ortho learn Flashcards by Becky Wall

IOTN grade 5 order and components

5i - impacted teeth (except 8s)
5h - extensive hypodontia (>1 in a quadrant)
5a - OJ >9mm
5m - reverse OJ >3.5mm, masticatory and speech difficulties
5p - defects CLP and other CF anomalies
5s - submerged deciduous teeth

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IOTN grade 4 order

4h
4a
4b
4m
4c
4l
4d
4e
4f
4t
4x

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IOTN 3f

deep OB complete on gingival or palatal tissues, but no trauma

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OJ >6mm less than or equal to 9mm

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reverse OJ >3.5mm, no masticatory or speech difficulties

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reverse OJ >1mm <3.5mm, masticatory and speech difficulties

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A/P CBs with >2mm discrepancy between RCP and ICP

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posterior lingual CB with no fct occlusal contact in one or both buccal segments

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contact displacements >4mm

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extreme lateral or anterior open bites >4mm

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increased and complete OB with gingival or palatal trauma

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pt selection for growth mod for increased OJ

growing pt
pt concerns
pt motivation
dental health risk
large dentoalveolar contribution to aetiology
absence of significant crowding
increased OB

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how does position in the arch affect crowding?

the further back in the arch the more marked the effect on crowding

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anterior CB problems

toothwear
gingival recession
displacement on closure

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diastema aetiology

developmental
generalised spacing
hypodontia (absent 2s)
midline supernumerary
proclination of U incisors
low frenal attachment
pathology

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aetiology of impacted FPMs

eruption angle
ectopic cyst
morphology of E crown
small maxilla

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consequences of impacted FPMs

pulpitis of E

premature exfoliation of E

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UE U1 if pt <9yrs

likely to have open apex and still potential for spontaneous eruption (80% will erupt spontaneously)

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class 2 div 2

L incisor occludes posterior to the cingulum plateau of the U incisor
U incisors retroclined
OJ reduced but can also be increased

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hypodontia presentation

delayed/asymmetric eruption
retained/infra-occluded primary teeth
absent primary tooth
tooth form

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in-out control

relative bucco-lingual position of teeth

determined by depth of bracket base

tip

MD angle of tooth - angle tooth makes to horizontal along line of arch
- all teeth tip mesially
angle of horizontal slot

round AW uses

tipping and vertical tooth movements

torque

BL angle (inclination) of tooth
determined by angle between bracket base and slot
only if rectangular wire - engages wall of slot

CLP dental issues

``` missing teeth impacted teeth crowding growth (class 3) caries ```

buccally placed canines exposing

apically repositioned flap to preserve attached mucosa

CLP pt journey

``` lip closure 3m palate closure 6-12m alv bone graft 8-10yrs definitive ortho 12-15yrs surgery 18-20yrs ```

tack/spot welding

base metal melted

soldering

only filler metal melted | flux powder

class 2 div 1

L incisor edges lie posterior to cingulum plateau of U incisors increased OJ U central incisors proclined or av inclination

tipping force

35-60g

bodily movement force

150-200g

intrusion force

10-20g

extrusion force

35-60g

rotation force

35-60g

torque force

50-100g

18-8 SS

``` 72% Fe 18% Cr 8% Ni 1.7% Ti 0.3% C ```

tooth eruption

``` pre-eruptive tooth movement intra-osseous eruption mucosal penetration pre-occlusal eruption post-occlusal eruption ```

theories for ortho tooth movement

differential pressure theory piezoelectric pressure theory mechanochemical pressure theory

piezoelectric pressure theory

piezoelectric currents generated when crystalline structures such as bone are deformed compression side more +, tension side more - OB and OC get preferentially recruited to certain sides

differential pressure theory

force = tension areas - deposition compression areas - resorption

light forces

``` hyperaemia within PDL OB and OC appear resorption of LD from pressure side apposition of osteoid on tension side remodelling of socket "frontal resorption" PD fibres reorganised gingival fibres appear not to become reorganised but remain distorted slow tooth movement ```

EC bone formation

hyaline cartilage precursor centres of ossification base of skull

how do maxilla and mandible develop?

IM but are preceded by a cartilaginous facial skeleton meckel's cartilage precedes mandible nasal capsule primary skeleton of upper face

why do you get more space if you ext L4s?

less mesial drift

mechanochemical pressure theory

mechanical stress release of neuropeptides from nerve endings stimulate FBs, endothelial cells and alv bone FBs also comm with OBs and OCs alv bone and PDL remodelling = tooth movement

mod force

occlusion of PDL vessels on pressure side hyperaemia of PDL vessels on tension side cell-free areas on pressure side (hylinisation) - no cells, not dead but nothing going on so can't resorb period of stasis increased endosteal vascularity "undermining resorption" increased OC activity - get OC coming in and nibble from below sudden movement of tooth CLUNK - tooth may become slightly loose healing of PDL - reorganisation and remodelling

excessive force

``` necrosis undermining resorption resorption of root surfaces pain permanent change ```

where does post-natal growth occur?

sutures synchondroses surface deposition

risks of ortho tx

``` decalcification root resorption relapse ST trauma recession/hyperplasia loss of perio support headgear injuries E fracture and toothwear loss of vitality allergy poor/failed tx ```

adult differences ortho to children

``` lack of growth PDD - ongoing or prev missing/heavily Rx teeth physiological factors adult motivation ```

MOCDO

``` Missing teeth OJs CBs Displacement of CPs OBs ```