L.3 SPACE maintenance and guidance Flashcards
There is much speculation on what causes eruption: ____ formation….proliferation of ______ Epithelial Root Sheath…..proliferation of connective tissues of _______…growth of jaw….*pressure of ________ action *apposition/resorption of ______
root….Hertwig…dental papilla… muscular..bone
ERUPTION begins with _________
crown completion
HOW MUCH OF THE ROOT is present at eruption (emergence)???
3/4
HOW LONG DOES IT TAKE for a tooth to erupt and be in occlusion?
5 freggin yeeeahs.
Of the 4 factors influencing SPACE LOSS..what are the two most important concepts of dental development when making a treatment decision?
1.actively erupting teeth and 2. stable occlusion has less loss
Early _______ loss nearly ALWAYS causes some decrease in arch length…you’ll see ______ movement of molars AND
______ movement of anteriors
primary molar…mesial….distal
How long does it take for the MOST space loss after losing a primary molar? Which happens faster-max or mand?
first 6 months…maxillary faster
There is MORE potential space loss if adjacent teeth are actively _______
erupting
Loss of any ________ needs to be addressed if the first permanent molar is erupting
primary molar
Less potential space loss if permanent molar in _______
occlusion
Follow this shiz: EARLIER loss of primary molar leads to _______ eruption of PREMOLARS
DELAYED
Follow this shiz: LATER loss of the primary molar leads to ______ eruption of premolar
early
If a primary tooth is lost prior to crown completion of premolar there will probably be _______ eruption
delayed
Age at the time of loss: earlier loss leads to _____ eruption
delayed
Age at the time of loss: later loss leads to _______ eruption
early eruption
Did you know: Premolars require @ ___-___ months to erupt 1 mm through bone
4-6 months
What type of eruption is being described? Impacted permanent successors erupt more slowly but may need the primary tooth removed and space management to improve eruption direction
Ectopic Eruption
Fundamental concepts: Limited space loss from lost primary incisors (NO BIGGIE) UNLESS…. primary _______ are still erupting
canines
Primary cuspids lost almost always cause
_______ shift of incisors…maybe thats wanted (to “unwind” the teeth)
DISTAL
What is the possible Tx for if the permanent molars are erupted and in occlusion, and the second primary molars are intact and the first molars are absent?
NOTHING! (may not be an issue)
Lost ___________ should always have space maintenance considered, regardless of timing.
SECOND PRIMARY MOLARS
How do maxillary molars drift of there is space? Which direction?
Rotate Mesial-Lingual direction around palatal root
HOW many mm of loss could you potentially have with the loss of a maxillary second primary molar?
greater than 8mm!
HOW many mm of loss could you potentially have with the loss of a Mandibular second primary molar?
greater than 4mm
What are the 4 fixed appliances used to maintain space?
1.Band & Loop 2. Distal Shoe 3.Transpalatal/Nance Arch 4.Lower Lingual Holding Arch
Which appliance is indicated with the loss of the FIRST primary molar and the 1st permanent molar has not erupted yet?
Band & Loop
What appliance is indicated if the primary second molar is lost and COMPLETE ERUPTION OF THE 1st PRIMARY MOLAR HAS NOT YET TAKEN PLACE?????
Distal Shoe
What is the main contraindication for the use of a distal shoe?
medically compromised
What is a necessary follow up step to placing a distal shoe?
a radiograph!
What appliance is indicated with bilateral loss of teeth in the maxillary arch?
Nance or Transpalatal Arch
What is indicated for bilateral loss in the mandible; multiple teeth generally not recommended in the primary dentition due to potential problems with permanent incisor eruption
Lower Lingual Holding Arch
What is preferred when mandibular bilateral loss of the 2nd primary molars occurs? Why?
a LLHA, because band and loops would lose their abutment teeth in a short amount of time
When is the best time to judge amount of space needed (Moyers or Tanaka-Johnson)?..Best done when __________ and all _________ are present
permanent first molars….permanent incisors
Which percentile is used my Moyers analysis?
75th percentile
Which space analysis uses the 75th percentile for measurements of teeth to determine future space?
Moyer’s Analysis
When we are using Tanaka-Johnson, we are using the mandibular incisors to gauge the space needed for what permanent teeth?
perm canine, 1st PM, 2nd PM
When making the full arch measurement for Tanaka-Johnson, what are your bookends?
mesial of 1st permanent molar to mesial of the other
Rules of thumb: Tx for lost primary incisor?
NONE! (unless you do a pedi partial)
Rules of thumb: Tx for lost primary canine with unerupted permanent incisors
NO tx
Rules of thumb: Tx for lost primary canine with erupted permanent incisors
MAYBE ORTHO if other indications are there too
Rules of thumb: Tx for lost primary first molar, no occlusion, first permanent molar uneruped
YES, distal shoe
Rules of thumb: Tx for lost primary first molar with the permanent 1st molar erupted and in occlusion
NO tx
Rules of thumb: Tx for lost primary second molar
YES (band and loop, etc)
Rules of thumb: Always try to use a ________ tooth as an abutment!
permanent
