Oral surgery and Orthodontics Flashcards
What Soft tissue procedures may an oral surgeon be required to do by an orthodontist to complete a txt plan for orthodontist pt?
- Frenectomy (either V to Y frenoplasty or Z-plasty)
- Impacted canines
- Via Buccal apically repositioned flap
- or Via Palatal open exposure - Impacted premolar exposures
What are the two most common hard tissue procedures an oral surgeon may be required to do for an orthodontist case?
- Impacted canine
- Impacted premolar
What may be required of an oral surgeon for an impacted canine?
- Buccal apically repositioned flap with bone removal
- Palatal open exposure with bone removal
- Buccal or palatal closed exposure with gold chain attachment
- Extraction
What may be required of an oral surgeon for an impacted premolar?
- Extraction
- Exposure of impacted premolars with bone removal
What less common hard tissue procedures may be required of an oral surgeon for an orthodontist case?
- Other extractions
- Submerged retained deciduous teeth
- Implants (useful for anchorage)
- Mini-implants
- Orthognathic surgery
What are the possible lines of approach for an oral surgeon for an impacted canine?
- Leave alone and monitor
- Extract the canine
- Surgical exposure and orthodontic alignment
- Mini-implants
- Corticotomy
- Auto-Transplant
What are some indications for canine transplantation?
- Can’t get a result by surgical exposure and orthodontic traction
- Likely to damage to other teeth via other methods
- Space is available or can be made without premolar XLA
- Older pt who is seeking quick solution
What are some risks of auto-transplants?
- Damage to PDL can lead to Ankylosis
- Root resorption of other teeth
What is common for a buccally placed canine to achieve after it has been moved into line of arch (not aesthetic for pt)?
- Tend to not bring overlying mucosa with them
- Poor gingival margin (not as aesthetic)
When performing a palatal flap to expose a palatally placed canine what nerve bundle does this affect?
- Destroys the nasopalatine nerve bundle
- Left with permanent anaesthesia on the palate (gingiva of anterior maxillary teeth)
What two splints are available to give a pt after a canine transplant?
- Old Chrome/cobalt cap splint
- Now use Titanium trauma splint
Why do you not luxate an impacted tooth?
- Luxating increases likelihood of damage to PDL and ankylosis
What is this an example of?
- Dilaceration of 33
What is this OPT an example of (think canines)
- Kissing canines 33 and 43
Using parallex what direction is this canine placed?
- Buccal
What type of flap is this? What incisions would you do to get this flap?
- Apically repositioned flap
- 1 crestal incision
- 2 relieving incisions
- do a broad relieving incision so there is better blood supply to the flap - improves healing)
Describe what is happening in this image?
- Open exposure of impacted 23
- Gold chain attachment
What is a closed exposure procedure of impacted canine ?
- Raise a flap (palatal flap)
- Remove bone above impacted canine
- Attach gold chain with etch and bond
- Replace the flap and suture with the chain sticking out the flap
- Stich the last chain to mucosa so as to not annoy pt
Why might a fraenectomy be performed?
- Poor oral hygiene due to excess mucosa
What procedure is this an example of?
Z- Plasty
Implants provide the qualities of an ideal orthodontic anchor, Give 5 advantages of implants in orthodontics?
- Patient compliance unnecessary
- Absolute anchorage as there is no periodontal ligament
- Easily used under a variety of treatment modalities
- Easily placed
- Removable, if necessary
What type of implant is this? What does it help with in orthodontics?
- Mini-implant
- Placed interproximally between 5 and 6 to provide orthodontic anchorage (placed from buccal)
What is a Corticotomy?
- Drill holes into bone surrounding impacted tooth
- Makes surrounding cortical bone weaker to facilitate tooth movement without loss of anchorage
Using parallex what position is this impacted canine?
- Buccal
