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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
Mixed Dentition space analysis
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)
26
Ideal OB and OJ
OB: 10-20% OJ: 1-3 mm
27
Late Lower Incisor Crowding
Anterior crowding gets worse in 20's and 40s * Due to **late mandibular growth** Results in: * **Added pressure on lower incisors**
28
inter canine Width
Increase as permanent teeth erupt
29
Intermolar width
Increases as molars erupt then stabilizes More expansion in max vs mandibular bc: * **Upper erupt divergently and lower erupt convergently**
30
Arch Length
Decrease during transition from mixed to permanent
31
Arch Perimiter
Increase in Max Decrease in Mand During transition from mixed to permanent
32
Ackerman-Profit Diagnostics
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
Malocclusion
Bad Bite Genetic Disposition
34
Molar Classification
35
Overjet
Horizontal Overlap: labial surface to labial surface Normal: 2-3 mm Excess > 3mm Reverse OJ: Max incisors behind mandibular incisors
36
Overbite
Vertical Overlap: Incisal edge to incisor edge Normal: 1-2mm
37
Anterior Crossbite
Aka Reverse Overjet Maxillary Anteriors are behind Mandibular anteriors
38
Posterior Crossbite
Aka Scissor Bite Maxillary posterior teeth are lingual to mandibular * Or completely buccal
39
Bolton Analysis
Measures Tooth Size Discrepancy * compares Upper and lower teeth Too large=Interproximal reduction (IPR) Too Small=Buildup
40
Face: Vertical 1/3s
41
Face: Horizontal Fifths
42
Skeletal Classification: Class 1 vs 2 vs 3
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
Facial Profile
Facial plane formed by: GLabella, Subnasale, ST pogonion Straight: Class 1 Convex/Posterior Divergence: Class 2 Concave/Anterior DIvergent: class 3
44
Nasolabial Angle
b/w nose and upper lip **90 degrees**
45
Mentolabial Fold
Aka Mentolabial Angle b/w lower lip and chin **120 degrees**
46
Cervicomental Angle
b/w chin and neck **90-120 degrees**
47
Lips
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
Incisal Display
at Rest: * Ideal: 2-4 mm show On Smile: * Ideal: 75-100% incisor w/1-2 mm gingival show
49
S-N Reference Plane
Cranial base
50
Po-Or Reference Plane
Frankfort Horizontal
51
ANS-PNS Reference Plane
Palatal Plane L6-L1: Occlusal Plane
52
Go-Gn reference plane
Mandibular plane
53
Sassouni Analysis
**All reference planes should intersect at back of head (Occupit)** Intersect earlier: Hyperdivergent Intersect later: Hypodivergent
54
SNA
maxilla to cranial base * **large angle-Prognathic Max** * **Small Angle: Retrusive max**
55
SNB
Mandible to cranial base * **Large angle: Protrusive mandible** * **Small angle: Retrusive mandible**
56
ANB
Maxilla to Mandible **/= 4 degrees: Class 2**
57
Soft Tissue Paradigm
58
Cephalometric analysis
eval **relationship b/w jaws & teeth** use: * SNA * SNB *ANB
59
Phase 1 ortho treatment
Early treatment during **Mixed dentition**
60
Phase 1 Ortho tx: Posterior Crossbite
Transverse issue: **narrow palate** **Tx early if functional shift** * **can cause skeletal asymmetry as pt grows into malocclusion** Tx: Palatal Expansion
61
Phase 1 Ortho tx: Anterior Crossbite
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
Phase 1 Ortho tx: Severe Overjet
Increased risk of Trauma Psychosocial concern
63
Phase 1 Ortho tx: Anterior Open Bite
Causes: **Thumb sucking**: * narrow maxilla w/posterior cross bite * Proclaimed max incisors & retroclined mandibular incisors **Tongue Thrust**: * Proclaimed incisors w/generalized spacing
64
Phase 1 Ortho tx: Impacted Teeth
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
Phase 1 ortho tx: Moderate Crowding
>/= 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
Phase 1 ortho tx: Severe Crowding
>/= 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
Class 2 appliances: General
Headgear: *restrains max growth Functional appliances * Stimulate mandibular growth
68
Class 3 Appliances: General
Reverse headgear: * stimulates max growth Chin cup * Restrains mandibular growth
69
Headgear
Best Prepubertal Growth Modification
70
High-Pull Headgear
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
Low-Pull Headgear
Aka Cervical-Pull Headgear * Class 2
72
Reverse-Pull Headgear
Facemask * Class 3
73
Chin Cup
Class 3
74
Growth Modification: Age of Boys vs Girls
Girls: 8-13 Boys: 10-15

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