Interceptive Orthodontics Flashcards by Amy Rooney

What is interceptive orthodontics?

This is any procedure that reduces or eliminates the severity of a developing malocclusion

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When does primary dentition erupt?

Within first 2.5 years

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What is sequence of eruption of primary teeth?

ABDCE
Uppers before lowers

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What is the eruption dates for permeant upper teeth?

1 = 6/7
2 = 6/7
3 = 11/12
4 = 10/11
5 = 11/12
6 = 6
7 = 12/13
8 = 18+

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What is the eruption dates for permeant lower teeth?

1 = 6/7
2 = 6/7
3 = 9/10
4 = 10/11
5 = 11/12
6 = 6/7
7 = 12/13
8 = 18+

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When does root formation complete?

3 years after eruptuon

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When does crown formation complete?

3 years before eruption

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When does crown formation begin?

6 years before eruption

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What arch erupts first?

lowers before uppers except second pre-molars

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What is the chance of crowding in permeant Denton if :
- no spacing
- <3mm
- 3-6mm
- >6mm

no spacing - 66%
<30mm - 50%
3-6mm - 20%
>6mm - 0%

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How Many 6 years old have a diastema?

91% - this is due to the upper canines being against the distal aspect of the upper teeth roots and when the 3 erupts it will shut the diastema as laterals come inwards

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What can cause diastema?

Normality
Microdontia
presence of supernumerary

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What will indicate that a diastema will close?

<2.5mm

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Why may central incisors not erupt?

Supernumarary present
trauma
failure of exfoliation of primary tooth
cyst/tumour

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What are the tx options for supernumeraries?

remove deciduous tooth and supernumerary
then we can expose the tooth and ensure space for it to erupt
give it 1.5-2 years - if not then it may need help

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Why can trauma of primary tooth affect eruption of permeant tooth?

Trauma force spreads up primary tooth to henrtwigs root sheath and can cause root to become dilacerated which can lead to loss of vitality

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What is leeway space?

Diff in size of crown width of primary canines and molars and permeant canines and molars

How do we asses if there is enough space for permeant dentition?

Measure mesial of 6 to distal of 2 = 18.5mm for no crowding

What can GDPs intervene at?

oEarlf decidious teeth
carious 6s
crossbites
habits
impacted 6s
potential crowding
transposed teeth

What is a balancing extraction?

This is where we take the same tooth from the other side of the arch

What is a compensating extraction?

This Is where we take the same tooth from the opposing arch (if we take lower, we take upper)

If we are losing an A early do we have to manage the other As?

No need to as no effect on the midline

If we are loising a B do we need to balance or compensate?

If losing a C do we need to balance or compensate?

Yes - we need to balance due to effect of loss on midline (we would get midline shift towards this side)

If losing a D do w need to balance or compensate?

No = unless under GA then can balancee s small midline shift

If losing an E do we need to balance or compensate?

No - we dont want to do this as if we lose the E there will be significant mesial drift of teeth behind

What is the general rule for extracting 6s?

ideally we want pt to have class I occlusion or else there will be forward drifting

If we are extracting 6s do we need to balance or compensate?

No need to balance unless a clinical need to - ie caries in both left and right 6s Compensating required if Xla lower tooth we need to XLa upper or else upper will over erupt and can affect occlusion

When is the ideal time to extract 6s?

Bifurcation of 7s forming, presence of 8s, class I occlusion, moderate lower crowding, mild/moderate upper crowding

What is a crossbite?

malocclusion (bite problem) where the top teeth and bottom teeth do not come together or bite in the correct position. Crossbites can be caused by either tooth position, jaw position, or a combination of both. Can have ANTERIOR OR POSTERIOR (unilateral or bilateral)

How do we ensure relapse correction of anterior crossbite is stable?

Ensure upper incisors are over lower incisors

How do we correct a bilateral corssbite?

URA with midline screw - idea is to widen the upper arch Adams classp on 4s and 6s and PMMA base plate with posterior bite planes

How long does habit have to pesistt for each day to have effect?

>6 hours

What does habits lead to? 4

Proclines uppers retroclined lowers AOB Posterior unilateral corssbite Narrowing of upper arch - vacuum like effect with thumb and force of muscles pushing against teeth and bone

What is the worst habit?

Thumb or finger as in comparison to dummy this can't be taken away

Why do we get a posterior unilateral crossbite?

Negative pressure from vacuum effect of habit, results inn tongue sitting lower, cheeks pulled in and forces of muscles push upper posterior teeth and narrow them

What age ideally should habit be quit by?

<10 as then dentition will return. to normal position within 3 years

When is too late to stop habit?

>10 as permeant dentition being established - can result in malocclusion

What are methods fo habit quitting?

Initial cessation of home - encourage pt to suit - nail polish, gloves etc If not successful can trial URAs with goalpost to prevent pt sucking can also try fixed URA

How long do we give habit quitting?

2 months - if pt hasn't quit then likely they dont want to and never will