Ortho/Surgical Treatment & Implants 18% 12Q Flashcards
do you have to level the COS before a mandibular advancement?
no, could help brachyfacial patients to level after b/c it will inc LAFH
what is the most stable surgical movement?
maxillary impaction
what surgical movements are highly stable?
- maxilla up
- mandible forward
- chin in any direction
- maxilla forward (just stable)
what surgical movements are stable when modifications are made?
- maxillary asymmetry
- maxilla up + mandible forward
- maxilla forward + mandible back
- mandibular asymmetry
what surgical movements are problematic?
- mandible back only
- maxilla down
- maxillary expansion
hard tissue:soft tissue changes for genioplasty is ___ : ___
1:1
hard tissue:soft tissue changes for maxillary advancement is ___ : ___
3:1
what are the 2 most common complications with a BSSO
condylar sagging
post-surgical trismus
which surgical movement is most likely to produce popping of crepitus?
mandibular advancement
what complication can lead to a change in occlusion with a mandibular setback?
condyles located posteriorly creating an anterior open bite
for patients with mandibular prognathism who undergo mandibular setback, the position of the hyoid bone includes (small / large / no ) AP changes in relation to the pharyngeal wall
no significant
for patients with mandibular prognathism who undergo mandibular setback, the position of the hyoid bone includes
- downward movement
- backward movement
- both
- downward only
- backward only
downward movement
for patients with mandibular prognathism who undergo mandibular setback, physiologic adaptations ( did / did not ) occur to ensure maintenance the airway
did
Early intervention surgery is done only if functional condyle is needed in the case of partial ____________ + ____________________ of one condyle
ankylosis
osteochondroma
what is one ST side effect after Mx impaction
alar base widens
distraction osteogenesis is used in patients with ____________ deficiency, like syndromic patients who have CLP or Crouzons, and in some instances in patients with mandibular __________
maxillary
crowding
with distraction osteogenesis, the latency period (from time of surgery to beginning traction) is:
5-7 days
one advantage to distraction osteogenesis is that it can increase bone in ___ planes of space with concomitant ___________ adaptation
all 3 planes
soft tissue
Cascade of events after surgical fracture
- ______________ forms due to vascular disruption
- Reorganization of clot as a result of invading ____________
- Initiation of healing and soft ____________ formation
- 5th – 7th day: inflammatory granulation tissue of the initial soft callus converted into an organized ______________ zone similar to RPE
- _____________ can be initiated
- Hematoma
- capillaries
- callus
- fibrous CT
- Traction
the surgical option of a true mandibular deficiency is:
distraction osteogenesis at the mandibular symphysis
with distraction osteogenesis, slow incremental traction has allowed for up to ___mm mandibular lengthening with NO associated pain
20mm
is there an increase in TMD with distraction osteogenesis patients?
no
distraction osteogenesis is the treatment of choice for what circumstances?
limb length discrepancies, skeletal deformities, severe bony defects
what is one main contraindication for rigid fixation?
condylar displacement
when considering soft tissue changes, the upper lip ratio is ___ : ___
3 : 1
when considering soft tissue changes, the chin ratio is ___ : ___
1 : 1
post-op paresthesia after L8 extraction ( is / is not ) common
is
the surgeon can minimize relapse by _____________ repositioning of the segments during surgery
passive
LeFort I osteotomy affects the ( middle / lower ) ⅓ of the face
lower
Maxillary advancement has what effect on upper incisor show
increases U1 display
the main blood supply to the maxilla is the:
ascending pharyngeal artery
which surgical movement can make a patient look older?
maxillary impaction
what is an indication for a LeFort II?
retursive maxilla and nose
the proximal segment of the mandible ( does / does not ) include the condyle
does
the distal segment of the mandible includes:
teeth
___________ fixation promotes stability
rigid
Name as many factors as you can that can cause or lead to an increased predilection for condylar resorption
- Rheumatoid arthritis
- Trauma
- Neoplasia
- Ortho Tx
- Orthognathic Sx
- Pre-Existing TMJ
- Age 15-35 female
- High mandibular plane angle
___% of non-impacted asymptomatic L8s eruption normally
33% or ⅓
with autotransplantation, _______________ is the most likely cause of tooth loss
external root resorption
just as in RPE, the limiting factor to overall expansion in SARPE Tx is the:
zygomatic ridge
the best mandibular surgical technique for patients with TMD is:
IVRO - intraoral vertical ramus osteotomy
When considering growth which continues after surgery:
maxillary ___________ dimension stops but _________ dimension continues, and mandibular growth is ___________
maxillary AP dimension stops but vertical dimension continues
normal
Head of implant fixture should be ___mm apical to desired gingival margin
4mm
maxillary implant healing time is ___ - ___ months while mandibular implant healing time is ___ - ___ months
Max 6-8
Mand 4-6
the implant study on experimental animals showed a ___% success rate
94%
Implant may be placed if there is no change in ___________ facial development taken from serial cephs 12 months apart
vertical
In general implants may be placed in females age ___, but is is better to wait until age ___. in males, you can place at age ___ but it is better to wait until age ___.
F 14, 17
M 19, 21
Bone on the (tension / compression ) side of the implant is thicker
compression (opposite to ortho)
When replacing an over-retained primary tooth, the implant placement timing is:
2 months after extraction
Type of movement most likely to cause disosseointegration of an implant
Tipping
how much force is necessary to disosseointegrate an implant?
none (N/A)
Worst type of bone to use for bone graft for later implant
Hydroxyapatite
what type of bone is present at the interface of an implant?
composite bone
the minimum osseointegration for TADs is ___%
5%
TADs that are osseointegrated show __________ movement
no movement
if cortical plate is difficult to penetrate, a ________________ may be needed to prevent high insertion torque and potential for screw failure (proffit)
Pilot hole
