Lec1_Intro to Ortho Flashcards
What is the largest specialty in dentistry?
Ortho.
What are 3 methods of correction used by orthodontists?
- Force application
- Growth and functional force stimulation or redirection
- Applied within a craniofacial complex
Who pioneered cleft lip and palate treatment in 1850?
Norman Kingsley.
1st systematic description of ortho.
Who is the father of modern orthodontics?
Edward Angle - 1890.
Developed concept of of normal occlusion and classifications of malocclusion.
Only recommended non-extraction treatment.
Think: he figured out all the different angles!
What does components are involved in malocclusion?
- Dental. Use Angle’s classes of malocclusion to describe. Use study casts, clinical exam, and radiographs to determine.
- Skeletal. Analyze a cephalometric radiograph.
- Facial. Analyze clinical exam and photographs.
Describe normal occlusion:
Correct anteroposterior position = mesiobuccal cusp of 1st max molar in mesiobuccal groove of 1st mand molar.
Teeth in general are well aligned to each other and to the opposite arch.
Describe class I occlusion:
Correct anteroposterior MOLAR position. Still have MB of 1st max molar in the MB groove of 1st mand molar.
BUT, now have some crowding, crossbites, deep bites, open-bites, spacing, etc.
Profile has normal convexity.
What is class II molar relationship?
The mandible is distal in relationship to the maxilla.
Mesiobuccal cusp of max is between the mand 1st molar and 2nd premolar.
What is class II, division 1 occlusion?
Max 1st molar MB cusp is between mand 1st molar and 2nd premolar.
Div 1: the max incisors are normal in their labial inclination. (good, normal overjet).
Profile has excess convexity at mouth (lower lip is too posterior).
What is class II, division 2 occlusion?
Max 1st molar MB cusp is between mand 1st molar and 2nd premolar.
Div 2: the max incisors are upright or have lingual inclination (appears as an overbite without much overjet).
Profile is inclined posteriorly from upper lip.
What is class III occlusion?
Mandible is anteriorly positioned.
Max 1st molar MB cups is between mand 2nd molar and 1st molar.
Also, the max canine is between the mand 1st and 2nd premolar.
Profile has too much convexity - a jutting chin.
Describe some psychosocial problems experience by those with a need for orthodontics.
- self image and self esteem
- perception of others
- Paradox of mental compensation: those with severe problems actually compensate better because they expect a negative response. Those with mild problems are uncertain about reactions from peers and have poor compensation.
Is TMJ dysfunction directly related to malocclusion?
No, not clear and directly related.
Though, there is a higher incidence of TMJD in patients with malocclusion.
**Orthodontics is neither a cure nor a cause.
Is malocclusion a disease?
No, it’s a deformity.
Caries and periodontal disease are also not clearly related to malocclusion. BUT, better alignment = easier oral hygiene.
Name the etiology of malocclusion:
Genetic + environment
–> though, stable after growth stops.
What age should treatment begin?
Varies!
Usually, 1st orthoodontic exam should be between 5 - 7 years old.
If there are craniofacial abnormalities, might meet with orthodontist right after birth.
If there are skeletal problems, these are best treated during adolescence.
What is the most common ortho problem?
Incisor crowding.
When to treat is controversial. Can either:
- treat early with expansion
- Wait until there are all permanent teeth to treat.
When to treat crossbites?
If there is a functional shift, treat as early as possible to prevent possible abnormal growth.
If there is not a functional shift, then treat later.
When is it best to treat a skeletal problem causing class II malocclusion (maxilla is forward, the mandible is back, combination)?
Best to treat during active growth.
Males: start at 10 - 11 years old
Females: start at 9 - 10 years old.
Also, there is better cooperation when young.
When is it best to treat a skeletal problem causing class III malocclusion (maxilla is back, the mandible is forward, combination)?
If the maxilla is back, start orthopedic treatment at 6 - 8 years.
If the mandible is forward, have orthognathic surgery after growth completed.
List possible environmental influences on malocclusion:
- thumb sucking
- mouth breathing
- tongue thrust
- caries (space loss)
- premature deciduous tooth loss
- tooth loss (from trauma or congenital)
List 2 main preventative measures for malocclusion:
- Space maintenance (in kids and adults!)
2. Good oral hygiene (most important)
What are treatment choices if only tooth movement is necessary (normal skeletal relationships)?
- extraction of teeth to eliminate crowding
2. non-extraction
What are treatment choices if the skeletal relationship is abnormal?
It all depends on if the patient is still growing or not.
Still growing:
- growth modification
- camouflage by moving teeth (extraction or non-extraction)
- Surgery
No longer growing:
- Camouflage by moving teeth (extraction or non-extraction)
- Surgery
