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Pedo/Ortho II > Lecture 13 > Flashcards

Lecture 13 Flashcards

1
Q

what the the 2 main causes of relapse after ortho treatment?

A

1-continued growth

2-tissue rebound

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2
Q

patients who have continued growth into malocclusion after completion of ortho tx need active retention in 1 of what 2 forms?

A

1-extraoral forces with retainers (headgear)

2-functional appliance

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3
Q

what fibers extend inter-proximally over the alveolar bone and are embedded in the cementum of adjacent teeth?

A

transeptal fibers

  • form interdental ligament
  • keep teeth in contact
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4
Q

what are the two ways to deal with rebound after ortho tx?

A

1-overtreatment

2-adjunctive perio surgery

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5
Q

how many mm of over treatment should be done for class II or III, and crossbite correction?

A

1-2 mm

*hold rotated teeth slightly over corrected for a few months

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6
Q

what are the 3 types of retainers given to patients after ortho?

A

1-hawley retainers
2-essix
3-bonded perm. retainers

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7
Q

what kind of bone is present when moving a tooth?

A

transitional

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8
Q

when moving a tooth, how long does it take for woven bone to mature to lamellar bone?

A

12 weeks

*3 month window where you MUST wear retainer full time

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9
Q

the rational for retainers is to allow time for PDL. How long does that take?

A

3-4 month

  • wear your retainer 24/7
  • part time for up to a year
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10
Q

In circumferential supracrestal fibrotomy you cut into the gingival sulcus down to the ____ of the _____

A

crest, alveolar bone

*interproximally labially and lingually (unless margins are thin)

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11
Q

Alternatively to CSF you can make and incision _____mm below hight of bone ______ and ______

A

1-2 mm, labially and lingually

*less chance of recession

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12
Q

T/F CSF or the papilla-dividing procedure should be done prior to ortho tx

A

FASLE. done after they have been aligned for several months

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13
Q

CSF is ineffective in what 3 circumstances?

A

1-irregular growth
2-disruption of envelope of stability
3-parafunctional habits

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14
Q

what is the primary indication for CSF?

A

severely rotated teeth

*most common on lateral incisors

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15
Q

what demographic is the fastest growing area in ortho?

A

older adults

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16
Q

adult tx is more difficult because there is no growth so treating jaw discrepancies must be done by what 2 things?

A

1-camouflage

2-sugery`

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17
Q

6 benefits for adult ortho

A 
1-better access to clean 
2-improve certain osseous defects
3-forced eruption to restore fracture
4-correct gingival embrasures
5-improve gingival margin esthetics
6-improve adjacent teeth for implants
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18
Q

3 goals of LIMITED adult ortho

A

1-improve perio health
2-establish favorable crown to root ratios
3-facilitate repositioning for things like implants

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19
Q

what are the 2 required steps for treatment planning limited adult ortho

A

1-diagnostic data
2-list of patient problems

*mounted casts, FMX

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20
Q

once all problems have been IDed what is the key treatment planning question for adult ortho?

A

is it necessary

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21
Q

when a perm. molar is lost and not replaced the 2nd molar drifts _____ and the premolars drift _______ and rotated into that space forming a ______

A
  • mesially
  • distally
  • pseuopocket
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22
Q

T/F uprighting a tipped molar by distal crown movement leads to decreased space for pontic?

A

FALSE, increases space

23
Q

uprighting the molar by mesial root movement does what to space needed for a prosthesis?

A

reduces it

  • might eliminate the need for a prosthetic
  • time consuming
24
Q

if both 2nd and 3rd molar are tipped, should they both be uprighted?

A

probably not, moves 3rd into hard position to clean. extract

25
Q

uprighting a tipped molar ________ the crown height while ______ depth of mesial pocket

A

increases, reduces

*crown reduction often necessary to improve crown to root ratio

26
Q

how long should an uprighted molar be held in position?

A 
2 months (simple)
6 months if grafts or osseous surgery occurred
27
Q

7 benefits of uprighting a molar

A

1-improves distribution of occlusal forces
2-decreases reshaping needed if an implant is placed adjacently
3-decreases potential for endo, pros, or perio
4-longer durability of restoration
5-improves perio environment (no psudopocket)
6-improves alveolar bone contour
7-better crown to root ratio

28
Q

what are the 8 guidelines in interdisciplinary treatment?

A 
1-realistic objectives
2- diagnostic set up
3-treatment sequence
4-stabilize/correct active disease
5-position teeth to facilitate restorative tx
6-evaluate gingival esthetics
7-radiographs
8-all members interact when finishing
29
Q

what # of wall defects are best treated with perio surgery, w/ or w/o braces?

A

2 wall perio defect

30
Q

T/F three wall defects are not resolvable with ortho

A

TRUE

  • best fixed with bone grafts
  • ortho can be done 6months later if desired
31
Q

what # of wall defects are best treated with ortho?

A

1 wall defects

32
Q

when placing an ortho bracket on an adult it is NOT determined by the _______ of the tooth, but by the interproximal ____________

A

anatomy, bone level

  • bone should be leveled by ortho
  • perio recall 2-3 months during tx
33
Q

T/F aligning teeth by the crowns my perpetuate tooth mobility if the teeth have an unfavorable crown to root ratio due to recession

A

true

*place brackets using bone level

34
Q

what are the most difficult lesions to maintain during ortho?

A

furcations

*2-3 mo recall

35
Q

when trying to move a tooth with a class 3 furcation via ortho, what can you do to the tooth?

A

hemi-section the crown

  • requires endo, perio, and restorative procedures
  • move 1st, hemisect 2nd
36
Q

long term incisal wear with subsequent over eruption results in what 2 things?

A

1-short clinical crowns

2- disproportionate marginal gingiva

37
Q

what 2 things can be done to correct long term incisal wear?

A

1-crown lengthening

2- ortho intrusion

38
Q

T/F ortho intrusion is more conservative than crown lengthening for patients with long term incisal wear?

A

true!

*limits restored area to enamel only (veneer)

39
Q

T/F it is appropriate for a dentist to request the ortho increase the pts vertical when there are worn down teeth

A

FALSE

*teeth usually undergo compensatory eruption keeping vertical the same

40
Q

what 3 things can ortho do for worn down teeth?

A

1-create restorative space
2-move gingival margins apically
3- eliminate the need for further tooth reduction

41
Q

T/F patients with severe attrition of mandibular anteriors may have insufficient crown length to place bracket or ferrule for crown

A

true

  • need 1.5mm ferrule
  • perio crown lengthening is useful here
42
Q

what is the first step to provide restorative space in the pt with deep overbite?

A

correct occlusal plane

43
Q

how do you identify the correct vertical plane?

A

contact between 2nd mand and max molar and level of upper lip anteriorly

44
Q

what are some of the downsides of using crowns rather than ortho to straighten teeth?

A

esthetics, gingival height, bone height, perio pockets, possible RCT, plaque traps, buccal lingual width, occlusal force direction

45
Q

sometimes black triangles appear after ortho if teeth are themselves triangularly shaped. What can you do?

A

recontour the teeth mesial/distally

46
Q

T/F ortho forced eruption can be used when a tooth fracture extends below gingival margin and terminates at alveolar ridge

A

true

*without forced eruption restoration may violate biological width

47
Q

during slow extrusion what 2 things normally follow the tooth?

A

bone and gingival tissues

48
Q

what is a disadvantage of slow eruption?

A

crown lengthening may be necessary to recontour the gingiva and bone

49
Q

what are the 6 criteria to determine if extraction or forced eruption is called for?

A 
1-crown to root ratio
2-root form
3-level of fracture
4-relative importance of the tooth
5-esthetics
6-endo/perio prognosis
50
Q

If a fracture extends to the level of the bone, how many mm must the tooth be forcibly extruded?

A

4mm

  • 2.5 to clean biologic width
  • 1.5 for crown ferrule
51
Q

considering root form for forced eruption what should the root and canal shape be?

A

root: broad and not tapered
canal: not more than 1/3 of overall width

52
Q

T/F if a tooth if fractured 2-3mm apical to alveolar bone it is nearly impossible to attach the root to erupt it

A

true

53
Q

T/F ortho extrusion can be used to increase vertical bone height and volume prior to implant placement PLUS assist in preservation of the interdental papilla

A

true

54
Q

what are the three disadvantages of forced ortho eruption?

A

1-wearing ortho
2-duration of tx
3-possible need for perio surgery

Pedo/Ortho II (11 decks)

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