L.3 SPACE maintenance and guidance

Question 1

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 ______

Answer 1

root….Hertwig…dental papilla… muscular..bone

Question 2

ERUPTION begins with _________

Answer 2

crown completion

Question 3

HOW MUCH OF THE ROOT is present at eruption (emergence)???

Answer 3

3/4

Question 4

HOW LONG DOES IT TAKE for a tooth to erupt and be in occlusion?

Answer 4

5 freggin yeeeahs.

Question 5

Of the 4 factors influencing SPACE LOSS..what are the two most important concepts of dental development when making a treatment decision?

Answer 5

1.actively erupting teeth and 2. stable occlusion has less loss

Question 6

Early _______ loss nearly ALWAYS causes some decrease in arch length…you’ll see ______ movement of molars AND
______ movement of anteriors

Answer 6

primary molar…mesial….distal

Question 7

How long does it take for the MOST space loss after losing a primary molar? Which happens faster-max or mand?

Answer 7

first 6 months…maxillary faster

Question 8

There is MORE potential space loss if adjacent teeth are actively _______

Answer 8

erupting

Question 9

Loss of any ________ needs to be addressed if the first permanent molar is erupting

Answer 9

primary molar

Question 10

Less potential space loss if permanent molar in _______

Answer 10

occlusion

Question 11

Follow this shiz: EARLIER loss of primary molar leads to _______ eruption of PREMOLARS

Answer 11

DELAYED

Question 12

Follow this shiz: LATER loss of the primary molar leads to ______ eruption of premolar

Answer 12

early

Question 13

If a primary tooth is lost prior to crown completion of premolar there will probably be _______ eruption

Answer 13

delayed

Question 14

Age at the time of loss: earlier loss leads to _____ eruption

Answer 14

delayed

Question 15

Age at the time of loss: later loss leads to _______ eruption

Answer 15

early eruption

Question 16

Did you know: Premolars require @ ___-___ months to erupt 1 mm through bone

Answer 16

4-6 months

Question 17

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

Answer 17

Ectopic Eruption

Question 18

Fundamental concepts: Limited space loss from lost primary incisors (NO BIGGIE) UNLESS…. primary _______ are still erupting

Answer 18

canines

Question 19

Primary cuspids lost almost always cause

_______ shift of incisors…maybe thats wanted (to “unwind” the teeth)

Answer 19

DISTAL

Question 20

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?

Answer 20

NOTHING! (may not be an issue)

Question 21

Lost ___________ should always have space maintenance considered, regardless of timing.

Answer 21

SECOND PRIMARY MOLARS

Question 22

How do maxillary molars drift of there is space? Which direction?

Answer 22

Rotate Mesial-Lingual direction around palatal root

Question 23

HOW many mm of loss could you potentially have with the loss of a maxillary second primary molar?

Answer 23

greater than 8mm!

Question 24

HOW many mm of loss could you potentially have with the loss of a Mandibular second primary molar?

Answer 24

greater than 4mm

Question 25

What are the 4 fixed appliances used to maintain space?

Answer 25

1.Band & Loop 2. Distal Shoe 3.Transpalatal/Nance Arch 4.Lower Lingual Holding Arch

Question 26

Which appliance is indicated with the loss of the FIRST primary molar and the 1st permanent molar has not erupted yet?

Answer 26

Band & Loop

Question 27

What appliance is indicated if the primary second molar is lost and COMPLETE ERUPTION OF THE 1st PRIMARY MOLAR HAS NOT YET TAKEN PLACE?????

Answer 27

Distal Shoe

Question 28

What is the main contraindication for the use of a distal shoe?

Answer 28

medically compromised

Question 29

What is a necessary follow up step to placing a distal shoe?

Answer 29

a radiograph!

Question 30

What appliance is indicated with bilateral loss of teeth in the maxillary arch?

Answer 30

Nance or Transpalatal Arch

Question 31

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

Answer 31

Lower Lingual Holding Arch

Question 32

What is preferred when mandibular bilateral loss of the 2nd primary molars occurs? Why?

Answer 32

a LLHA, because band and loops would lose their abutment teeth in a short amount of time

Question 33

When is the best time to judge amount of space needed (Moyers or Tanaka-Johnson)?..Best done when __________ and all _________ are present

Answer 33

permanent first molars….permanent incisors

Question 34

Which percentile is used my Moyers analysis?

Answer 34

75th percentile

Question 35

Which space analysis uses the 75th percentile for measurements of teeth to determine future space?

Answer 35

Moyer’s Analysis

Question 36

When we are using Tanaka-Johnson, we are using the mandibular incisors to gauge the space needed for what permanent teeth?

Answer 36

perm canine, 1st PM, 2nd PM

Question 37

When making the full arch measurement for Tanaka-Johnson, what are your bookends?

Answer 37

mesial of 1st permanent molar to mesial of the other

Question 38

Rules of thumb: Tx for lost primary incisor?

Answer 38

NONE! (unless you do a pedi partial)

Question 39

Rules of thumb: Tx for lost primary canine with unerupted permanent incisors

Answer 39

NO tx

Question 40

Rules of thumb: Tx for lost primary canine with erupted permanent incisors

Answer 40

MAYBE ORTHO if other indications are there too

Question 41

Rules of thumb: Tx for lost primary first molar, no occlusion, first permanent molar uneruped

Answer 41

YES, distal shoe

Question 42

Rules of thumb: Tx for lost primary first molar with the permanent 1st molar erupted and in occlusion

Answer 42

NO tx

Question 43

Rules of thumb: Tx for lost primary second molar

Answer 43

YES (band and loop, etc)

Question 44

Rules of thumb: Always try to use a ________ tooth as an abutment!

Answer 44

permanent