Lecture 12

Question 1

DESIRED EFFECT OF ANCHORAGE

Answer 1

CONCENTRATION OF DESIRED FORCES AND DISSIPATION OF REACTIONARY FORCES

Question 2

PALATAL EXPANSION GUIDELINES

Answer 2

BEST AND MOST SUCCESSFULLY COMPLETED IN CHILDREN < 16 Y.O.
CROSS-BITE EXPANSION IDEALLY TREATED AS YOUNG AS POSSIBLE
ADULT CROSS-BITE MAY ONLY NEED DENTAL EXPANSION, NOT PALATAL EXPANSION

Question 3

RPE

Answer 3

RESULTS IN .5-1mm OF EXPANSION PER DAY
ACHIEVES SKELETAL EXPANSION, BONE FILLING OCCURS SIMULTANEOUS
CAN BE TOOTH / BONE / TOOTH AND BONE SUPPORTED
EX. HYRAX

Question 4

SPE

Answer 4

SCREW OF THE EXPANDER TURNED 4X PER WEEK WHICH RESULTS IN 1mm OF EXPANSION PER WEEK
CAUSES LESS PAIN B/C SLOW EXPANSION SIMULATES PHYSIOLOGICAL MOVEMENTS OF BONE
ALLOWS A 1:1 RATIO OF SKELETAL AND DENTAL CHANGES (LESS OF A DIASTEMA IS FORMED)
EX. NITANIUM PALATAL EXPANDER

Question 5

SARPE

Answer 5

USED WHEN INTERMAXILLARY SUTURE FUSES PALATE HALVES IN MATURE/POST-PUBERTAL PALATES WITH A CONSTRICTED MAXILLARY ARCH
VIA SX. WEAKEN THE BONE TO ALLOW LATERAL PRESSURE TO CAUSE MOVEMENT WHEN THE EXPANDER IS USED
CAUSES MANDIBULAR GROWTH ROTATION

Question 6

HEADGEAR

Answer 6

SUTURAL COMPRESSION TO TREAT CLASS II MALOCCLUSION (HOWEVER, THERE ARE COMPLIANCE PROBLEMS)
MANDIBLE CAN STILL BE MODIFIED, SPECIFICALLY AT THE CONDYLE BECAUSE OF THE PRESENCE OF THE 2˚ CARTILAGE
BOTH MAN/MAX UNDERGO ANTERIOR/POSTERIOR ROTATION

Question 7

BIONATOR

Answer 7

WORN 16HRS/DAY
CORRECTS OVERBITE
PROMOTES MANDIBULAR GROWTH
EXPANDER NOT MANAGED BY THE PATIENT

Question 8

CRANIOFACIAL DISORDERS

Answer 8

SYNDROME - AGGREGATE OF SIGNS AND SYMPTOMS ASSOCIATED WITH ANY MORBID PROCESS AND CONSTITUTING TOGETHER THE PICTURE OF THE DISEASE AND RELATED TO EACH OTHER ANATOMICALLY, BIOCHEMICALLY OR PHYSIOLOGICALLY
ANOMOLY - DEVIATION FROM THE AVERAGE OR NORM
SEQUENCE - PATTERN OF MULTIPLE SEQUENTIAL ANOMOLIES BROUGHT ABOUT BY ONE DISORDER

Question 9

APERT SYNDROME

Answer 9

CONDITION INVOLVED DISTORTION OF HEAD (CRANIOSYNOSTOSIS- BRACHYCEPHALY) AND FACE AND WEBBING OF THE HANDS AND FEET
BELIEVED TO ORIGINATE FROM GENETIC MUTATION (FGFR2) EARLY IN PREGNANCY
NO LINK TO ANY MATERNAL PREGNANCY ISSUES
SOME DEVELOP CLEFT PALATE - ~30%
MUTATION IN FGFR2 YIELDS PROLONGED SIGNALING WHICH YEILDS FUSION OF BONES IN THE HANDS, SKULL AND FEET (OCCURS DURING EMBRYOGENESIS)
AUTOSOMAL DOMINANT, NO FAMILY HISTORY
1 IN 65,000 - 200,000

Question 10

PIERRE ROBIN SEQUENCE

Answer 10

MICROGNATHIC MANDIBLE
GLOSSOPTOSIS
HORSESHOE-SHAPED CLEFT LIP/PALATE OR HIGH-ARCHED PALATE W/O CLEFT (MAY OR MAY NOT BE PRESENT)
FEEDING AND BREATHING PROBLEMS AS AN INFANT
NO LINK TO ANY MATERNAL PREGNANCY ISSUES
MAY BE A RESULT OF FETAL POSITION DURING EARLY WEEKS OF DEVELOPMENT
OCCURS IN 1 IN 85,000-14,000 BIRTHS
CAN BE SYNDROMIC OR NON-SYNDROMIC

Question 11

TREACHER-COLLINS SYNDROME

Answer 11

CHEEK AND JAW BONES ARE UNDERDEVELOPED
CHARACTERISTICS INCLUDE - 
DOWNWARD-SLANTED EYES
NOTCHED LOWER EYELIDS
UNDERDEVELOPED/MALFORMED EARS
CHEEKBONES ARE UNDERDEVELOPED OR ABSENT 
NORMAL DEVIATION AND INTELLIGENCE
SMALL/SLANTING MANDIBLE
OFTEN IN CONJUNCTION WITH CLEFT PALATE
EVIDENCE OF MUTATION ON THE 5TH CHROMOSOME (AFFECTS FACIAL DEVELOPMENT)
AUTOSOMAL DOMINANT (1 IN 50,000)
RANDOM MUTATION OF TCOF1 - ENCODES FOR TREACLE PROTEIN (LARGE COMPONENT OF CRANIOFACIAL DEVELOPMENT)
TREATMENT = 
1.) REPAIR CLEFT PALATE
2.) ZYGOMATIC AND ORBITAL RECONSTRUCTION
3.) MAXILLOMANDIBULAR RECONSTRUCTION