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Ortho Competency > Ortho Faults > Flashcards

Ortho Faults Flashcards

1
Q

What do you do if a fixed bonded retainer de-bonds across three teeth?

A

Take off wire and check teeth
Give pt options:
Option 1. Leave it off completely
1i. Warn there’s a chance of relapse
1ii. If pt agrees with this, document in notes and get pt to sign it
Option 2: Get the retainer bonded back on.
2i Will need to take an impression and make an appointment and get lab to bend splint.

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2
Q

What do you do if a fixed bonded retainer de-bonds across one tooth in the middle?

A
  1. High-speed bur to thin the composite down until wire is exposed then remove composite
  2. Check tooth that you removed composite from to see if there’s any caries
  3. If tooth is healthy and wire is passive, can re-bond on
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3
Q

What do you do if a fixed bonded retainer de-bonds across the last tooth?

A
  1. wire is no longer passive
  2. cut wire and make it safe
  3. advise pt risk of relapse of tooth that is no longer part of the fixed bonded retainer.
  4. Risk of relapse overall is lower as only one tooth debonded.
  5. If want it replaced, need to remove the whole thing and re-do
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4
Q

What do you do if a URA has a Southend clasp that has fractured close to the acrylic?

A
  1. If it’s right at the beginning of treatment, get it re-made.
  2. If it’s at the end of treatment, do not wat the pt to be without the appliance as there’s a risk of relapse.
  3. So cut off the bit that’s fractured and smooth it off
  4. With the other bit, bend it back on itself to make a C clasp
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5
Q

What do you do if a URA has a Southend clasp that has fractured in the middle?

A

Make two C clasps and refer back to ortho

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6
Q

What to do with a URA that has completely fractured, as if the pt has stamped on the appliance?

A
  1. tell the pt not to wear the appliance
  2. Make sure that if it is broken intraorally that all the pieces are accounted for and the pt has not inhaled it
  3. Offer a thermoplastic retainer as it’s quicker to make and it freezes the ortho treatment and prevents relapse (otherwise treatment will take longer)
  4. Can’t make the URA as we don’t know the treatment plan
  5. Teeth are most prone to relapse halfway through treatment as bone is being remodelled
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7
Q

What to do if Adams clasp is missing. Only bits you can see are the parts of the Adams clasp that is embedded into the acrylic?

A
  1. Check to see where the Adams clasp has gone.
  2. If it was there when they went to bed at night but it was missing in the morning, they may have inhaled it. So send to A and E
  3. Always account for all components
  4. Check to see if the appliance is still retentive. If not get the component replaced.
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8
Q

How do you get a missing Adam’s clasp replaced on a URA?

A
  1. Go to lab to check if they still have the original working cast.
  2. If they don’t have the original, need to take a new impression with URA in situ
  3. Lab people can cut away the part of the acrylic that has the broken clasp on it then replace the clasp and add back the acrylic
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9
Q

Why do you need to take an impression with the appliance in situ to replace an Adam’s clasp?

A
  1. The appliance will not sit correctly on the model as air / saliva will cause blows and there will be a void between the new model and the old URA
  2. This will avoid acrylic creep which is contamination of the fitting surface
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10
Q

What do you do if an Adam’s clasp has fractured at the arrowhead?

A

Arrowheads are not an area of flex so can solder it

It is also far away from the acrylic so that you won’t set fire / melt acrylic

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11
Q

What are the areas of flex on an Adam’s clasp?

A
  1. s bend
  2. flyover
  3. can NOT solder in these areas
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12
Q

What do you do if there’s a fracture of the Adam’s clasp close to the retainer?

A
  1. can’t solder as too close to acrylic
  2. Cut and smooth off bit that is close to the acrylic
  3. Bend the other half of the adams clasp so you can still get a bit of retention
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13
Q

What do you do if a bracket has debonded from a fixed appliance?

A
  1. Check to see if there is a ligature on the bracket that has de-bonded. If there is, take the ligature off
  2. Do not rebond as you do not know the prescription
  3. Slide off the wire if the bracket is round arch wire
  4. Refer back to ortho
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14
Q

What type of wire can a bracket be removed from?

A

round NOT square wire

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15
Q

What do you do if a bracket has debonded from a fixed appliance and the arch wire is square?

A
  1. Brackets won’t come off a square wire.

2. Check tooth and send back to ortho

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16
Q

What do you do if a band is loose on a 1st molar?

A
  1. Cut wire between 5 and 6
  2. Take molar band off
  3. Make wire safe ie bend it
  4. Tell pt to go back to ortho
17
Q

If a band is loose on a molar tooth, why can’t we just cement it back on?

A

We don’t know the prescription of the band ie how far down it is supposed to go

18
Q

What is the purpose of a fixed appliance with a transpalatal arch?

A

Anchorage

19
Q

What do you do if a patient comes in with a fractured transpalatal arch wire?

A
  1. Use high speed bur to cut wire and smooth ends

2. Tie floss around the archwire so it doesn’t go down the airway

20
Q

What do you do if a patient has a fixed appliance and the wire has come out the back?

A
  1. Cut of the long bit of wire that has come out the back. Make the end safe
  2. Check the other end of the wire. If it is still in the molar bracket, cut it off inter-proximally and make it safe / put a retentive tag in it.
21
Q

Why must we put a retentive tag on a wire that has come out of the back of a fixed appliance?

A

The wire will keep moving along the teeth and you will end up with the wire coming out the back again

22
Q

What do you do if there is a fixed appliance missing lots of brackets. Brackets have debonded?

A
  1. Usually from trauma where a child has fallen off their bike
  2. Always account for all components. If at all unsure, send them to A and E
  3. Take off ligatures and take arch wire off
  4. if brackets traumatising soft tissue, put wax on
  5. Do not remove brackets that are still bonded
  6. Remove wire
23
Q

Why do we not remove the remaining brackets if a lot of brackets have fallen off a fixed appliance and we are taking the arch wire off anyway?

A

Trauma may have made the teeth mobile and last thing you want to do is ping off brackets from mobile teeth.
May have to splint teeth above or below brackets

24
Q

Why would we remove the arch wire if a lot of brackets have fallen off a fixed appliance?

A

The arch wire is not serving a purpose

Ortho Competency (2 decks)

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