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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
implications of supernumerary teeth
``` prevention or delay in eruption of permanent dentition occlusal interference crowding traumatic eruption failure to erupt ```
26
4 intraoral signs of thumb sucking
proclined upper incisors retroclined lower incisors AOB/ incomplete open bite narrow upper arch +/- unilateral posterior crossbite
27
BSI definition class 1 incisal
lower incisor edge occludes with or sits just below cingulum plateau of upper incisor normal OJ
28
BSI definition class II div 1 incisal
lower incisal edge occludes posterior to cingulum of upper incisor overjet is increased upper incisors are proclined or normal
29
BSI definition class II div II incisal
lower incisal edge occludes posterior to cingulum of upper incisor overjet is increased upper incisors are retroclined
30
BSI definition class III incisal
lower incisal edge occludes in anterior to cingulum of upper insicors
31
Angle's molar classification
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
Ways in which functional appliance works
``` 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
clinical signs of impacted canines? (5)
``` delayed eruption asyymetrical eruption loss of vitality of 2s discolouration of 2s retained cs distal tipping of 2s unable to palpate 3 ```
34
risks of impacted canines?
resorption of 2s cyst formation aesthetics
35
tx options impacted canines
monitor xla of c at 10-13 y/o surgical extrusion with gold bonded chain autotransplantation
36
incidence of CLP uk
1/700 births
37
general health indications CLP
``` aesthetics speech hearing cardiovascular defects assoc/w/ down's syndrome ```
38
dental implications CLP
``` hypodontia impaction increased risk of caries high vaulted narrow palate crowding class III ```
39
5 members of CLP team
``` paediatric dentist orthodontist ENT speech therapist psychologist maxillofacial surgeon cleft nurse geneticist ```
40
outline stages of CLP tx
``` 1 month - lip closure 3 month - palate closure 8-10 years- bone graft 15 years - definitive ortho 18+ years - definitive surgery ```
41
what is dentoalveolar compensation
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
pt presents with Class III incisors. what other dental features are usually associated with this? tx options
``` 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
name 4 components of fixed orthodontics
wire molar bands brackets modules
44
name 4 types of anchorage for orthodontics
baseplate transpalatal arch nance button (prevents mesial drift of 6s) temporary anchorage device TAD
45
how does tooth movement work in orthodontics?
frontal resorption tension side- bone deposition pressure side- hyperaemia .:. increased osteoclasts and blasts .:. bone resorption
46
dental/oral features associated with class II div II
class II molars and canines increased overbite retroclined upper incisors crowding higher lip line lip trap trauma to gingiva/palate from traumatic overbite
47
dental/oral features assoc/ w/ class II div I tx?
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
how to manage 4 main risks of ortho
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
4 reasons for a diastema
``` high fraenum natural space supernumerary at midline proclined incisors hypodontia ```
50
3 ways of expanding arch
mid-palatal screw quadhelix rapid maxillary expansion
51
Which teeth are most commonly infraoccluded? How do they appear radiographically and clinically? tx options?
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
SNA? SNB? ANB?
SNA- anterior cranial base to maxilla, 81 +/-3 SNB- anterior cranial base to mandible, 78 +/- 3 ANB = SNA-SNB, 2-4
53
Average FMPA
27 degrees
54
Average incisal angle
109/93 degrees
55
4 methods to stop non nutritative sucking habit
``` 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
Explain long term effects of digit sucking on posterior dentition
``` habit causes mandible to drop open tongue held in lower position than previously cheeks suck in narrowing maxillary dentition causing crossbite ```
57
4 reasons for an unerupted 1?
supernumerary crowding trauma to a dentigerous cycts/ other pathology
58
when might you consider balancing a primary tooth extraction
upper cs in crowded dentition
59
what 4 factors make early loss of primary teeth worse
age tooth - es are worst maxilla rather than mandible if already crowded
60
4 signs a pt has been wearing URA
``` 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
design a URA to retract Upper 3s
``` 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
design a URA to retract upper 3s and reduce overbite
???? B - self cure PMMA w/ anterior bite plane
63
design a URA to retract buccally placed 3s and reduce overbite
palatal finger spring 0.5 adams clasps yes self cure PMMA
64
design a URA to correct anterior crossbite of 12
z-spring 0.5 adams clasps 6s and es/4s yes self cure pmma, posterior bite plane
65
design a URA to expand upper arch
mid palatal screw 0.5 | adams clasps 6s and es/4s
66
design a URA to reduce oj and ob
???? B- self cure PMMA w/ anterior bite plane
67
name 5 active components, measurements, uses
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
What could cause a first molar to be impacted?
shape/size of e size of maxilla angle of eruption ectopic crypt
69
figures for leeway space
1. 5/Qmandible | 2. 5per quadrant maxilla

Past MSAs (23 decks)

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