Ortho Treatment Options Competency Flashcards
name the five broad treatment options for a class II div 1
accept
growth modification
simple tipping of teeth
camouflage
orthognathic surgery
when would you accept class II div 1 malocclusion
if mildly increased OJ
significant OJ but patient not bothered
name growth modification appliances for class II div 1
headgear = prevents growth of maxilla
removeable functional appliance = twinblock
fixed functional appliance = herbst
when are growth modification appliances used
during growth and coincide with pubertal growth spurt
in class II div 1, what movement are you expecting after use of a growth modification appliance
distal movement of uppers
mesial movement of lowers
retroclination of upper incisors
proclination of lower incisors
name risks of growth modification
early use may not sustain long term changes
overall treatment time increased
name benefits of growth modification
improves appearance earlier
reduced trauma risk
better patient compliance
when would URAs to correct a class II div 1 malocclusion be used
very mild class II or class I skeletal
where overjet is due to proclined and spaced uppers
OB favourable
construct a URA for correction of class II div 1
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
what is the camouflage option for class II div 1
accept underlying skeletal discrepancy
may need to XLA in upper arch for space to retract with fixed appliances
when is surgery an option for class II div 1
when growth is complete
skeletal discrepancy is severe
fixed appliances required before, during and after
why may you be more inclined to treat a class II div 2
aesthetic concerns
traumatic overbite concerns
what are the four options for treatment of class II div 2
accept
growth modification
camouflage
surgery
when would you accept a class II div 2 malocclusion
malocclusion not severe
acceptable aesthetics
patient not concerned
OB not significant problem
when would you use growth modification for class II div 2
during growth spurt
patient has mild/ moderate skeletal pattern
to convert class II div 2 into class II div 1
what would be involved in functional appliances to correct a class II div 2
procline upper incisors with modified twinblock, springs/ screws
ELSA spring - expansion labial segment aligner
for full benefit, how often should functional appliances be worn
22 hours a day
6-9 months
when would you decide to camouflage in class II div 2
accept underlying skeletal pattern
careful consideration with XLAs
use fixed appliances to reduce OB and correct interincisal angle
how is the inter incisor angle treated with fixed appliances in class II div 2
palatal root torque of upper incisors
proclination of lower incisors
what other appliance may be used to camouflage a class II div 2 into class I incisors
FABP
what is a risk of correcting inter-incisal angle in class II div 2
root resorption
why may surgery be considered for class II div 2
too severe malocclusion for orthodontics alone
non-growing patient
profile concerns
what are the 5 treatment options for class III
accept
simple tipping of teeth (URA)
growth modification
camouflage
surgery
why may it be important to treat class III malocclusions
aesthetics
dental health - attrition and gingival recession
function - speech and mastication
what elements of class III malocclusion may make treatment more difficult
increase in number of teeth in crossbite
skeletal element involved
increase AP discrepancy
AOB present
when may you choose to monitor class III cases
when no dental health concerns
no displacement
no attrition
what may you use for simple tipping and tilting of teeth in class III malocclusion
URA to procline anterior incisors
correct anterior crossbite
when is it a good idea to use URAs in treatment of class III malocclusion
when the malocclusion has arisen due to early contact of upper incisors on lowers and a mandibular displacement
when is growth modification indicated in treatment of class III malocclusions
growing patient to restrict mandibular growth or promote maxillary growth
name types of functional appliances that can be used in growth modification of class III malocclusions
RME
protraction headgear
reverse twin block
frankel III
chin cup
how is camouflaging achieved in class III malocclusions
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
when is surgery indicated for class III malocclusions
aesthetic or functional concerns
skeletal discrepancy too severe for orthodontics alone
patient has stopped growing
