Orthodontic Prevention Flashcards
List 6 risks of orthodontic treatment
demineralisation root resorption pulp damage gingivitis/periodontal problems soft tissue damage other factors e.g TMD, burns
define demineralisation
early stage of caries
loss of tooth substance
what causes demineralisation
plaque bacteria metabolise dietary sugars
acid produced which attack tooth surface
what is the critical pH of enamel and dentine
enamel- 5.5
dentine- 6.5
what is the appearance of demineralised enamel
brown/white staining
what are the 4 requirements for demineralisation/caries
plaque bacteria
carbohydrate/substrate
susceptible tooth surface
time in contact with tooth surface
why may GI cement be used on bands?
F- release
prevent demineralisation?
how long can it take for non cavitated lesions to remineralise?
6-12 week post de bond
what is contraindicated for remineralisation and why
high F-
stops remineralisation process
define micro abrasion
mechanical removal of a small amount of tooth structure to eliminate superficial enamel discoloration defects not removed by bleaching techniques
name a common abrasive used in micro abrasion
pumice
HCL acid
define root resorption
progressive loss of dentine and cementum by osteoclasts
how much root length is lost on average during treatment
1-2 mm
3 risk factors for root resorption
family history
previous trauma
resorption pre-treatment
what prevention steps would you take for root resorption
radiographs to assess pre-treatment lengths
light forces during treatment
if pt at risk- radiographs 6 qmonths into treatment
what can previously traumatised teeth be at risk of and what should be done ?
pulp damage/pulpitis so monitor pulp vitality
2 ways pulp vitality can be measured
thermal or electical pulp testing
How can rotary instruments (composite removing etc) affect the pulp
can damage due to overheating so take care when using
how can risk of pulp damage be managed
little can be done
warn patients can last 2-7 days after appliance fitted
analgesic for pain
what should patient with heavily restored dentition be warned about
periapical abscess
why can gingival inflammation increase during orthodontic treatment
as reduced access for cleaning
what periodontal problems can occur during ortho treatment?
increased gingival inflammation due to reduced access to cleaning
apical migration of periodontal attachment and bony support
what does poor gingival health prior to treatment indicate
pt is unsuitable for ortho treamment
define periodontal drift
tooth drifting due to periodontitis
what can removeable appaliances be associated with?
gingival inflammation particularly of palatal tissues
what is the management for periodontal problems
OHI
periodontal monitoring
3/12 s+p
what is required after treatment for patients with periodontal problems
permanent retention due to altered ST balance
name 4 types of soft tissue that can occue
traumatic ulcerations
friction against components of applainces
archwire ends lacerating- cut this
clumsy instrumentation- careful
why can headgear be considered a risk
headgear bow can be displaced during sleep etc
bow is sharp and if eye is penetrated can cause an eye infection and eventual loss of eye
=sympathetic opthalmitis
what is the risk with TADs
risk of perforation/infection
name 2 possible allergic reactions
latex
nickel
name 6 ‘other risk factors’
TMD relapse burns allergic reactions anchorage- headgear, TADs prolonged treatment
