Interceptive Orthodontics 1 Flashcards
At birth, what are your jaws and gums like?
Gum pads Upper rounded Lower U shaped Often appear very class 3 Anterior open bite Thin layers of enamel
In mm, what width should a diastema close?
Under 2.5mm.
How many 6 year olds have a diastema (in percentage)?
96%.
What will no spacing, under 3mm, 3-6mm and over 6mm cause crowing in the permanent dentition (in percentage)?
No spacing- 66% will dev crowding
Under 3mm- 50% crowding
3-6mm- 20% crowding
Over 6mm- no crowding.
What is interceptive orthodontics?
Any procedure that will reduce or eliminate the severity of a developing malocclusion.
What are the teeth like in a deciduous dentition?
Incisors more upright
Spaced
Wear.
When do the 6’s, 1’s and 2’s erupt?
6- 6 years
1- 7 years
2- 8 years.
What is a diastema?
A diastema is a space (gap) between two teeth, most often noticeable between the two front teeth. This condition usually occurs when there is a disproportionate relationship between the jaw and the size of the teeth, but can also be caused by alignment problems, protruding teeth, or over-sized tissue.
What do you do when you notice the sequence of eruption is wrong?
Take a history, do an examination, palpate and take radiographs.
How many months should the contra lateral tooth erupt within?
6 months.
What might cause unerupted central incisors?
Supernumeraries
Trauma/Dilaceration
Other pathology.
What do you do when a central incisor hasn’t erupted due to a supernumerary?
Remove deciduous and supernumerary
Expose/bond
Create space
Monitor (over 1 and a half years).
When removing a supernumerary tooth due to an unerupted central incisor- what percentage of people will this tooth erupt within 16 months?
80%.
What happens if we lose one C?
The permanent incisor shifts off to one side- might not have an effect if you have a spaced dentition.
What would you do if your patient lost a C on one side and the permanent incisor shifts off to one side?
Extract the other C.
Does mesial drift happen quicker in the upper or lower arch?
Upper arch.
What is the aetiology of a median diastema?
Normal (small teeth)
Supernumerary
Missing teeth
TAKE A RADIOGRAPH!
What does compensating mean?
If you take something out in the upper take it out in the lower.
If a central incisor isn’t erupting- what should you ask them?
If they have had a traumatic episode in the past.
What is a dilaceration?
dilaceration is defined as the deformity of a tooth due to a disturbance between the unmineralized and mineralized portions of the developing tooth germ.
What are the general rules of a 6 extraction (class 1)?
If extracting lower take upper
Don’t balance with sound tooth
If extracting upper don’t necessarily need to take lower.
Do lowers or uppers tend to overerupt?
Lowers.
What is the leeway space?
The differences in space between edc and 345
Maxillary- 1.5mm
Mandibular- 2.5mm.
What is the space required at 9 years for premolars and canines?
Minimum 18.5mm from lateral - first molar for no crowding.
When is the ideal circumstance to extract a first molar?
7’s furcation forming 8s are present Class 1 av/reduced overbite Moderate lower crowding Mild/moderate upper crowding.
There is a few examples of interceptive orthodontics on these slides but you would have to look at the radiograph to understand them (can’t insert pictures into this).
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How is a posterior unilateral cross bite treated in orthodontics?
A midline screw- adams clasps on 4&6, base plate with posterior bite plane. They have to wear it all of the time and turn it 2 quarters per week. This causes the palate to expand.
How do you fix an anterior cross bite?
Z spring
Double adams clasps at the front
Can put adams clasps on the 6a and ds if can’t get them on the anterior as appliance will displace down if no retention at the front
Posterior bite plane
This is a simple tipping of the tooth which takes 6-8 weeks.
What percentage of posterior cross bites relapse?
50%- this is why we over correct.
What effects does a thumb or digit sucking habit have on the dentition?
Proclaimed upper incisors
Retro lined lower incisors
Asymmetric AOB or reduced OB.
*If a patient was going to have a big anyway because they are a class 2 with mandibular retrognathia and they suck their thumb as well then their overheat is going to be more increased.
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What habit is easier to get rid of- thumb or pacifier?
Pacifier.
What appliances are used to stop a digit sucking habit?
Removable habit breaker (double adams on the es and 6s and a goal post is at the front to remind the patient that the thumb should not be there)
-should stop within 2-3 months
Fixed habit breakers- cemented to permanent teeth and cannot be removed- they are only a reminder that the patient should not be sucking their thumb.
At what age should you get the patient to stop sucking their thumb by?
Age 10 years old.
Does a unilateral cross bite and displacement need treated?
YES!
What do you do if you lose a C on one side?
Consider balancing it by taking out the c on the other side- however it is not critical and can be fixed later.
What do you do if a carious lower 6 needs removed?
Remove this tooth and the upper 6 as well even if there is no pathology on it.
From what ages is there not a lot of change to the mixed dentition?
8-10 years.
Should you be bothered by a complaint of lower labial segment crowding in the mixed dentition?
No as you know the patient has the potential to grow transversely- up to 3.5mm by the age of 10.
When removing a lower 6 in the mixed dentition- what happens if you remove it and the premolar (5) is distally inclined?
It can drift off significantly before it emerges into the mouth and this often pleads to unsightly spacing in the lower buccal augments and can impact the erupting lower second molar.
