Interceptive Ortho Flashcards
Why is interception ideal and what is involved
Early identification and management of potential problems and early appliance of tx
Avoidance of a worse malocclusion
Different stages of orthodontic timetable?
Primary dentition
Early mixed dentition
Late mixed dentition
Permanent dentition
What are the 2 options of development for each stage?
Normal development = monitor
Problems = interception or tx
What are the possible problems in primary dentition?
Delayed eruption Missing teeth Supernumerary teeth Abnormal teeth Crowding
SCAM’D
What to do in primary dentition for following problems: overjet, class III, cross bite, caries/trauma, habits
Overjet - prob be greater permanent dentition - no tx this stage
Class III - prob be present perm dentition
- no tx just observe
Crossbite - tend to persist
Caries/trauma - if trauma primary incisors possible ankylosed - look deflection perm successor
Habits - cause AOB, unilateral posterior cross bite - no intervention yet
What is the size discrepancy between primary and permanent incisors?
Upper arch 7mm greater
Lower arch 5mm greater
Permanent teeth more proclined
What problems would you see in early mixed dentition?
Delayed eruption Early loss - loss centre liners First perm molars - if poor prog referent ortho opinion XLA Median diastema Increased overjet Crowding Anterior/posterior XB Habits Skeletal class
FOXED DCHB
What are the 3 different types of supernumerary teeth and how tx?
Erupted mesiodens - extract and align
Unerupted supernumerary - XLA supernumerary (see guidelines)
Supplemental - usually XLA most displaced or poorly formed
What can premature loss of primary canine cause?
Shift of centre line to XLA side
Need balance loss of primary canine in either arch
What can premature loss of primary first molar (D) cause?
In crowded case - shift of centre line to XLA side
Consider balancing
What can premature loss of second primary molar (E) cause?
Mesial movement first permanent molars
Space loss greater in upper arch
Don’t balance - disrupt occlusion
Should compensation in primary dentition?
No
What are space maintainers?
Can be fixed or removable
Pt often unsuitable
Must be fitted immediately
What tx options are available for impacted first molars?
Disimpact 6 or XLA E’s
Causes midline diastema?
Normal Supernumerary teeth Generalised spacing Proclined upper incisors - class II div I Digit sucking Trauma Pathology (cyst)
PPSSNT
If crowding in mixed dentition - what would be indications for XLA?
Permit laterals to align
Allow incisors to be moved over bite
Potentially improve position of palatally displaced perm canines
How to tx anterior XB in mixed dentition?
Tx early
Correct w/ 2x4 or URA
How tx posterior XB in mixed dentition?
Consider early tx - look mandibular displacement on closure
Adams cribs 6s
Interceptive correction of posterior XB affecting 6s
Tx of class III in early mixed dentition?
Some pt aged 8-10 are suitable for tx
What are the problems in late mixed dentition?
Missing teeth Infraoccluded teeth Crowding Poor quality 6s Ectopic canines Habits Increased overjet
CHEMO IQ
How to deal w/ missing teeth in late mixed dentition?
Monitor
Refer to hospital for tx planning - multi-disciplinary care
How to deal w/ infra occluded teeth in late mixed dentition?
Monitor
XLA under LA
How to deal w/ crowding in late mixed dentition?
Refer to ortho
How to deal w/ poor quality 6s in late mixed dentition?
Refere to orthodontics for opinion re timing
How to deal w/ ectopic canine in late mixed dentition?
Refer time diagnosis
Screen all 9 year olds - palpate/ radiograph
How to deal w/ habits in late mixed dentition?
Best time to deal
Educate pt and advise to stop
Habit breaking appliance / passive removable appliance
If stop habit before 8 can get spontaneous correction occlusion
What can digit sucking cause?
Proclined upper incisors, AOB, unilateral posterior XB, increased OJ
What is Hyrake passive removable appliance?
Correction AOB in relation to habits
How to deal w/ increased overjet in mixed dentition?
Refer to orthodontic - functional appliance best during growth spurt (11-13yrs)
Problems w/ tx problems in permanent dentition?
Lack growth - slower tx
Co-operation
Difference expectations
