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Ortho > Ortho Tx Planning Primary Dentition (Resident) > Flashcards

Ortho Tx Planning Primary Dentition (Resident) Flashcards

1
Q

What are the 5 advantages of early tx?

A

Increase possibility of achieving better result
Some tx can only be corrected at early age
Some habits tx early avoid ingrained habit reinforcement
Psychosocial considerations important
Younger patients more cooperative

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2
Q

What are the 4 goals of interceptive ortho

A

1= prevent progressive, irreversible soft tissue or bony changes
2= eliminate CR-CO shift (functional shift)
3= improve Skeletal malrelationships by influencing the direction of facial growth
4= prevent excessive dental and skeletal compensation resulting from functional disharmony

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3
Q

Identification of problems

A

Eruption
Space
Occlusal relationship
Habits

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4
Q

Eruption problems

A

Over retained primary teeth
Ectopic eruptions
Supernumerary teeth

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5
Q

Space problems

A

Missing primary molars
Missing anterior teeth

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6
Q

Occlusal relationship problems

A

Posterior crossbite
Anterior crossbite with anterior shift

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7
Q

Habit problems

A

Dental open bite

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8
Q

Over retained primary teeth definition

A

Permanent too should replace its primary predecessor when approximately 3/4th of the root of the permanent too this formed

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9
Q

Tx of over retained primary teeth

A

Extraction of primary tooth - prevent deflected eruption paths (irregularity, crowding, crossbite) and gingival inflammation and hyperplasia (pain and bleeding)

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10
Q

Result of extracting primary tooth over retained primary teeth

A

If space is adequate, moderately abnormal facial or lingual positioning will be corrected by equilibrium forces of lips, cheeks and tongue

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11
Q

Ectopic eruption lateral incisors

A

Permanent lateral incisor erupts, resorption of one or both primary canines is common.
Indicates lack of enough space for all perm. Incisors
May result from aberrant eruption path

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12
Q

Ectopic eruption lateral incisors tx

A

Space analysis, assessment of AP incisor position and the facial profile - determine space maintenance, space management, space regaining or more complex tx

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13
Q

Ectopic eruption maxillary canines

A

~ 10 yrs, primary canine is not mobile and no observable/papable facial canine bulge, ectopic eruptions considered, 1-2% range

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14
Q

Problems that Ectopic eruption maxillary canines can cause

A

Impaction of canine
Resorption of permanent lateral and/or central incisor roots

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15
Q

Ectopic eruption permanent first molars

A

Perm. Tooth causes resorption of primary tooth other than the one its supposed to replace or resorption of adjacent permanent tooth.

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16
Q

Ectopic eruption permanent first molars limited resorption vs moderately advanced resorption

A

Limited = immediate tx not required
Advanced = requires active intervention, self correction unlikely

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17
Q

The permanent tooth is dislodged _______ with spring mechanics and erupts past the ________ tooth

A

Distally, primary

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18
Q

Supernumerary teeth

A

Can disrupt normal eruption of other teeth- crowding, spacing
If not inverted, will erupt before or along the normal tooth, can be extracted before interferences with adjacent teeth

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19
Q

Most common location of supernumerary teeth

A

Anterior maxilla, take any shape

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20
Q

Supernumerary teeth tx

A

Extract supernumeraries as soon as identified, prevent problems or minimize effect on other teeth if already displaced

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21
Q

Quantification of a space problem

A

Space available
Space required

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22
Q

Space available

A

Dividing dental arch into 4 straight segments. Each measured individually with a ruler or sharpened boley gauge

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23
Q

Space required

A

Sum of mesiodistal widths of all individual erupted permanent teeth plus the estimated sized of the unerupted permanent teeth

24
Q

Premature tooth loss with adequate space : space maintainers

A

Band and loop
Partial denture
Distal show
Lingual arch

25
Q

Band and loop space maintainer

A

Unilateral fixed appliance - posterior space
Loop - limited strength, must be restricted holding space of one tooth not accept functional forces of chewing

26
Q

Bilateral band and loop indication

A

Single primary molar has been lost bilaterally before eruption of the lower permanent incisors

27
Q

The permanent incisor tooth buds are _______ to the primary incisors and often erupt _______

A

Lingual, lingually

28
Q

Distal shoe space maintainers

A

Appliance of choice when primary second molar is lost before eruption of permanent first molar
Guide plane must extend into alveolar process, located approximately 1 mm below mesial MR of permanent 1st molar, at or before emergence from bone

29
Q

Lingual arch space maintainer indicated from

A

Multiple primary posterior teeth missing
Permanent incisors have erupted

30
Q

Lingual arch space maintainers attachment

A

To bands on primary 2nd or permanent 1st molars and contacting incisors

31
Q

What does lingual arch space maintainers prevent

A

Anterior movement of post. Teeth
Post movement of anterior teeth

32
Q

The nance arch is an _________ space maintainer, but soft tissue _______ can be a problem

A

Effective, irritation

33
Q

Partial denture space mainters

A

-For bilateral post. Space maintenance when more than 1 tooth been lost per segment and perm. Incisors have not erupted yet
- band and loop contraindicated
-post. Space maintenance in conjunction with replacement of missing prim. Or delayed perm. Incisors

34
Q

Are anterior teeth required for nutrition or speech development?

A

No, children adapt readily to missing teeth, replacements is for appearance

35
Q

Space deficiency largely due to allowance for molar shit

A

-Some children, more severe transitional crowding occurs when incisors erupt
-analysis shows that space availed is adequate or nearly so
-major component of the projected space deficiency is due to mesial movement of the perm. First molar to a class I relationship when the second primary molars are lost
-loss of leeway space could be prevented, little or no space deficiency

36
Q

Posterior crossbite mixed dentition %

A

Pretty common
7.1% age 8 - 11

37
Q

Crossbite reasons

A

Skeletal - narrow maxilla
Dental - lingual tipping of max teeth

38
Q

When is early correction indicated in posterior crossbite

A

If the child shifts on closure or if the constriction is severe enough to significantly reduce the space within the arch

39
Q

Posterior crossbite tx deferred

A

Comprehensive ortho needed later

40
Q

Is the tx usually the same if the crossbite is skeletal or dental?

A

Yes, since relatively light forces will move teeth and bones
Expansion of palatal arch is best choice

41
Q

Equilibration to eliminate mandibular shift

A

-Prim or early mixed dentition, shift into posterior crossbite will be due to occlusal interferences caused by the canines or prim. Molars, can be diagnosed by positioning mandible and comparing CR to CO
-width of maxilla is adequate, no crossbite without the shift
-child requires limited equilibration of primary teeth (reduction of prim canines), eliminate interferences and resulting lateral shift into crossbite

42
Q

Expansion of a constricted maxillary arch

A

-More commonly, lateral shift into crossbite = constriction of maxillary arch
-even small constriction creates dental interferences that force mandible to shift to a new position for maximum intercuspation and moderate expansion of maxillary dental arch needed from correction
-general guideline = expand to prevent the shift when diagnosed

43
Q

Appliance for expansion of constricted maxillary arch

A

Quad helix
W arch

44
Q

Anterior crossbite

A

-Usually all incisors, rare who do not have skeletal class III jaw relationship
-relationship of one or two ant teeth, may develop in child who has good facial proportion
- ~3% with mixed dentition

45
Q

Planning tx for anterior crossbite

A

Critically important to differentiate skeletal problems (deficient max or excessive mand) from cross bites due only to displacement of teeth (eruption problems)

46
Q

Truly skeletal problem anterior crossbite

A

Changing the incisor position is inadequate tx

47
Q

Non skeletal anterior crossbite

A

One or two teeth
Almost always due to lingual displaced max central or lateral incsiros
Teeth erupt to lingual because of lingual position of developing tooth buds and may be trapped in that location, especially if not enough space

48
Q

In a young child, one way to tip the maxillary and mandibular anterior teeth out of crossbite is with a __________ appliance, using ______ ________ for facial movement of maxillary incisors

A

Removable, finger springs

49
Q

Non skeletal anterior crossbite

A

Tip the maxillary incisors forward with 2x4 fixed appliance
2 bands on first molars
4 bonded incisor brackets
Rare- no skeletal , this is best choice for mixed dentition for - crowding, rotations, need for bodily movement, more perm. Teeth in crossbite

50
Q

Open bite causes

A

-normal transition perm teeth erupting
- habit, finger sucking or tooth displacement by resting soft tissue (lip entrapment)
-skeletal problem (excessive vertical growth and rotation of jaws that would create a disproportionately large lower anterior face height)

51
Q

What happens to many of the transitional and habit problems?

A

Resolve with either time or cessation of the sucking habit

52
Q

Open bites that persist until adolescence, with the exception of those related to habits, or those that involve more than just the incisors almost always have a significant ______ _____ and careful diagnosis of the contributing factors is requires. These are termed _______ _____ bites and require _______ treatment

A

Skeletal component, complex open, advanced

53
Q

What happens if the habits stop before the eruption of the permanent incisors?

A

Most of the changes resolve spontaneously with the exception of posterior crossbite

54
Q

What happens if a child does not want to quit a habit?

A

Therapy is not indicated

55
Q

Non dental habit intervention

A

As the time of eruption of the perm incisors approach, simplest approach is straightforward discussion
“Adult approach” more effect with older children

56
Q

Appliance therapy habit intervention

A

Child who wants to stop - fitted with cemented appliance impedes sucking
Appliances can be deformed and removed by children - not compliant
Need cooperation

Ortho (19 decks)

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