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Pedo/Ortho II > Lecture 10 > Flashcards

Lecture 10 Flashcards

1
Q

when extraoral force is applied to the maxillary teeth, where is the force effective?

A

sutures of maxilla

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2
Q

What does occipital pull head gear do to growth?

A

restricts max growth in anterior-posterior and vertical demensions

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3
Q

in what class would restriction of growth in the maxilla be beneficial?

A

class II

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4
Q

what are the two general philosophies for implementing max. expansion?

A

1-fixed expansion

2- removable expansion

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5
Q

4 negative effects from using removable expansion appliances

A

1-apical and crestal stress in anchor teeth is higher
2-higher stress in cortical and spongy bone from forces produced against hard palate and alv. bone
3-vertical displacement (crown tipping) of molar cusps
4-poor patient compliance

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6
Q

what are the 2 internal rotations of the mandible?

A

1- rotation around the condyle (matrix rotation)

2-rotations centered within body (intra matrix rotation)

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7
Q

T/F over time mandibular plane increases

A

False. body of mandible rotates (up anteriorly, down posteriorly)

*rotation of around condyle or centered within mand. body

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8
Q

What makes the mandible more challenging to expand?

A

there is no mandibular suture

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9
Q

T/F moving lower incisors is problematic for stabilty

A

True.

*lip pressure increases too much

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10
Q

What area of the mandible is the only one that can be expanded and maintain stability?

A

expansion across the premolars

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11
Q

expansion for canines and maintain stability

A

0-1mm

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12
Q

expansion for premolars and maintain stability

A

1st premolars: 2mm

2nd premolars: 2-3mm

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13
Q

expansion for molars and maintain stability

A

3 mm

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14
Q

T/F the mandible can be pushed and pulled the same way the maxilla can to alter growth

A

False. The TMJ is difficult to transfer force through

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15
Q

what is the main problem for the cupping device?

A

it has to be worn 24/7 and kids just wont do that.

It also runs the risk of tilting incisors lingually

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16
Q

what is the purpose of the delaire-type facemask, AKA reverse pull headgear?

A

enhance A-P maxillary growth in a class III px

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17
Q

mechanism the Delaire-type facemask works

A

1-pulls maxilla while pushes mandible

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18
Q

3 effects of Delaire-type face mask

A

1-some forward max. movement
2-forward movment of max. teeth
3-downward and back rotation of mandible

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19
Q

it is easier to restrain or stimulate mandibular growth?

A

stimulate

*mandible can be pulled into protrusion and held for long duration with moderate force

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20
Q

when do you know true stimulation of mandibular growth has occurred?

A

when on the growth chart you see faster than normal growth that continues thereafter

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21
Q

how do functional appliances move the dentition? (2)

A

1-repositioning the skeletal bases, placing force on teeth by stretching the muscles and tissues
2-changing occlusion relationships and therefore occlusal forces on teeth

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22
Q

what is the threshold needed to move a tooth?

A

6 hours

*may or may not also apply to sutures

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23
Q

when is the best time to wear functional appliances?

A

sleeping hours

*longer than 6 hours and HGH is being released

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24
Q

Treating a deficient mandible can be treated in what 3 ways

A

1-modify growth
2-ortho camouflage
3-surgery

*teach px the pros/cons of each and that they may yield slightly different resutls

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25
Q

in phase 1 ortho, what area is one of the most actively adaptable areas of bone growth?

A

alveolar process

  • between primary and adult dentition
  • idea for ortho
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26
Q

what are the 2 aspects of the mixed dentition stage?

A

1-utilize arch perimeter

2-the adaptive changes in occlusion that occur during transition of one dentition to another

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27
Q

what makes phase 1 ortho limited?

A

it can only occur in the presence of at least 1 primary tooth

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28
Q

how long does phase 1 ortho usually last?

A

6-12 months

29
Q

what 3 things does phase 1 ortho do?

A

1-corrects existing abnormalities
2-creates conditions where the dentition can function and developing normal
3-final primary teeth are lost and perm. erupt

30
Q

When does the American Association of Ortho recommend every child receive ortho eval and pano?

A

before age 8

31
Q

when can a pt move on to phase 2 ortho?

A

after phase 1 and after all primary teeth are lost

*around 11 or 12

32
Q

what are 4 reasons to refer your patient for early ortho?

A

1-crowding
2-abnormal growth and development
3-ectopic eruption and impactions
4-traumatic occlusion/crossbites

33
Q

phase 1 (early) ortho can help correct what 3 things?

A

1-abnormal growth
2-abnormal habits
3-fix things that may result in trauma

34
Q

what 3 things can phase 1 ortho help correct regarding possibility for trauma

A

1-severe deep bites
2-cross bites
3-protruded maxillary incisors

35
Q

T/F anterior crossbites in primary dentition is common

A

False. Anterior cross bites in primary dentition indicates a skeletal growth problem

  • same with class III
  • mandibular growth lags
36
Q

what types of abnormal habits can phase 1 ortho help?

A

mouth breathing, finger sucking, tongue position posture

37
Q

What is the most basic sign of future crowding?

A

Lack of inter-dental spacing in the primary dentition

38
Q

the maxillary anterior primary teeth are what % smaller than their perm. successors?

A

75% smaller

39
Q

mandibular anterior primary teeth combine to be how many mm smaller mesio-distally than their successors?

A

6 mm smaller

40
Q

T/F arch perimeter does increase after eruption, however it is a small increase in the maxilla and essentially non-existent in the mandible

A

TRUE

41
Q

T/F because of arch growth, it can be relied upon for further dental alignment to alleviate crowding

A

FALSE

*arch growth is not sufficient for that

42
Q

what 3 things are used to create space in mandible for mild crowding?

A

1-increase arch width across canines
2-labial positioning of the central and lateral incisors
3-distal shift of perm. canines when primary molars are lost

43
Q

what is leeway space?

A

size differential between primary molars and perm premolars

*AKA E space

44
Q

how big is mandibular leeway space on each side?

A

2.5 mm

45
Q

how big is maxillary leeway space on each side?

A

1.5 mm

46
Q

what is the mesial distal diameter of the maxillary perm. teeth?

A

128 mm

47
Q

what is the mesial distal diameter of the mandibular teeth?

A

126mm

48
Q

the maxillary arch is aprox. how many mm larger than the mandibular arch?

A

2 mm

49
Q

flared maxillary incisors (ugly duckling stage) may cause waht?

A

impacted canines

50
Q

what percent of 11 year olds have diastemas?

A

49%

51
Q

what 4 things can cause a diastema?

A

1-tooth size discrepancy
2- mesiodens
3-abnormal frenum
4-a normal stage of deveopment

52
Q

what event may cause a diastema to close on its own?

A

eruption of perm. canines

53
Q

what size of diastema has the greatest chance of closing on its own?

A

less than 2mm

54
Q

what does premature loss of the primary canines reflect?

A

insufficient arch size in the anterior region

55
Q

During eruption sometimes the lateral incisors impinge on _______ causing them to ______ and be lost

A

canines, resorb

56
Q

what happens if only 1 canine is missin?

A

the midline will shift

57
Q

what are 3 options for maxillary crowding?

A

1-expansion
2-limited ortho on 1st molars and incisors
3- extract primary canines to create space

58
Q

when can palatal expansion be done?

A

any time prior to the end of the adolescent growth spurt

59
Q

what are the 4 reason for early palatal expansion?

A

1-stop mand. shifts on closure
2- space of erupting max. teeth
3-lessen arch distortion and tooth abrasion interferences on anterior teeth
4- reduce mandibular skeletal asymmetry

60
Q

what 3 options are available for mandibular crowding?

A

1-expansion (no suture to expand, but lip bumpers/schwarz may help)
2-limited ortho on mand. perm. teeth
3-extract primary canines to create space

61
Q

T/F class III are easy to control

A

False

*limited ortho, reverse pull head gear

62
Q

T/F early treatment is really helpful for class II

A

FALSE. early tx is no more helpful than just regular phase 1

63
Q

ectopic eruption of the perm. 1st molar can cause resorption of the primary 2nd molar and requires _________

A

active intervention

  • impacted molar is susceptible to decay
  • may need to extract primary tooth
64
Q

if ectopic eruption of 1st molar occurs what 2 options besides extraction might be called for?

A

1-spacer between them

2-active ortho

65
Q

permanent teeth often erupt in abnormal positions due to _____________

A

over retained primary teeth

66
Q

perm. teeth normally move in what 2 directions while erupting?

A

occlusally an buccally

67
Q

_____ is when 2 tooth buds fuse together to make one large crown

A

Fusion

  • 2 independent pulp chambers and roots
  • count teeth 1 less than normal
68
Q

__________ is when one tooth bud tries to divide into 2 teeth

A

gemination

  • normal tooth count
  • 2 pulp chambers, 1 root

Pedo/Ortho II (11 decks)

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