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Ortho DEN305 > Interceptive treatment > Flashcards

Interceptive treatment Flashcards

1
Q

What is interception?

A

Early identification and management of potential problems
Avoidance of a worse malocclusion
Early appliance treatment

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2
Q

Normal development of the primary dentition?

A

Established by 30 months
Positive overjet and overbite
Spacing normal

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3
Q

Primary dentition problems?

A
  • Delayed eruption
  • Missing teeth
  • Supernumery teeth
  • Abnormal teeth
  • Crowding
  • Overjet
  • Class III
  • Crossbite
  • Caries/trauma
  • Habits
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4
Q

When is delayed eruption of primary teeth a problem?

A

Contralateral side different

Abnormal sequence of eruption

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5
Q

What can missing primary teeth indicate?

A

Missing permanents - affects less than 1% of pts

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6
Q

Prevalence of supernumerary teeth?

A

30-35% of pts with primary supernumary will have a permanent one

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7
Q

How to treat geminated primary teeth?

A

Consider extracting early to allow alignment of single permanent tooth

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8
Q

How many mms of spacing is needed in primary dentition?

A

> 6mm

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9
Q

What can primary overjets indicate?

A

Overjet greater in permanent dentition - just observe primary overjet

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10
Q

How to manage primary class III?

A

Observe

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11
Q

What tends to persist?

A

Skeletal crossbites

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12
Q

How to manage caries/trauma to primary incisors?

A

Trauma to primary incisor = possible ankylosis, look out for deflection of permanent successor

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13
Q

What can habits e.g. thumb sucking cause?

A

Anterior open bite

Unilateral posterior crossbite

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14
Q

How do 6s often erupt?

A

Into half unit class II - corrects to class I in time with the leeway space

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15
Q

How much larger are permanent incisors compared to lower incisors?

A

Upper arch - 7mm greater
Lower arch - 5mm greater
Permanents more proclined, inter-canine width growth

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16
Q

What is the most common cause of delayed eruption?

A

Supernumerary teeth

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17
Q

How to manage erupted mesiodens?

A

Extract and align teeth

18
Q

How to manage unerupted supernumery?

A

XGA supernumery

19
Q

How to manage supplemental teeth?

A

Usually extract most displaced or poorly formed teeth

20
Q

If a tooth is lost early, what should you think about?

A

Centre lines e.g. premature loss of C = shift of centre line to extraction side
Solve by balancing loss of primary canine
Balancing extractions
Compensating extractions
Space maintenance

21
Q

When can occur in crowded cases when the LLD is lost early?

A

Lower centre line shift to left

22
Q

Premature loss of ULE results in?

A

Mesial movement 1st permanent molars
Space loss greater and faster in upper arch
Do NOT balance as disrupts occlusion

23
Q

How to maintain space?

A

Fixed and removable appliances

24
Q

Problems with space maintainers?

A

Pts unsuitable for appliances
Must fit immediately
Often unnecessary

25
Q

Options with impacted 1st permanent molars?

A

Disimpact UR6

Extract E

26
Q

What causes a median diastema?

A

Normal - ugly duckling stage (= 21/12 distally inclined due to position of canine crowns, upper midline diastema)
Supernumerary tooth
Generalised spacing
Proclined upper incisors - class II div 1, digit sucking
Trauma
Pathology (cysts, tumours)

27
Q

Indications for XLA of primary canines?

A

• Permit lateral incisors to align
• Allow incisor to be moved over the bite
• Potentially to improve the position of palatally
displaced permanent canines
• Severe upper and lower crowding
• Upper laterals palatal/ impacted

When anterior crowding:
• All primary canines
extracted
• Upper laterals
erupted, lower
laterals
spontaneously align
• Crowding transferred
to buccal segments
(no space for 3s)
28
Q

When to treat an anterior crossbite? Posterior crossbite of 6s?

A

Anterior crossbite = Early

Posterior crossbite of 6s = early (look for mandibular displacement on closure)

29
Q

How to correct a posterior crossbite?

A

Adams cribs on 6s
0.7mm diameter stainless steel
(retention and anchorage)

Midline screw

Acrylic baseplate
(anchorage)

30
Q

How to manage mixed dentition digit sucking?

A

Educate patient and parents and

advice cessation of habit

31
Q

When to refer class III skeletal pts to ortho?

A

When pt 8-10 yrs old

32
Q

How to manage missing teeth in the late mixed dentition?

A

Monitor/ refer to hospital for treatment plan
jointly with Paediatrics/ Restorative
(multi-disciplinary care)

33
Q

How to manage infraoccluded teeth in the late mixed dentition?

A

Monitor then extract under LA

34
Q

Problems in the late mixed dentition?

A 
Missing teeth
• Infraoccluded teeth
• Crowding
• Poor quality 6s
• Ectopic canines
• Habits
• Increased overjet
35
Q

How to manage poor quality 6s in the late mixed dentition?

A

If poor prognosis = refer to ortho for opinion on extraction timing

36
Q

How to manage ectopic canines in the late mixed dentition?

A

Refer at time of diagnosis

37
Q

What to do when the pt is 9 years old?

A

Screen for palpation of maxillary canines buccally
- radiographs

Refer to ortho if ectopic

38
Q

Effects of digit sucking?

A

Proclined upper incisors
Anterior open bite
Unilateral posterior crossbite
Increased overjet

39
Q

Habit breaking appliances?

A 
Better spontaneous correction if stops before 8 yrs old
Passive removable appliance:
- 3 months full time
- 3 months nights only 
- Hayrake (for correction of AOB)
40
Q

How to manage increased overjet in the late mixed dentition?

A

Refer to ortho - mixed appliance in growth spurt:

11-13yrs old

41
Q

Problems with adult treatment?

A

Lack of growth – treatment slower
• Mutilated dentition determining extraction
patterns, reduced periodontal support,
periodontal disease…
• Co-operation can be more difficult – ability to
attend/ willingness to participate
•Different expectations

Ortho DEN305 (16 decks)

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