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Ortho > Orthodontic Extraction Patterns > Flashcards

Orthodontic Extraction Patterns Flashcards

1
Q

Reasons for extractions

A

Gain space to align crowded teeth
Reduce dental protrusion
Camouflage skeletal discrepancies
Correct midling discrepancies
Preparation for orthognathic surgery

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2
Q

<4 mm of crowding

A

Ext rarely
Expand arch’s or IPR

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3
Q

5-9 mm crowding

A

Either non ext or ext
Soft tissue profile
Gingival tissues

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4
Q

> 10 mm crowding

A

Ext almost always indicated

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5
Q

What limits the ability to protract or retract incisors

A

Soft tissue

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6
Q

What creates fuller lips

A

Proclining the incisors

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7
Q

Patients with thin lips, large nose and strong chin

A

Extracting teeth and retracting incisors can prematurely age the patient

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8
Q

What is the first choice in borderline cases

A

Non - ext

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9
Q

What does success depend on in borderline cases

A

Hard and soft tissues
Characteristics of the patient
Final incisor position

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10
Q

Fixed lingual retainers

A

Can help in maintaining alignment in patients who may be a higher risk for relapse

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11
Q

What should NOT be sacrificed to save premolars

A

Long term function and stability

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12
Q

Alternative to extractions

A

Move incisors facially
Expansion of the arch to create space
Interproximal reduction (IPR)

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13
Q

Potential problems of non ext treatment

A

Relapse potential
Periodontal concerns
Open bite tendency

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14
Q

Relapse potential - non ext tx

A

Lip pressure increases if lower incisors move >3mm forward from original position
Expansion across lower canines is not as stable as expansion across premolars and molars

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15
Q

Periodontal concerns - non ext tx

A

Recession
Fenestration of roots

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16
Q

Class 1 profile

A

Straight

17
Q

Class 2 profile

A

Convex
Maxillary excess
Mandibular deficient
Combination

18
Q

Class 3 profile

A

Concave
Maxillary deficient
Mandibular excess
Combination

19
Q

Canine class I

A

Mesial incline of the maxillary canine occludes with the distal incline of the mandibular canine and the maxillary canine cusp tip occludes with the occlusal embrasure between the mandibular canine and 1st PM

20
Q

Class 2 Canine

A

Mesial incline of the maxillary canine occludes mesial to the distal incline of the mandibular canine

21
Q

Class 3 canine

A

Mesial incline of the maxillary canine occludes distal to the distal incline of the mandibular canine

22
Q

Class 1 crowding (moderate to severe) ext pattern

A

Generally - four 1st premolars - crowding is in ant, want to create space
OR- extract four 2nd premolars- reduce effect on soft tissue - ext 1st premolars bring back lips further

23
Q

Class 1 w dentoalveolar protrusion

A

Anterior teeth flare out during eruption
Lip fullness
Mentalis muscle strain
Lip incompetence

24
Q

Class 1 w dentoalveolar protrusion tx

A

Ext four 1st premolars
Retract anterior segments to reduce protrusion

25
Q

Class 1 crowding with retrusive lips tx

A

Extract four 2nd premolars
Reciprocal closure of ext spaces - post teeth move ant, ant teeth move post
Less of soft tissue effect

26
Q

Class 2 ext - dental etiology

A

There is crowding and ext are indicated

27
Q

Class 2 skeletal etiology - ext patterns

A

Severe case - surgery
Mild to moderate case- functional appliances, surgery, ext to camo

28
Q

Class 2 dental crowding or class 2 skeletal camo tx

A

Extraction
Max 1st premolars and mand 2nd premolars

29
Q

Class 2 ext pattern allows us to differentially move the molars and canines into what class relationship

A

Class I
Retract max anterior segment
Protract mand posterior segment

30
Q

Class 2 - pt non growing, good mandible/profile, little mandibular crowding, 5 -10 mm overjet -tx

A

Ext max 1st premolars only
Retract maxillary anterior segment

31
Q

Overjet > 10 mm class 2 tx

A

Surgery

32
Q

Class 3 ext patterns - etiology

A

Usually skeletal
Many surgery
Mild - camo with ext

33
Q

Class 3 ext pattern tx

A

1 - max 2nd premolars and mand 1st premolars (primary ext pattern) (retract mand ant segment, reciprocal closure of max)
2- mand 1st premolars or single lower incisor (mild class 3, max arch not crowded, moderate to severe mandibular crowding)(reciprocal closure of ext space)

34
Q

Asymmetric ext

A

1-2 premolars may be extracted on one side only
Helps shift the dental midline to center of face

35
Q

Ext 2nd molars

A

Helps correct class 2 and/or close an open bite
Relies on third molars to erupt later and take second molars position
Rare

36
Q

Class 2 ext vs class 3 ext (skeletal malocclusion)

A

Class 2 = extract lower 1st or 2nd premolars
Class 3 = extract upper 1st or 2nd premolars
Make surgical movements larger = more noticeable profile change

37
Q

The timed sequence of extraction of primary teeth and ultimately permanent teeth to relieve severe crowding (>10 mm)
Increase available space for eruption permanent teeth by extraction of certain deciduous teeth
Allows teeth to erupt over alveolus and through keratinized tissue

A

Serial extractions

38
Q

Indications for serial ext

A

Severe mesial tipping or ectopically erupting perm 1st molars
Early loss mand deciduous canine
Fanned out U/L perm incisors
Abnormal resorption of prim teeth
Permanent canines erupting buccally

39
Q

Serial ext pattern

A
  1. Ext prim canines
  2. Ext prim 1st molars
  3. Ext 1st premolars

Ortho (19 decks)

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