes from the ______________. The tongue also pushes ______________
inside out; outside in; forward
T/F Crowding of mandibular incisors is normal
True
T/F Self-correction of crowded mandibular incisors can occur due to tongue pressure
True
In what scenario is there a decreased chance of crowding due to the eruption of laterals? What does this allow for?
> 6mm spacing between the primary canines & central incisors
Allows for correction via tongue, cheek, lips
A habit that is not apart of feeding/survival and disrupts the balance
Parafunctional habit
What is an example of a parafunctional habit?
Thumb sucking
How does thumb sucking cause a posterior crossbite?
Depresses the tongue, which decreases the lateral push of the tongue on the maxillary molars
What are the types of sucking responses?
Nutritive
Non-nutritive
Chronic
Sucking of a digit or pacifier not related to the ingestion of nutrients
Non-nutritive response
How prevalent is non-nutritive response in the 1st year of life?
50-70%
When must the non-nutritive response stop?
By age 3
What 3 things in order make non-nutritive sucking worse?
Duration > Magnitude > Frequency
Continues after age 3 and causes distortion of dento-alveolar structures
Chronic response
What are examples of distorted dento-alveolar structures as a result of the chronic response?
Increased overjet
Class II malocclusion
Posterior crossbite
Anterior open bite
What is the MOST addictive and detrimental habit for babies?
Pacifier
What are other things that can cause open occlusion?
Allergies, asthma, sleep disturbances
Impact on occlusion?
Habits maintained < 12 months
NO adverse effects
Impact on occlusion?
Habits maintained > 36-48 months
Altered occlusions
Impact on occlusion?
Thumb sucking
Anterior openbite and increased overjet
Impact on occlusion?
Pacifier
Posterior crossbite
What has a worse impact on occlusion, bottle or breast?
Bottle
Order of congenital missing teeth (ON EXAM)
Mandibular 2nd premolar > maxillary lateral incisors > maxillary 2nd premolars
The tooth that is supposed to be erupted normally will over-erupt and the neighboring teeth of the congenitally missing tooth will lean mesial and distal filling the space
Result of infra-occlusion
When will infra-occlusion occur?
At ages 11-12 you have infra-occlusion of .47mm (.5mm) that is telling us that the tooth might go into infra-occlusion in the long run
At ages 19-20, tooth has a good prognosis, and primary tooth will stay long term
Are laterals the same height as centrals?
NO
Supernumerary teeth often __________
fuse
Where are mesiodens located most often?
Palate
SLOB Rule stands for
Same-Lingual Opposite-Buccal
What do you do when you know there is an extra tooth in the patient’s oral cavity but you do not know where in relation to the permanent tooth it is located? (SLOB rule)
- Place the sensor in the patient’s mouth.
- Angle the Cone beam on the right side.
- If the tooth moves to the left in the x-ray the beam and tooth are on OPPOSITE sides therefore it is located on the buccal.
Alteration of normal eruption path
Ectopic eruption
Can occur with any teeth; can occur when there is no space so the permanent tooth moves to wherever there is space
Ectopic eruption
Cessation of eruption due to a physical barrier
Impaction
Examples of impaction
Bone
Soft tissue
Iatrogenic
Cessation of eruption prior to emergence. Eruption is stopped before the gingiva is broken
Primary retention
Cessation after emergence
Secondary retention
Grade I-II of ectopic eruption of 1st permanent molar
Self-corrected (2/3 or 67% will self correct)
Grade III-IV of ectopic eruption of 1st permanent molar
Less likely to be self-corrected
What do you do if the permanent canine crown is pointed medial to the midline of the lateral incisor root?
Treatment must be planned immediately - extraction is the best option!
(The permanent canine will find the correct placement if the deciduous lateral incisors are extracted)
20% of ectopic canine eruption results in what?
Root resorption of adjacent teeth
What are ectopic molars more common with?
E space preservation
Mandibular = 1.7mm (on one side)
Maxillary = 0.9mm (on one side)
The union of a tooth root to the alveolar bone due to the lack of periodontal ligament space
Ankylosis
What tooth is ankylosis most common in? (ON EXAM)
Mandibular 2nd deciduous molar
What are the characteristics of ankylosis teeth?
Submerged due to variable degree of root resorption
Development of malocclusion, local periodontal disturbances and dental caries occur
Lack of mobility
Failure of tooth to move after ortho
Malposition of adjacent teeth due to submersion
What should you NEVER do with an ankylosed tooth?
Put an ortho bracket on it
(will cause all other teeth around it to move down to its level!!)
How to determine if there will be crowding or not
6mm+ = no crowding
3-6 mm = 20% crowding
less than 3 mm = 50% crowding
no spacing = 66% crowding
crowding in primary means crowding in permanent
Primate spaces (maxillary and mandibular)
Maxillary = mesial to canine, distal to lateral
Mandibular = mesial to 1st molar, distal to canine
When do you place a space maintainer?
ONLY if the permanent tooth is not erupted
(you do not place space maintainer if tooth is very close to erupting or is erupting!)
What is a space maintainer for the 1st primary molar dependent on?
Eruption of the 1st permanent molar
(if permanent tooth has erupted, no need to place space maintainer)
What is a space maintainer for the 2nd primary molar dependent on?
Eruption of the 1st and 2nd permanent molars
(if they are already in occlusion, no need to place space maintainer)
T/F It is not probable that you will have to use a space maintainer in the anterior teeth in a child over the age of 5 or 6 because those permanent teeth will already be erupting
True
Predicts unerupted permanent teeth in the mixed dentition stage
Space analysis
First: Measure the total arch length, measure to the mesial side of the 1st permanent molar
Second: Measure the widest area of all four of the incisors but only for the MANDIBULAR
Third: Predicted Width, (sum of the incisors)/2 and then add 11 mm (maxillary) or 10.5 (mandibular); THEN multiply whatever you get times two
Tanaka-Johnson
Tanaka-Johnson equation
Available arch length = total arch length - sum of incisors - 2(predicted width)
Tanaka-Johnson + vs - result
+ = need space maintainer
- = need space regainer
Types of malocclusion
- Dental: simple (single tooth) vs compound (multiple teeth)
- Complex: skeletal discrepancy
- Compound and Complex: dental and skeletal component
Abnormal buccal-lingual relationship in centric relation
Crossbite
Midline undergoes a compensatory or habitual shift when the teeth occlude due to crossbite, can occur due to an early contact point
Functional shift
Molar relationship, canine relationship and overjet →Anterior crossbite
Sagittal relationship
Overbite/deep bite (positive #) vs open bite (negative #)
Vertical relationship
Posterior crossbite
Transverse relationship
Class II Division 1 bite
Pro-inclined
Class II Division 2 bite
Retro-inclined
4 principal physiological functions affecting the size and shape of the oral cavity
- Swallowing
- Mastication
- Speech
- Respiration (secondary to the nose)
Functions of the nose
- Olfaction
- Respiration
- Filter
- Sterilize
- Control volume, temp, & humidity of air
Percentage of airway blocked; helps determine if sedation is an option
Brodsky score
Causes of airway disorders
- Enlarged tonsils and head forward position (middle of the shoulder does not come at the same level as the ear canal)
- Enlarged adenoid and tonsils
- Enlarged turbinates: the same thing as the nasal concha
- Deviated septum
- Soft tissue dysfunction in a growing child can lead to abnormal facial growth and malocclusion
Adequate position of the TMJ in the articular eminence (anterior and superior position), relaxed muscles, independent of tooth position, pure rotations, position can be repeated
Centric relation
Good vs poor prognosis when opening jaw
Early problem = good
Late problem = poor
Good vs poor prognosis when closing jaw
Early problem = poor
Late problem = good
