Interceptive Treatment (Allen)

Question 1

What dentition is the patient in where the permanent teeth include central and lateral incisors, first molars and the child is 2-4 yrs away from full adult dentition?

Answer 1

Early mixed dentition

Question 2

What dentition is the patient in where the primary teeth remaining are the primary second molars?

Answer 2

Late mixed dentition

Question 3

What is the orthodontic treatment in the mixed dentition, knowing that a comprehensive treatment will be necessary later?

Answer 3

Phase I treatment

Question 4

What is a minimal orthodontic appliance of 2 brackets / bands on molars and 4 brackets on incisors in the mixed dentition?

Answer 4

Two by Four

Question 5

What will be necessary post Phase I therapy?

Answer 5

Retention until phase 2

Question 6

When should oral habits be stopped to avoid orthodontics later?

Answer 6

Prior to eruption or permanent incisors

Question 7

What are 2 orthodontic results of unaddressed oral habit?

Answer 7

1. Open bite

2. Maxillary constriction

Question 8

When is crowding normal in the mandible?

Answer 8

Mixed dentition as permanent lower incisors replace their smaller primary incisors

Question 9

Why is the initial crowding the early mixed dentition not an immediate worry?

Answer 9

Because premolars are smaller than the primary molars they replace giving room for teeth to shift
Leeway space

Question 10

Term for permanent lower incisors being larger than the primary incisor they replace?

Answer 10

Incisor liability

Question 11

This is crucial if the loss of a primary second molar in the early mixed dentition

Answer 11

Space maintenance

Question 12

Is space maintenance a concern if there is early loss of the primary first molar and why?

Answer 12

No, because primary 2nd molars prevent mesial movement of permanent first molar

Question 13

What is indicated in the late mixed dentition if there is anterior crowding or loss of primary 2nd molars for reasons other than eruption of 2nd premolar?

Answer 13

Lower lingual holding arch

Question 14

What holds the lower permanent first molars back to allow anterior crowding to be resolved posteriorly (move into the Leeway space)?

Answer 14

Lower lingual holding arch

Question 15

How much space can be gained with a lower lingual holding arch?

Answer 15

5mm

Question 16

Is anterior crowding in the early and late mixed dentition a local tooth issue normally or a whole arch issue?

Answer 16

Whole arch issue

Question 17

Is Phase I treatment indicated to correct anterior crowding (e.g. should primary canines be extracted early to allow permanent incisors to drift into that space and align)?

Answer 17

No. Wait until the whole arch can be treated.

Question 18

Should you take out primary teeth to align four permanent incisors?

Answer 18

No

Question 19

What is treatment if permanent incisor are blocked out i.e. have not erupted by age 6-7?

Answer 19

Make room for them via treatment

Question 20

Why is treatment indicated for blocked out incisors but not indicated for crowded incisors?

Answer 20

Blocked out incisors run risk of never erupting impacting which will require more invasive procedure later

Question 21

If a canine buccal bulge cannot be palpated in the vestibule between ages 9-11 what can be expected and should be confirmed radiographically?

Answer 21

Palatally impacted canines

Question 22

Is a palatally displaced canine caused by crowding?

Answer 22

No

Question 23

What is the percentage of palatally displaced canines that will erupt if left untreated?

Answer 23

36%

Question 24

What percentage of palatally displaced canines will have normal eruption if the primary canine is extracted?

Answer 24

65%

Question 25

What percentage of palatally displaced canines will have normal eruption if the primary canines are extracted and Headgear, or and an expander or a transverse palatal arch are placed in conjunction with the primary canine extraction?

Answer 25

85+%

Question 26

Class II patient can usually be treated well with what treatment: 2 stage or single stage

Answer 26

Single stage only (no early intervention indicate)

Question 27

Is there a correlation between the amount of over jet of the prevalence of trauma?

Answer 27

No

Question 28

If the patient has a partial anterior crossbite e.g. a maxillary tooth locked out behind a mandibular tooth, is treatment indicated immediately?

Answer 28

Yes must avoid gingival stripping and tooth wear

Question 29

If the patient has a complete anterior crossbite e.g. all maxillary anterior teeth are locked out behind mandibular teeth, is treatment indicated immediately?

Answer 29

Yes, if it is fixable

Question 30

How does one determine if the complete anterior crossbite if treatment early?

Answer 30

If the patient can bite end to end and is only functionally shifting into the crossbite

Question 31

When is a complete anterior crossbite not treated with early intervention?

Answer 31

When doing so would flare the maxillary teeth too far forward or mandibular teeth too far back and be unesthetic

Question 32

In normal growth, is overbite and over jet maintained through growth?

Answer 32

Yes

Question 33

In normal growth, what does the lower dentition do?

Answer 33

Mesialize

Question 34

In class III malocclusion growth, how long will the overbite and over jet be maintained?

Answer 34

Until skeletal discrepancy is too large to compensate

Question 35

What does the lower dentition do in the Class III growth?

Answer 35

Lower incisors tip back. Lower dentition DOES NOT mesialize.

Question 36

What intervention is indicated if the patient has an anterior crossbite and a class III skeletal appearance and the patient is 8 years old?

Answer 36

Protraction face mask (advances maxillae 2-3mm and brings teeth forward)

Question 37

What intervention is indicated if pt has an anterior crossbite and a class III skeletal appearance and pt is 10-12 yrs old?

Answer 37

Bone -anchored maxilla protraction (use miniscrew plates to advance maxilla up to 5mm)

Question 38

What intervention is indicated if pt has an anterior crossbite and a class III skeletal appearance and pt is 16-17 yr old female or 17-20+ male ?

Answer 38

Wait until pt completely done growing then deteremine treatment plan

Question 39

What is the maxillary advancement and mandibular growth decrease found in the early intervention method of bone anchored maxillary protraction for moderate age intervention?

Answer 39

+4mm maxilla | -2mm mandible

Question 40

Is early intervention indicated for complete posterior crossbite?

Answer 40

The belief on this is split between yes and no

Question 41

What is rationale for correcting a complete posterior crossbite in the early mixed dentition?

Answer 41

Easier to expand a younger patient. | Disadvantage is that the patient will require retention until Phase II

Question 42

What is rationale for waiting to correct a complete posterior crossbite until the late mixed dentition?

Answer 42

Most likely not any harder to expand an 11 yr old vs. a 9 yr old. The 11 yr old could be expanded and followed immediately with single stage orthodontics

Question 43

95% of unilateral crossbites are truly bilateral issues involving what?

Answer 43

Asymmetric functional shift to one side

Question 44

What is the character of a unilateral crossbite pt’s maxilla and mandible in relation to each other?

Answer 44

Both maxilla and mandible are symmetrically constricted

Question 45

What type of problem is a unilateral posterior crossbite?

Answer 45

Symmetrical problem

Question 46

Is early intervention indicated for a unilateral posterior crossbite?

Answer 46

Yes and retention will be necessary

Question 47

Is early intervention indicated for a patient with a deep bite?

Answer 47

No

Question 48

What is a normal maxillary diastema in the early mixed dentition that may correct itself when the canines erupt?

Answer 48

2mm or less

Question 49

What should be checked for if there is a maxillary diastema in the early mixed dentition that is greater than 2mm?

Answer 49

Mesiodens

Question 50

Will a >2mm maxillary diastema in the early mixed dentition close on its own?

Answer 50

No, early intervention is indicated

Question 51

What will be required for a corrected maxillary diastema in the early mixed dentition?

Answer 51

A fixed lingual retained on #8-#9

Question 52

What trumps everything when determining early intervention?

Answer 52

Psychosocial issues