Brainscape's Knowledge GenomeTM

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


See full index

BDS3 Orthodontics > Interceptive Orthodontics > Flashcards

Interceptive Orthodontics Flashcards

1
Q

Interceptive orthodontics

A
  • ‘any procedure that will reduce or eliminate the severity of a developing malocclusion’

general practitioners need to be able to spot

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

3 characteristics of deciduous dentition

A

incisors more upright

spaced

wear - thin layer of enamel

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

eruptioins of deciduous dentition

A

6 months - 2.5 years

a-b-d-c-e

lowers before uppers

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

no spacing in deciduous dentition ->

A

66% will develop crowding

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

<3mm spacing in deciduous dentition ->

A

50% crowding

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

3-6mm spacing in deciduous dentition ->

A

20% crowding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

>6mm in deciduous dentition ->

A

no crowding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is likely if there is missing or double teeth in deciduous dentiton

A
  • fusion of central and lateral incisor
    • likely Absent permanent successor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

eruption dates permanent dentitions

A

6s

6 years

1s

7years

2s

8years

4s

10years

3s and 5s

11-12years

7s

12-13years

variation exists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

6s erupt

A

6 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

1s eruot

A

7 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

2s erupt

A

8 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

4s eruot

A

10 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

3s and 5s erupt

A

11-12 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

7s erupt

A

12-13 years

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

early mixed dentition

A

6-8 years

6s, 1s, 2s erupted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

late mixed dentition

A

10-13 years

4s, 3s and 5s, 7s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

lower labial crowding that can improve spontaneously

A

up to 3.5mm of crowding may spontaneously improve

  • Primary canines present with permanent incisors

Grow transversely naturally and improve (3.5mm till 10)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

antropoid spacing

A

space that is localized mesial to the upper primary canine and distal to the lower primary canine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

ugly duckling stage effect on upper incisors

A

spaced upper incisors

  • diastema
  • laterals pointing distally
    • upper canines leaning against upper distal aspect of lateral roots as the 3s erupt the spacing will disappear

Despite mixed dentition looking spaced it is common to have crowding (need to fit in 3, 4, 5 between 2 and 6)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

size of diastema that will close naturally

A

<2.5mm should close between mixed and permanent dentition transition

frenectomy has little effect on longterm closure of diastema - not advocated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

% diastemas at 6 yeards Vs 12 Years

A

6years 96% have diastema

12years 7% have diastema (3’s erupted – more space than c)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is not advocated for diastema management

A

frenectomy - little effect on long term closure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

4 things needed to know about development of mixed dentition

A
  • knowledge of normal
  • sequence
  • symmetry
  • chronological guidelines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

issue here

A

Issue in sequence of eruption

  • Deciduous upper centrals (attrition and erosion worn)
  • But have both permanent laterals

Shouldn’t – CENTRALS BEFORE LATERALS

  • History, examination and radiographs – something wrong
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

issue here

A

symmetry

  • Contralateral tooth should erupt within 6 months

Upper right central fully erupted – not left one

  • But left lateral has -> alarm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

3 causes for unerupted central incisors

A
  • supernumeraries
  • trauma/dilaceration
  • other pathology
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

management of supernumeraries

A
  1. Remove deciduous and supernumeraries
  2. Create space
  3. Expose/bond
  4. Monitor (>1.5years)
  • Most will erupt between 1.5-2 years

Bond onto unerupted tooth possible (chain to pull down) or should just make space for it - debate

  • 80% 16 months Av. If you only make the space
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is not allowing 21 to erupt?

A

Present but supernumerary tooth bocking eruption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

history and exam for trauma causing issue in eruption sequence

A

dilaceration

History – ask about trauma

  • Usually remembered as significant

Exam

  • Palpate to see where incisor has gone
  • Radiograph – see it is displaced
    • Trauma to deciduous tooth transmits force up to hertwigs root sheath
      • Bend
        • Significant – no way can line up as part will be exposed if crown straight (non vital)
        • Need removed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

issue here

A
  • Symmetry and sequence issues*
  • 11 but no 21, 22 has started to erupt*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

3 aetiology possibilities of median diastema

A
  • Normal (small teeth)?
  • Supernumerary? 10%
  • Missing teeth?

radiograph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

7 cases for interceptive orthodontics

A
  • impacted 6s
  • potential crowding
  • early loss of deciduoud teeth
  • carious 6s
  • cross-bites
  • transposed teeth
  • habits
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

leeway space

A

normal development

difference between e,d,c and 3,4,5

  • Mandibular 2.5mm
  • Maxillary 1.5mm

deciduous teeth wider than permanent teeth

Measure from mesial 6 to distal 2 – want to have 18.5mm for no crowding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

mm spacing for no crowding

A

18.5mm

measure from mesial 6 to distal 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

balancing

A

take contralateral on other side of same arch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

compensating

A

take out opposing tooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

early loss of deciduous teeth effects

A

localises crowding

effect varies with

  • crowding
  • age
  • arch
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

crowding effect on early loss of deciduous teeth

A

more crowding = greater balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

age impact of early loss of deciduous teeth

A

loss early = larger than if naturally about to lose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

management techniques of early loss of deciduous teeth

A
  • Balancing – take contralateral on other side of same arch
  • Compensating – take out opposing tooth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

management early loss As and Bs

A

little impact

don’t balance or compensate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

management early loss of Cs

A

balance

  • midline will shift - unless very spaced
    • as permanent incisors are present
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

management of early loss of Ds

A

small CL shift - balance if already under GA potentially

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

management of early loss of Es

A
  • Not to balance – no effect on centre line
  • Major space loss
    • significant mesial drift of 6 – compound a future crowding issue (less space for 3, 4, 5)
  • Upper > lower rate of mesial drift
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

which arch has a faster rate of mesial drift

A

upper > lower

significant mesial drift of 6s if Es lost early - compound a future crowding issue (less space for 3, 4, 5)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

when to assess carious 6s

A

assessment at 9 years

  • any doubts re long term prognosis - refer for advice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

6s extraction general rules in relation to both arches (class 1) 3

A
  • If extracting lower take upper
  • Don’t balance with sound tooth – tx each side mouth separately
  • If extracting upper don’t necessarily take lower
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

why if extracting lower 6 take out upper 6?

A

upper 6s will overerupt and impinge gingiva (nothing to occlude against)

but if extracting upper 6 don’t necessarily take out lower 6

50
Q

5 ideal condition for extraction of 6s

A
  • 7s furcation forming
  • 8s present
  • Class 1 av/reduced OB no skeletal element
  • Moderate lower crowding
  • Mild/moderate upper crowding mesial drift faster
51
Q

assess this radiograph for extraction of 6s

A
  • Grossly carious 16
  • Grossly carious 26
  • Carious 36 and 46

Supernumerary inverted conical in maxillary midline

Can see furcation of 47 – good sign for 46 extraction – will close the gap

  • Remember 5 uses mesial aspect 6s root to bump against and erupt
    • Here 45 is rather vertical so if remove 46 teeth will likely come up OK
    • If was distally inclined, then could be issue – drift distally – spacing in buccal segments or impact 7s

Signs 8s developing

This case – all 4 6s extracted – likely under GA, may also remove supernumerary tooth too

  • Work with parents
    • Diet issue and OHI needed
    • Need more regular check ups
52
Q

different types of crossbite

A

anterior and posterior

unilateral or bilateral

53
Q

what type of cross bite are ortho concerned with

A

unilateral cross bite - may interfere with way mandible is closing

54
Q

how to assess if posterior unilateral crossbite needs interceptive orthodontics?

A

displacement on closure?

  • IOTN

>2mm

TREAT

55
Q

appliance for treating posterior unilateral cross bite which is causing displacement greater than 2mm

A
  • Active –* midline screw
  • Retentive -* Adam’s clasp on 4s and 6s
  • Anchorage -*
  • Baseplate –* PMMA with posterior bite planes

Wear 24/7

Turn screw ¼ once Sunday and once

56
Q

how long does posterior crossbite take to correct

A

6-9 months to correct

but retention of inactivated device for 3 months at night to prevent relapse

tend to OVERCORRECT

  • posterior bite planes
    • centrelines now coinceident after tx - weren’t before tx
      • due to mandibular displacement
      • uniformly narrow maxilla - widen with screw - to remove displacement
57
Q

when to treat anterior unilateral cross bites

A

if causing displacment

tend to treat early (when 2s through) with URA

58
Q

anteriot unilateral cross bites can cause

A
  • uneven wear on incisal edge (chisel like)
  • lower incisor is pushed forward - gingival recession (slightly out alveolar bone)
59
Q

URA for anterior unilateral crossbite

A
  • Active –* Z spring on 12
  • Retentive -* Doubles Adam’s clasp on Es and 6s and Adam’s clasp on 11 (can be bulky – use southend, or used 6s and Ds)
  • Anchorage -*
  • Baseplate –* self cure PMMA with posterior biteplanes

Pt needs to disclude so can push the tooth forward

ALL CROSSBITES NEED

  • Simple easy treatment – just tipping one tooth
  • Quick
60
Q

all appliances for unilateral crossbite tx need

A

posterior bite plane

pt needs to disclude so can push the tooth forward

61
Q

cross bite correction stability

A

Anterior

  • Overbite
    • if good won’t relapse despite growth (upper incisors in front of lower)

Posterior

  • 50% relapse
62
Q

habits cauing malocclusion issues

A

thumb or dummy sucking

63
Q

impact of thumb/dummy sucking

A
  • Proclined upper incisors
  • retroclined lower incisors
  • Asymmetric AOB or reduced OB
    • Can tell which thumb with side
    • hyperkeratotic pad on thumb too
  • Unilater posterior crossbite
    • Tendency for upper arch to be narrow
      • bucal segment teeth meet edge-to-edge pt displaced one way or the other

superimposed on genetic makeup of pt – increase OJ etc

64
Q

when do affects of habit sucking become increased

A

longer it is a habit

esp post 5 years as beginning to enter mixed dentition phase

thumb sucking tends to persist longer than dummy sucking - peer pressure, parents influence

65
Q

interceptive orthodontics deterrants for habits (thumb, dummy sucking)

2 options

A

removable appliances

  • double adam’s on Es and 6s
  • goal post – behind anterior to remind pt thumb shouldn’t be there
  • need pt to be determined – only 2-3 months

Fixed habit breakers (top and bottom)

  • Reminder pt shouldn’t be sucking there thumb
66
Q

can effects of thumb/dummy sucking be reversed?

A

Give up ASAP and teeth will erupt into normal position

Within 3 years of eruption! (<10 years)

67
Q

possible issues for interceptive orthodontic tx in late mixed dentition (4)

A
  • Retained deciduous teeth
  • Infra-occluded deciduous teeth
  • Canines
  • Overjets
68
Q

issue with retained deciduous teeth

A

permanent teeth pushed buccally as primary teeth still present (lingual)

69
Q

how to tx retained deciduous teeth in late mixed dentition

A

take out deciduous teeth as soon as

permanent teeth can drift in eruption but if fully erupted need appliance

70
Q

infra-occluded deciduous teeth

prevalence

A
  • 10%
  • Lowers > uppers
71
Q

what are infra-occluded deciduous teeth?

A

a.k.a submerging teeth

but aren’t - everything else is growing up around it

can be ankylosed to bone - no vertical bony development around it

72
Q

diagnosis of infra-occluded decdiduos teeth

A

percussion - dull craked cup sound

radiographs

73
Q

management of infra-occluded permanent teeth depends on

A

if permanent successor present or not

74
Q

management for infra occluded deciduous tooth if permanent successor present

A

observe 1 year - should exfoliate normally

75
Q

management of infra-occluded deciduous tooth if no successor present

A

extract (when 1mm crown is showing)

76
Q

normal development of upper canines (3 facts)

A
  • Development palatal
  • Migrate and lie labial and distal to root apex of upper laterals
  • 90% palpable by 11 years

  • Ugly duckling stage*
  • Upper laterals distally tipped – good sign*
77
Q

3 canine checks

A

visual

palpate (pinkies best - feel for bulge)

radiographs

78
Q

3 things to be considering when delayed eruption/ectopic position of canines

A
  • Should palpate by 11 years
  • Assess position of upper canines from 10 years onwards
  • Mobile C’s (canine resorbing root), symmetry
79
Q

what age should radiographs be taken if unable to palpate canines

A

11 years

Generally, OPT and anterior maxillary occlusal or PA

(can do CBCT but rare due to dose)

80
Q

what parallax shift is used here

A

horizontal

SLOB - lingual

81
Q

ectopic maxillary canines can cause resorption of

A

central incisors in 15%

lateral incisors in 34%

82
Q

if extract a deciduous canine what action needs to be taken

A

balance with other side of arch to prevent midline shift

83
Q

what factors impact success of canine extractions for interceptive ortho

A

work till the age of 13 years with reasonable chance of success

  • Depend on high canine is
  • How much adjacent incisor it overlaps
    • (cross midline lateral – cross more than 1/2)
84
Q

benefit of interceptive extraction of canines

A

avoid 2-3 years ortho tx (costs)

1-2% of population - relatively common

85
Q

success rate of interceptive canine extraction depending on how much lateral incisor it overlaps

A

doesn’t cross midline - 90% success

cross midline - 60% (still good - better than coin toss)

86
Q

what is the prime age for interceptive extraction of cs

A

10 -13 years

too late - simple intervention not available

87
Q

positio of canines and tx option

A
  • Palatal ectopic upper canines (both)*
  • Quite significant ectopic
  • Interceptive Extraction cs – large benefit – straightened up canine and come done in line – save to NHS*
88
Q

impact of extraction of Cs on space

A
  • Rapid maxillary expansion (RME)
  • High pull headgear

Get even higher success rates possibly

89
Q

reverse overjet

A

lower teeth biting in front of uppers

Class III

90
Q

3 causes of reverse OJ

A
  • dental/skeletal/combination
  • refer for advice early
  • management
91
Q

assessment of reverse overject (class III)

A
  • able to get Edge to edge?
  • Incisor angulations?
    • Uppers less than 120
    • Lowers greater than 80

Scope to tip

  • Limits for class III camouflage – getting class I teeth whilst accepting skeletal issues
92
Q

incisor angluation needed to use class III camoflage in reverse OJ

A

upper less than 120

lowers greater than 80

If at 120 and 80 - no room to tip really

93
Q

effect of time on class III relationship

A

growth emphasises issue

94
Q

interceptive orthodontic tx options for class III (2)

A
  • growth modification
  • camouflage RA
95
Q

growth concern with interceptive orthodontic class III tx

A

be wary

nearly into class I at end of tx

but mandible contiued to grow and back into class III

don’t want to have to repeat tx - wary in acting as may continue to grow

96
Q

class III growth modification options (3)

A
  • functional appliances
    • Functional regulator (FR)
    • Frankel (FR) III
      • Buccal shields
      • Pelots
      • Tight lower labial bow
      • Spring to procline ULS –
  • maxillary protraction
  • removable appliances
    • z spring
    • screw section
97
Q

funtional appliance

action

evaluation for class III growth mod

A
  • Change soft tissue environment so teeth can move in right direction*
  • Hard to wear, expensive – low success rate*
98
Q

maxillary protraction for Class III growth modification

A

Reverse pull headgear with facemask

  • down and forwards
  • Can be with rapid maxillary expansion

Under 10

Quick tx but carries forward into subsequent growth

  • 70% success
  • 90+% success
99
Q

removable appliance features for Class III orthodontic tx

A

z spring

screw section

100
Q

increased Overjet

A

class II div 1

101
Q

causes of increase OJ

A

dental/skeletal (mandibular retromaphia)/combination

102
Q

3 impacts of increase OJ

A

appearance

function

risk of trauam - incompetent lips

103
Q

IOTN assessment for increased OJ

A

measure overjet using a ruler

  • >6mm 4a
  • >9mm 5a
104
Q

interceptive ortho for class II

growth modification

2 options

A

functional appliances

  • headgear to restrict maxillary forward growth*
  • Unacceptable mostly now
105
Q

functional appliances for class II

impact due to success

A

huge difference for pt - Teasing

  • 75% dental – tipping back UIs and proclination Lis
  • 25% skeletal – growth promotion in lower and restriction in upper
106
Q

functional appliances for Class II

method of action

A

Harness muscles forces

  • promote mandibular growth,
  • restrict maxillary growth,

tip lower teeth forward and top teeth back

80% have mandibular retromaphia – so promoting growth good

107
Q

what types of functional appliances are these (for class II)

A

All single block

Bar top left – twin block appliance

  • 2 individual components come together and pt posture forward

Twin block has 80% success compared to 30% of single so more likely to be worn

108
Q

describe malocclusion

ideal tx option?

A

Class II div 1 malocclusion

  • Mixed dentition
  • Large OJ
  • Incompetent lips
  • Retromaphic mandible

Ideal candidate for functional

109
Q

discuss if these lat ceph findings mean this pt can be tx with functional appliance interceptive orthodontics

A

class II div 1

  • ANB 6 = moderate group
  • Upper incisors = 130 normally 110 so scope to retrocline them back
  • Lower incisors = 91 OK don’t want to procline them more

after

  • Profile and lip competence improved despite LI inc proclination
110
Q

spacing in primary dentition is

A

OK

>6mm will lead to no crowding in permanent

111
Q

what to do if unerupted incisors?

A

radiograph

remove deciduous and obstruction

ensure space for them

observe

112
Q

balance Cs?

A

good

not critical (can affect midline – can be fixed later)

113
Q

carious lower 6s management?

A

take upper – despite if healthy

114
Q

unilateral cross bite management

A

IOTN displacment -> YES needs tx

115
Q

when should habits be stopped at the latest in order for chance of normal dental development

A

9 years

116
Q

infra-occluded deciduous deciduous tooth with successor management

A

wait and observe for 1 year

117
Q

infra-occluded deciduous tooth with no successor

A

extract when only 1mm tooth showing

118
Q

when to palpate for canines

A

9-10 years

119
Q

-ve overjet management

A

growth

camouflage - correct teeth, accept skeletal

120
Q

+ve overjet interceptive management

A

functional appliance

BDS3 Orthodontics (13 decks)

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