Ortho/Pedo 2

Question 1

What is the treatment for a posterior skeletal crossbite?

Answer 1

Expansion lingual arch (slow continuous) for primary and early mixed dentition

• palatal expansion (rapid or slow) for late mixed

Needs to be completed PRIOR to the end of growth spurt.

Question 2

When should palatal expansion be completed?

Answer 2

Prior to end of growth spurt

Question 3

In rapid palatal expansion, you get ___ activation and expansion/day. It exerts __-__lb pressure. It causes ___ in the sutures.

Answer 3

0.5mm

10-20lb pressure

Microfractures in interdigitated bone spicules

Question 4

In slow palatal expansion, it allows for ___mm expansion per week. ___lb pressure.

Answer 4

1mm

2lbs

Suture stays in tact, same long-term results with less trauma

Question 5

What kind of palatal expansion devices do you use for preadolescent?

Answer 5

Quad helix or W arch

Question 6

What kind of palatal expansion device do you use for adolescents?

Answer 6

Rapid or slow palatal expander

Question 7

What is a common side effect of palatal expansion?

Answer 7

Tends to extrude posterior teeth and cause anterior open bite

Question 8

What is the treatment for excess overjet?

Answer 8

Class 2 elastics

Tip back maxillary incisors with removable

Question 9

What is the difference between simple and complex anterior open bite?

Answer 9

Simple = dental

Complex = skeletal

Question 10

Simple anterior open bite is often due to ___

Answer 10

Prolonged thumbsucking habit in childhood

Question 11

What is the clinical presentation of prolonged thumbsucking habit?

Answer 11

Flaring maxillary incisors, lingual tipping mandibular incisors (overjet)

Maxillary constriction (posterior crossbite)

Overeruption of posterior teeth

Open bite

Question 12

What is the treatment of simple anterior open bite if the patient is in primary dentition?

Answer 12

No treatment

Question 13

What is the treatment of simple anterior open bite in mixed dentition due to thumbsucking?

Answer 13

Thumbsucking therapy

Question 14

A complex anterior open bite is a ___ found in adults and adolescents. They have a __ face appearance. Name 4 features of complex anterior open bite.

Answer 14

Vertical discrepancy

Long

Posterior maxilla tips down

Downward and backward rotation of mandible

Steep MPA

Excessive eruption of posterior teeth

Question 15

What is the treatment for a complex anterior open bite for adolescents? What about adults

Answer 15

Adolescents = growth modification

Adults = jaw surgery

Question 16

What kind of growth modification device can be used to treat complex anterior open bite?

Answer 16

High pull headgear

Question 17

How does high pull headgear work?

Answer 17

Maintains vertical position of maxilla

Intrude upper molars and closes bite

Force vectors should be placed through the trifurcation so no tipping occurs

Attached to maxillary splint for all maxillary teeth

(Very tough to treat, poor prognosis)

Question 18

How can bite blocks be used to treat complex anterior open bite?

Answer 18

Blocks eruption of posterior teeth

Allows eruption of anterior teeth

Usually combined with functional appliance.

Question 19

In dental deep bite there is overeruption of ___ incisors. It is class __ malocclusion. What is the treatment?

Answer 19

Mandibular

2

Intrude anteriors

Allow eruption of posterior

Question 20

What are 5 features of a skeletal deep bite?

Answer 20

Long mandibular ramus

Upward and forward rotation of mandible

Low MPA

class 2 division 2

Decreased eruption of posterior teeth

Question 21

What kind of growth modification device is used to treat skeletal deep bite? How does it function?

Answer 21

Cervical pull headgear

Extrudes upper molars and opens bite

Question 22

Which is easier to treat via growth modification, complex anterior open bite or skeletal deep bite?

Answer 22

Skeletal deep bite

Question 23

How does the deep bite functional appliance work?

Answer 23

Only allows mandibular posterior teeth to erupt

Levels an excessive curve of spee