Midterm Flashcards
What are the causes of skeletal malocclusion?
- Trauma
- Pathology
- Congenital - clefts, syndromes
- Developmental - condylar hyperplasia
What is the cause of most malocclusions?
Developmental
What are the three ways to treat skeletal malocclusion?
- Growth redirection
- Orthodontic camouflage
- Orthognathic surgery
T/F: Orthodontic camouflage involves moving the teeth in the opposite direction that you would for pre-surgical orthodontics.
True
Camo - make it better
Pre-surgical - make it worse
_______ have allowed for more tooth movement than is described in the envelope of discrepancy.
TADs
What are the advantages of orthognathic surgery?
- Increased stability
- Decreased treatment time
- Improved occlusion
- Improved esthetics
What are the indications for orthognathic surgery?
- Skeletal discrepancy w/ masticatory difficulty
- Impingement on palatal tissue
- Speech difficulty
- OSA
- Psychosocial problems
- Esthetics
T/F: There is pre and post-surgical orthodontics involved with surgery.
True
T/F: All facial types can have a normal occlusion.
True
T/F: Patients with a straight profile are usually skeletal and dental class I.
True
T/F: Convex profile is usually associated with skeletal and dental class III.
False
Convex = class II Concave = class III
T/F: Class II is more common than class III.
True
T/F: Class II needs surgery more often than class III.
False
40% class III needs surgery
T/F: The vertical position, AP position, and transverse position of surgery are all determined by the stent.
False
AP and transverse = stent
Vertical = k-wire
T/F: Most patients with BSSO surgery do not experience any nerve damage.
False
Many experience some post-op symptoms, but nearly all of them are still happy
What is a stable treatment often used for anterior open bites?
LeFort I Osteotomy
How long is the jaw wired shut after LeFort surgery?
Shut with liquid diet for 3 days
6 weeks soft diet
T/F: Clefts can cause large maxillary AP deficiencies.
True
Who benefits the most from distraction?
Cleft patients
What is the key to reconstruction after trauma?
Re-establish proper occlusion
What is a complication of mandibular fractures?
Some can cause patients to swallow their tongue and block airway
T/F: Abrasions are very painful for patients.
True
Epithelial layer removed and nerves exposed
When stitching a laceration involving the lip where should the stitches start?
Vermillion border
What bacterial infection is common with animal bites?
Pasteurella multocida
Augmentin for 7 days
Cats have greater risk than dogs
T/F: A fracture is more favorable if it is posterior to the teeth.
True
What are the five principles of managing facial trauma?
- Reduction - put bone back
- Stabilization
- Immobilization
- Prevent infection
- Occlusion
What types of fractures can be treated non-surgically?
Fractures without malocclusion and a compliant patient.
Ex. Subcondylar, greenstick
Describe a closed reduction.
No incisions needed. Use the opposite arch as a handle to reduce fracture. Teeth wired shut for 4-8 weeks.
Describe a open reduction with internal fixation.
Open to visualize fracture and fixate with plate/screws.
Can contaminate and cause more trauma
What are the advantages of intraoral surgical approaches?
No external scar and no facial nerve damage
What are the advantages of extraoral approach surgical reduction?
Excellent access for reduction and fixation
Clefting is the result of the failure of which processes to fuse?
Median nasal process and maxillary process
What can be a major issue managing a patient with a cleft palate that goes up through the nose?
Impression material and fluoride can get stuck in the patients nose
What are the various cleft diagnoses?
- Cleft palate
- Cleft lip w/ palate
- Cleft lip w/o palate
Who is most likely to have a cleft lip with or without palate?
Asian male on the left side
T/F: Females are more likely to have isolated cleft palate.
True
It is less common than cleft lip with or without palate
What is the rule of 10s?
Describes how cleft lip should be treated.
At 10 weeks, 10 lbs
When should the palate be repaired?
12 months
What is a treatment for speech problems with a cleft? What are the negatives of this treatment?
Velopharyngeal flap to help with nasally speech.
Can lead to mouthbreathing and OSA
At what point is it critical to have a bone graft done in the alveolus of a cleft patient?
At mixed dentition stage
T/F: All unerupted teeth are impacted.
False
Impacted teeth do not erupt in the expected development time.
What is the most common type of 3rd molar In the mandible?
Mesioangular (43%)
Generally the easiest to remove
Which type of 3rd molars are the most difficult to remove?
Distoangular
What is the least common type of 3rd molar?
Horizontal (mandible and maxilla)
What is the most common third molar in the maxilla?
Vertical followed by distoangular
What are the two indications for third molar removal?
Therapeutic - to treat current disease
Prophylactic - to prevent future problems
What is the ideal patient selection for third molar removal?
- 2/3 root formation
- 18-25 yrs old
- Healthy
- No psychological contraindications
- No job restrictions to “numb lip”
What are some contraindications to third molar removal?
Extreme ages old or young
