Ortho questions Flashcards
Name methods to prevent decalcification other than FV?
- Careful case selection
- fissure sealants
- fluoride supplements ( tablets , drops)
- fluoride mouthwash 225ppm
- High strength fluoride toothpaste
- OHI - correct toothbrushing and use of interdental brushes beneath wire and around brackets 2x daily
- Diet advice
- Regular hygiene appointments
List 8 other potential risks of orthodontics other than decalcification?
- relapse
- root resorption
- gingival recession
- trauma
- failure to complete treatment
- ulceration
- TMJ problems
- Risk of periodontal disease
- wear of adjacent teeth
- loss of periodontal support and vitality
- mucosal irritation
How would you assess a patient anterior-posterior relationship?
- visually with Frankfort plane parallel to floor
- Palpate skeletal bases at at two points (upper , lower)
- By lateral cephalometry - SNA - SNB = ANB
What are the classes of AP relationships?
- Class 1 - maxilla 2-3mm in-front of mandible (ANB 2-4)
- Class 2 - maxilla more than 2-3mm infront of mandible (ANB more than 4)
- Class 3 - mandible infront of maxilla (ANB less than 2)
Name 4 special investigations an orthodontist would do?
- Clinical photographs
- Study models
- Radiographs - OPT , lateral ceph
- Sensibility testing
Class 3 incisor relationship definition?
- Lower incisors edge lie anterior to the cingulum plateu of the upper central incisors
- Overjet is reduced or reversed
Name 8 intra-oral features of a class 3 malocclusion?
- reduced overbite , AOB may be present
- Posterior buccal or anterior crossbite
- reverse overjet
- maxilla often crowded
- mandible often aligned or spaced
- proclined upper incisors
- retroclined lower incisors
- tendency for displacement upon closing
What systemic disease causes the mandible to grow?
Acromegaly
How is a Class III malocclusion managed?
- Accept and monitor - if mild and pt still developing
- interceptive ortho URA - correct incisor relationship
- Growth modification ( functional appliance , headgear with RME to reduce and redirect mandibular growth , TAD’s)
- Camouflage - accept underlying skeletal base and correct incisors to class I
- Combined orthognathic and orthodontic treatment to correct functional and appearance issues
What functional appliances can be used for class III relationship?
- reverse twinblock
- frankel III
- chin up
Pt with anterior cross-bite
When is it best to begin ortho treatment?
Intercept as soon as detected with URA
Anterior crossbite involving 21
What featured of the malocclusion makes it suitable for treatment with a URA?
- Tooth in cross-bite is palatally tipped
- Good overbite (aids stability)
- Adequate space to move the teeth forward
Design a URA for fixing an anterior crossbite involving 21?
A - z spring on UR1 0.5 HSSW
R - adam’s clasp 16,26 0.7 mm HSSW + URd , ULd 0.6mm HSSW
A - only moving one tooth
B - selfcure PMMA with FPBP
URA for posterior cross bite
A - midline palatal screw
R - 16 + 26 + 24 + 14 adam’s clasp 0.7mm HSSW
A - reciprocal anchorage
B - self cure PMMA - posterior bite plane
URA for retracting canines
A - Palatal finger spring + gaurd ; 0.5mm HSSW
R - 6s adam’s clasp , 11+ 12 south end clasp 0.7mm HSSW
A - only moving 2 teeth
B - self cure PMMA
URA for moving canines palatally
A - buccal canine retractor + tubing
R - adam’s and south end clasp
A - y
B - selfcure PMMA
URA for overbite
A - robert’s retractor with I.D tubing
R - adam’s clasp 6s
A - y
B - self cure PMMA with anterior bite plane OJ +3mm
What syndromes are associated with hypodontia?
Cleft lip and palate
Axenfeld-rieger syndrome
Ectodermal dysplasia
Down’s syndrome
How may hypodontia present to you as a GDP?
- delayed or asymmetrical eruption
- retained or infra-occluded deciduous teeth
- Ectopic canines
- Absence of decidious teeth
- tooth malformation
Name members of MDT involved in treating hypodontia?
- othodontist
- restorative dentist
- paediatric dentist
- speech and language therapise
- Clinical psychologist
- Oral surgeon
- GDP
What factors can make early loss of primary teeth worse?
- Age of patient - early extraction is worse as will lead to premature eruption of permanent teeth
- space loss
- losing the E’s lead to issues with position of 6
- If it occurs in the maxilla its worse as more space is lost in upper than lower
- in crowded arches lead to evident space loss
- If it is in the anterior teeth will lead to psychological consequences affect appearance
When might you consider a balancing extraction of a primary tooth?
- balancing extractions are extraction of the same tooth in the same arch , this is to avoid centrelines shiftor relieve crowding
- Primary canines for centreline shift
- First primary molars for crowding
Give 4 reasons for an unerupted 1?
- supranumerary teeth (tuberculate)
- Trauma to A
- Crowding
- Pathology - dentigerous cyst
- Ankylosis
- Genetics
What are the treatment options for an impacted 11?
- Accept and monitor
- Surgical exposure and bonding using gold chain (over age of 9) using orthodontic traction
- XLA of supernumerary teeth if present
- Surgical extraction of 11