Ortho Flashcards
What are the habit treatment principles?
Stop habit- reinforcement, removable appliance habit breaker, fixed appliance habit breaker
Allow spontaneous improvement of malocclusion
Treat residual malocclusion if required
What are the management options of a Class 2 Div 1 malocclusion?
Accept
Attempt growth modification- patient has to be the right age - twin block
Simple tipping of teeth- URA
Camouflage
Orthognathic surgery
What are the treatment options for Class 2 div 2 malocclusion?
Accept
Growth modification - modified twin block
Camouflage
Orthognathic surgery
What are the management options for a Class 3 malocclusion?
Accept/monitor
Early interception with URA - reverse twin block
Growth modification
Camouflage
Combined orthognathic and orthodontic tx
What is the MOCDO acronym stand for?
Missing teeth - includes congenital absence, ectopic and impacted
Overjets- including reverse
Crossbites
Displacement of contact points
Overbites
What is IOTN comprised of?
Aesthetic component
Dental health component
What are the checks to carry out when fitting a URA?
Check for correct patient and appliance is correct
Check for protruding wires or sharp acrylic
Check wirework integrity
Fit appliance
Check for blanching
Check arrowheads and activation
Demonstrate insertion and removal
Review-4-6 weekly and adjust active component
What are the instructions to the patient after fitting a URA?
Will feel big and bulky
Will affect speech until muscles and tongue adjust
May have mild discomfort
Initially will have an increase in saliva
Wear 24 hours a day including meals
Can remove to clean with a soft toothbrush after meals or when taking part in contact sports
Avoid hard/sticky foods
Be cautious with hot foods as base plate can act as insulator
Non-compliance will lengthen treatment
Give emergency contact number
What is a flat anterior bite plane?
Used to correct deep overbites
No posterior occlusion, therefore opens bite posteriorly
What are the risks of ectopic canines?
Root resorption of the laterals and the central incisors
Cyst formation
When would you suspect the canines to be ectopic?
Not palpable in the buccal sulcus by 10-11 years old
If palpation indicates an asymmetrical eruption pattern or the position of adjacent teeth implies a malposition
Abnormal mobility of the adjacent permanent teeth
What radiographic technique is used to determine position of ectopic canines?
Parallax
Uses 2 different radiographs
What radiographs are used for horizontal parallax?
Upper oblique occlusal and periapical
Two periapicals
What are the treatment options for ectopic canines?
Interceptive treatment by XLA of primary canine- need to maintain space (between 10-13 years)
Surgical exposure and orthodontic alignment
Surgical removal of the palatally ectopic permanent canine
No active treatment/monitor
Autotransplantation
What is the acronym to determine canine position from parallax? What does this mean?
Same Lingual Opposite Buccal
If an object moves in the same direction as the tube shift on a second radiograph, it’s located lingually, if it moves in the opposite direction, it’s buccally located
What radiographs are used for vertical parallax?
Upper oblique occlusal and an OPT
Periapical and an OPT
What are the issues associated with an increased overjet?
Trauma
Speech
Mastication
Dry mouth
What are the issues associated with an overbite?
Trauma - palatal gingivae
Recession
What are the causes of ectopic canines?
Crowding - last tooth to erupt in 345 sequence-pushed out if not enough space
Genetics
Associated with other dental anomalies- Class II div 2, hypodontia, missing laterals (lack of guidance)
Longest path of eruption
Ectopic position of tooth germ
When would you accept ectopic canines?
XLA of c’s unlikely to make different to permanents
Positioned mesial to the midline of U2’s
Patient above age where interceptive treatment for ectopic canine is likely to work
Insufficient space for 3’s
What are the risks of doing nothing with ectopic canines?
Resorption of roots of adjacent teeth- 40% risk to lateral incisor root resorption
Resorption of canine crown
Ankylosis of unerupted canine
Eventual loss of primary canine and complex restorative solutions
Cystic change of canine
What are the indications for surgical removal of ectopic canines?
If deemed not to be alignable
-too high above apical third of incisor roots
-too close to midline
-angle greater than 55 degrees to the midsagittal plane
No significant risk of damaging adjacent teeth during procedure
Patient is happy with appearance and retained primary has good prognosis
Radiographic evidence of early root resorption of adjacent teeth
Patient does not want to wear ortho appliances
What are the issues associated with peg-laterals?
Over-eruption
Spacing
Crowding
What are the causes of infra-occlusion?
Trauma
Infection
Missing successor
What are the treatment options for infra-occluded teeth?
Monitor if not dropped below contact point
XLA primary- maintain space with URA
Retain tooth and build up-if no successor
What are the treatment options for impacted 6’s?
Extract E’s if not severe
Disimpact using ortho seperator
Distal removal of the E for space
Extraction of pre-molars to relieve crowding
Fixed appliance to distalise 6
What are the main risks of orthodontic treatment?
Decalcification
Root Resorption
Relapse
Soft tissue trauma/ulceration
What are the malocclusion features most prone to relapse?
Crowded lower incisors
Rotations
In-standing 2’s
Spaces/diastemas
AOB
Short roots
What are the principles of URA design?
A= active component
R= retentive components
A= anchorage
B=baseplate
What is anchorage?
Resistance to unwanted tooth movement
