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Tim's Cards > Ortho Exam II > Flashcards

Ortho Exam II Flashcards

1
Q

What are the 3 Growth Concepts?

A

Pattern

Variability

Timing

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2
Q

The Pattern growth concept refers to how proportional relationships change over ______

Variability is ______

Timing refers to _______ vs _______

A

Time

Quantitative (growth charts)

Developmental vs. Chronological age (Biologic Clock)

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3
Q

The cranial vault has what kind of growth?

Remodeling/growth occur where?

Bone is removed from inner surface and added to outer surface in response to what?

A

Intramembranous

Sutures

Growth of brain

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4
Q

Cranial base has what kind of growth?

Precedes the growth of the jaw and is not affected by what?

A

Endochondral

Growth of brain

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5
Q

Maxilla is what kind of growth?

Moves in what direction during growth?

Growth occurs where?

A

Intramembranous

Forward and Downward

Sutures connecting maxilla to cranium

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6
Q

Mandible has what kind of growth?

Direction?

Growth occurs where?

A

Endochondral and Periosteal

Downward and Forward

Condyles (endohcondral), Everywhere else (Periosteal)

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7
Q

Roof of mouth grows downward and forward by adding on oral and removing on ______

A

Nasal

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8
Q

Cranial Vault:

Cranial Base

Maxilla

Condyles

non condylar Mandible:

A

Intramembranous

Endochondral

Intramembranous

Endochondral

Periosteal

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9
Q

4 Direct measurements for assessing growth:

A

Craniometry - dry skulls

Anthropometry - soft tissue points covering bony landmarks

Cephalometric radiology - combines craniometry and anthropometry

3-D imaging - CBCT/MRI

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10
Q

2 Experimental measurements for assessing growth:

A

Vital Staining

Implant Radiography

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11
Q

Hemifacial Microsomia, deformed…

2 deficient soft tissues:

Occlusal plane…

A

external ear

Ramus/Mandible

Canted

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12
Q

Treacher Collins, what 2 areas underdeveloped?

Bilateral but maybe not…

_____ deformities

2 areas of hypoplasia:

A

Maxilla/Mandible

Symmetric

Ear

Malar/Mandibular

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13
Q

What is the most common congenital defect?

A

Cleft Lip/Palate

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14
Q

2 Craniosynostosis Syndromes:

Which is most common?

A

Crouzon’s syndrome (most common)

Cleidocranial Dysplasia

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15
Q

Crouzon’s Syndrome, hypoplasia where?

Crossbites where?

Crowding where?

A

Midface

Anterior/Posterior

Maxillary (severe)

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16
Q

Cleidocranial dysplasia, palate….

Deficient…

Teeth…

A

high arch

Premaxilla

multiple supernumerary/lack of permanent eruption

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17
Q

Primate space is seen in what dentition?

Maxillary:

Mandibular:

A

Primary

lateral incisors/canines

canines/first molars

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18
Q

Leeway space refers to what?

A

Space occupied by primary canines/molars often greater than succedaneous teeth

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19
Q

Leeway space in each Maxillary Quadrant:

Leeway space in each Mandibular Quadrant:

A

1-1.5 mm

2-2.5 mm

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20
Q

What is the greatest contributor to the Leeway Space?

To preserve Leeway space to alleviate Crowding, clinicians often use what?

A

Primary Second Molar

LLHA (lower lingual holding arch)

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21
Q

Early mesial shift refers to the mesial migration of the erupting mandibular ______

Occurring at what age?

Using up…

A

1st Molar

6 y/o

Mn primate space (leeway space)

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22
Q

Late mesial shift refers to the mesial migration of the erupting mandibular permanent first molar after what?

Using up the…

Occurring at what age?

A

Loss of Primary 2nd Molar

Leeway Space

11 y/o

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23
Q

Distalizers move the teeth where?

A

Backwards

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24
Q

3 types of Distalizers

A

Pendulum (T-Rex)

Temporary Anchorage Device (TAD)

Lip Bumper

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25
Q

Pendulum (T-Rex) distalizer moves what teeth?

Using what as anchorage?

A

Maxillary molars

Palate

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26
Q

TAD’s (temporary anchorage device) have many designs

A

True

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27
Q

A Lip Bumper uses lip pressure to move what teeth distally?

A

Mandibular Molars

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28
Q

Frankel II restrains pressure originating where?

Moves what?

What direction?

A

Buccal/Labial musculature

Mandible

Forward

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29
Q

What is the only tissue-borne device used to change functional/skeletal architecture?

A

Frankel II

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30
Q

7 Tooth-borne devices used to change functional/skeletal architecture:

A

Activator

Twin Block

Mandibular Anterior Repositioning Appliance

Herbst Appliance

Forsus Appliance T

Twin Force bite corrector

Headgear

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31
Q

Activator, advances the _______, may cover _______ teeth in acrylic to prevent eruption

Posterior eruption of lower may improve ______

A

mandible, maxillary

Deep Bite

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32
Q

Twin Block has separate ______

Function:

A

U/L components

Holds mandible forward

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33
Q

Mandibular Anterior Repositioning Device (MARA) places ______ on the Molars

Function (2 functions)

A

4 Crowns on Molars

Distalizes Mx molars, slight Proclination of lower incisors

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34
Q

Herbst Appliance redirects remaining Mandibular growth to be more ________

also….

A

Horizontal

Proclines mandibular incisors

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35
Q

Forsus Appliance requires…

Proclined _______

Attaches how?

A

Full braces

Mn incisors

Upper headgear to lower archwire

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36
Q

Twin Force bite corrector attaches to…

A

U/L archwires

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37
Q

3 Types of Headgear:

A

Cervical

High-Pull

Straight-Pull

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38
Q

Cervical headgear restricts…

High-pull headgear restricts…

Straight-pull headgear force is…

A

Anterior growth of Maxilla

Anterior/Downward growth of Maxilla

Directly distal to upper molar

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39
Q

3 ways to treat Deep Bites

A

Facemask

Chin cup (Mn protrusion)

Camouflage treatment (Mn protrusion)

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40
Q

Facemask for Deep Bites treats a _____ deficiency

Most effective prior to…

Must be worn…

A

Mx

10 y/o

10 hrs/day

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41
Q

3 types of Open Bites:

A

Habit

Dental

Skeletal

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42
Q

Direct bonding:

Indirect bonding:

A

etch, rinse, dry, sealant, air, light cure, brackets, remove flash

Impressions, draw guide lines on cast, bracket/resin, silicone tray over brackets/teeth, remove tray/brackts, clean pads, (unfilled resin)

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43
Q

Nasal bone growth is completed at what age?

A

10 y/o

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44
Q

Cranial growth:

Cranial base:

Maxilla:

Mandible

A

growth of brain

endochondral/synchondrosis

sutural/remodeling (intramembranous)

endochondral (condyle) else apposition/resorption

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45
Q

When is the optimal time to start orthopedic treatments?

A

PHV - peak height velocity (adolescent growth spurt)

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46
Q

PHV is closely related to what 2 indicators?

A

Calcification in hand (hand wrist films)

Cervical vertebrae shape

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47
Q

Compare the sesamoid, ulnar, hamate, and capping of first proximal phalanx and compare to _____ to determine approximately how much growth is left

A

Atlas

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48
Q

CVMS (cervical vertebral maturation stage) is viewed in what image?

2nd, 3rd, and 4th vertebrae indicate what?

PHV usually falls between what CVMS stages?

A

Lateral cephalogram

timing of peak of growth

II and III

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49
Q

Boney expansion in a transverse maxillary deficiency should be done when?

A

prior to closure of suture

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50
Q

Late Mn growth is most often seen in males and cause a patient to outgrow ortho Tx (esp in prognathic cases)

A

True

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51
Q

The nose and chin continue to grow throughout life

A

True

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52
Q

Mandible tends to grow horizontally

Mandible tends to grow vertically

A

Brachycephalic

Dolichocephalic

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53
Q

Fetal alcohol syndrome takes place in the _____ layer at day _____

Anencephaly takes place during ____ formation at day _____

Hemifacial microsomia (Treacher Collins) takes place at day _____ and is origin, migration, and interaction of cell populations

Primary palate (cleft lip/palate) day____

Secondary palalte (celft palate) day ______

Achondroplasia (Crouzon’s) day ____

A

17, germ layer

neural tube, 18

19-28

28-38

42-55

50 to birth

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54
Q

1st and 2nd Branchial arches affected in Hemifacial Microsomia

A

True

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55
Q

Treacher Collins comes from general lack of mesenchymal tissue

A

True

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56
Q

Cleft lip is the failure of fusion between median/lateral nasal processes and maxillary prominence in the _____ week of development

Cleft palate only is the incomplete fusion of secondary palate

A

6th

True

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57
Q

Craniosysostosis Syndromes occur when?

Due to the early closure of what?

What is the most common?

A

Fetal

Facial/Cranial Sutures

Crouzon’s

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58
Q

Superior/Posterior Mx sutures fuse prematurely

May extend into the cranium and distort cranial vault

Midface hypoplasia, bulging eyes, severe Mx crowding

A

Crouzon’s

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59
Q

Defect in bone resorption, heavy fibrous gingiva, supernumerary teeth, short broad skull, maxillary hypoplasia,

A

Cleidocranial Dysplasia

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60
Q

Mx permanent incisors are about __mm larger than primary incisors

Mn permanent incisors are about ____ mm larger than permanent incisors

A

8 mm

5-6 mm

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61
Q

Mx Primate space =

Mn Primate space -

A
  1. 7 mm

1. 5 mm

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62
Q

Greatest contributor to Leeway Space:

A

Primary second molar (2 mm)

63
Q

Distal step in primary molars often leads to …

Mesial step leads to…

A

Class II

Class III

64
Q

Teeth can be moved by light forces and extrinsic factors sustained up to 6 hours/day can alter equilibrium

A

True

65
Q

Serial extractions should be done at what age?

A

Early mixed (6-8 years)

66
Q

Should extractions be done on 3rd molars to alleviate crowding?

A

No

*no difference in anterior crowding when extracted

67
Q

Lower bilateral space maintainer that can resolve anterior crowding

A

LLHA

68
Q

Good for early loss of primary second molar, unilateral

A

Band and Loop

69
Q

Loss of second primary molar prior to eruption of first permanent molar

contraindication:

A

Distal shoe

multiple missing teeth

70
Q

Maxillary bilateral space maintainer, can be used for anchorage, hygiene problems

A

Nance appliance

71
Q

Maxillary bilateral space maintainer, can be used for anchorage, can be adjusted to rotate molars

A

Transpalatal Arch (TPA)

72
Q

Palatal expanders are best used prior to end of puberty and must hold expansion for ____ months to allow bone to fill

*Hyrax, Haas, Bonded RPE

A

6

73
Q

W arch and Quadhelix are palatal expanders

A

False

*dental only

74
Q

Distalizes Mx molars by using palate as anchorage, unilateral/bilateral, will get anterior flaring

A

Pendulum (T-Rex)

75
Q

Lip pressure pushes Mn molars distal to regain lost space

A

Lip Bumper

76
Q

Changes the posture of the Mandible by tissue (only one) or tooth-borne

A

Functional appliances

77
Q

The only tissue borne functional appliance (moves Mn)

A

Frankel II

78
Q

Advances the mandible, may cover Mx teeth in acrylic, posterior eruption of lower may help improve deep bite

A

Activator

79
Q

Separate U/L components, (upper molars, lower pm’s) holds mandible forward

A

Twin Block

80
Q

Four crowns on molars, distalization of Mx molars, slight proclination of lower incisors

A

MARA

mandibular anterior repositioning appliance

81
Q

Redirect remaining mandibular growth more horizontal, increase total length of mandible, procline Mn incosors, does not require fixed braces

A

Herbst Appliance

82
Q

Used for Class II correction, requires full braces, proclined Mn incisors, attaches from upper headgear to lower archwire

A

Forsus Appliance

83
Q

Attached to U/L archwires and allows Mn lateral movements

A

Twin Force bite corrector

84
Q

Cervical headgear restricts what?

High pull?

Straight pull force directed where

Straight pull can limit what?

A

anterior Mx growth

Anterior/downward Mx

distal upper molar

limits bite opening

85
Q

Pseudo class III is more common than Class III at what age?

Anterior crossbite, forward shift of Mn, retroclined Mx incisors, proclined Mn incisors

A

8-12 y/o

86
Q

Face Mask (reverse pull) used for what?

moste effective prior to what age

A

Class III malocclusion

10 y/o

87
Q

Chin up was designed for Mn excess but is no longer used

A

True

88
Q

3 strategies to Tx Deep Bite

A

Incisor intrusion

Molar extrusion

Incisor proclination

89
Q

Dental open bite may be from habit

Skeletal open bite may be from

A

True

Excessive vertical growth, short Mn ramus, Mn over-eruption

90
Q

4 basic components of fixed appliances

A

Brackets

Bands

Arch wires

Auxiliaries (ties)

91
Q

Bracket dimensions:

No superior system, Dr. preference

A

.025 by .018 or .028 by .022

True

92
Q

Self ligating bracket has a flexible component that entraps arch wire

It improved hygiene

A

True

True

93
Q

Lingual appliances can treat any case buccal braces can

A

True

94
Q

Ortho bands have better anchorage

Zinc phosphate cement can be a pulp irritant

A

True

True

95
Q

4 ideal properties of Ortho arch wires

A

Hight strength

Low stiffness

High working range

High formability

96
Q

Nickel-titanium wires resistant to _______, have low_____

Beta titanium is in between

Stainless steel has highest ______, lowest _____

A

permanent deformation, elasticity

True

modulus of elastisity, springback

97
Q

Hawley retainer is very durable

Thermal plastic retainer is esthetic, easy to wear

A

True

True

98
Q

Bonded retainers typically Mn canine to canine

A

True

99
Q

3 strategies to relieve crowding:

A

Expansion/proclination of dentition

Reduction of tooth width

Extraction

100
Q

3 considerations if expansion/proclination to relieve crowding:

A

Profile

Alveolar bone thickness

Overjet/Overbite

101
Q

If reducing tooth width to reduce crowding, how much per tooth?

How much from 1st molar to 1st molar?

A

.5mm per side of tooth

5.5 mm max

102
Q

When should Serial Extractions be done to alleviate crowding? (4 conditions)

A

7 mm or more crowding in Anteriors per Arch

U/L arch midlines coincident

Class I molars

Balanced Skeletal pattern

103
Q

CD4

A

C primary canine

D primary 1st molar

4 first bicuspid

104
Q

When does extracting primary tooth speed up eruption of succedaneous tooth?

When does it slow down subsequent eruption?

A

If 1/2 root formed

If extracted too early

105
Q

5 ideal properties of arch wires

A

High strength

Low stiffness

high range

high formability

can weld/solder

106
Q

Shape Memory Effect is ability to _______ shape

Occurs due to temperature (_____) or stress (____)

dependent shift in materials crystalline structure between 2 phases

A

Remember

thermoplasticity

super-elasticity

107
Q

2 phases contributing to Shape Memory Effect through thermoplasticity and super-elasticity

A

Martensite (softer, low temp, better formability)

Austenite (harder, high temp, super-elasticity)

108
Q

Wire used at First Stage (level and align)

Wire used at Second Stage (correction of molars/space closure)

Wire used at Third Stage (finishing)

A

Nickel Titanium (NiTi) - very light flexible wires

Beta Titanium (TMA) - heavier arch wires

Stainless Steel (SS) - low friction, best sliding

109
Q

At what stage in are brackets not aligned?

A

First stage

*fully aligned at second, third stages

110
Q

Gold and Cobalt-Chromium are not used much anymore as wires

A

True

111
Q

Internal distribution of load (force/area)

Internal distortion produced by load (deflection/length)

A

Stress

Strain

112
Q

Force-Deflection Curve, slope:

highest point:

Permanent deformation:

highest stress can withstand and return to form:

Breaks:

A

Stiffness

Strength

Proportional limit point

Yield strength

Failure point

113
Q

Point around which a free body is perfectly balanced

A

Center of mass

114
Q

Point of a tooth where a force application results in Translational Movement

A

Center of Resistance

115
Q

Center of Resistance = Center of Mass when?

A

Free body

116
Q

Center of resistance location single rooted tooth:

multi-rooted tooth:

A

1/3 of root length from CEJ

apical to furcation

117
Q

Center of resistance is constant

Center of rotation is not constant

A

True

True

118
Q

Rotation occurs when?

A

Force applies away from center of resistance

119
Q

Uncontrolled Tipping (invisalign/spring retainers)

A

Center of rotation near center of resistance

*crown goes opposite apex

120
Q

Controlled tipping:

Center of rotation:

A

Crown and Root tip in same direction

apex

121
Q

All points on a rigid body move the same amount in the same direction

A

Translation

122
Q

Keeps the crown in the ideal spot and moves only the root to the desired location

A

Root torque

123
Q

Take out what teeth to alleviate crowding, retraction of incisors, some ant/post correction

A

Upper/Lower 1st PM’s

124
Q

Take out what teeth for Class II correction

A

Upper 1st PM

Lower 2nd PM

125
Q

Take out what teeth for Class III correction

A

Upper 2nd PM

Lower 1st PM

126
Q

If take out the Upper PM’s only, will finish w/ Class I _______

Class II _____

A

canines

molars

127
Q

Why would you take out a Lower central incisor?

1st molar extraction?

2nd molar extraction?

A

slight Class IIIj

if compromised and 3rd molar forming

1st molar distalized

128
Q

7 mm or more of crowding in the anterior areas per arch

coincident upper and lower midlines

class I molar relationship

balanced skeletal pattern

A

Serial Extractions

129
Q

Serial extractions can be complicated if molars are class III or II, unbalanced skeletal pattern, unequal crowding in arches, over 2 mm midline discrepancy, open bite, or deep impinging bite

A

True

130
Q

When to do serial extraction?

A

When permanent laterals erupt rotated or are blocked from eruption

131
Q

If the permanent laterals are rotated/blocked, then extract ______

A

primary canines

132
Q

When permanent laterals erupt (rotated/crowded)

Extract primary canines

6-12 months, extract primary 1st Molars

Extract permanent 1st PM’s

Ortho

A

Serial extractions

CD4

(Canines, 1st primary molars, permanent 1st PM’s)

133
Q

The stress/strain response to an external load

A

Elastic behavior

134
Q

2 bracket sizes are .018 and .022

A

True

135
Q

Round wires cause all kinds of movement except?

Rectangular wires can control?

A

Torque

Torque

136
Q

In 2nd Stage Ortho, brackets are fully aligned and the molar relationship is guided via what 2 factors?

A

Differential growth of jaws

Differential movement of U/L teeth

137
Q

Root parallelling

Incisor torque

Correction of overjet/overbite

Correction of midline

Final settling of posterior occlusion

A

Third Stage Ortho

138
Q

Ni-Ti is good for leveling and aligning due to low stiffness and high range

A

True

139
Q

What has the highest friction of all the wires?

A

Beta Titanium (TMA)

140
Q

Stainless steel is _____ chromium and _____ nickel

A

18% chromium

8% nickel

141
Q

Stainless steel is softened by ______

Hardened by ______

A

annealing

cold working

142
Q

Most elastics lose elasticity in 12 to 24 hours

Latex elastics last 4-6 times longer

A

True

True

143
Q

1st law

2nd law

3rd law

A

inertia

F=MA

equal and opposite rxn

144
Q

The center of resistance in constant and is located about 1/3 of the root length from the CEJ

A

True

145
Q

The center of rotation is constant

A

False

*determined by type of movement

146
Q

Moment is the tendency for a tooth to rotate around the center of resistance

A

True

147
Q

Brackets are the only way to bring multiple forces to a tooth for Controlled Tipping

A

True

148
Q

In root torque, the center of rotation is found where?

A

Incisal tip

149
Q

Couple is created by two equal/opposite non coplanar forces acting on an object and are the only force systems that create ______

A

pure rotation

150
Q

Variation in bracket slot location/orientation is known as what?

A

Prescription

151
Q

3 reasons there is more to straightening teeth than presciption

A

slop

wire rigidity

biomechanics

152
Q

Pure translation is difficult b/c center of resistance is in the bone

A

True

153
Q

What is the most common treatment of Deep Bites?

A

Molar extrusion

Tim's Cards (140 decks)

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