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Past MSAs > Ortho > Flashcards

Ortho Flashcards

1
Q

general implications of large overjet

A 
trauma risk
psychological impacts
teasing
difficulty eating
difficulty speaking
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2
Q

dental implications of retainer?

A

fixed: difficult to clean around,
can debond,
wire fracture
increased gingivitis risk

vacuum formed: 
low compliance
chipped/fractured
become lost
alter occlusion
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3
Q

design appliance to correct posterior crossbite

A

Aim: appliance to correct posterior crossbite
Active: mid-palatal screw
Retentive: adams clasps 6s, 4s 0.7 HSSW
Anchorage: yes
Baseplate: self cured PMMA, posterior bite plane

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4
Q

what is right deviation on closing and

complications that could come from this?

A

mandibular displacement on closure due to interarch discrepency

tooth wear
TMD
parafunctional habits

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5
Q

List 10 potential risk of orthodontic treatment

A

decalcification
relapse
root resorption
gingival recession

mucosal irritation
loss of vitality
loss of periodontal support
failure to complete
ulceration
wear of adjacent teeth
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6
Q 
pt aged 30 concerned about appearance
has class III incisor relationship
what condition could be causing this?
what intraoral features would a pt with class III have?
A

acromegaly
- hormone disorder, pituitary gland secretes too much growth hormone. occurs in middle aged pts

reduced/reversed overjet
attrition
retroclined lower incisors
displacement on closure

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7
Q

design a URA to treat anterior crossbite of 12

what features of dentition would make this good URA case

A

A - palatal z-spring on 12 - 0.5 HSSW
R - adams clasps 6s 0.7 HSSW
A -yes
B - self cure PMMA w/ post bite plane

enough space
only one tooth needing tilted
palatal tipped 12
good overbite for stability

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8
Q

5 factors that can resist displacement forces

A 
gravity
mastication
active component
speech
tongue
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9
Q

pt w/ fixed ortho comes in with loose bracket

A

check if any other brackets loose
if missing account for them - if unknown chest x-ray
check health of tooth
check if wire round or square -
if round- need to remove as can swivel and come off
if square - keep in place, give OHI (moving bracket from side to side)
refer back to orthodontist
inform pt of decal if present

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10
Q

risks of extracting sound teeth due to aesthetics

A

reduction in labial profile
resorption of bone
drifting

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11
Q

6 uses of a URA

A 
tipping of teeth
space maintainer
retainer
reduce of OB
expand arch
habit breaker
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12
Q

6 pieces of advice to give on delivery of URA

A
  • will feel uncomfortable
  • will feel bulky
  • practice reading aloud to help with speech
  • avoid hard and sticky foods
  • take out for contact sport
  • clean by brushing over with dry toothbrush after meals
  • wear as much as can 24/7 if possible
  • poor compliance increases tx time
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13
Q

outline the 10 steps of URA delivery

A
  • check correct pt and correct appliance
  • check correct appliance for prescription/ design
  • check for sharp edges
  • check wire integrity
  • insert- check for blanching of gingiva
  • posterior retention - flyovers then arrowhead
  • anterior retention
  • ACTIVATE
  • demonstrate insertion and removal, get pt to demonstrate back
  • book in for review 4-6 weeks
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14
Q

design URA for an anterior crossbite. pt 8 y/o

A 
A- z-pring 0.5 HSSW
R- Adams clasps on 6s 0.7 HSSW
Adams clasps on Es 0.6 HSSW
A - yes
B- self cure PMMA w/ post bite plane

self retentive after reverse over bite fixed
single tooth movement
increases overbite

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15
Q

incidence of hypodontia in the uk

A

6%

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16
Q

most common teeth to be missing (in order of prevalence)

A

mand 6s
max 2s
max 6s

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17
Q

how may hypodontia present to you as GDP

A 
delayed/ abnormal eruption
infraocclusion
missing primary teeth
ectopic 3
CLP
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18
Q

tx options hypodontia

A

accept and monitor
restorative - bridge, rpd, implant
ortho
ortho + restorative

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19
Q

how would you localise ectopic canines?

A

vertical parallax

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20
Q

age to intervene with ectopic canines

A

start palpating at 9

if not present at 11 intervene

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21
Q

how long after XLA cs for ectopic canines tx to review?

A

6 months

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22
Q

4 tx options ectopic canines

A

open exposure palatal +/- bone removal
open buccal apically repositioned flap +/- bone removal
closed exposure w/ gold chain
surgical extraction of 3

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23
Q

What is a supernumerary

Most likely location

A

an extra tooth to the permanent dentition

maxilla - between centrals. mesioderm

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24
Q

Types of supernumerary - explain features

A

COST

odontome - denticles OR mass of disorganised dental tissue
tuberculate - barrel shaped
conical - peg shaped
supplemental - extra tooth of normal dentition

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25
Q

implications of supernumerary teeth

A 
prevention or delay in eruption of permanent dentition
occlusal interference
crowding
traumatic eruption
failure to erupt
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26
Q

4 intraoral signs of thumb sucking

A

proclined upper incisors
retroclined lower incisors
AOB/ incomplete open bite
narrow upper arch +/- unilateral posterior crossbite

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27
Q

BSI definition class 1 incisal

A

lower incisor edge occludes with or sits just below cingulum plateau of upper incisor
normal OJ

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28
Q

BSI definition class II div 1 incisal

A

lower incisal edge occludes posterior to cingulum of upper incisor
overjet is increased
upper incisors are proclined or normal

29
Q

BSI definition class II div II incisal

A

lower incisal edge occludes posterior to cingulum of upper incisor
overjet is increased
upper incisors are retroclined

30
Q

BSI definition class III incisal

A

lower incisal edge occludes in anterior to cingulum of upper insicors

31
Q

Angle’s molar classification

A

Buccal groove of mandibular first molar occludes with mesiobuccal cusp of maxillary first molar

II: buccal groove mand occludes posterior to mb cusp of max

III: occludes anterior to

32
Q

Ways in which functional appliance works

A 
a.k.a twin block
for pt with class II occlusion

promoted mandibular growth and restricted maxillary growth
dento-alveolar compensation- retroclined uppers, proclined lowers
constant wear

33
Q

clinical signs of impacted canines? (5)

A 
delayed eruption
asyymetrical eruption
loss of vitality of 2s
discolouration of 2s
retained cs
distal tipping of 2s
unable to palpate 3
34
Q

risks of impacted canines?

A

resorption of 2s
cyst formation
aesthetics

35
Q

tx options impacted canines

A

monitor
xla of c at 10-13 y/o
surgical extrusion with gold bonded chain
autotransplantation

36
Q

incidence of CLP uk

A

1/700 births

37
Q

general health indications CLP

A 
aesthetics
speech
hearing
cardiovascular defects
assoc/w/ down's syndrome
38
Q

dental implications CLP

A 
hypodontia
impaction
increased risk of caries
high vaulted narrow palate
crowding 
class III
39
Q

5 members of CLP team

A 
paediatric dentist
orthodontist
ENT
speech therapist
psychologist
maxillofacial surgeon 
cleft nurse
geneticist
40
Q

outline stages of CLP tx

A 
1 month - lip closure
3 month - palate closure
8-10 years- bone graft
15 years - definitive ortho
18+ years - definitive surgery
41
Q

what is dentoalveolar compensation

A

process whereby development of dental and aveolar arches are controlled so as to secure occlusion of the teeth and adaptation to basal parts of jaw

e.g proclination uppers
retrocline lowers

42
Q

pt presents with Class III incisors. what other dental features are usually associated with this?

tx options

A 
AP class III
class III canines and molars
AOB
Reverse overjet
crowding 
crossbite

tx:

  • accept and monitor
  • orthodontic camouflage
  • orthognathic surgery w/ fixed app before and after. if ANB >5mm
  • interceptive orthodontics - URA -anterior crossbites/+ to procline uppers over lowers
43
Q

name 4 components of fixed orthodontics

A

wire
molar bands
brackets
modules

44
Q

name 4 types of anchorage for orthodontics

A

baseplate
transpalatal arch
nance button (prevents mesial drift of 6s)
temporary anchorage device TAD

45
Q

how does tooth movement work in orthodontics?

A

frontal resorption
tension side- bone deposition
pressure side- hyperaemia .:. increased osteoclasts and blasts .:. bone resorption

46
Q

dental/oral features associated with class II div II

A

class II molars and canines
increased overbite
retroclined upper incisors
crowding

higher lip line
lip trap
trauma to gingiva/palate from traumatic overbite

47
Q

dental/oral features assoc/ w/ class II div I

tx?

A

proclined upper incisors
class II molars and canines
increased OJ

incompetent lips
lip trap
tongue thrust

  • accept and monitor
  • URA
  • growth mod - main use here for twin blocks. frankel 3. headgear
  • camouflage
  • orthodontic surgery
48
Q

how to manage 4 main risks of ortho

A

Relapse → pt education and consent. Advised will require some form of retention e.g. fixed bonded retainer, vacuum
retainer lifelong esp. diastema and rotation.
Decalcification → pt education. OHI, Diet, Fluoride.
Resorption →
advised pt of risk. Radiographs pre-treatment to assess, not excessive ortho forces to limit. Advised 1mm is normal.

49
Q

4 reasons for a diastema

A 
high fraenum
natural space
supernumerary at midline
proclined incisors
hypodontia
50
Q

3 ways of expanding arch

A

mid-palatal screw
quadhelix
rapid maxillary expansion

51
Q

Which teeth are most commonly infraoccluded?

How do they appear radiographically and clinically?

tx options?

A

Lower Ds
8-14%

appear:

clin: no physiological mobility, low in arch, metallic percussive note
rads: no pdl radiographically, root resorption

tx: if permanent successor present, monitor only- usually resolves w/o tx
if doesn’t resolve, XLA
if no successor XLA as can get worse

52
Q

SNA?
SNB?
ANB?

A

SNA- anterior cranial base to maxilla, 81 +/-3

SNB- anterior cranial base to mandible, 78 +/- 3

ANB = SNA-SNB, 2-4

53
Q

Average FMPA

A

27 degrees

54
Q

Average incisal angle

A

109/93 degrees

55
Q

4 methods to stop non nutritative sucking habit

A 
positive reinforcement, 
removable habit breaker, 
fixed habit breaker, 
plaster on finger, 
gloves, 
swap for dummy as
less likely to continue past school age, 
preventative nail varnish
56
Q

Explain long term effects of digit sucking on posterior dentition

A 
habit causes mandible to drop open
tongue held in lower position than previously 
cheeks suck in 
narrowing maxillary dentition
causing crossbite
57
Q

4 reasons for an unerupted 1?

A

supernumerary
crowding
trauma to a
dentigerous cycts/ other pathology

58
Q

when might you consider balancing a primary tooth extraction

A

upper cs in crowded dentition

59
Q

what 4 factors make early loss of primary teeth worse

A

age
tooth - es are worst
maxilla rather than mandible
if already crowded

60
Q

4 signs a pt has been wearing URA

A 
pt arrives wearing URA
active component now passive
tooth has moved
pt can speak with URA in
can take out and put in URA well
signs of wear on palate
signs of wear on URA
61
Q

design a URA to retract Upper 3s

A 
A- buccal canine retractors UR3, UL3, 0.5mm HSSW w/ tubing 0.7 diameter sleeve for 0.5mm HSSW wire 
R- adams clasps UR6, UL6- 0.7 HSSW
Southend clasp 0.7 HSSW
A- yes
b- self cure PMMA
62
Q

design a URA to retract upper 3s and reduce overbite

A

????

B - self cure PMMA w/ anterior bite plane

63
Q

design a URA to retract buccally placed 3s and reduce overbite

A

palatal finger spring 0.5
adams clasps
yes
self cure PMMA

64
Q

design a URA to correct anterior crossbite of 12

A

z-spring 0.5
adams clasps 6s and es/4s
yes
self cure pmma, posterior bite plane

65
Q

design a URA to expand upper arch

A

mid palatal screw 0.5

adams clasps 6s and es/4s

66
Q

design a URA to reduce oj and ob

A

????

B- self cure PMMA w/ anterior bite plane

67
Q

name 5 active components, measurements, uses

A

All 0.5mm HSSW.

Palatal finger spring → 0.5mm HSSW w.guard. Retract teeth.

Buccal canine retractor → 0.5mm
HSSW w/0.5mm tubing. Retract buccally placed canines.

Z-Spring → 0.5mm HSSW. Anterior crossbite.

Mid-palatal screw → expand upper arch.

Robert’s retractor → 0.5mm HSSW w/ 0.5mm tubing. Reduce overjet.

68
Q

What could cause a first molar to be impacted?

A

shape/size of e
size of maxilla
angle of eruption
ectopic crypt

69
Q

figures for leeway space

A
  1. 5/Qmandible

2. 5per quadrant maxilla

Past MSAs (23 decks)

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