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4th yr- CCD2- Ortho > interceptive orthodontics > Flashcards

interceptive orthodontics Flashcards

1
Q

What is interceptive orthodontics

A

Any treatment which eliminates or reduces the severity of a developing malocclusion

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2
Q

What should interceptive orthodontics hopefully reduce in the future

A

To eliminate or simplify the need for future treatments

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3
Q

What are the aims of interceptive orthodontics

A
  1. Maintain centrelines
  2. Maintain class I incisor relationship
  3. Maintain good vertical and transverse relationship
  4. Eliminate crossbones associated with displacement./ pathology
  5. Prevention of trauma
  6. Minimise crowding
  7. Minimise psychological factors- bullying
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4
Q

When carrying outage patient history what do we want find out

A
  1. Patients perception of the problem
  2. Medical history
  3. Social history
  4. Dental history
  5. Habits
  6. Growth status
  7. Motivation
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5
Q

What habits do we need to ask about when carrying out our patient history

A
  1. Thumb sucking
  2. Digit sucking
  3. Fingernail biting
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6
Q

Name the 3 planes of space an orthodontic patient is examined in

A
  1. Anteroposterior
  2. Vertical
  3. Transverse
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7
Q

What do we examine extra orally in the Anteroposterior plane

A

Does the patient have a class I, II or III occlusion

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8
Q

What do we examine extra orally in the vertical plane

A
  1. Facial thirds

2. Angle of the lower border of the mandible to maxima

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9
Q

What do we examine extra orally in the transverse plane

A

Facial symmetry

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10
Q

What other information may we want to record extra orally

A
  1. Smile aesthetics
  2. Soft tissues
  3. TMJ
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11
Q

What do we examine intra orally in the Anteroposterior plane

A
  1. Incisal classification
  2. Overjet
  3. Canine relationship
  4. Molar relationship
  5. Do they have an anterior cross bite
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12
Q

What do we examine intra orally in the vertical plane

A
  1. Does the patient have an overbite?
  2. AOB
  3. LOB
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13
Q

What do we examine intra orally in the Anteroposterior plane

A
  1. Closing and opening

2. Posterior cross bite

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14
Q

What other information may we want to record intra orally

A
  1. Teeth present?
  2. Is there any crowding or spacing
  3. Periodontal health
  4. Tooth quality
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15
Q

When dow e carry out interceptive orthodontics?

A
  1. Failure/ delayed eruption
  2. Crossbites with displacement/ wear
  3. Teeth with a poor prognosis
  4. When there is trauma to permanent teeth
  5. If there is severe skeletal patterns where early treatment may be appropriate
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16
Q

What can fall under the category of failure/ delayed eruption?

A
  1. Impacted first permanent molars
  2. Unerupted upper central incisors
  3. Infraoccluded deciduous teeth
  4. Unerupted upper canines
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17
Q

What is the incidence percentage of impacted first permanent molars

A

4.3%

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18
Q

What is the aetiology of impacted first permanent molars

A

Multifactorial:

  1. Increased m-d width of 6
  2. Increased eruption angle of 6
  3. Crowding posterior maxilla
  4. Genetics
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19
Q

What problems can impacted first permanent molars lead to

A
  1. Can cause caries of 2nd deciduous molar tooth and first permanent molar tooth
  2. Can lead to root resorption of 2nd deciduous molar tooth
  3. Space loss if the 2nd deciduous molar tooth is lost
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20
Q

What is management of impacted first permanent molars dependent on

A
  1. Is it reversible?
  2. It is irreversible
  3. Is the E viable
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21
Q

If the impacted first molars is of the reversible when does ti fix itself?

A

90% correct themselves by the age of 7 and 100% by age 8

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22
Q

How do we mange impacted first permanent molars if the E is viable

A
  1. Disimapct the 6 and the E using separators/ brass wire

2. Distalise the 6 with URA

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23
Q

How do we mange impacted first permanent molars if the E is not viable

A

Extract E and Distalise 6 once fully erupted

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24
Q

What is the incidence percentage of unerupted upper central incisors

A

0.13%

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25
What is the aetiology of unerupted upper central incisors
1. Developmental eg supernumerary 2. Genetic eg Holoprosencephaly 3. Environmental eg dilaceration
26
How do we mange unerupted upper central incisors
1. Remove caries of impaction and create space 2. Give time for eruption in younger patients 3. Active treatment may be needed in older patients
27
When is an unerupted maxillary central incisor of high concern
If the tooth is not palpable or the contra lateral incisor erupted more than 6-12months ago
28
How do we treat an unerutped maxillary central incisor of high concern
1. Take an OPT and intra oral periapical (can also take an anterior occlusal radiograph) 2. Localise the tooth, check morphology and presence of supernumerary 3. treatment then depends on age
29
When is an unerupted maxillary central incisor of moderate concern
If the tooth is not palpable but the contra lateral incisor hasn't erupted
30
How do we treat an unerutped maxillary central incisor of moderate concern
1. Take an OPT and intra oral periapical (can also take an anterior occlusal radiograph) 2. wait till contra lateral incur has erupted for more than 6-12 months
31
What is the incidence percentage of infra occluded deciduous teeth
1-9%
32
What is the aetiology of infra occluded deciduous teeth
1. Genetics 2. Disturbed local metabolism 3. Gaps in the periodontal membrane 4. Local mechanical trauma 5. local infection
33
Why is intervention of infra occluded deciduous teeth important
To prevent: 1. Tipping of adjacent teeth that could lead to Periodontal problems 2. Alveolar ridge defects due to growth restriction 3. Space loss 4. Displacement of developing successor teeth 5. Over eruption of teeth in the opposing arch 6. caries 7. Gingival hyperplasia
34
What does the management of infra occluded deciduous teeth depend on
1. Severity 2. Presence of class permanent 2 3. The prognosis of the primary 1s 4. Malocclusion
35
How do we classify the severity of infra occluded deciduous teeth
Mild Moderate Severe
36
Describe mild infra occluded deciduous teeth
When the occlusal surface is 1mm below the expected occlusal plane for the tooth
37
Describe moderate infra occluded deciduous teeth
When the occlusal surface is approx level with the contact points of one or both adjacent tooth surfaces
38
Describe severe infra occluded deciduous teeth
When the occlusal surfaces are level with or below the inter-proximal gingival tissue of one of both adjacent tooth surfaces
39
How do we treat mild infra occluded deciduous teeth
Monitor
40
If we diagnose a patient with moderate/ severe infra occluded deciduous teeth what is the next step
Take a radiograph to determine if their is a permanent successor for the tooth
41
If there is a permanent successor and the patient has moderate infra occluded deciduous teeth what is the treatment
Monitor
42
If there is a permanent successor and the patient has severe infra occluded deciduous teeth what is the treatment
Orthodontic referral or If pathology present extract
43
If there is NOT a permanent successor and the patient has moderate infra occluded deciduous teeth what is the next thing we check
Does the patient have malocclusion
44
If malocclusion is present in a patient with moderate infra occluded deciduous teeth and no permanent successor what do we do
Orthodontic referral
45
If malocclusion is not present in a patient with moderate infra occluded deciduous teeth and no permanent successor what do we do
Monitor
46
If there is NOT a permanent successor and the patient has severe infra occluded deciduous teeth what is the treatment
Orthodontic referral
47
What is the incidence percentage of unerupted upper canines
2% due to impaction | 0.08%. due to developmentally absent
48
What is the initial management for unerupted upper canines
1. Clinic examination at 9 years old 2. Palpate for canine bulge buccally 3. If not palpable by 1- years investigate further
49
What is the aetiology of unerupted upper canines
1. Long path of eruption 2. Delayed exfoliation of the deciduous canine 3. Small/ developmentally absent 2s 4. Polygenic inheritance 5. Presence of supernumeraries 6. Crowding
50
What are the clinical signs of an unerupted upper canine
1. Visual inspection of the canine bulge 2. Palpation 3. Prolonged retention of the C 4. Loss of vitality of the U2/1
51
Which radiographs might we take to assess unerupted upper canines
1. Horizontal parallax (2 periapicals) 2. Vertical parallax (Anterior occlusal and OPT) 3. CBCT
52
What do we look at when assessing the prognosis of an unerupted upper canine
1. Overlap of the incisors 2. Vertical height of incisor 3. Angulation 4. Position of the apex
53
Talk through an unerupted upper canine with a good prognosis
1. No horizontal overlap between canine and incisor 2. CEJ is halfway up the root 3. Angulation of 0.15 degrees 4. The apex of the canine is in the correct position
54
Talk through an unerupted upper canine with an average prognosis
1. Horiztonal overlap up to half the root width between the canine and incisor 2. Vertical height of the canine is 0.5 to full root length 3. Angulation of 16-30 degrees 4. The apex of the canine is above the 1st premolar
55
Talk through an unerupted upper canine with a poor prognosis
1. There's complete overlap between the canine and upper incisors 2. Vertical is root is more than the full root length 3. Angulation is more than 30 degrees 4. The apex of the canine is above the 2nd premolar
56
how do we manage impacted Canines
1. No active treatment 2. Interceptive treatment 3. Surgical exposure and orthodontic alignment 4. Surgical repositioning 5. Extractions
57
Name the 2 different types of crossbite
1. Anterior X bite | 2. Posterior X bite
58
What is the anterior x bite incidence percentage
2.2-11.9%
59
What is the posterior x bite incidence percentage
In primary dentition 1-16%
60
What is the aetiology for crossbites
1. Local causes 2. Skeletal 3. Soft tissues 4. Pathology/trauma
61
How do we manage crossbites
1. Removal appliance 2. Quadhelix 3. 2x4 appliance
62
Why might treatment for cross bite be carried out early
1. Eliminate displacements 2. To prevent perpetuation into permanent dentition 3. To prevent periodontal breakdown/ wear
63
What can poor prognosis deciduous teeth be due to
1. Caries | 2. Trauma
64
What problems can poor prognosis deciduous teeth lead to
1. Centreline shift | 2. Localisation of pre existing crowning
65
What is the management of poor prognosis deciduous teeth dependent on
1. Age 2. Existing space requirements 3. Tooth type
66
If we were to extract a primary incisor how would we manage the contra lateral tooth
No interceptive treatment as there is minimal effect on the midline
67
If we were to extract a primary canine how would we manage the contra lateral tooth
Balance the dentition and extract the other canine to preserve midline
68
If we were to extract a primary first molar how would we manage the contra lateral tooth
1, Spaced arch no interceptive treatment | 2. Crowded arch: balance extraction to persevere midline
69
If we were to extract a primary second molar how would we manage the contra lateral tooth
No interceptive treatment
70
What can poor prognosis first permanent molar teeth be due to
1. Caries | 2. Molar incisor hypominerlaisation
71
What problems can arise if we extract the first permanent molars
1. Spacing 2. Occlusal interferences 3. Anchorage concerns 4. Alveolar defects 5. Tipping of teeth
72
What is the best course of treatment for a poor prognosis first permanent molar
Extraction
73
What might we consider if we extract a mandibular first molar
Compensating and extracting the opposing maxillary first molar
74
For the best sponateoud occlusal results when should we extract the first primary molar
1. Between ages of 8-10 | 2. After eruption of lateral incisors but before eruption of 2nd permeant molars
75
In which type of dentition can we best predict the outcome of first molar extraction
Class I occlusion where all permanent teeth are present
76
What is the incidence percentage of early loss of maxillary central incisors due to trauma
3% (more common in boys)
77
What immediate intervention of we give to a child who has most their permeant maxillary central incisor due to trauma
Reimplantation to act as a space maintainer
78
If preimplantation fails how do we mange early loss of the permanent maxillary central incisor
1. Space maintainer if lost EARLY 2. Premolar transplant 3. Orthodontic space closure
79
What is the longterm management for the early loss of the permanent maxillary 1
1. Denture 2. Bridge 3. Implant
80
What is the aetiology of a class II skeletal pattern
1. Skeletal 2. Soft tissues 3. Habits
81
What habits can cause class II skeletal pattern
Digit suckign
82
why do we need to manage class II skeletal patterns
1. Trauma limitation | 2. Psychosocial benefits
83
How common is digit sucking in 9 year olds
12%
84
How common is digit sucking in 12 year olds
2%
85
What is the extent the malocclusion due to digit sucking dependant on
1. Frequency of digit sucking 2. Intensity of digit sucking 3. Duration of digit sucking
86
How can we manage digit sucking
1. Encouragement 2. Positive reinforcements 3. Bitter nail varnish 4. wearing gloved to bed 5. Removable appliance
87
List the characteristic features of digit sucking
1. Proclamation of upper incisors 2. Retroclination of lower incisors 3. Asymmetrical Anterior open bite 4. Narrowed upper arch 5. Posterior cross bite
88
What is the aetiology of class III skeletal patterns
1. Skeletal | 2. Genetic
89
Why might we carry out early class III management
To reduce the need for OGN surgery in the future

4th yr- CCD2- Ortho (7 decks)

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