Interceptive XLA Of Primary

Question 0

What are the reasons for doing interceptive extractions on primary teeth?

Answer 0

Guide/ permit eruptions of permanent successors
Encourages space closure in hypodontia
Reduce localised gingival recession
Preserve symmetry and molar relationship
Impacted 6's

Question 1

What are interceptive extractions?

Answer 1

Extractions undertaken to minimise or eliminate the severity of the developing malocclusion or elk ate a potentially harmful occlusion befor damage occurs

Question 2

When would we consider interceptive extra hind to guide eruption of ectopic teeth?

Answer 2

Unerupted upper central
Palatally positioned upper lateral
Lingually positioned lower
Ectopic canine
Submergence

Question 3

What is the diff dx for an unerupted central?

Answer 3

Trauma: Periapical granulmoa or ankylosed, dilacerstion,
Supernumerary
Dentigerous cyst
Developmentally absent

Question 4

Where do 2/2 erupt relative to 1/1?

Answer 4

Palatally and they will remain Palatal if too crowded

Question 5

What interceptive actions are there for palatally erupting 2/2?

Answer 5

If very Palatal then xla c/c and b’s if present as the 2/2 being to erupt and before reaching occlusal level

Question 6

How do you manage lingually positioned incisor?

Answer 6

If the predecessor is still there xla primary’s

Question 7

What is the affect of crowding on canine?

Answer 7

This severely and adversely affects the outcome of extractions of C’s therefore need to maintain the space
Power and short 1993

Question 8

What are submerged teeth?

Answer 8

When the baby teeth fail to meet or maintain the occlusal relationship with adjacent and opposing teeth

Question 9

What are the causes ?

Answer 9

Primary teeth are not continuously resorbed but they go through phases of resorption and repair if there is a temporary period where resorption predominates then this can lead to Submergence

Question 10

What is the prevelence of submerge teeth?

Answer 10

9%

Question 11

Where are submerged teeth more commonly seen?

Answer 11

Mandible

Question 12

According to who, what happens to the submerged tooth if the permanet is present?

Answer 12

Kurol and thilander 1984

It is usually shed

Question 13

T/F submerged teeth usually occur when the permanent is absent?

Answer 13

T
But can occasionally occur in situations where the permanent tooth is present and thus it stops the permanent tooth from erupting

Question 14

What are the treatment options for submerged teeth?

Answer 14

Extarct tooth if
No permanent
Severe eg approaching gingival level
Adjacent tooth tips over the tooth

Or could consider build up with onlay

Question 15

Which teeth are most commonly absent?

Answer 15

8 
upper 2
Lower 5
Upper 5
1

Question 16

When would you extract baby teeth to promote space closure in hypodontia?

Answer 16

When upper 2 and 5 missing

Question 17

When there is missing upper laterals what could you do?

Answer 17

Extarct b and c early and encourage good contac between 1 and 3

Question 18

If missing lower 5 what could you do?

Answer 18

Consult orthodontist

Consider early xla of e if crowding present

Question 19

What teeth could you consider extractions of there if redession?

Answer 19

Consider extracting C’s if crowding is quite bad and there is localised recession on one of the lower incisors and the soft tissue will move incisors to neutral zone

Question 20

In a crowded case , what can happen when the permanent lower incisor is erupting?

Answer 20

This can resorb the root of the c and this can be lost prematurely and therefor need to balance with the other c to preserve the centre line

Question 21

What us balancing?

Answer 21

Extraction of the a tooth on the opposite side of the arch to minimise and correct centre line discrepancy

Question 22

Which tooth would you balance with ?

Answer 22

A tooth of dubious quality if there is one

If all teeth are sound then xla c since it is nearest the midline and most likely tone affective

Question 23

Every time you detract a tooth you need to balance. T/F

Answer 23

F

Only need to do one balancing extraction

Question 24

What is the purpose of compensation ?

Answer 24

This is the extraction of the same tooth in the opposite side of the arch and this preserve buccal segment relationships and prevents over eruption of the opposing teeth

Question 25

When does over eruption apply when compensating?

Answer 25

Only applies for the permanent teeth

Question 26

What are the factors affecting the outcome following deciduous extractions?

Answer 26

1. The tooth to be extracted: further from the midline the less effect on CL but more on molar relationships
   2 crowding: if there is no crowding then no space will be lost and therefor do not need to compensate or balance
2. Timing: closer to the eruption of the permanent tooth the less the effect of loosing tooth early

Question 27

What percentage of 6s are ectopic? Ref

Answer 27

3-4% Kennedy 1987

Question 28

In which arch are ectopic teeth more commonly seen in?

Answer 28

Maxilla

Question 29

What is the association with ectopic 6’s and family?

Answer 29

There is a familial link on 20% of cases

Question 30

Which group of patients are impacted 6’s more common in?

Answer 30

CLP

Question 31

What happens with impacted 6’s?

Answer 31

66% Are self correcting

Question 32

What should you do in cases with impacted 6’s?

Answer 32

Leave e is asymmptomatic otherwise extract e