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BOARDs > Ortho > Flashcards

Ortho Flashcards

1
Q

Syndrome vs Sequence

A

Syndrome:
* pattern of annomolies
* that occur together in a predictable fashion
* due to single etiology (genetic)
* Like a recipe from a cookbook

Sequence:
* Group of related anomalies
* Stem from a major anamoly
* alters the development of surrounding structures
* like a row of dominos

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2
Q

Fetal Alcohol Syndrome: Cause

A

Exposed to high levels of ethanol
* Teratogen=alcohol

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3
Q

Fetal Alcohol Syndrome: S/S

A

CNS problems: Neural Plate Tissue Deficiency
* abnormal brain development
* microcephaly (small head)

Midface deficiency:
* smooth philtrum
* thin upper lip
* small parpebral fissures

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4
Q

Treacher Collins Syndrome: Cause

A

Genetic Mutation:
Altered development of neural crest cells

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5
Q

Treacher Collins Syndrome: S/S

A

underdevelopmed mandible
Downslanted palpebral fissures
Celft palate (35%)
Microtia (Small ear)

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6
Q

Hemifacial Microsomia: Cause

A

Loss of neural crest cells during migration

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7
Q

Hemifacial Microsomia: S/S

A

Deficient Ear & Mandibular Ramus
* On affected side

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8
Q

Down syndrome: Cause

A

Nondisjuction leading to extra chromosome 21

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9
Q

Down syndrome: S/S

A

Midface deficiency
Upslanted palpebral fissures
No Increased caries risk
Increased perio risk

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10
Q

Cleft Lip & Palate

A

Class 3 w/deficient maxilla

Cleft Lip:
* week 4-6 in utero
* No fusion b/w Medial Nasal Prominence and Maxillay Process Anteriorly
* Usually off midline and unilateral

Cleft Palate:
* week 6-8 in utero
* No fusion b/w Medial Nasal Prominence and Maxillary Process posteriorly
* Primary Palate: caries lateral incisor to lateral incisor. why they are missing lateral incisors
* Complete Cleft Palate: Primary and Secondary palate both do not fuse

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11
Q

Pierre Robin Sequence

A

Mary Gray Cunningham BF is Difficult

  1. Micrognathia (small mandible)
  2. Glossoptosis:
  3. Cleft Palate
  4. Breathing & Feeding Difficulties
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12
Q

Crouzon Syndrome: S/S

A

Craniosynostosis: early closure of skull sutures
(Brady’s Hyper Front Boss has Prop Class @ 3)
Brachycephalic (short skull)
Midface deficiency
Frontal Bossing (Prominent forehead)
Hypertelorism (wide separated eyes)
Proptosis (Bulging eyes)
Class 3 occlusion

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13
Q

Alpert Syndrome: S/S

A

Craniosynostosis:

Acrocephalic: Tall Skull
Byzantine Arch: (narrow palate w/high vault)
Syndactyly (Fused fingers and toes)

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14
Q

Hurler & Hunters Syndrome

A

Build up of Glycosaminoglycans (GAGs)
* Due to enzyme deficiency

HURL.. vomitting.. GAG

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15
Q

Gum Pad Stage

A

Birth to 6 months
End=eruption of 1st primary tooth

  • lateral Sulcus: separates primary K9 from primary 1st molar
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16
Q

Primary Dentition Stage

A

6 months to 6 y.o.

Minimal OB & OJ

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17
Q

Interdental Spacing

A

Space b/w primary incisors

normal Space
* permanent incisors filll gaps
* w/o=crowding

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18
Q

Primate Spacing

A

Max: B/w primary lateral & K9
Mand: B/w Primary K9 & 1st molar

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19
Q

Leeway Spacing

A

Difference of combined MD width b/w:
* primary K9/1st molar/2nd molar
* permanent K9/1st premolar/2nd premolar

Gains us space:
* permanent premolars are smaller than primary molars they replace

Max: 1.5 mm per side (3mm total)
Mand: 2.5 mm per side (5 mm total)

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20
Q

Primary Molar Relationships

A

Relationship b/w:
* Mandibular Terminal Plane
* Maxillary Terminal Plane

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21
Q

Mixed Dentition Stage

A

6 yrs to 12 yrs
end=exfoliation of last primary tooth
* interdental, primate, and leeway spaces all close

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22
Q

Ugly Duckling Stage

A

11-12 yrs old

Hallmark: diastema b/w 8 &9, </= 2mm
* closed w/max K9 eruption

If > 2mm: will not close fully

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23
Q

Anterior Transition:

A

permanent tooth buds are lingual and apical to primary counterparts

Incisors erupt lingually
* Except Upper Central & K9s erupt labially

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24
Q

Posterior Transition

A

Flush terminal plane–> class 1 by differential teeth shift and differential jaw growth

Early Mesial Shift= 1st molars -> close primate space (around 6 y.o.)

Late Mesial Shift=2nd molars ->close leeway space (around 12 y.o.)

Late mandibular growth

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25
Q

Mixed Dentition space analysis

A

compares Space available and space required for incoming permanent teeth

requires all 4 lower incisors erupted

Objective: Predict MD width of unerupted B segment (k9/1st and 2nd premolar)

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26
Q

Ideal OB and OJ

A

OB: 10-20%
OJ: 1-3 mm

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27
Q

Late Lower Incisor Crowding

A

Anterior crowding gets worse in 20’s and 40s
* Due to late mandibular growth

Results in:
* Added pressure on lower incisors

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28
Q

inter canine Width

A

Increase as permanent teeth erupt

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29
Q

Intermolar width

A

Increases as molars erupt then stabilizes

More expansion in max vs mandibular bc:
* Upper erupt divergently and lower erupt convergently

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30
Q

Arch Length

A

Decrease during transition from mixed to permanent

31
Q

Arch Perimiter

A

Increase in Max
Decrease in Mand

During transition from mixed to permanent

32
Q

Ackerman-Profit Diagnostics

A

Facial Proportions and Esthetics:
* Lip Posture
* smile arc

Alignment & Symmetry:
* crowding
* Spacing
* rotation

Transverse:
* Posterior cross bite
* Midline

Anteroposterior:
* OJ
* Angles Class

Vertical:
* OB
* CUrve of spee

33
Q

Malocclusion

A

Bad Bite

Genetic Disposition

34
Q

Molar Classification

A
35
Q

Overjet

A

Horizontal Overlap: labial surface to labial surface
Normal: 2-3 mm
Excess > 3mm
Reverse OJ: Max incisors behind mandibular incisors

36
Q

Overbite

A

Vertical Overlap: Incisal edge to incisor edge
Normal: 1-2mm

37
Q

Anterior Crossbite

A

Aka Reverse Overjet

Maxillary Anteriors are behind Mandibular anteriors

38
Q

Posterior Crossbite

A

Aka Scissor Bite

Maxillary posterior teeth are lingual to mandibular
* Or completely buccal

39
Q

Bolton Analysis

A

Measures Tooth Size Discrepancy
* compares Upper and lower teeth

Too large=Interproximal reduction (IPR)
Too Small=Buildup

40
Q

Face: Vertical 1/3s

A
41
Q

Face: Horizontal Fifths

A
42
Q

Skeletal Classification: Class 1 vs 2 vs 3

A

Class 1:
* jaws well related to N-vertical

Class 2:
* Prognathic/protrusive maxilla
* Retrognathic/retrusive mandible (most common)
* Combo of both

Class 3:
* Prognathic mandible
* Retrognathic Maxilla (most common)
* Combo

43
Q

Facial Profile

A

Facial plane formed by: GLabella, Subnasale, ST pogonion

Straight: Class 1
Convex/Posterior Divergence: Class 2
Concave/Anterior DIvergent: class 3

44
Q

Nasolabial Angle

A

b/w nose and upper lip
90 degrees

45
Q

Mentolabial Fold

A

Aka Mentolabial Angle

b/w lower lip and chin
120 degrees

46
Q

Cervicomental Angle

A

b/w chin and neck
90-120 degrees

47
Q

Lips

A

3 P’s:
Position:
* Rickets E Plane (line from nose to chin)
* Lower lips should be behind
* Upper lips should be on the line

Posture=lip competence at rest
* competent vs incompetent
* Incompetent=3-4 mm seperation at rest + Mentalis strain on closure

Proportions:
* How much vermilion is showing?
* Thick or thin lips

48
Q

Incisal Display

A

at Rest:
* Ideal: 2-4 mm show

On Smile:
* Ideal: 75-100% incisor w/1-2 mm gingival show

49
Q

S-N Reference Plane

A

Cranial base

50
Q

Po-Or Reference Plane

A

Frankfort Horizontal

51
Q

ANS-PNS Reference Plane

A

Palatal Plane L6-L1: Occlusal Plane

52
Q

Go-Gn reference plane

A

Mandibular plane

53
Q

Sassouni Analysis

A

All reference planes should intersect at back of head (Occupit)

Intersect earlier: Hyperdivergent
Intersect later: Hypodivergent

54
Q

SNA

A

maxilla to cranial base
* large angle-Prognathic Max
* Small Angle: Retrusive max

55
Q

SNB

A

Mandible to cranial base
* Large angle: Protrusive mandible
* Small angle: Retrusive mandible

56
Q

ANB

A

Maxilla to Mandible

</= 0 degrees: Class 3
2 Degrees: Normal Class 1
>/= 4 degrees: Class 2

57
Q

Soft Tissue Paradigm

A
58
Q

Cephalometric analysis

A

eval relationship b/w jaws & teeth

use:
* SNA
* SNB
*ANB

59
Q

Phase 1 ortho treatment

A

Early treatment during Mixed dentition

60
Q

Phase 1 Ortho tx: Posterior Crossbite

A

Transverse issue: narrow palate

Tx early if functional shift
* can cause skeletal asymmetry as pt grows into malocclusion

Tx: Palatal Expansion

61
Q

Phase 1 Ortho tx: Anterior Crossbite

A

Few teeth:
* dental issue
* results in wear & gingival strain
* Tx: 2x4 braces or active retainer

Full Underbite:
* Skeletal class 3 malocclusion
* Tx: Reverse Pull headgear

62
Q

Phase 1 Ortho tx: Severe Overjet

A

Increased risk of Trauma
Psychosocial concern

63
Q

Phase 1 Ortho tx: Anterior Open Bite

A

Causes:
Thumb sucking:
* narrow maxilla w/posterior cross bite
* Proclaimed max incisors & retroclined mandibular incisors

Tongue Thrust:
* Proclaimed incisors w/generalized spacing

64
Q

Phase 1 Ortho tx: Impacted Teeth

A

Kurol’s Rule:
* K9 Not past midline of lateral incisor=91% chance of eruption
* K9 past midline of lateral incisor=64% chance of eruption

3 H’s:
* How High?
* Is it horizontal?
* Has it crossed midline of lateral?

65
Q

Phase 1 ortho tx: Moderate Crowding

A

> /= 4 mm crowding
* not a big deal in mixed dentition bc of leeway space
* No EXTractions

Tx: Focus on maintaining space for permanent teeth
* Lip bumper
* LLHA

66
Q

Phase 1 ortho tx: Severe Crowding

A

> /= 8mm crowding
Tx: Serial Extraction (C-D-4)
* start when max perm laterals erupt: EXT C’s (Primary K9s)
* Ext primary 1st molars
* Perm 1st premolars Erupt= Ext Them

Contraindication:
* Skeletal Discrepancy

67
Q

Class 2 appliances: General

A

Headgear:
*restrains max growth

Functional appliances
* Stimulate mandibular growth

68
Q

Class 3 Appliances: General

A

Reverse headgear:
* stimulates max growth

Chin cup
* Restrains mandibular growth

69
Q

Headgear

A

Best Prepubertal
Growth Modification

70
Q

High-Pull Headgear

A

Aka Occipital-Pull Headgear
* Class 2

Skeletal: Restrains max forward growth

Dental: intrudes and distalizes upper molars

Best for Class 2 Open Bite:
* Class 2: restrains max growth
* Open Bite: Intrudes posterior teeth

71
Q

Low-Pull Headgear

A

Aka Cervical-Pull Headgear
* Class 2

72
Q

Reverse-Pull Headgear

A

Facemask
* Class 3

73
Q

Chin Cup

A

Class 3

74
Q

Growth Modification: Age of Boys vs Girls

A

Girls: 8-13
Boys: 10-15

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