Ortho Treatment Options Competency

Question 1

name the five broad treatment options for a class II div 1

Answer 1

accept
growth modification
simple tipping of teeth
camouflage
orthognathic surgery

Question 2

when would you accept class II div 1 malocclusion

Answer 2

if mildly increased OJ
significant OJ but patient not bothered

Question 3

name growth modification appliances for class II div 1

Answer 3

headgear = prevents growth of maxilla
removeable functional appliance = twinblock
fixed functional appliance = herbst

Question 4

when are growth modification appliances used

Answer 4

during growth and coincide with pubertal growth spurt

Question 5

in class II div 1, what movement are you expecting after use of a growth modification appliance

Answer 5

distal movement of uppers
mesial movement of lowers
retroclination of upper incisors
proclination of lower incisors

Question 6

name risks of growth modification

Answer 6

early use may not sustain long term changes
overall treatment time increased

Question 7

name benefits of growth modification

Answer 7

improves appearance earlier
reduced trauma risk
better patient compliance

Question 8

when would URAs to correct a class II div 1 malocclusion be used

Answer 8

very mild class II or class I skeletal
where overjet is due to proclined and spaced uppers
OB favourable

Question 9

construct a URA for correction of class II div 1

Answer 9

A - robert’s retractor 0.5mm tubing
R - adams clasps 0.7 HSSW
A - stops mesial to 13 and 23
B - self cure PMMA and FABP

Question 10

what is the camouflage option for class II div 1

Answer 10

accept underlying skeletal discrepancy
may need to XLA in upper arch for space to retract with fixed appliances

Question 11

when is surgery an option for class II div 1

Answer 11

when growth is complete
skeletal discrepancy is severe
fixed appliances required before, during and after

Question 12

why may you be more inclined to treat a class II div 2

Answer 12

aesthetic concerns
traumatic overbite concerns

Question 13

what are the four options for treatment of class II div 2

Answer 13

accept
growth modification
camouflage
surgery

Question 14

when would you accept a class II div 2 malocclusion

Answer 14

malocclusion not severe
acceptable aesthetics
patient not concerned
OB not significant problem

Question 15

when would you use growth modification for class II div 2

Answer 15

during growth spurt
patient has mild/ moderate skeletal pattern
to convert class II div 2 into class II div 1

Question 16

what would be involved in functional appliances to correct a class II div 2

Answer 16

procline upper incisors with modified twinblock, springs/ screws
ELSA spring - expansion labial segment aligner

Question 17

for full benefit, how often should functional appliances be worn

Answer 17

22 hours a day
6-9 months

Question 18

when would you decide to camouflage in class II div 2

Answer 18

accept underlying skeletal pattern
careful consideration with XLAs
use fixed appliances to reduce OB and correct interincisal angle

Question 19

how is the inter incisor angle treated with fixed appliances in class II div 2

Answer 19

palatal root torque of upper incisors
proclination of lower incisors

Question 20

what other appliance may be used to camouflage a class II div 2 into class I incisors

Answer 20

FABP

Question 21

what is a risk of correcting inter-incisal angle in class II div 2

Answer 21

root resorption

Question 22

why may surgery be considered for class II div 2

Answer 22

too severe malocclusion for orthodontics alone
non-growing patient
profile concerns

Question 23

what are the 5 treatment options for class III

Answer 23

accept
simple tipping of teeth (URA)
growth modification
camouflage
surgery

Question 24

why may it be important to treat class III malocclusions

Answer 24

aesthetics
dental health - attrition and gingival recession
function - speech and mastication

Question 25

what elements of class III malocclusion may make treatment more difficult

Answer 25

increase in number of teeth in crossbite
skeletal element involved
increase AP discrepancy
AOB present

Question 26

when may you choose to monitor class III cases

Answer 26

when no dental health concerns
no displacement
no attrition

Question 27

what may you use for simple tipping and tilting of teeth in class III malocclusion

Answer 27

URA to procline anterior incisors
correct anterior crossbite

Question 28

when is it a good idea to use URAs in treatment of class III malocclusion

Answer 28

when the malocclusion has arisen due to early contact of upper incisors on lowers and a mandibular displacement

Question 29

when is growth modification indicated in treatment of class III malocclusions

Answer 29

growing patient to restrict mandibular growth or promote maxillary growth

Question 30

name types of functional appliances that can be used in growth modification of class III malocclusions

Answer 30

RME
protraction headgear
reverse twin block
frankel III
chin cup

Question 31

how is camouflaging achieved in class III malocclusions

Answer 31

ANB is not less than 0 - average or increase OB
XLA further back in upper and forward in lower arch
aim to procline uppers and retrocline lowers and correct OJ

Question 32

when is surgery indicated for class III malocclusions

Answer 32

aesthetic or functional concerns
skeletal discrepancy too severe for orthodontics alone
patient has stopped growing