Interceptive orthodontics 2 Flashcards
When a patient has an anterior cross bite what would you clinically assess
Displacement?
Mobility of lower
incisor
Tooth wear
Gingival recession
What would the active components be for a appliance design to fix anterior cross bite
Z-spring UL1 ((or whatever tooth applies))(double cantilevered spring) 0.5mm HSSW)
What is the problem with correcting a posterior crossbite
50% relapse
What would aid in the anterior Cross-bite Correction Stability
Creating a overbite as this would stop the relapse
Why would you want to treat a digit habit early
To maximise potential for spontaneous correction of anterior open bite whilst there is still eruptive potential for incisors (8-10 years/ root formation still incomplete)
To prevent effects on vertical and transverse
skeletal development which could lead to
permanent skeletal change if habit persists
How would you manage a digit habit
- Positive reinforcement
- Bitter-tasting nail varnish
- Glove on hand, elastoplast
- Habit breaker appliance (habit deterrent) – fixed or removable
What do you call the bit on a habit breaker appliance that prevents a digit habit
URA – Palatal goal post(s)
Fixed – Tongue rake
How do you know that your patient is still wearing the appliance
- Ask them
- Did they walk into surgery wearing it?
- Can they speak with it in?
- Are they still suffering from excess salivation?
- Can they take it in and out without difficulty?
- Are there any signs of wear on the appliance?
- Does the palate look as though the appliance has been in place….. Gingival erythema? Palatal erythema?
- Has the tooth moved? Is the active component now passive?
- Does the appliance still fit
What are the eruption dates
6’s -6yrs
1’s- 7yrs
2’s- 8yrs
4’s- 10yrs
3’s & 5’s- 11-12yrs
7’s- 12-13yrs
Infra occlusion is more likely to occur where
Lower > Uppers
What is the aetiology of infra occluded teeth
Ankylosis of primary tooth. Surrounding
alveolar bone continues to grow. Primary
tooth gets left behind
How could you achieve a diagnosis of infra occlusion
Percussion, the sound it gives is ‘duller’
Check for mobililty
Radiographs ( PA or OPT)
What would you assess the radiograph of a tooth that is infraoccluded for
Presence /absence of successor
Ankylosis of primary tooth (no PDL space/no clear lamina dura)
Root resorption of primary
What would the treatment be for a infraoccluded tooth where the successor is still present
Monitor 6-12 months
Extract if primary tooth is below the interproximal contact point
Consider extraction if root formation of
successor near completion
If extract maintain space
What are the risks of doing nothing with a Infra-occluding Tooth where the Permanent successor is present
Permanent successor can become more ectopic
Infra-occlusion worsens with tipping of adjacent teeth
primary tooth becomes inaccessible for extraction
Caries and periodontal disease
