Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

FINALS - Orthodontics > Interceptive orthodontics 2 - Late mixed dentition > Flashcards

Interceptive orthodontics 2 - Late mixed dentition Flashcards

1
Q

What is a URA design to correct anterior cross bite with 21 out of line of arch?

A

Active - Z-spring UL1 (double cantilevered spring) 0.5mm HSSW
Retentive - Adams clasps 16,17 and 26,27 0.7mm
HSSW
- Southend clasp 11 0.7mm HSSW
Anchorage - Only moving one tooth
Base plate - Self cure PMMA acrylic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the digit habit management?

A
  1. Positive reinforcement
  2. Bitter-tasting nail varnish
  3. Glove on hand, elastoplast
  4. Habit breaker appliance (habit deterrent ) fixed or removable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why should you treat a digit habit early?

A
  • Maximise potential for spontaneous correction of anterior open bite whilst still eruptive potential for incisors
  • 8-10 years whilst root formation still incomplete
  • Prevent effects on vertical and transverse skeletal development which could lead to permanent skeletal change if habit persists
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What URA can be used as deterrents for digit habit?

A
  • One piece baseplate with single goal post
  • Split baseplate with expansion screw and 2X palatal goal posts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What fixed appliance can be used as deterrents for digit habit?

A
  • Tongue rake
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do you know if pt is wearing their appliance?

A
  • Ask
  • Did they walk into surgery wearing it?
  • Can they speak with it?
  • Can they take it in and out without difficulty?
  • Does appliance still fit?
  • Does palate look as though appliance has been place - Gingival erythema? Palatal erythema?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are infra-occluded teeth?

A
  • One or more teeth fail to project as far as normal occlusal plane
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the probability of infra-occlusion?

A
  • 10%
  • Lower > uppers
  • Permanent successor absent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the aetiology of infra-occluding teeth?

A
  • Ankylosis of primary tooth
  • Surrounding alveolar bone continues to grow
  • Primary tooth tooth gets left behind
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What should you assess the radiographs for when think it’s infra-occluding teeth?

A
  • Presence/ absence of successor
  • Ankylosis of primary tooth (no PDL space/ no clear lamina dura)
  • Root resorption of primary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the treatment for infra-occluding teeth if permanent successor is present?

A
  • Monitor 6-12months
  • Extract if primary tooth below IP contact point
  • Consider XLA if root formation of successor near completion
  • If XLA then maintain the space
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the risks of doing nothing with an infra-occluding tooth?

A
  • Permanent successor become more ectopic
  • Infra-occlusion becomes worse and tipping of adjacent teeth
  • Caries and Periodontal disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the treatment for infra-occluding teeth is permanent successor is absent?

A

Depend on
- Degree of crowding
- Degree of infra-occlusion
- Any other features of malocclusion

  • Retain primary if in good condition and consider onlay
  • XLA if below IP contact point and plan space management
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the treatment for plan spacing management for infra-occluding teeth if permanent successor absent?

A
  • Either maintain space for prosthetic tooth
  • Reduce space to one premolar unit (needs fixed appliance)
  • Close space with fixed appliance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is an URA design to maintain space of 25?

A

A - None
R - Adams clasps 16 and 26 0.7mm HSSW
Southend clasp 11 and 21 0.7mm HSSW
A - Not required
B - Extend baseplate distal to 24 or consider wire stop (0.6mm or 0.7mm HSSW) Self cure PMMA acrylic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the normal development of upper Canines?

A
  • Development starts high and palatal
  • Migrate and lie labial and distal to root apex of upper lateral
  • 90% palpable by 11 years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When should you assess position of upper canines?

A
  • 9-10 years
  • Palpate by 11
  • Mobile C’s and symmetry
  • Angulation of lateral incisors
  • Radiograph if unable to palpate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What can occur with ectopic maxillary canines?

A
  • Central incisors resorb by 15%
  • Lateral incisors resorb by 66.7% using CBCT
  • Most root resorption occurs before age 13
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the management of ectopic maxillary canines?

A
  • XLA of C
  • Consider if need space maintainer
  • Wait 12months for eruption then reassess
20
Q

When is the XLA of C’s for ectopic maxillary canines likely to be successful?

A
  • Age between 10-13years
  • Canine is distal to midline of upper lateral incisor
  • Sufficient space available
  • Canine less then 55° to mid-sagittal plane
21
Q

What are some risks of doing nothing for ectopic maxillary canines?

A
  • Permanent successor become more ectopic
  • Permanent canine then fails to erupt (impacted canine)
  • Risk of root resorption of adjacent teeth
  • Risk of root resorption of canine crown
  • Risk of cysts formation around canine
  • Permanent canine become ankylosed (incidence increases with age)
22
Q

What should you be aware of with reverse overjet?

A
  • Is it Skeletal or is it dental?
  • Is there incisor angulations
  • Is it edge-edge
  • Is there mandibular displacement on closing?
23
Q

What is the interceptive treatment of Class III?

A
  • Growth modification
  • Camouflage with URA
24
Q

What are the growth modification options for Class III?

A
  • Enhance maxillary growth and/or reduce mandibular growth
  • Do this by
    • Protraction headgear +/- Rapid maxillary expansion (RME)
    • Functional appliances e.g. Reverse twin block / Frankel III
25
Q

When is growth modification in class III most successful?

A
  • Skeletal I or only mild class III
  • Maxillary retrusion
  • Anterior displacement on closing
  • Average or reduced lower face height
  • Patient age 8-10yrs
  • Needs to wear for 14+hrs per day
26
Q

What implants are used for anchored maxillary protractions?

A
  • Bollard implants
  • Into bone
27
Q

Why should you treat an increased overjet early?

A
  • Risk of trauma due to incompetent lips
  • Appearance (bullying, self esteem)
  • More difficult to achieve correction once pt stopped growing
28
Q

What is the IOTN of increased OJ?

A

> 6mm = 4a
9mm = 5a

29
Q

What is the interceptive treatment of Class II?

A
  • Growth modifications with functional appliances or headgear
  • Restrain maxillary growth
  • Promote mandibular growth
30
Q

Summary of interceptive orthodontics?

A

Spaced primary dentition = ok
Unerupted incisors = remove ob. / space/ obs
Balance c’s = not critical
Carious lower 6’s = Take upper
Unilateral cross bites = displacement
Habits = stop before 9yrs
Infra occluded decidious teeth = wait 1yr
Canines = Look at 11
-ve OJ = Growth
+ve OJ = functional app

31
Q

What is an unusual tooth movement following interceptive XLA?

A
  • Submerging left or right lower e
  • Use band and loop space maintainer
32
Q

What are the digit habits outcome?

A
  • Posterior crossbite
  • Anterior open bite
  • Increased overjet
  • Proclined upper anteriors
  • Retroclined lower anteriors
33
Q

What is the maximum angulation of the incisors if we are looking to procline them?

A
  • Max is 120° so if they are already at this we can’t do anymore
34
Q

What is the maximum angulation of lower incisors?

A
  • 80°
  • If already have this then can’t retrocline them anymore
35
Q

What does ankylosis of tooth mean?

A
  • Tooth root becomes fused to underlying bone typically as result from trauma or injury
  • Can prevent eruption and lead to infra-occluded teeth
  • Can lead to ankylosis-related root resorption and requires extraction
36
Q

Why do patients with a digit sucking habit end up with a unilateral cross bite?

A

They have a narrow upper arch, which leaves them cusp to cusp, then to the jaw displaces one side to compensate.

37
Q

What are the causes of anterior open bite?

A

Digit sucking habit

Teeth not fully erupted

Traumatic intrusion

Tongue thrust

Skeletal pattern - long facial type

38
Q

What steps can be taken to correct a digit sucking habit?

A

Conservative measures first:
- Discuss stopping habit
- Gloved hand
- Elastoplast
- Poor tasting nail varnish

Less conservative:
- Habit breaker on a URA
- URA with a mid palatal expansion screw

39
Q

What is the benefit of giving a patient with a digit sucking habit a URA with a mid palatal expansion screw?

A

Can correct unilateral cross bite and prevent dentition from erupting into cross bite.

40
Q

How long should a patient be required to wear a habit breaking URA, and how long after the habit is stopped should orthodontic treatment start?

A

24 hours

Within 2-6 months should work, beyond this it probably won’t work.

When habit stops continue for one month after to ensure habit broken.

No treatment 4-6 months after habit is broken, as could allow spontaneous resolution.

41
Q

What % of children have MIH?

A

15%

42
Q

What factors are important to consider for removal of first molars?

A

Between 8-10 years

Calcification of the furcation of the 7s

Angulation of the 7s

Development and orientation of the eights

43
Q

What factors influence space loss when primary teeth are extracted?

A

Upper teeth runs out of space quicker.

Crown of tooth swings forward over the root, leading to angled teeth.

Age of the patient also plays a factor.

How crowded the patient is to begin with.

44
Q

Why might primary teeth ankylose?

A

Sitting on infection
No permanent successor

45
Q

What are the causes of upper midline diastema?

A

Mismatch between size of the arch and size of teeth

Low frenum attachment

Presence of supernumerary

Absence of the lateral incisors, or missing teeth in general.

Overjet can cause teeth to splay out.

46
Q

Why do dens en dentate teeth have poor prognosis?

A

There is almost always a communication between the pulp and the incisal/cuspal edge.

Direct contact with oral cavity, leading to loss of vitality.

FINALS - Orthodontics (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions