orthodontic appliances Flashcards by nina dorego

what are removable appliances?

-appliances that are not attached to the teeth-they can be removed for cleaning/sports

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what are the components of removable appliances?

BARA
-baseplate
-active component
-retentive component
-anchorage

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what active components are in removable appliances?

SSB
-springs
-screws
-bows

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what is the force applied by springs dependent on?

-length of wire
-radius of wire
-elastic stiffness of wire

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give examples of retentive components…

CLASPS
-Adam clasps
-delta clasps
-ball-ended clasps
-southend clasps

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what is the base plate made of?

acrylic

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what is the function of the base plate?

-holds all components together
-provides anchorage of the appliance

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define anchorage

anchorage is the resistance to unwanted tooth movements

newtons 3rd law

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how do you increase the anchorage?

-use more clasps
-move only 1 or 2 teeth at a time
-use lighter forces

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what are the advantages of removable appliances to patients?

-can be removed for cleaning and sports/hobbies

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what are the advantages of removable appliances to orthodontists?

-cheap
-less chair side time than fixed
-good anchorage
-can move blocks of teeth
-easy to adjust

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what are the disadvantages to patients?

-must be worn
-lower appliances less tolerated
-can temporarily affect speech/eating

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what are the disadvantages to orthodontists?

-dependent on pt cooperation
-limited movement
-retention post correction can be difficult

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what are the post op instructions for fitting removable appliances?

give verbal and written instructions:
-must be worn 24hrs/day
-can be removed for cleaning/sports/hobbies and eating if necessary
-warn of initial discomfort
-warn of initial difficulty eating/speaking
-inform pt/parent how to activate screw
-inform pt/parent who to contact if any problems

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when do you review fitting of removable appliance?

-4 weeks

then every 4-6 weeks

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what do you do at reviews?

-check OH
-check if any problems e.g sharp edges
-reactive active components
-teeth move approx 1mm/month
-note any speech problems
-check signs of wear
-encourage pt

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what are common problems seen at review of removable appliances?

-wear
-breakages
-appliance is loose
-poor pt compliance
-excessive tilting (spring in wrong position)
-candida infections
- poor OH- canidida and gingival inflammation

what kind of patients do functional appliances require?

-good OH
-good compliance
-pre-adolescent growth phase

what are the contra-indications of functional appliances?

-poor OH
-poor motivation
-non-growing pt (>15/16)

give an example of a fixed functional appliance

Herbst appliance

name a removable functional appliance

twin block appliance

what are advantages of twin blocks?

-removable for cleaning
-may avoid extractions
-may accelerate growth
-may reduce incidence of trauma
-may reduce complexity of tx needs
-effective for class II malocclusions

what are the disadvantages of twin blocks?

-affect speech and eating
-bulky appliance
-may cause ST trauma

what are fixed appliances?

-made of brackets and wires
-attached to the tooth- cannot be removed by pt
-appliance moves teeth by wire and its interactions with bonds/brackets

what are orthodontic wires made of?

-nickel titanium -stainless steel

what shapes do orthodontic wires come in?

-round -rectangular

name some fixed appliance types

-labial/lingual fixed appliances -TPA -QUAD HELIX -RME -TADS

what kind of pt is suitable for fixed appliances?

-good OH -free from pathology/disease -motivated pt -IOTN-suitability

what are the contraindications of fixed appliances?

-poor OH -poor motivation/attendance -pathology/disease -pre-existing root resorption

what are the advantages for fixed appliances?

-full range of tooth movements are possible -provides optimal tooth control -flexible

what are the risk of fixed appliances?

-poor OH -caries -gingivitis -periodontitis -ST trauma -pulpal necrosis -root resorption -gingival recession

what will be seen at end of fixed appliance tx?

-class I/II molars -class I canines -no spacing -no rotations -flat occlusal plane -normal incisor angulting -normal incisor inclination

what is essential after fixed appliances?

retainers

describe the importance of retainers?

-active phase -retention phase the biggest risk to orthodontics is relapse

what is the current advice for retainers?

-must be worn 7 nights/week -removable retainers are used for life -removable must be worn even with fixed retainer

what are the two main retainers used?

-hawley retainers -clear plastic retainers

what do fixed retainers need?

-maintainance -removable retainer

do clear plastic retainers require follow up?

yes in primary care- won't last a lifetime and can be remade by gdp

what orthodontic emergencies can be treated by therapists?

-broken removable retainer-can be remade - all other removable appliances need referred -wire out- can be cut in emergencies then referred -all other problems with fixed appliances should be referred.

what should you do if patients bracket has debonded?

-cover with wax to secure and refer

if pt's wire comes out of tube, what should do?

-rewire if skilled and cut wire distal to easy bracket excess -if cutting wire-refer to orthodontists -use wax to cover wire