Ortho- risks and benefits

Question 1

List some benefits of orthodontic treatment?

Answer 1

Improved appearance
Improved function (mastication- this is especially seen in severe malocclusions)
Improved dental health.

Question 1

List the risks of orthodontic treatment

Answer 1

Failure of treatment
Decalcification
Recession
Root resorption
Loss of vitality.
Relapse
Periodontal health risk
soft tissue trauma
Tooth wear/enamel fracture.
Allergies

Question 2

What is decalcification?

Answer 2

Early demineralisation caries which presents as white chalky marks on the teeth. This also weakens the enamel to caries.

Question 3

How do we prevent decalcification ?

Answer 3

• Good case selection (Motivated/ Good OH/ low caries risk)
• Maintenance of Good oral hygiene (brushing teeth/ using interdental brushes under the wires/Fluoride varnish every 4 months)
• Diet advice.

Question 4

Discuss the orthodontic risk of root resorption?

Answer 4

This is an inevitable consequence.

There is an average 1mm of root resorption over 2 years.
More affected teeth UI> LI>6s
This is more likely in roots that are pipette shaped/ blunt/ already experienced root resorption/previous trauma

Risk factors:
Type of movement (prolonged/high force/ intrusion/large movements/ torque)

Question 4

Discuss the orthodontic risk of relapse?

Answer 4

The return of the features of the original malocclusion following correction.
More likely to relapse (diastema/ crowded Lower incisors/rotations/ instanding 2s/Class II div2/ anterior openbites/ reduced roots)
We use retainers to prevent this.

Question 5

Discuss the orthodontic risk of soft tissue trauma?

Answer 5

The orthodontic apliance can cause pain and discomfort.
We can use orthowax to help with the ulceration.

Question 6

Discuss the orthodontic risk factor of recession?

Answer 6

This is associated with expansion treatment and may not manifest until years later.

Question 7

How do we reduce the orthodontic risk of recession?

Answer 7

Avoid overexpansion during treatment planning & keep the teeth in the bone.

Question 8

How do we manage the orthodontic risk of recession?

Answer 8

Gingival graft if it is bad.

Question 9

When is there a greater risk of loss of tooth vitality with orthodontics?

Answer 9

If the tooth has had previous trauma or is already compromised.

Question 10

What allergies a risk for patients undergoing orthodontic treatment?

Answer 10

Nickel allergies & colophony.

Question 11

What are we looking for in the IOTN that affects dental health?

Answer 11

Missing/ectopic teeth
overjets >6mm
crossbites with displacement
Displacements
Overbite
root resorption/cyst formation
Upper incisor trauma
Tooth wear/gingival recession/assymetric growth
Limited threat of caries/perio disease
Trauma/gingival damage.