Ortho- Class II Div 1 Treatment. Flashcards

1
Q

Define Class II div1 incisor relationship

A

Lower incisor edges are located posterior to the cingulum of UI
Increased overjet
Upper central incisors are proclined or average angulation.

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2
Q

How does class II div 1 incisor relationship affect a patient’s dental health?

A

Patient is at risk of trauma.
Overjet >9mm 2x more likely to suffer from trauma.

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3
Q

Discuss the skeletal pattern associated with class II div 1 incisors?

A

Normally class II skeletal base. More likely retrognathic mandible (instead of maxillary protrusion)
Sometimes class I.

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4
Q

What can cause an overjet?

A

Tooth inclination
Skeletal pattern.
Combination.

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5
Q

Discuss the soft tissues normally associated with class II div 1 incsior relationship?

A

Patient normally has an incompetent lip due to incisor proclination or underlying skeletal pattern

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6
Q

How does a patient with incompetent lips achieve an anterior oral seal.

A

Mentalis muscle overactivity and protrusion of the maxilla. or
Lower lip drawn behind upper incisors and tongue placed forward between incisors to the lower lip.

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7
Q

List some dental factors assoicated with class II div 1 incisor relationship?

A

Overjet
Varied overbite

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8
Q

How can habitally parted lips affect the gingviae?

A

Gingivae are exposed to air so can dry up.
This also exacerbates any pre-existing gingivitis.

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9
Q

At what age would we be concerned about a patient’s sucking habits?

A

Age 9

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10
Q

How can we treat sucking habits?

A

Reinforcement
Removable habit breaker
Fixed habit breaker

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11
Q

List the treatment options for a Class II div 1 incisor relationship.

A

Accept
Growth modification Tipping teeth
Camoflauge
Orthognathic surgery.

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12
Q

What should be highlighted to any patients selecting to accept their class II div 1 relationship?

A

Treatment may be more difficult to complete in the future

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13
Q

What is growth modification?

A

This is trying to change the underlying skeletal base using functional appliances with the force of muscles correcting the malocclusion.
Maxillary growth is restrained and mandibular growth is encouraged.

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14
Q

Explain the dento-alveolar effects of growth modulation?

A

Distal movement of upper dentiton Mesial movement of lower dentition.
Upper incisors are retroclined.
Lower incisors are proclined.

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15
Q

List some growth modification options

A

Headgear (uncommon)
Removable appliance (Twin block)
Fixed appliance (Herbst)

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16
Q

When would we use a functional appliance?

A

during growth.
either in primary dentition (age 10) or in mixed/ permanent dentition.

17
Q

Compare early and late treatment with a functional appliance.

A

There is no difference in the treatment outcome.
Early treatment- earlier aesthetic improvement. Reduced risk of trauma. But will require further treatment later.
Late treatment- only requires one set of treatment.

18
Q

In what situations could an URA be used to treat increased overjets?

A

Class I
Very mild class II
Overjet caused by proclined and spaced incisors.
Overbite.

19
Q

What is camoflauge and when is it used?

A

This is when the skeletal relationship is not bad enough for orthognathic surgery so we use a fixed appliance to correct the incisor relationpship (we do not change the jaws)

20
Q

What is orthognathic surgery?

A

This is treatment for severe skeletal discrepancy in the A/P or vertical direction which includes mandibular surgery but sometimes surgery to the maxilla.
Fixed appliances are also required before, during and after treatment.

21
Q

When do we provide orthognathic surgery?

A

When patient is at least 18/19/20