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ortho > intra arch malocclusion > Flashcards

intra arch malocclusion Flashcards

1
Q

BSI definition of class i malocclusion

A

lower incisor edges occlude with/lie immediately below cingulum plateau of upper central incisor

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2
Q

BSI definition of class ii malocclusion

A

lower incisor edges lie posterior to cingulum plateau of upper incisors (div I upper central incisors proclined/average inclination, div II upper central incisors retroclined

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3
Q

BSI definition of class iii malocclusion

A

lower incisor edges lie anterior to cingulum plateau of upper incisors. Overjet is reduced or reversed

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4
Q

Angle’s classification of class ii malocclusion

A

Lower first permanent molar distal to upper first permanent molar by at least width of half a cusp

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5
Q

soft tissue features of patient with class ii div 1 malocclusion

A
  • Convex facial profile
  • Significantly retrognathic mandible and increased overjet
  • Lower lip trap, incompetent lips
  • Acute naso labial angle
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6
Q

skeletal features of patient with class ii div 1 malocclusion

A
  • Protrusive maxilla

- Retrusive mandible, shorter total mandibular length

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7
Q

dental features of patient with class ii div 1 malocclusion

A
  • Protrusive maxillary dento alveolus
  • Retrusive mandibular dentoalveolus
  • Proclined/retroclined upper incisors
  • Increased overjet
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8
Q

cephalometric features of patient with class ii div 1 malocclusion

A
  • Maxilla and teeth anterior in relation to cranial base
  • Maxillary teeth anterior in normally positioned maxilla
  • Mandible normal size but posteriorly positioned
  • Mandible underdeveloped
  • Mandibular teeth posteriorly placed on mandible which is in a normal position
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9
Q

soft tissue factors that can exacerbate class ii div 1

A
  • Lower lip trap (due to increased over jet)
  • Active lower lip
  • Lip habit eg suck on lower lip
  • Low lip line ie lower lip does not cover upper incisors at all
  • Forward resting tongue posture
  • Lip incompetence/reduced lip tonicity
  • Short upper lip
  • Lip to lip seal by circum oral muscle activity
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10
Q

how does lower lip trap exacerbate class ii div 1 malocclusion

A

Lower lip exerts subtle force on upper and lower incisors further proclining upper incisors and may further retrocline lower incisors

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11
Q

what soft tissue factors retrocline lower incisors, exacerbating class ii malocclusion

A
  • Active lower lip

- Lip habit eg suck on lower lip

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12
Q

what soft tissue factors procline upper incisors, exacerbating class ii div 1 malocclusion

A
  • Low lip line ie lower lip does not cover upper incisors at all –> Upper incisors pushed by tongue more labially
  • Forward resting tongue posture
  • Lip incompetence/reduced lip tonicity
  • Short upper lip
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13
Q

What are the possible soft tissue features of patient with class II div 2 malocclusion

A
  • Hypodivergent
  • Short LAFH
  • Prominent chin point
  • Deep bite
  • Well developed and very active orbicularis oris and mentalis muscles/high in tonicity
  • Lower lip curl
  • High lower lip due to reduced LAFH (exert force on upper incisors from lower lip and cause upper incisor retroclination)
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14
Q

What are the skeletal features of patient with class II div 2 malocclusion

A
  • Acute gonial and mandibular plane angle
  • Shorter LAFH
  • Excessive overbite
  • Upward and forward mandibular rotation
  • Horizontal palatal plane
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15
Q

What are the dental features of a patient with class II div 2 malocclusion

A
  • Inverted maxillary occlusal plane with two occlusal levels ie anterior teeth are over erupted, posterior teeth infraoccluded
  • Exaggerated mandibular curve of spee
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16
Q

Children with incompetent lips and overjet greater than ___mm are at increased risk of suffering trauma to upper incisors

A

7-8mm

17
Q

Etiology of class III malocclusion

A
  • Skeletal
    • Maxillary deficiency
    • Mandibular excess
    • Combination
    • Forward growth rotation
  • Dental
    • Palatally displaced/retroclined upper incisors
    • Labially displaced/proclined lower incisors
    • Mesial drifting of lower 6s
  • Functional
    • Anterior superior functional shift
18
Q

What are the dental etiologies for class III malocclusion

A
  • Localised crowding/displacement
  • Early loss of lower primary Es/missing lower second premolars
  • Pseudo class III malocclusion
19
Q

How does early loss of lower primary Es/missing lower second premolars lead to class III malocclusion

A

mesial drift of 6s hence molars appear to be in class III relationship

20
Q

what is pseudo class iii malocclusion

A

Dental interference (premature contact usually between incisors). There is forward displacement of mandible to disengage incisors and permit further closure into posterior occlusion.

21
Q

What are the skeletal etiologies of a class III patient

A
  • Increased mandibular length
  • More anteriorly positioned glenoid fossa
  • Maxilla hypoplasia
  • Reduced anterior cranial base length
  • Forward growth rotation
22
Q

What are the features of patient with pseudo class III MI

A
  • Forward functional displacement of mandible
  • Class III malocclusion/anterior cross bite in MI
  • Premature contact between maxillary and mandibular incisors in CR
  • Class I skeletal base in CR
  • Max incisors retro, mand incisors proclined
  • May have traumatic occlusion
23
Q

What are the consequences of untreated pseudo class III MI malocclusion

A
  • Functional occlusion remodel over time to become true mandibular skeletal asymmetry/mandibular prognathia via adaptive remodelling. Constant forward posturing induce growth stimulus.
  • Dental asymmetry from DAC in presence of lateral component
  • Teeth in traumatic occlusion may become mobile over time and/or present with gingival recession
24
Q

What feature of the primary dentition indicates that patient has higher risk of developing class III malocclusion

A

Mesial step molar relationship; worsens with maturity due to cephalocaudal gradient of growth

25
Q

What can cause displaced teeth

A
  • Abnormal position of tooth germ
  • Space deficiency (usually affect teeth that erupt last in a segment)
    • Tooth size arch length discrepancy
    • Early loss of primary teeth
  • Retained primary teeth
  • Habits eg forward resting tongue
  • Supernumerary teeth/cysts that deflect path of eruption
26
Q

What causes late lower incisor crowding

A
  • Late anterior mandibular growth in class III patients –> bring lower incisors forward into lip
  • Late mandibular growth in downward rotation in patients with hyperdivergent mandible –> bring lower incisors into lip
  • Late mandibular growth in upward rotation of patient with deep bite –> bring lower incisors upwards against upper incisors
27
Q

Physiological causes of median diastema

A
  • Crowns of unerupted canines press against root of upper laterals, causing roots to tilt distally
  • Labial frenal attachment in mixed dentition stage tends to attach to incisive papilla, migrates labially and apically as child matures
28
Q

Pathologic causes of median diastema

A
  • Supernumerary (mesiodens)
  • Thick frenal attachment
  • Frenal attachment close proximity to interdental papilla
  • Digit sucking habit, forward resting tongue posture
  • Microdontia (laterals)

ortho (8 decks)

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