Interceptive Treatment (Allen) Flashcards
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?
Early mixed dentition
What dentition is the patient in where the primary teeth remaining are the primary second molars?
Late mixed dentition
What is the orthodontic treatment in the mixed dentition, knowing that a comprehensive treatment will be necessary later?
Phase I treatment
What is a minimal orthodontic appliance of 2 brackets / bands on molars and 4 brackets on incisors in the mixed dentition?
Two by Four
What will be necessary post Phase I therapy?
Retention until phase 2
When should oral habits be stopped to avoid orthodontics later?
Prior to eruption or permanent incisors
What are 2 orthodontic results of unaddressed oral habit?
- Open bite
2. Maxillary constriction
When is crowding normal in the mandible?
Mixed dentition as permanent lower incisors replace their smaller primary incisors
Why is the initial crowding the early mixed dentition not an immediate worry?
Because premolars are smaller than the primary molars they replace giving room for teeth to shift
Leeway space
Term for permanent lower incisors being larger than the primary incisor they replace?
Incisor liability
This is crucial if the loss of a primary second molar in the early mixed dentition
Space maintenance
Is space maintenance a concern if there is early loss of the primary first molar and why?
No, because primary 2nd molars prevent mesial movement of permanent first molar
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?
Lower lingual holding arch
What holds the lower permanent first molars back to allow anterior crowding to be resolved posteriorly (move into the Leeway space)?
Lower lingual holding arch
How much space can be gained with a lower lingual holding arch?
5mm
Is anterior crowding in the early and late mixed dentition a local tooth issue normally or a whole arch issue?
Whole arch issue
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)?
No. Wait until the whole arch can be treated.
Should you take out primary teeth to align four permanent incisors?
No
What is treatment if permanent incisor are blocked out i.e. have not erupted by age 6-7?
Make room for them via treatment
Why is treatment indicated for blocked out incisors but not indicated for crowded incisors?
Blocked out incisors run risk of never erupting impacting which will require more invasive procedure later
If a canine buccal bulge cannot be palpated in the vestibule between ages 9-11 what can be expected and should be confirmed radiographically?
Palatally impacted canines
Is a palatally displaced canine caused by crowding?
No
What is the percentage of palatally displaced canines that will erupt if left untreated?
36%
What percentage of palatally displaced canines will have normal eruption if the primary canine is extracted?
65%
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?
85+%
Class II patient can usually be treated well with what treatment: 2 stage or single stage
Single stage only (no early intervention indicate)
Is there a correlation between the amount of over jet of the prevalence of trauma?
No
If the patient has a partial anterior crossbite e.g. a maxillary tooth locked out behind a mandibular tooth, is treatment indicated immediately?
Yes must avoid gingival stripping and tooth wear
If the patient has a complete anterior crossbite e.g. all maxillary anterior teeth are locked out behind mandibular teeth, is treatment indicated immediately?
Yes, if it is fixable
How does one determine if the complete anterior crossbite if treatment early?
If the patient can bite end to end and is only functionally shifting into the crossbite
When is a complete anterior crossbite not treated with early intervention?
When doing so would flare the maxillary teeth too far forward or mandibular teeth too far back and be unesthetic
In normal growth, is overbite and over jet maintained through growth?
Yes
In normal growth, what does the lower dentition do?
Mesialize
In class III malocclusion growth, how long will the overbite and over jet be maintained?
Until skeletal discrepancy is too large to compensate
What does the lower dentition do in the Class III growth?
Lower incisors tip back. Lower dentition DOES NOT mesialize.
What intervention is indicated if the patient has an anterior crossbite and a class III skeletal appearance and the patient is 8 years old?
Protraction face mask (advances maxillae 2-3mm and brings teeth forward)
What intervention is indicated if pt has an anterior crossbite and a class III skeletal appearance and pt is 10-12 yrs old?
Bone -anchored maxilla protraction (use miniscrew plates to advance maxilla up to 5mm)
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 ?
Wait until pt completely done growing then deteremine treatment plan
What is the maxillary advancement and mandibular growth decrease found in the early intervention method of bone anchored maxillary protraction for moderate age intervention?
+4mm maxilla
-2mm mandible
Is early intervention indicated for complete posterior crossbite?
The belief on this is split between yes and no
What is rationale for correcting a complete posterior crossbite in the early mixed dentition?
Easier to expand a younger patient.
Disadvantage is that the patient will require retention until Phase II
What is rationale for waiting to correct a complete posterior crossbite until the late mixed dentition?
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
95% of unilateral crossbites are truly bilateral issues involving what?
Asymmetric functional shift to one side
What is the character of a unilateral crossbite pt’s maxilla and mandible in relation to each other?
Both maxilla and mandible are symmetrically constricted
What type of problem is a unilateral posterior crossbite?
Symmetrical problem
Is early intervention indicated for a unilateral posterior crossbite?
Yes and retention will be necessary
Is early intervention indicated for a patient with a deep bite?
No
What is a normal maxillary diastema in the early mixed dentition that may correct itself when the canines erupt?
2mm or less
What should be checked for if there is a maxillary diastema in the early mixed dentition that is greater than 2mm?
Mesiodens
Will a >2mm maxillary diastema in the early mixed dentition close on its own?
No, early intervention is indicated
What will be required for a corrected maxillary diastema in the early mixed dentition?
A fixed lingual retained on #8-#9
What trumps everything when determining early intervention?
Psychosocial issues
