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bds3 exam revision > orthodontics > Flashcards

orthodontics Flashcards

1
Q

The lateral cephalogram above is of a 12 year-old female.
1. What is the incisor relationship of this patient? (1 mark)

A

class II div 1

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2
Q
  1. Describe TWO methods you could use to clinically assess a patient’s antero-posterior skeletal pattern. (2 Marks)
A

cephalometric analysis - eastman analysis
SNA, SNB

casts of the face
3d laser scanning
3D photogrammetry

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3
Q
  1. Give TWO possible non-skeletal aetiological factors that can contribute to this type of malocclusion? (2 Marks)
A

incisors larger than normal
delayed eruption of the lower incisors = protrusion
crowding or spacing issues

dysfunction in MOM
thumb sucking
tongue trusting
mouth breathing

muscular imbalances from abnormal swallowing or TMJ disorders

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4
Q
  1. What type of orthodontic appliance might be used to harness growth potential for the patient shown in the Lateral Cephalogram above. (1 Mark)
A

twin block U and L RA

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5
Q
  1. Give a very brief account of how it is thought that mandibular growth occurs. (3 Marks)
A

endochondral ossification - where a cartilaginous template gradually ossifies into bone
chondrocytes proliferate, hypertrophy and mineralise

remodelling and appositional growth
growth continues through remodelling and apposition growth
osteoblasts deposit new bone matrix on the outer surface of the mandible
while osteoclasts resorb bone from the inner surface, allowing for expansion and reshaping of the mandibular bone in response to functional forces such as mastication and muscular activity

it is influenced by a variety of factors, including genetic predisposition, hormonal regulation, functional demands such as chewing and swallowing and environmental factors

hormones e.g. growth hormone, insulin like growth factors and sex hormones play crucial roles in regulating skeletal growth and developmental growth

mechanical forces exerted by muscles, teeth and the surrounding soft tissues contribute to modulation of growth patterns

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6
Q
  1. If this patient subsequently has a forward growth rotation, describe a skeletal feature that you could expect to observe? (1 Mark)
A

increase in the vertical dimension of the lower face =
increase in vertical mandible height or downward forward rotation of the mandible relative to the cranial base

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7
Q

A 9-year-old poorly co-operative child attends your surgery with gross caries evident clinically in teeth 16, 36 and 46. The prognosis of these teeth is poor and they require extraction. All other teeth are caries free.

  1. What special investigation would be appropriate for this patient?
    (1 mark)
A

OPT

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8
Q
  1. What information are you ideally looking for to establish the suitability of the timing of these extractions? (2 marks)
A

degree of crowding
malocclusion type
condition of other teeth
capacity to receive treatment (LA or GA)
any signs of hypodontia
cooperation
are 8s present

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9
Q
  1. Detail your management of tooth 26. (1 mark)
A

xla for balancing and compensating

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10
Q
  1. List TWO advantages of extraction of first permanent molars of poor prognosis at this stage of development?
    (2 marks)
A

7s are expected to drift mesially to replace = facilitation of improving occlusion
prevention of further damage
alleviation of pain
prevention of complications
improved long term OH

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11
Q
  1. List TWO disadvantages of extraction of first permanent molars of poor prognosis at this stage of development?
    (2 marks)
A

potentially space loss -> crowding and misalignment
aesthetics
loss of masticatory function
possible xla complication
impact on occlusal relationship
possible phobias if uncooperative

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12
Q
  1. What might this child require to enable these extractions? (2 marks)
A

GA or sedation

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13
Q

An 8-year-old boy in the mixed dentition attends your surgery complaining that he does not like the look of his front teeth (see photograph above). The deciduous tooth upper incisor became black and firm 3 years ago and fell out recently. He has no relevant medical history.

  1. What feature of the patient’s dental history is it important to determine?
    (1 mark)
A

ask history - any trauma

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14
Q
  1. What part of the physical examination is important?

(1 mark)

A

palpate the gum to see if u can feel permanent tooth labially and palatally

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15
Q
  1. What radiographic view would be most suitable for this child?
    (1 mark)
A

OPT

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16
Q
  1. Given the history, give an account of the sequence of events that have most likely caused non-eruption of upper central incisor?
    (2 marks)
A

trauma to deciduous tooth -> interrupted development -> dilaceration of permanent tooth

permanent successor is congenitally missing

is delayed due to premature loss

got obstruction of eruption path = supernumeraries

17
Q
  1. What are the principles of the orthodontic management of non-eruption of upper central incisors?

(4 marks)

A

maintain space

since patient is 9, check if root apex is mature
if tooth present - surgically expose by raising mucoperiosteal flap and bond gold chain to apply orthodontic traction

18
Q

A 17-year-old boy attends your surgery complaining that he does not like the look of his front teeth. He requests advice about orthodontic treatment (see photographs above). He has no relevant medical or dental history.

  1. Describe TWO clinical ways to assess the antero-posterior skeletal relationship (2 marks)
A

facial profile analysis
lip position
chin projection
overjet measurement
ANB angle

19
Q
  1. Describe TWO clinical ways to assess the vertical skeletal relationship
    (2 marks)
A

FMA facial angle measurement
facial height proprtion
overbite, open bite and deep bite - dental occlusion evaluation
palpation of MOM

20
Q
  1. How should the patient’s head be positioned during these clinical assessments?
    (1 mark)
A

natural head posture
upright, relaxed, and comfortable posture with the head in a neutral position, neither tilted nor rotated.

21
Q
  1. Looking at the intra-oral photograph, what is the patient’s incisor relationship?
    (1 mark)
A

class III

22
Q
  1. What is the British Standard Institute’s definition of this relationship?
    (2 marks)
A

“A skeletal relationship in which the mandible is located anterior to its normal position relative to the maxilla, resulting in a concave profile, an anterior crossbite, or a combination of both.”

23
Q
  1. How would you describe the patient’s skeletal relationship in terms of growth or development?
    (2 marks)
A

maxillary hypoplasia
mandibular prognathism

24
Q
  1. Give a definition of local causes of malocclusion?
    (2 marks)
A

A localised problem or abnormality within either arch, usually confined to
one, two or several teeth producing a malocclusion.

25
Q
  1. Local causes of malocclusion may be due to variation in tooth number. Please give FOUR examples of these conditions:
    (4 marks)
A

Supernumerary teeth
Hypodontia
Retained Primary Teeth
Early Loss of Primary Teeth
Unscheduled loss of permanent teeth

26
Q
  1. List FOUR types of supernummary?
A

Conical
Tuberculate
Supplemental
Odontome

27
Q
  1. A 13-year-old girl presents as a new patient for a routine examination. She gives a history of digit sucking. List FOUR occlusal features that can present due to a prolonged digit sucking habit:
    (4 marks)
A

Proclined Upper incisors
Retroclined Lower incisors
Anterior open bite or incomplete open bite
Unilateral Posterior Crossbite
Narrowed Upper arch

28
Q
  1. Describe FOUR methods that could be used to dissuade a digit sucking habit?
    (4 marks)
A

Behaviour management therapy (positive reinforcement)
Plasters, gloves or bitter flavoured agents applied to digits to make habit less
satisfying
URA with a rake
Switch to dummies
Habit reversal: do another activity when urge to suck arises

29
Q
  1. Explain the effect that a prolonged digit sucking habit can have on the posterior dentition:
    (2 marks)
A

POSTERIOR CROSSBITE
The patient’s thumb and digits are positioned in the mouth in such a way that
they result in the mandible to drop open. This causes the patient’s tongue to
be held and occupied in a lower position that what is deemed normal.
The sucking action initiated by the muscular forces in the cheeks narrows the
maxillary arch, causing a posterior crossbite.

30
Q

upper central incisor fails to erupt, trauma to previous primary and
exfoliated, 4 initial management options ( 4 marks)

A

Maintain space/create space
Surgical exposure/bond with orthodontic gold chain
Monitor for 1 and half year
Take a radiograph
Check if contralateral has erupted and when it erupted
Palpate palatally and buccally in case ectopic
Refer to orthodontic/paediatric specialist

31
Q

2 causes of failed eruption

A

Supernumerary - tuberculate
Early loss of primary tooth
Hypodontia

32
Q

4 principle of aim of ortho treatment for this tooth (4 marks)

A

Restore stability, function, aesthetics and facilitate other forms of dentistry eg.
Crowns and bridges etc

bds3 exam revision (13 decks)

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