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Ortho > ortho-perio > Flashcards

ortho-perio Flashcards

1
Q

what time period is preventative ortho?

A

primary - early mixed

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2
Q

what time period is interceptive ortho?

A

mixed

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3
Q

what time period is corrective ortho?

A

permanent dentition

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4
Q

adult and geriatric ortho is considered

A

limited treatment

need healthy perio and no bisphosponates

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5
Q

adult patient characteristics

A

no growth

aging of maxillofacial structures

bone biology

dental status

chief complaint

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6
Q

aging of adult geriatric maxillofacial structures

A

small skeletal modifications

nose tip, chin and ears keep growing

resorption at basal bone (holding teeth), anterior areas

point A and B move somewhat back

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7
Q

geriatric patient dental consequence

A

reduced inter-canine distance (why we dont try to do this in general)

increased crowding (lower more likely)

increased Overbite

class II and III tend to worsen with time

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8
Q

soft tissue changes in adult / geratirc patient

A

nose and chin increase

retrusion of lips - flatten profile

loss of muclscle tone

less U incisor - more lower incical display

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9
Q

bone biology in this patient population

A

no growth
less growth factors

periodontal disease

diminished attachment apparatus

flaring of teeth

*always a continue of bone remodeling though

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10
Q

detnal status of older

A

dentiiton alterations
- wear sgns and irreeuluar pattern

loss of some VDO

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11
Q

tx goals in adult patients

A

prepate mouth for complex restorative treatment

minimum tx duration

improve periodontal prognosis

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12
Q

ortho - perio diagnosis

A

perio diagnosis
orrtho diagnosis

perio basic therapy – need to be addressed before ortho

perio surgery could be before during or after
- NEED TO BE ON 3 MONTH RECALL

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13
Q

ORTHO BEFORE PERIO?

A

no — paper did say ortho tx can only be truly considered to improve perio health in those relatively rare cases where treatment corrects an occlusal relationship causing traumatic injury to the periodonta tissue

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14
Q

improving oral hygeine

A

something we can do as ortho for our perio patients

  • crowding and tipping make it more difficult to maintain periodontal health
  • resolve crowding
  • proper alignment
  • stabilization of teeth with mobility with fixed lingual retainer, maintenance of results long term
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15
Q

plan of action with perio ortho patients

A

consults (perio, resto, ortho)

basic perio therapy and restorative therapy and surgical SRP if needed

extractions if needed

ortho intervention

gingivoplasty - grafts if needed

maintenance (perio and ortho)

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16
Q

breakdown of improve smile esthetics

A
  1. gummy smile
  2. gingival architecture
  3. black triangles
  4. recession
17
Q

causes of gummy smile

A

skeletal
- vertical maxillary excess

perio
- altered passive eruption

18
Q

skeletal cause of gummy smile

tx?

A

teeth normally shaped, with an increased lower anterior facial height with vertical maxillary excess, all maxillary teeth seem over erupted

tx
- combo ortho and orthgnathi surgery

or plastic surgery
NEW tx: botox upper lip

19
Q

perio cause of gummy smile

A

altered passive eruption
- NONE OR REDUCED gingival margin after active eruption phase – late adolescence
so thick fibrotic tisssue migrates slower

teeth seem square and short, margin > 1 mm from CEJ
thick fibrotic gingiva
APICAL migration did not occur normally

tx
- perio surgery to normalize contours

20
Q

perio surgery timing with gummy smile

A

if incisal edges are intact, surgery can be delayed until after orthodontic tx is complete and teeth are aligned

in some areas might be necessary to position brackets properly

21
Q

teeth look short and square

A

altered passive eruption

perio due to gummy smile

22
Q

when to do perio surgery DURING ortho?

A

if incisal edges are abraded – CEJ might not be leveled within the teeth

surgery during
- to allow corrections of discrepencies with intrusion - extrusion or restoration

23
Q

gingival margin on centrals and cuspids position

A

1 mm apical than on the lateral incisor

24
Q

altered architecture causes

A

altered passive eruption - localized

supra or infraeruption of teeth - loo incisal edges / wear pattern

recession

25
Q

altered passive eruption with gingival architecture discrepencies

A

more localized
- teeth are in normal position, CEJ in correct relatino, excessive soft tissue present

gingival recontouring after ortho if needed– gingivectomy /CLP

26
Q

supra or infraeruption of teeth with gingival architecture

A

causes altered arhitecture

either uneven or if even, abnormally worn
CEJ position is ALTERED

tx intrude / extrude tooth in worst relation and restore tooth structure
- composite, veneer, crown

27
Q

bone defects that can be treated with ortho

A

hemiseptal osseous defects
1 or 2 walled

craters and 3 wall defects DO NOT IMPROVE WITH ORTHO

28
Q

root proximity that improves perio health

A

2-3 mm of root separattion improves perio health in the area

29
Q

furcation involvment with ortho?

A

furcations tend to WORSEN with ortho - class 3 might need hemisection and crowns (think implant maybe)

if ortho is choses FIRST address the perio tx and follow up closely with perio recalls

30
Q

often seen in tipped or supraerupted teeth?

A

hemisectal osseous defects - 1 or 2 wall defects

31
Q

hemisectal

osseous defects

A

1 or 2 wall defects that are often seen in tipped or supra-erupted teeth

tx - address perio treatment
extrude / upright teeth and stabilize for months
move teeth closer to THE TREATED DEFECT

32
Q

ortho with recesssin?

A

either generalized or local recesssion –> basic perio therapy BEFORE ortho

ortho should , minimize expansion to avoid worsening recession

gingival grafting can be used

33
Q

Interdental papilla missing b/c?

tx with ortho?

A

due to

  1. advanced perio disease
  2. loss of attachment, w/ or w/out flaring teeth
  3. divergent roots
  4. abnormal tooth shape

tx - ADDRESS PERIO FIRST – then ortho tx to close spaces

might NOT correct black triangles - IPR may improve appearance
fixed on may be needed

34
Q

divergent root effects

A

can be cause of interdental papilla missing
- on incisors, positioning of contact is too incisasal but shape of tooth can be normal

tx - upright incisors and close space
NO firther perio involvment needed - might require incisal restoration if edges is worn

35
Q

effect of abnormal tooth shape

A

can make interdental papilla be missing
- triangular central incisors make contact too small (less than 1 mm long) located in ot close to the incisal edge

perio health?

tx - reshape teeth removing .25 to .75 mm of enamel and close the space - no further perio needed

Ortho (19 decks)

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