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Orthodontics II > Lecture 3 > Flashcards

Lecture 3 Flashcards

1
Q

During the mixed dentition, the “GOLDEN stage of dentition”, both skeletal and dental structures change _____

A

Concurrently

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2
Q

For a child with all developmental spaces, prediction goes towards what?

A

A well aligned permanent dentition

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3
Q

What will result with increased or decreased developmental spacing in the primary dentition?

A

Any disturbance in these spaces can potentially alter the permanent spacing

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4
Q

What does space analysis quantify?

A

The amount of needed space (crowding/spacing) within the arches estimating the severity of space discrepancy

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5
Q

What does space analysis estimate?

A

The severity of space discrepancy

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6
Q

Space analysis requires a COMPARISON between what two things?

A
  1. The amount of space AVAILABLE for the alignment of teeth
  2. The amount of space REQUIRED to align them adequately
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7
Q

What are the 3 requirements of space available AND space required comparison?

A
  1. Excess
  2. OK (enough space)
  3. Deficiency (crowding)
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8
Q

Upon the space analysis, if the result states there will be a deficiency, this means:

A

Crowding

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9
Q

What three groups is space deficiency (crowding) divided into?

A
  1. mild
  2. moderate
  3. severe

(there are NOT such categories for excess spacing, each case will be assessed based on etiology and other factors)

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10
Q

What is more common- lack of space or excess space in an arch?

A

LACK of space

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11
Q

What is SPACED DENTITION characterized by?

A

Interdental spaces and the lack of contact points between the teeth

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12
Q

T/F: Spacing is a common esthetic problem for many patients

A

True

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13
Q

Is spacing in BOTH arches more common in girls or boys?

A

BOYZ

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14
Q

Spacing can be _____ or ____ due to the number of teeth included

A

Localized; generalized

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15
Q

How is it determined if spacing is localized or generalized?

A

Number of teeth involved

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16
Q

The causes of GENERALIZED spacing may be:

A
  1. heredity
  2. acquired
  3. functional
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17
Q

HEREDITARY causes of generalized spacing include:

A
  1. tooth size-arch size discrepencies
  2. protrusive teeth
  3. congenitally missing teeth
  4. macroglossia
  5. supernumerary teeth
  6. small teeth
  7. hypertrophic frenum
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18
Q

ACQUIRED causes of generalized spacing include:

A
  1. pathologic conditions increasing tongue size
  2. missing teeth
  3. delayed eruption of permanent teeth
  4. periodontal disease
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19
Q

FUNCTIONAL causes of generalized spacing:

A

Oral habits

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20
Q

What plays an important role in the management of spaced dentition often in the cooperation of other dental departments like oral surgery, periodontics, esthetic dentistry and prosthodontics?

A

Orthodontics

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21
Q

For orthodontists to achieve the most esthetic and functional result, they most carefully evaluate:

A

etiologic factors (why the issue arises)

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22
Q

What may be useful in the treatment planning process when informing the patient?

A

Diagnostic set-up

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23
Q

Why should we correct SPACING?

(Because it can result in:)

A
  1. gum problems due to the lack of protection by the teeth
  2. prevention of proper functioning of teeth
  3. making smile less attractive
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24
Q

What are the three TREATMENT OPTIONS to treat SPACING?

A
  1. esthetic intervention using composite resin, veneers or crowns
  2. orthodontics space closure
  3. closure of anterior spaces and opening posterior spaces
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25
Q

T/F: in order to resolve spacing in the anterior, spaces in the posterior may be opened as a treatment

A

true

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26
Q

after orthodontic treatment, it is frequently necessary to apply _____ as these cases have a higher risk of relapse

A

Fixed retention

27
Q

What is a diastema?

A

It is a space or gap between the maxillary central incisors

28
Q

T/F: A diastema can be a normal growth characteristic during primary and mixed dentition

A

True

29
Q

What race/ethnicities are diastemas more present in?

A

African Americans 19%

Caucasians 8%

30
Q

What may be causing diastemas?

A
  1. tooth size discrepancy
  2. missing teeth
  3. oversized labial frenum
  4. overjet
  5. protrusion of teeth
31
Q

What are the TREATMENT options for DIASTEMAS:

A
  1. keep the diastema
  2. orthodontic treatment
  3. composite/porcelain veneers
  4. crown or bridge work or replacement of teeth with implants (adults only)
32
Q

If the patient has an OVERSIZED labial frenum, what might happen?

A

The patient may be referred for a frenectomy

33
Q

Patient presents with oversized frenum and gets frenectomy, if this treatment is conducted on a child, what might happen?

A

The space may close by itself

34
Q

Patient presents with oversized frenum and gets frenectomy, if this treatment is conducted on a teen/adult, what might happen?

A

The space may need to be closed with braces PRIOR to frenenctomy, It is due to scar tissue which may prevent space closure by orthodontic forces

35
Q

How can you determine if a patient needs a frenectomy?

A

Look for blanching of the papilla

36
Q

T/F: If there is NOT blanching of the papilla there still may be an indication to remove frenum

A

False- when evaluating for need of frenectomy, papilla must blanch to deem frenectomy necessary

37
Q

In most cases will diastemas close SPONTANEOUSLY as the canines erupt?

A

Yes

38
Q

T/F: Little disagreement can be found that intervention to close the diastema should be DEFERRED until the canines have fully erupted

A

True

39
Q

Generally diastemas more than ____mm require active intervention

A

2mm

40
Q

How do REMOVABLE appliances generally close diastemas?

A

They tip the crowns of the incisors

41
Q

T/F: FIXED dental appliances do a better job of controlling dental alignment, than removable appliances for diastema closure

A

True

42
Q

In the mixed dentition, what must you be cautious of with orthodontic treatment?

A

Be sure to avoid tipping the roots of the lateral incisors distally because they interfere with the erupting path of canines

43
Q

In the mixed dentition, why must we be cautious of tipping the roots of the lateral incisors DISTALLY?

A

To avoid interference with the eruption path of canines

44
Q

Why is a fixed retainer necessary following ortho?

A

Because there is a strong tendency for relapse

45
Q

The lack of space for all the teeth to fit normally in the jaws:

A

Crowding

46
Q

What four things can cause crowding?

A
  1. twisted or displaced teeth
  2. disharmony in the tooth to jaw size relationship
  3. early or late loss of primary teeth
  4. improper eruption of teeth
47
Q

What is the exact cause of crowding or malocclusion?

A

Unknown- several researchers have suggested that the problem is hereditary and is associated with the evolutionary development of modern humans

48
Q

T/F: Researchers have attributed the MAIN cause of crowding to be a progressive reduction in the jaw size as compared with tooth size

A

True

49
Q

Why should we correct CROWDING?

(Because it can)

A
  1. prevent adequate hygiene
  2. promote dental decay
  3. increases chances of gum disease
  4. prevent proper functioning of teeth
  5. make smile less attractive
50
Q

Based on diagnosing the space problems, treatment options for providing management of space in the primary and mixed dentition should be divided into what three categories?

A
  1. MILD crowding (less than 4.5 mm)
  2. MODERATE crowding (5-9 mm)
  3. SEVERE crowding (greater than 10 mm)
51
Q

Mild crowding =

A

Less than 4.5 mm

52
Q

Mild crowding can be resolved through:

A
  1. Preservation of the leeway space
  2. Regaining space
  3. Limited expansion in the late mixed dentition
53
Q

Moderate crowding =

A

5-9 mm

54
Q

Moderate crowding can be approached with:

A
  1. expansion
  2. extraction of permanent teeth
55
Q

Severe crowding =

A

greater than 10 mm

56
Q

Severe crowding will need:

A
  1. extractions
  2. serial extraction or guidance of eruption is reserved for treatment for severe tooth size/arch discrepencies
57
Q

When was bolton analysis introduced?

A

Bolton 1958

58
Q

What does Bolton analysis determine?

(2)

A

It determines the RATIO of the MD widths of the maxillary teeth to the mandibular teeth

AND

Shows whether there is any tooth size discrepancy between the upper and lower teeth

59
Q

Determine the ratio of the MD widths of the maxillary teeth to the mandibular teeth:

A

Bolton analysis

60
Q

Is the bolton analysis recommeded for primary, mixed or permanent dentition?

A

PERMANENT

61
Q

When is the recommended time to do bolton analysis?

A

AFTER the eruption of all the permaent teeth from 1st molar to 1st molar

62
Q

Bolton analysis determines _____ ratio and ____ ratio

A

Overall; anterior

63
Q

How do you determine the bolton analysis calculation?

A
  1. SUM of mandibular 12 & SUM of maxillary 12
  2. Overall ratio: according to bolton the sum of the MD width of the mandibular teeth to maxillary teeth is 91.3%
  3. Interpretation (overall ratio)

(if the overall ratio is less than 91.3% it indicates maxillary teeth take up too much space- the maxillary teeth are relatively too large compared to the mandibular teeth)

  1. Anterior ratio: according to bolton, the sum of the anterior widths of the anterior mandibular teeth to the anterior maxillary teeth is 77.2%
  2. Interpretation (anterior ratio)

(if the overall ratio is less than 77.2% it indicates the maxillary anterior teeth take up too much space- the maxillary anterior teeth are relatively too large compared to the mandibular anterior teeth)

  1. Calculation in mm
    -after calculation of the bolton ratio, the arch with the relatively smaller tooth material is determined and the actual figure/value corresponding tot he arch tooth size is located in the table

-the ideal value for the size of the opposing teeth is read off from the accompanying column

-the difference between the actual value and the ideal value for the relatively enlarged tooth materials represents in mm the amount of excess tooth size in the arch

64
Q
A

Orthodontics II (6 decks)

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