Interceptive Orthodontics 2

Question 1

why do we treat habits early

Answer 1

maximise potential for spontaneous correction of AOB whilst still eruptive potential for incisors
prevent effects on vertical and transverse skeletal development which could lead to permanent skeletal change if habit persists

Question 2

what issues can come from the late mixed dentition

Answer 2

retained deciduous teeth
infra-occluded deciduous teeth
canines
overjets

Question 2

what issues can come from the late mixed dentition

Answer 2

retained deciduous teeth
infra-occluded deciduous teeth
canines
overjets

Question 3

what is the aetiology of an infra-occluded teeth

Answer 3

ankylosis of primary tooth. surrounding alveolar bone continues to grow. primary tooth gets left behind

Question 4

how do you diagnose infra-occluded teeth

Answer 4

percussion
check for mobility
radiographs (PA or OPT)

Question 5

what do you assess radiographs for in infra-occluded teeth

Answer 5

presence/absence of successor
ankylosis of primary tooth
root resorption of primary

Question 6

what do you do if the permanent successor is present in an infra-occluded tooth

Answer 6

monitor 6-12 months
extract if primary tooth is below the interproximal contact point
consider extraction if root formation successor near completion
if extract maintain space

Question 7

what are the risks of doing nothing with an infra-occluded tooth when the permanent successor is present

Answer 7

permanent successor can become more ectopic
infra-occlusion worsens with tipping of adjacent teeth and primary tooth becomes inaccessible for extraction
caries and periodontal disease

Question 8

what does the treatment plan depend on if the permanent successor is absent

Answer 8

degree of crowding
degree of infra-occlusion
any other features of malocclusion

Question 9

what is the treatment for infraoccluded tooth if permanent successor is absent

Answer 9

retain primary if in good condition and consider onlay
extract if below interproximal contact point

Question 10

what space management options are available once extracted an infra-occluded tooth with no permanent successor

Answer 10

maintain space with prosthetic tooth
reduce space to one premolar unit
close space

Question 11

what are the options of space maintainer

Answer 11

band and loop space maintainer
URA with extended baseplate into space wanting to maintain

Question 12

when should most canines be palpable

Answer 12

11 years

Question 13

when do you assess the position of upper canines

Answer 13

from 9-10 years onwards

Question 14

what do you do if you cannot palpate the canines by 11

Answer 14

radiograph (OPT)

Question 15

when would most root resorption occur due to ectopic maxillary canines

Answer 15

before 13 years

Question 16

when would extraction of C’s be successful

Answer 16

patient is aged between 10-13 years
canine is distal to the midline of upper lateral incisor
sufficient space available
canine less than 55 degrees to mid-sagittal plane

Question 17

what do you do following extraction of c’s

Answer 17

await eruption 12 months then reassess

Question 18

what are the risks of doing nothing with ectopic maxillary canines

Answer 18

permanent successor can become more ectopic
permanent canine then fails to erupt
risk of root resorption of adjacent teeth
risk of resorption of canine crown
risk of cyst
permanent canine can become ankylosed

Question 19

how do you assess a reverse overjet

Answer 19

edge to edge
mandibular displacement on closing
is aetiology skeletal or dental
incisor angulations
limits to how far upper incisors can be proclined and lower incisors retroclined

Question 20

what is the interceptive treatment for class 3

Answer 20

growth modification through maxillary growth/reduction of mandibular growth, protraction headgear or functional appliances
camouflage with URA

Question 21

when is growth modification in class 3 most successful

Answer 21

skeletal class 1 or only mild class 3
maxillary retrusion
anterior displacement on closing
average or reduced lower face height
patient age 8-10 years

Question 22

how long per day would a patient need to wear a growth modification device

Answer 22

14+ hours

Question 23

why do you treat increased overjet early

Answer 23

risk of trauma - incompetent lips
appearance - bullying/patient self esteem
more difficult to achieve correction once patient stopped growing

Question 24

what is the interceptive treatment for class 2

Answer 24

growth modification through functional appliances and headgear
restrain maxillary growth and promote mandibular growth