Interceptive Ortho

Question 1

Multiple teeth in anterior crossbite would suggest what?

Would you refer to orthodontist?

Answer 1

Skeletal component.

Yes

Question 2

Why do anterior teeth erupt into crossbite?

Answer 2

• Trauma to primary tooth, causing ankylosis.
• Pulpectomy on primary tooth (gutta percha prevents root resorption).
• Mesiodens/supernumerary.
• Crowding.
• Tooth erupts end to end with lower incisor and deflects into a crossbite.

Question 3

Why would you treat a single tooth anterior crossbite?

Answer 3

1) Puts the lower incisor at risk for recession.
2) If the patient occludes end to end, it can chip or traumatize the tooth.
3) Esthetic concern

Question 4

What do you do if there’s no room to move the crossbitten incisor forward?

Answer 4

Ortho referral.

Question 5

Interceptive tx for a single tooth anterior crossbite.

Answer 5

1) Fixed option: 2 x 4

2) Removable option: Hawley bow with active Z spring

Question 6

Describe the 2 x 4 method to correct a single tooth anterior crossbite.

Answer 6

Put buttons on two molars to open up the bite, then put brackets on 4 incisors to pull the crossbite anterior tooth out more.

Question 7

Describe the removable method for correcting a single tooth anterior crossbite.

Answer 7

Hawley bow guides the arch form.

The active Z spring pushes the single crossbitten tooth out.

Posterior bite plate opens the bite so the tooth has room to come forward.

Question 8

This type of posterior crossbite represents bilateral constriction of the maxilla with functional shift of the mandible to get intercuspation.

Answer 8

Unilateral

Question 9

Treatment for posterior crossbite in the MIXED dentition.

Answer 9

Hyrex RPE
Quad Helix
Schwartz plate (removable appliance)

Question 10

This happens if you throw the pacifier out too early.

Answer 10

Thumb-sucking.

Question 11

You want the thumb-sucking habit to end by this age.

Answer 11

3

Question 12

Critical time to correct the non-nutritive sucking habit is…

Answer 12

When the permanent incisors come in.

Question 13

Potential problems with non-nutritive sucking habits.

Answer 13

• Anterior open bite
• Flared incisors
• Posterior maxillary constriction
• High arched palate
• Asymmetry
• Tongue thurst habit on swallowing to create a seal.

Question 14

Prevents thumb sucking.

Answer 14

• Mavala
• Thumb guard
• Appliance

Question 15

When a permanent tooth resorbs the wrong baby tooth, or it resorbs an adult tooth.

Answer 15

Ectopic eruption

Question 16

Ectopic eruption of the maxillary first molar causes resorption of which tooth?

Answer 16

Primary second molar

Question 17

Ectopic eruption of the maxillary first molar self-corrects what percent of the time?

Answer 17

66

Question 18

Treatment options for ectopic eruption of the maxillary first molar.

Answer 18

• Ortho separator
• Brass wire separator
• Extraction of the primary second molar with space maintenance.
• Severe cases will cause loss of the primary second molar.

Question 19

A band is placed on the second primary molar, and a button is placed on the ectopic adult first molar so that it can be distalized away from the baby second molar.

Answer 19

Halterman appliance

Question 20

Appliance that distalizes the adult maxillary first molar.

Answer 20

Halterman appliance

Question 21

An appliance that distalizes and derotates the maxillary first molar.

Answer 21

Shammy appliance

Question 22

Can cause ectopic eruption of the primary canine.

Answer 22

Lateral incisor

Question 23

An ectopic canine can cause resorption of which tooth?

Answer 23

Lateral incisor

Question 24

What fraction of the time are maxillary canines PALATALLY impacted?

Answer 24

2/3