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FINALS > Orthodontics > Flashcards

Orthodontics Flashcards

1
Q

name four possible orthodontic treatment options for growing patients

A

growth modification
functional appliances
headgear
RME or reverse pull facemask

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2
Q

what are the three main risks of orthodontic treatment

A

relapse
root resorption
decalcification

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3
Q

name three benefits of orthodontic treatment

A

improve function
improve appearance
reduce risk of trauma

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4
Q

what are the two ages where orthodontic assessments can be made

A

brief at 9 years old
comprehensive at 11/12

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5
Q

name andrew’s six keys

A

molar relationship
crown anulation
crown inclination
no rotations
no spaces
flat occlusal planes

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6
Q

what three planes is the facial skeleton considered in

A

AP
transverse
vertical

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7
Q

what can a lip trap induce

A

proclination of upper incisors

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8
Q

what does a hyperactive lower lip cause and why is this relevant for the end of treatment

A

can retrocline lower incisors
indicates likely instability at end of treatment

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9
Q

what aspect of malocclusion is a tongue thrust commonly associated with

A

anterior open bite

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10
Q

name five features of a digit sucking habit

A

proclined upper anteriors
retroclined lower anteriors
AOB
narrow upper arch
posterior crossbite

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11
Q

when would you be concerned about an anterior crossbite and want to intercept

A

if there is mandibular displacement

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12
Q

name three unfavourable outcomes of mandibular displacement

A

lower incisors become mobile
labial gingival recession of lower incisors
tooth surface loss on labial surface of lower anteriors and palatal surface of upper anteriors

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13
Q

what is the value of degree of upper incisors to the maxillary plane

A

109 degrees

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14
Q

what is the value of degree of lower incisors to mandibular plane

A

93 degrees

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15
Q

what is the SNA angle related to

A

the maxilla to the anterior cranial base

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16
Q

what is the SNB angle related to

A

the mandible to the anterior cranial base

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17
Q

what is it called when dento-alveolar structures disguise underlying skeletal discrepancy

A

dento-alveolar compensation

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18
Q

what is the frankfort plane

A

orbitale to porion

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19
Q

what is the mandibular plane

A

menton to gonion

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20
Q

what is the normal value of FMPA

A

27 degrees

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21
Q

name 5 causes of local causes of malocclusion

A

variation in tooth number
variation in tooth size
abnormality of position
soft tissue abnormality
local pathology

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22
Q

name the four types of supernumerary teeth

A

conical
tuberculate
supplemental
odontome

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23
Q

name Three causes of a primary tooth being retained

A

absent successor
supernumerary
ectopic successor

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24
Q

what are the two options for management of a retained primary tooth with an absent successor

A

retain primary tooth for as long as possible if good prognosis
extract deciduous tooth to encourage space closure

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25
Q

should you compensate extraction of primary teeth

A

no

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26
Q

what is the only teeth you should contemplate balancing in the deciduous dentition

A

Cs

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27
Q

what should you consider when there is early loss of Ds or Es

A

space maintainers

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28
Q

name three factors that impact the rate at which space closes after tooth loss

A

age
degree of crowding
arch (mandible loses space quicker)

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29
Q

where do premolars develop in relationship to the deciduous tooth

A

right above/ below it
will not be able to palpate

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30
Q

if a premolar is ectopic where is it more likely to sit

A

palatally

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31
Q

as a GDP what should you do if you find a tooth that is ankylosed and infra-occluded below the level of the contact points of adjacent teeth

A

extract and space maintain if permanent successor

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32
Q

as a GDP what should you do if a deciduous tooth is infra-occluded with no permanent successor

A

refer early (hypodontia patient)
keep infra-occluded tooth to do a crown
take out tooth to close the space

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33
Q

what is a transposition

A

interchange in the position of two teeth

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34
Q

what s a soft tissue cause of midline diastema

A

low labial frenum

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35
Q

what two habits are associated with AOB

A

tongue thrust
digit sucking habit

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36
Q

what occurs in areas where bone is compressed

A

bone is resorbed

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37
Q

what occurs in areas where bone is under tension

A

bone is deposited

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38
Q

what can functional appliances achieve in a class II

A

retroclination of upper
proclination of lower
mesial migration of lower teeth
distal migration of upper teeth

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39
Q

what forces are required for a tipping movement

A

35g - 60g

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40
Q

what do light forces achieve when applied to the teeth

A

multinucleate cells absorb bone directly and there is hyperaemia in the PDL

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41
Q

what do moderate forces achieve when applied to the teeth

A

force exceeds the capillary blood pressure and creates a cell free zone on pressure side
resorption at hyalinisation occurs at reduced rate

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42
Q

what is it called when the force exceeds the capillary blood pressure and creates area of no cells on pressure side

A

hyalinisation

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43
Q

what occurs when there is excessive pressure applied to the teeth

A

there are unwanted side effects like pain and necrosis and root resorption
this can lead to anchorage loss and loss of vitality of the tooth

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44
Q

what degree of tooth movement per month is optimal

A

1mm

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45
Q

why may cleft lip and palate occur independently from one another

A

the upper lip and anterior part of palate have different embryological origins from the posterior palate and they fuse at separate times

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46
Q

what are the three main site of secondary cartilage formation in the mandible

A

condylar cartilage
coronoid cartilage
symphyseal cartilage

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47
Q

what two areas of secondary cartilage disappear before/ around time of birth

A

coronoid and symphyseal

48
Q

what secondary cartilage in the mandible continues growth until age 20

A

condylar

49
Q

how does the vault of the skull form

A

intramembranous ossification

50
Q

how does the base of the skull form

A

endochondral ossification

51
Q

by which means do the mandible and maxilla form

A

intramembranously

52
Q

what is a primary abnormality

A

defect in the structure of an organ traced back to anomaly in development

53
Q

what is secondary abnormality

A

interruption of normal development of organ that can be traced back to influences such as infection, trauma ect

54
Q

what is agenesia

A

absence of organ due to failed development during embryonic period

55
Q

what is a syndrome

A

group of anomalies that can be traced back to common origin

56
Q

name two syndromes that can be atributed to maxillary hypoplasia

A

Apert’s syndrome
Achondroplasia

57
Q

name two syndromes that can be atributed to mandibular problems

A

Treacher Collins syndrome
Turner’s syndrome

58
Q

name three aetiologies of cleft lip/ palate

A

monozygotic twins
familial pattern
smoking

59
Q

at birth, cartilaginous growth centres remain between which bones

A

sphenoidal and occipital
nasal septum

60
Q

what are the three sites of facial growth

A

sutures
synchondroses
surface deposition

61
Q

how does growth at sutures occur

A

growing structures separating the bone
new bone forms in sutures when the bones are pushed apart

62
Q

how does growth occur at synchondroses

A

new cartilage forms in the centre of synchondroses and the cartilage at the periphery is turned into bone

63
Q

how does growth occur at surface deposition

A

new bone is deposited beneath the periosteum over surface of cranial and facial bones
so they maintain their shape - resorption also occurs

64
Q

what is the term for a change in position of bone due to remodelling

A

cortical drift

65
Q

how does growth occur in the cranial vault

A

bone growth at sutures
surface deposition

66
Q

what causes bone growth in the forehead after neural growth ceases

A

accommodation of air sinuses

67
Q

how does growth occur in the cranial base

A

endochondral ossification
surface remodelling

68
Q

how is the maxilla displaced in relation to anterior cranial base

A

forwards and downwards

69
Q

at what age does growth at the maxilla and mandible slow

A

maxilla - 7 years
mandible - 17

70
Q

in what planes does growth slow in both jaws - from first to last

A

width
length
height

71
Q

how can growth be used to facilitate orthodontic treatment outcome

A

use of functional appliances
use of rapid maxillary expansion
use of protraction headgear
overbite reduction

72
Q

what is a growth rotation due to

A

imbalance in growth of anterior and posterior face height

73
Q

what does a backwards growth rotation lead to

A

long face (anterior open bite)

74
Q

what does a forwards growth rotation lead to

A

short face (deep bite)

75
Q

name four errors in cephalometry

A

magnification/ distortion
non-linear fields
quality of image
landmark definition and location

76
Q

what do movements of teeth in the eruptive phase occur in response to

A

positional changes of neighbouring crowns
growth of mandible and maxilla
resorption of deciduous tooth roots

77
Q

what is the first stage in the intra-osseous tooth eruption

A

root formation by proliferation of epithelial sheath and continues with production of dentine and pulp

78
Q

what is the second stage in the intra-osseous tooth eruption

A

movements of the developing tooth - in occlusal direction

79
Q

what is the third stage of intra-osseous tooth eruption

A

reduced enamel epithelium fuses with oral epithelium

80
Q

what is the eruption pathway comprised of

A

area resulting from blood vessels decreasing in number and nerve fibres breaking into pieces

81
Q

what is the first phase in the extra-osseous eruption of teeth

A

penetration of tooths crown tip through epithelial layers

82
Q

what is the second phase in the extra-osseous tooth eruption

A

crown moves through mucosa in occlusal direction until contacting opposing tooth

83
Q

what is the last phase in the extra-osseous eruption of teeth

A

muscle forces (tongue, cheeks, lips) help to determine final tooth position

84
Q

what do teeth move in response to in the post-eruptive phase

A

increases in height of growing alveolar bone and jaws
attrition and abrasion

85
Q

name three roles of the dental follicle

A

initiates resorption of bone overlying the teeth
facilitates connective tissue degradation to produce eruption pathway
provides traction forces in the PDL

86
Q

in what position do the permanent incisors develop compared to their deciduous counterparts

A

palatal/ lingual

87
Q

how is space created in the jaws anteriorly

A

intercanine space gained through lateral growth of jaws
upper incisors erupt into wider arc and more proclined

88
Q

what is leeway space in the upper arch

A

the C D and E width is 1.5mm more than 3 4 and 5 width

89
Q

what is leeway space in the lower arch

A

the C D and E width is 2.5mm more than the 3 4 and 5

90
Q

what are 5 management options of an impaction of FPM

A

wait - 90% self correct
orthodontic separator
attempt to distalise the first molar
extract E and space maintain
distal disking of E

91
Q

name three reasons central incisors may fail to erupt

A

supernumeraries
trauma to primary tooth
congenital absence (rare)

92
Q

what are the four management options of an unerupted permanent incisor when there is a supernumerary tooth present

A

XLA supernumerary teeth and primary incisor
Space maintain
monitor for 12 months
if the above fails - expose and apply orthodontic traction with gold chain

93
Q

how is early loss of a C managed

A

balance

94
Q

how is early loss of an E managed

A

space maintainer as major space loss
more space loss in upper than lower

95
Q

what are the components for a URA as a space maintainer

A

Adams clasps
labial bow
extend acrylic around teeth to prevent unwanted mesial drift

96
Q

what is the guidelines for treatment of FPM of poor prognosis

A

do not routinely remove upper FPM if removing lower (and vice versa)
refer for orthodontic and paediatric assessment combined
look for position of 7 as well as the bifurcation (mesially tilted is favourable)

97
Q

what would be the components for a URA to correct posterior unilateral crossbite

A

adams clasps (no retentive component across midline)
Active component - Hyrax screw
posterior bite plane to disclude teeth

98
Q

what would be the components for a URA to correct an anterior crossbite

A

A - Z-spring
R - adams clasp and the anterior tooth you are not moving
A - only moving one tooth
B - PMMA

99
Q

name four digit habit breakers

A

positive reinforcement
bitter tasting nail varnish
glove on hand
habit breaker appliance

100
Q

name 2 ways a habit breaker appliance for digit habits could be constructed

A

one piece baseplate with single goal post
expansion screw and 2 goal posts if wanting to include maxillary expansion treatment

101
Q

what should you check clinically when a patient appears with an anterior cross bite

A

is patient displacing mandible anteriorly (wear on lingual of lowers and labial of uppers)
mobility of lower incisor
tooth wear
gingival recession

102
Q

how would you manage a tooth that has ankylosed and infra-occluded below the level of contact points of adjacent teeth and there is a permanent successor

A

extract and space maintain

103
Q

how would you manage a patient with an infra-occluded tooth where there is no permanent successor

A

refer as URGENT as now a hypodontia patient
keep infra-occluded tooth to do a crown on
take tooth out to space close or maintain space for prosthesis

104
Q

how should you clinically assess when canines are going to erupt

A

palpate at 9 and 11 years
mobile Cs
angulation of lateral incisors

105
Q

name three risks of doing nothing with an ectopic maxillary canine

A

permanent canine fails to erupt
root resorption of adjacent teeth
cyst formation around canine

106
Q

what are the three risks of doing nothing with an infra-occluded primary when the permanent successor is present

A

permanent successor becomes ectopic
primary tooth becomes inaccessible for XLA
caries and periodontal disease

107
Q

give three treatment options for Class III malocclusions

A

RME to enhance maxillary growth
functional appliance - reverse twin block
camouflage with URA

108
Q

what are treatment options for class II malocclusions

A

functional appliances - twin block
headgear

109
Q

what are the components of a twin block that means it will treat class II malocclusion

A

expansion of upper palate - gives space for teeth to be moved back into position
upper and lower pieces of twin block meet so mandible is placed more forward
further eruption of rear teeth to complete treatment

110
Q

removal of which premolar will give more space

A

although 5s are larger than 4s there is usually mesial drift of 6s so removing 4s is better

111
Q

what two molar relationships are considered acceptable

A

class I
full unit class II

112
Q

what is mild crowding

A

0-4mm

113
Q

what is moderate crowding

A

5-8mm

114
Q

what is severe crowding

A

more than 8mm

115
Q

how can space be created in spacing cases

A

derotating teeth
uprighting teeth
molar distalisation (head gear)
expansion
incisor proclination
extraction

116
Q
A

FINALS (25 decks)

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