Intro to Ortho Principle Flashcards
What three problems does irregular, protruding, or maloccluded teeth cause?
1- Psychological Problems
2-Oral functions (trouble with jaw movement)
3-Perio, trauma, tooth decay
How does poor occlusion affects the psychology of a px?
Malocclusion and facial skeletal abnormalities hinder you socially because you can be perceived as dumb
T/F teachers seem to have higher expectations for kids with crooked teeth?
False. Teachers tend to favor those with straight teeth
Besides esthetics, how might malocclusion/skeletal abnormalities affect a kid psychologically?
A child my have resulting poor speech which hinders his/her interactions with peers.
Patients with a class III sometimes can’t say which two sounds?
“f” and “v”
Kids with articulation disorders are known do what 4 speech impediments?
1-delete sounds
2- substitute sounds
3- add sounds
4- distort sounds
T/F for patients with facial disfigurements it is better and easier to cope if people they interact with a have a consistent response (even if negative)
True. The unpredictable responses cause anxiety
What is the major reason people seek ortho treatment?
for psychosocial reasons
*smaller percentage seek tx to help with occlusion or TMD
T/F px with severe malocclusion have poor function and do not adapt will
false
*adapt well, everything requires a little more effort
What is pathologic occlusion?
px can’t function without contributing to dentitions, and the oral facial complexes destruction
*excessive wear, TMD, Pulp changes, and perio probs
What is it called when a patient does not necessarily have a class I occlusion, but adapts and is functional?
Physiologic Occlusion
Malocclusion places stress and strain on what 4 things in the dental complex?
1-TMJ
2-Musculature
3-Dentition
4-Supporting bone and perio
Pain in the TMJ may result in pathologic changes in the joint, but more frequently causes what?
Muscle fatigue and spasm
T/F TMJ pain is common in children
false
T/F the relationship between TMD and occlusion is highly controversial
True
*ortho can sometimes help with TMD, but can’t be relied on
Ortho patients are classified into what 4 groups?
1-Masticatory muscle disorder
2- TMJ disorders
3-Chronic Hyper mobility
4-Growth disorders
TMD comes from what 2 major causes?
1-muscles spasms (clenching, grinding)
2-internal joint pathology
*ortho can help spasms, but try simpler things first
what is the primary cause of TMD?
malocclusion
Degenerative joint disease can appear as what 3 things?
1- Arthritic involvement
2- Disk displacement
3-myofascial pain
What causes disk displacement?
trauma or aging to the ligaments that oppose the action of the lateral pterygoid muscles
What is the most compelling argument against malocclusion as the primary cause of TMD?
TMD is no more prevalent in patients with severe malocclusion than in the general population
What are 5 simple treatments for TMD
1-stress control 2-stop chewing gum 3- teach px not to clench 4-anti-inflammatory drugs 5-splint
What is the purpose of splint therapy in TMD therapy?
it identifies IF malocclusion is a cause of TMD
What is the goal of splint therapy?
create a bite plane with no occlusal interferences
*if splint works, ortho will likely work
T/F drastic alteration of occlusion by restorative procedures or braces can be use as a primary means to correct TMD
False. Logical ONLY IF less invasive, stress-control approaches have failed
T/F braces may be used to help px better tolerate parafunctional habits
true
What are the chances that a kid with untreated class II will have trauma to the upper incisors?
1 in 3
A px with an extreme overbite where the lower incisors contact the palate is at risk of what 3 things?
1-tissue damage and bone loss to lingual aspect of max incisors
2-early loss of max incisors
3-extreme wear on mand incisors
Crossbites and traumatic occlusions can cause what 3 things?
1-extreme wear
2-gingival recession
3-bone loss
Malocclusion can contribute to ________ and _______
dental decay and periodontal disease
Tooth alignment or motivation is a bigger factor at determining oral hygiene?
motivation
T/F orthodontic treatment itself can cause perio problems?
False
*higher risk for decay and white spots
In tooth eruption, what is significant about age 6?
mandibular centrals, and 1st molars erupt
In tooth eruption, what is significant about age 8?
Maxillary lateral incisors erupt
In tooth eruption, what is significant about age 11?
Mandibular canines, and first premolars erupt
In tooth eruption, what is significant about age 12?
Maxillary canine, and 2nd premolars erupt
*2nd molars a few months later
In tooth eruption, what is significant about age 15?
The roots of all permanent teeth (except 3rd molars) are complete
*formation of 3rd molar crowns complete
What is pre-emergent eruption?
eruption of a tooth until it breaks through gingival tissues
what is post-emergent eruption?
Eruption of tooth after it has broken through gingiva
what two processes are necessary for pre-emergent eruption?
1-resorption of bone and tooth roots
2-propulsive mechanism
Why don’t teeth erupt in px with cleidocranial dysplasia?
abnormal resorption of bone and primary teeth
T/F if the mechanical obstruction of eruption is removed in cleiodocranial dysplasia, teeth will erupt?
true
T/F rate of bone resorption and rate of tooth eruption are controlled by the same mechanism
False
what is the rate limiting factor in pre-emergent eruption?
resorption of the overlying bone and primary tooth
The apical area of a tooth _____ the _____ while the crown moves occlusally
remains the same
If eruption is mechanically blocked, proliferating apical area will move in opposite direction
what causes a dilaceration?
Mechanical blockage of the apical area, resulting in it moving to the opposite direction
What is Eruption failure with absence of mechanical obstruction?
Primary failure of eruption
What does primary failure of eruption indicate?
defect in the propulsive mechanism
Primary failure of eruption is more common in what teeth?
posterior teeth
**1st and 2nd molars are more affected than premolars and canines
If the _____ teeth are affected with primary failure of eruption, than the ________ are also sometimes affected
Anterior, Posterior
T/F deciduous and permanent teeth can both be affected by primary failure of eruption
True
teeth affected by primary failure of eruption resorb the alveolar bone ______ the crown
above
T/F primary failure of eruption is usually symmetrical
False
PFE, non-ankylosed teeth become ankylosed before, during, or after ortho forces are applied?
During– as soon as the forces are applied
*which came first? we don’t know
Experiments with application of pressure against eruption premolars showed that eruption stopped for how long?
2-3 minutes
*tongue pressure/trusting
what 2 forces oppose the eruption of teeth?
1-Chewing forces
2-soft tissue forces
eruption typically occurs during quite periods (8pm to 1am) indicating that ________ forces are more important in controlling eruption than _______
soft tissue forces, heavy forces
T/F teeth that are in function erupt at a different rate than mandibular growth
False-It eruptions at a rate that parallels it
How far is the total eruption path of a 1st perm. molar?
2.5 cm
During the eruption path of a 1st molar, how much of the distance is transversed when tooth has reached occlusal level?
1.25 cm
- growth makes ankylosed teeth appear to submerge over time*
- also seen in px with lateral tongue thrust
What are the 3 options for an adult tooth that undergoes ankylosis during post emergent eruption?
1-extraction
2- crowns
3- surgery
ankylosis can be an especially big problem when the ______ ______ is missing
Adult tooth
When do you extract a ankylosed primary tooth when there is no adult tooth?
It is recommended when the primary tooth is below the height of contour
*can leave tooth as is, or build it up to occlusion
does eruption continue throughout life?
Yes, but at a very slow rate
T/F eruption throughout life means that the face height of the teeth change as you age
False. Typical occlusal wear compensates for the additional eruption.
