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Ortho > Lecture 8 > Flashcards

Lecture 8 Flashcards

1
Q

___ is credited as the first person to use an appliance to straighten teeth. what year was this?

A

pierre fauchard in 1728

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2
Q

what was the design of the appliance that fauchard first used to straighten teeth? what type of movement did it produce?

A
  • it was an arch shaped metal band with holes drilled in preselected sites, with strings to pull the teeth into alignment
  • like a hawley retainer, this device only created tipping movements of teeth
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3
Q

who is edward angle?

A
  • he became the first acknowledged exclusive specialist in orthodontics in the world in 1892
  • he developed angles classification of occlusion
  • he developed the angle school of orthodontics and formally established orthodontics as the first specialty in dentistry
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4
Q

angle coined the term ___ to refer to abnormalities of tooth position, and classified various abnormalities of the teeth and jaws

A

malocclusion

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5
Q

what was angles first book?

A

treatment of malocclusion of the teeth and fractures of the maxillae: angle’s system

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6
Q

what is the angles classification that is still used today?

A
  • angle class I
  • angle class II
  • angle class III
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7
Q

in 1910, angle developed the ___ and ___ appliance. what was it?

A
  • pin and tube appliance

- it had gold and platinum bands and attachments for most of the teeth

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8
Q

was angle’s pin and tube appliance easy to use? why or why not?

A
  • it was very difficult to use and had many disadvantages
  • the appliance required adjustments every few days to position the pins during treatment
  • the appliance also wasn’t capable of controlling tooth rotations
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9
Q

the ___ bracket developed slowly, and angle went through many different types of bracket designs from 1915-1932 until he finally developed the ___ bracket

A
  • edgwise

- twin

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10
Q

what was the edgewise appliance?

A
  • all modern orthodontics are based on this appliance
  • it had identical brackets for all the teeth and tooth movements were accomplished by placing necessary bends in rectangular archwires to position all the teeth
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11
Q

what are some of the different types of edgewise brackets to choose from?

A
  • self-ligating
  • ceramic
  • plastic
  • metal
  • single wing
  • twin
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12
Q

what are the two different slot size dimensions to choose from for edgewise brackets?

A
  • 0.22 inch (0.55mm)

- 0.018 inch (0.45mm)

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13
Q

the ___ is the most common and widely used system today and incorporates a rectangular arch wire, which fits into a rectangular slot in the bracket

A

edgewise appliance system

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14
Q

what are the different prescriptions that each edgewise orthodontic bracket comes with?

A

torque, angulation, and offset

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15
Q

what is the theory behind the edgewise straight wire system?

A

through a prescription in the orthodontic bracket, you can place a straight rectangular wire in the brace, which then will place all the proper tips, torques, in and outs, and angulations on all the teeth

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16
Q

T or F:
the buccal surfaces of the maxillary incisors are aligned, and the lingual surfaces of the mandibular incisors are aligned

A
  • false
  • you want to align the surfaces of the teeth that will be occluding
  • so the lingual of the maxillary incisors and canines should be aligned, and the buccal of the mandibular incisors and canines should be aligned
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17
Q

in practice, the edgewise straight wire system does a good job of doing what?

A

getting the teeth in the “ball park”

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18
Q

using the edgewise straight wire system, due to individual variation in teeth, ___ typically need to be placed in the archwires to finish orthodontic cases

A

positioning bends

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19
Q

the most popular self-ligating bracket is the ___ bracket

A

damon

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20
Q

what are some of the claims made about damon brackets?

A
  • shorter treatment times (6 months shorter treatment time because patients don’t have to have as many orthodontic visits)
  • less painful treatment (greater comfort throughout treatment, lighter forces to move teeth)
  • won’t have to extract teeth (damon brackets produce a broader, natural smile and a nicer profile)
  • eliminates the need for rapid palatal expansion and head gear
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21
Q

adherence to the tenets of evidence-based orthodontic practice requires that, for any orthodontic intervention applied to a patient, what 3 factors must be integrated?

A
  • the relevant scientific evidence
  • the clinician’s expertise
  • the patient’s needs and preferences
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22
Q

___ are types of literature reviews that collect and critically analyze multiple research studies or papers

A

systematic reviews

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23
Q

___ are studies in which people are allocated at random to receive one of several clinical interventions

A

randomized controlled trials

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24
Q

___ studies typically observe large groups of individuals, recording their exposure to certain risk factors to find clues as to the possible causes of disease

A

cohort studies

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25
Q

___ are studies that compare patients who have a disease or outcome of interest with patients who do not have the disease or outcome

A

case-control studies

26
Q

___ and ___ are detailed reports of symptoms, signs, diagnoses, treatment, and follow-up of an individual patient

A

case series and case reports

27
Q

___ and ___ are beliefs or judgements about something given by an expert on the subject

A

editorials and expert opinions

28
Q

what is the hierarchy of scientific evidence, from the top of the pyramid to the bottom, and which areas include most of dental research?

A
  1. systematic reviews
  2. randomized controlled trials
  3. cohort studies
  4. case-control studies (used in dental research)
  5. case series, case reports (used in dental research)
  6. editorials, expert opinions (used in dental research)
29
Q

regarding maxillary expansion, does lateral expansion of the dental arch by self-ligating brackets “grow” buccal alveolar bone?

A
  • this claim is weakly supported by low-level evidence that has not been independently confirmed
  • currently, no peer-reviewed scientific evidence supports this claim
30
Q

regarding maxillary expansion, is lateral expansion of the dental arch by self-ligating bracket systems comparable with lateral expansion gained by rapid maxillary expansion followed by conventional edgewise treatment?

A
  • this claim is weakly supported by low-level evidence that has not been independently confirmed
  • currently, no peer-reviewed scientific evidence supports this claim
31
Q

regarding maxillary expansion, is lateral expansion of the dental arch gained by self-ligating bracket systems stable in the long term?

A
  • this claim is weakly supported by low-level evidence that has not been independently confirmed
  • currently, no peer-reviewed scientific evidence that lateral expansion of the dental arch with a self-ligating bracket system has long-term stability
32
Q

are self-ligating bracket systems more efficient and more effective than conventional edgewise brackets systems in treating malocclusions?

A
  • current evidence does not support the assertion that self-ligating bracket systems are more efficient or more effective in treating malocclusions
  • current evidence does not indicate differences between self-ligating systems and conventional systems for treatment time, rate of alignment, rate of space closure, final arch dimensions, or occlusal outcomes.
  • data from a few studies do indicate that chair time is, on average, 20 seconds less per arch, and final mandibular incisor inclination is, on average, 1.5° less for self-ligating bracket systems
33
Q

do self-ligating bracket systems provide less friction between archwire and bracket?

A
  • the evidence for less friction between archwire and self-ligating brackets presently comes from results found under specific laboratory conditions, which do not fully emulate a clinical setting
  • in-depth understanding of friction between bracket and archwire in vivo, and its relationship to tooth movement, remains uncertain
  • the difference between static friction and sliding friction needs to be considered in studies
34
Q

do self-ligating bracket systems provide lower clinical forces compared with conventional brackets?

A
  • at present, no studies have measured the forces in vivo to answer this question
  • two in-vitro studies suggest that initial forces on buccally or lingually displaced teeth might be greater in self-ligating systems compared with conventional brackets
35
Q

do patients treated with self-ligating bracket systems experience less pain during treatment?

A

-at this time, there is insufficient data that compare self-ligating bracket systems and conventional bracket systems with regard to the pain experienced by patients during orthodontic treatment

36
Q

are conventional edgewise brackets less hygienic than self-ligating brackets?

A

-evidence does not support the claim that conventional edgewise brackets are less hygienic than self-ligating brackets

37
Q

T or F:

sliding friction is higher than static friction

A
  • false

- static friction is higher than sliding friction

38
Q

the ___ bracket system has a narrow slot where an archwire is loosely fitted and held in place with a locking pin and only round wires are used

A

begg bracket system

39
Q

___ orthodontic treatment is an alternative for patients who don’t want to show their braces in their mouth

A

lingual ortho treatment

40
Q

what are the advantages of lingual braces?

A

improved esthetics is the only advantage

41
Q

what are the disadvantages of lingual braces?

A
  • increased cost
  • difficult to work with
  • all wires must be bent around the different sizes of the teeth to position them
  • do not have direct vision of the braces when doing adjustments
  • very technique sensitive
  • patients could experience tongue discomfort and speech difficulties
  • occlusal interferences
42
Q

what are the steps to bonding brackets?

A
  • prophy the tooth surface
  • etch the surface using 37% phosphoric acid for 30 seconds then rinse with water
  • seal/prime tooth surface
  • spatula bonding cement into the wire mesh on the base of the bracket
  • place the bracket on the tooth and light cure for 20-30 seconds
43
Q

how are bands placed?

A
  • prophy tooth surface
  • apply glass ionomer cement to the interior of the bands
  • cement in place
44
Q

what are the indication for using bands instead of bonded brackets?

A
  • to provide better anchorage
  • for teeth that will need both lingual and labial attachments
  • teeth with short clinical crowns
  • tooth surfaces that are incompatible with successful bonding
45
Q

what are the two types of orthodontic bands?

A
  • plain (no bracket)

- with bracket

46
Q

___ bonding is the placement of brackets directly on the patients teeth, and ___ bonding is the fabrication of a splint on a model which contains the brackets

A
  • direct

- indirect

47
Q

what are the advantages of direct bonding?

A
  • don’t have to fabricate a bonding splint
  • don’t have errors in splint placement
  • can directly clean off excess adhesive before cure
48
Q

what are the disadvantages of direct bonding?

A
  • longer chair time/doctor time

- can be difficult to place some brackets

49
Q

what are the advantages of indirect bonding?

A
  • placement of all the brackets all at once
  • reduced chair time
  • more precise location of brackets, especially lingual appliances
  • can control thickness of resin between the tooth and the bracket interface
  • can be delegated to staff
50
Q

what are the disadvantages of indirect bonding?

A
  • very technique sensitive

- clean up of excessive adhesive can be difficult

51
Q

what is invisalign?

A
  • created as an alternative to braces

- uses a series of clear aligners that patients swap out every two weeks to align their teeth

52
Q

how does invisalign work?

A
  • PVS impression, treatment plan, patient pictures and x-rays are submitted to invisalign
  • patient’s treatment is finalized using Align software
  • receive trays from invisalign
  • bond attachments
  • interproximal stripping
  • begin treatment
  • patient’s swap out new trays every 2-3 weeks until treatment is complete
53
Q

what are the pros of invisalign?

A
  • patient doesn’t have to wear braces

- improved esthetics

54
Q

what are the cons of invisalign?

A
  • patient compliance is critical
  • trays have a difficult time “grabbing” the teeth even with the attachments, causing errors in the final result
  • patient must occlude on the invisalign trays throughout treatment, and posterior open bites are often seen
  • poor modalities to place inter-arch forces on the teeth
  • patients often require limited orthodontic treatment at their completion of invisalign to correct mistakes
55
Q

in a study conducted on the efficacy of tooth movement using invisalign, the mean accuracy of tooth movement was ___%. the most accurate movement was ___. the least accurate movement was ___, specifically ___.

A
  • 41%
  • lingual constriction (47.1%)
  • extrusion (29.6%)
  • mesiodistal tipping of the mandibular canines (26.9%)
56
Q

according to a study comparing invisalign with traditional orthodontic brackets, which group finished treatment sooner?

A
  • on average, invisalign patients finished 4 months sooner than those with fixed appliances
  • however, invisalign did not treat malocclusions as well as braces
57
Q

what cases are best treated with invisalign?

A
  • a very compliant patient
  • adults (not teenagers) with a class I molar and canine relationship
  • 2-4mm of crowding or 2-4mm of spacing
  • patients without rotations
  • patients where intrusive and extrisive movements are minimal
58
Q

what is six month smiles?

A
  • “braces in a box” kit provided to general dentists with all of the parts included
  • dentist pays a fee and attends a 2-day seminar to become a provider
  • at the “braces on” appointment, the brackets are placed using mouthpieces provided by the company and the wires are installed
59
Q

how does the cost of six month smiles compare to traditional braces?

A

it is generally less expensive but cost varies depending on specific treatment goals and location

60
Q

what is the smile care club?

A
  • uses dental professionals to oversee a patients treatment
  • patient takes pictures of their teeth and impressions of themselves, and the smile care club, with the input of the overseeing doctor, provide a treatment plan for the patient without ever seeing the patient
  • a series of aligners are made and sent to the patient who switches them out, much like invisalign, until they have a “perfectly straight smile”
61
Q

what are “do it yourself” braces aimed towards?

A
  • the market of budget-conscious individuals who have always wanted the benefits of orthodontic treatment but for some reason never received treatment
  • also overseas, braces are looked at as a status symbol, and many youth will place the braces themselves to impress others
62
Q

what can happen if people try to use elastics and tied floss to close spaces between teeth?

A
  • the elastics used to close the space slide down the lateral aspects of the teeth to the cervical margin
  • a patient that wear the elastic overnight can wake up and no longer see the elastic because it has become submerged below the gingival margin
  • if the elastic is not removed, it will continue to move apically, destroying the gingival attachment and bone, causing the teeth to fall out

Ortho (15 decks)

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