Interceptive Orthodontics 2 Flashcards
what should you assess when a patient presents with an anterior cross bite
displacement
mobility of lower incisor
tooth wear
gingival recession
what is the acronym used when designing an ortho appliance
ARAB
what active component could be used to correct and anterior crossbite
Z-spring
what does stability of a cross bite correction long term depend on
overbite
growth
why is it less likely for an anterior crossbite to relapse than a posterior
if the anterior cross bite is in a slight overbite, the lower centrals prevent the teeth from tipping back
what is the difference in teeth appearance from a thumb vs dummy habit
thumb gives a more asymmetrical anterior open bite
dummies can be thrown out - no need for as much management
why do you want to treat a digit sucking habit early
so there is potential for spontaneous correction of anterior open bite
prevent effects on transverse and vertical skeletal elements
what are four aspects of digit habit management
positive reinforcement
bitter-tasking nail varnish
glove on hand
habit breaker appliance
what is the aspect of appliance design that is a deterrent to digit sucking
goal post - wire on the palatal aspect
what are effects of digit habits on teeth
anterior OB
proclines upper incisors
retroclines lower incisors
narrows upper arch - posterior crossbite
what should you be looking for in the late mixed dentition stage
infra-occluding teeth
canines
overjets
what is the aetiology of an infra-occluded tooth
primary tooth ankyloses to the bone and surrounding alveolar bone continues to grow
what might be an indication when an infra-occluded tooth is present
there is not a permanent successor
how would you treat an infra-occluded tooth with a permanent successor present
monitor for up to a year
extract if tooth is below the interproximal contact point
consider extraction if root formation of successor near complete
how would you treat an infra-occluded tooth if there is no permanent successor
treatment plan depends on degree of crowding, degree of infra-occlusion
retain primary if in good condition and consider onlay
extract if below contact point
how do you assess canines before they erupt
radiograph - OPT and upper occlusal
palpate buccal mucosa
what would the interceptive treatment if primary canines have not shed but the permanent canines are present
extraction of primaries
what can occur with an impacted permanent canine
root resorption of lateral incisors - as the canine lies distal to the position of the lateral incisor root
when is there a very high chance that extracting the primary canine will allow permanent canine to move into place
if permanent canine has not crossed the middle of the lateral incisor root
what should be considered after extraction of primary teeth
space maintainers
what are risks of ectopic maxillary canines
permanent canine fails to erupt
root resorption of adjacent teeth
what class of occlusion would a reverse overjet be associated with
class III
what would you look for when assessing a patient with a reverse overjet
they can get edge to edge relationship
what limits treatment of reverse overjets
upper incisors proclined more than 120 degrees already
what would the plan be if the patient has an underlying skeletal problem causing the reverse overjet
wait until growth has stopped
what is interceptive treatment for class III malocclusion
enhance maxillary growth and reduce mandible growth
protraction headgear and RME
functional appliances - twin block
what are the indications for growth modification in class III
mild class III
maxillary retrusion
anterior displacement in closing
average or reduced lower face height
patient age 8-10
what are risks of increased OJ
risk of trauma
incompetent lips
appearance - bullying
what IOTN scores would mean treatment for overjets
4 - more than 6mm
5 - more than 9mm
what are the IOTN scores
3 - borderline
4 - need for treatment
5 - high need for treatment
what is the aim of interceptive treatment for class II malocclusion
restrain maxillary growth and promote mandibular growth
