Ortho III Flashcards
2 reasons 1st Ortho check-up should be prior to 7 years old:
Posterior occlusion established (1st molars)
Incisors begun to erupt (crowding/deep bites/open bites)
AAO does not advocate comprehensive Tx at age 7
True
6 indications for Phase 1 treatments:
Anterior/Posterior Crossbites
Impacted teeth
Skeletal growth problems
Habit
Space loss (from premature tooth loss)
What type of malocclusion is more prevalent in 8-12 year olds?
Pseudo Class III
*rather than Class III
Pseudo Class III is characterized by what 4 characteristics?
Anterior crossbite
Forward functional shift of mandible
retroclined max incisors
proclined, spaced mandibular incisors
Correction of Pseudo Class III crossbite
increases max arch perimeter
decreases risk of gingival recession
decreases risk of incisal wear
True
Unilateral crossbites represents U/L ______ discrepancy
Mandible shifts to avoid ______
transverse ridge
interferences
Bilateral crossbite is a true ________
What is more common cause?
skeletal discrepancy
Mx constriction (rather than Mn enlargement)
Canine exposure technique depends on canine position
labial/mid-alveolar/palatal
apical/coronal to attached gingiva
True
4 techniques to expose Canine:
Gingivectomy
Apically positioned flap (plus bracket)
Closed eruption (tip and pin)
Open eruption (lingual/bracket)
Canine exposure technique if mid alveolus:
If Buccal:
If Lingual:
Gingivectomy or Closed eruption
Apically positioned flap
Open eruption
Lit says to treat Class II in early treatment
False
*no difference in final overjet, etc…
Lit says facemask effective for correcting anterior crossbite, improving overjet, with slight relapse - to treat Class ____
III, early Tx
Pacifiers should stop at what age?
Behavioral mods/reinforcement
at home techniques
what is last resort?
2 years
Appliances
Band and Loop
Distal Shoe
Lingual Arch (TPA/Nance/LLHA)
Partial Denture
all do what?
Maintain space from early tooth loss
Lip bumper can be used to ameliorate 3mm or less of localized space loss
True
Moderate to Severe generalized crowding, 2 options:
Expansion
Extraction
There should be no active Periodontal disease in an ortho patient
True
If a tooth needs a crown, determine stability enough to the end of ortho treatment
*bond/bracket to crown will alter finish on porcelain
True
Discuss spacing with orthodontist for restorative Tx
true
Need to check root position if implant is indicated prior to de-bonding
True
Active agent in Prevident:
Sodium fluoride 1.1%
MI paste is calcium phosphate
Icon infiltrant is most promising Tx, low viscosity light curing resins
True
True
*with Prevident, 3 ways to mitigate WSL’s
There is no difference between MI paste, prevident, fluoride varnish, standard OH to prevent WSL’s
*and lit says remineralizing agents aren’t effective
True
Etching is a risk factor for WSL’s
True
External Apical Root Resorption can resolve after 6 months
True
EARR is usually less than ___mm
Severe (over 4mm) is seen in ___% of teeth
Seen most in what incisors?
2.5 mm
1-5%
Mx incisors > Mn incisors > first molars
Increased duration, magnitude, intrusive movement, apical movement, method of force are all risk factors for EARR
True
Bolton analysis is tooth size discrepancy leading to arch discrepancy
True
Ortho is not a significant risk factor in TMD
True
Malocclusion does not cause TMD
True
If TMD, ortho Tx changes from intercuspal stability to a stable functioning masticatory system
True
Minor tooth movement should be called isolated tooth movement
Tx time around 6 months
True
4 examples that indicate minor tooth movement
(there are like 10 more than this)
Reposition drifting teeth for fixes/removable/implant
Align anterior teeth (esthetic/splinting)
Correct crossbite
Forced eruption for crown placment
What 3 procedures should dentists NOT attempt
Ortho for TMJ
Intrusion
Alleviation of crowding > 4mm
Molar uprighting, bringing mesial root forward to close space is more difficult than tipping
True
Ortho forces must be lighter in adolescent patients
True
Labial movement of incisors to alleviate crowding can result in gingival recession
True
Width of attached gingiva and thickness of gingival tissuea re equally important in predicting recession
True
If minimal perio involvement, need what 2 things?
probing depths
level of attached gingiva
If moderate perio involvement, need what?
Control perio condition
Defer restorative until ortho complete
Ovoid bands, consider self ligating brackets
Perio maintenance every 2-4 months while in Tx
If severe perio:
maintenance every 4-6 weeks
Tx mechanics need to be altered, keep forces minimal
May keep hopeless teeth for anchors
Most common Tx at old extraction sites:
Upright tipped teeth, place implant/bridge
What is the exception of the rule to never move tooth into extraction space?
Juvenile aggressive perio - can close space of 1st molar
Invisalign (clear aligner therapy), extrusion, rotation, and space closure are not as predictable as other movements
True
Lingual orthotics are custom made for every tooth, and short span between brackets allows for what?
Stiffer wire
3 retention devices:
Essix retainer (Hx perio/loss of tooth support)
Occlusal splint
Wraparound retainer
5 factors to have good results w/ camouflage
Short, avg facial pattern
mild A-P discrepancy
< 4-6 mm crowding
Normal soft tissue pattern
No transverse skeletal issues
Tension side
Pressure side
Oseoblasts
Osteoclasts
What is the rate limiting factor in moving a tooth?
Pressure side (osteoclasts)
Inflammatory markers signal bone resorption/remodeling
True
RAP
Regional Acceleratory Phenomenon
A tissue reaction that increases the healing capacities of affected tissues
RAP
RAP is characterized by acceleration of normal cellular activities
True
AOO
Accelerated Osteogenic Orthodontics
Wilckodontics
