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BDS5 OSCE Revision > Orthodontics > Flashcards

Orthodontics Flashcards

1
Q

when should a brief orthodontic assessment first take place

A

9 years old

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2
Q

when should a more comprehensive orthodontic assessment take place

A

11-12 years old once premolars and canines erupt

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3
Q

what are Andrew’s six keys of normal occlusion

A

Molar relationship - distobuccal cusp of upper 6 occludes with mesiobuccal cusp of lower 7
Crown angulation - gingival part of crown more distal than incisal part
Crown inclination
Teeth free from rotations
No spaces present (tight occlusion)
Flat occlusal plane

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4
Q

what should be examined as part of an orthodontic E/O exam

A

skeletal pattern (AP relationship)
vertical jaw relationship (LAFH and UAFH)
FMPA
Asymmetry
lips competency
habits
TMJ

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5
Q

what should be assessed as part of an orthodontic I/O exam

A

teeth present
incisor and molar relationship
overjet
anterior crossbites
overbites
centreline
labial segment
buccal segment

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6
Q

what is a normal overjet

A

2-4mm

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7
Q

what is a normal overbite

A

upper incisors overlap lowers by 1/2 to 2/3

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8
Q

what is a reduced overbite

A

upper incisors do not overlap lowers by at least 1/3

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9
Q

what is an increased overbite

A

upper incisors overlap lowers by more than 1/2

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10
Q

what is an AOB

A

incisors do not overlap at all

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11
Q

what are the incisor relationship classifications

A

Class I - lower incisors edge occlude or lie immediately below cingulum plateau of uppers
Class II div 1 - lower incisor edge lies posterior to cingulum plateau of uppers and upper incisors are proclined = increased overjet
Class II div 2 - lower incisor edge lies posterior to cingulum plateau of uppers, upper incisors are retroclined
Class III - lower incisors edge lies anterior to cingulum plateau of uppers

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12
Q

what are the buccal segment relationships

A

class I - mesiobuccal cusp of upper 6 sits in the anterior buccal groove of lower 6
1/2 unit class II - edge to edge
full unit class II -distobuccal cusp of upper 6 sits in anterior buccal groove of lower 6
Class III - mesiobuccal cusp of upper 6 contacts distobuccal cusp of lower 6

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13
Q

what are the standard class I cephalometrics (SNA/ SNB and ANB)

A

SNA - 81 degrees (+/- 3)
SNB - 78 degrees (+/- 3)
ANB - 3 degrees (+/- 2)

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14
Q

what is the aesthetic component of IOTN

A

grades 1- 4 = no tx required
grades 5-7 = moderate/ borderline need for tx
grades 8-10 = ortho tx required

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15
Q

what is the acronym used for the dental health component of IOTN

A

MOCDO

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16
Q

what does MOCDO stand for

A

missing teeth
overjet
crossbites
displacement of contact points
overbite and openbite

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17
Q

what are errors associated with cephalometry

A

magnification or distortion of image
non-linear fields
quality of image
operator error

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18
Q

what are the 4 main types of local causes of malocclusion

A

variation in tooth number
variation in tooth size/ form
abnormalities of tooth position
local abnormalities of soft tissue

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19
Q

what are aspects of variation of tooth number

A

supernumeraries (odontome, supplemental, tuberculate, conical)
hypodontia
retained primary teeth (absent successor, ectopic successor, infra-occluded primary molar)
early loss of primary teeth (decay, trauma, resorption by successor)
unscheduled loss of primary teeth

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20
Q

what are five features of a digit sucking habit

A

proclined upper incisors
retroclined lower incisors
narrow maxilla
AOB
unilateral posterior crossbite

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21
Q

what is interceptive orthodontics

A

any procedure that reduces or eliminates severity of a developing malocclusion

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22
Q

how should impacted first permanent molars be treated

A

if patient less than 7 wait 6 months for self correction
orthodontic separator for 1 week
distal discing of E
XLA E

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23
Q

how should early loss of deciduous teeth be treated

A

space maintainers - removable/ fixed
- passive URA with adams clasps on 6s and baseplate covers area to prevent unwanted shift
- band and loop space maintainer

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24
Q

how is a unilateral posterior crossbite corrected

A

URA
A - hyrax screw or coffin spring
R - adams clasp only (no southend)
A - achieved
B - PMMA with posterior bite plane to disclude teeth
If posterior unilateral crossbite due to habit can add goal posts to URA

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25
how can anterior crossbites be corrected
URA A - Z-spring R - adams clasps A - achieved B - PMMA with posterior bite plane having a deeper overbite anteriorly favours no relapse
26
how should infraoccluded primary teeth be treated
if permanent successor present - monitor for 6 months - XLA if occluded below contact point - maintain space if permanent successor absent - retain if primary tooth in good condition and consider onlay - XLA if below contact point - space manage - band and loop retainer - close space with fixed appliance
27
how much movement is achieved each month with URA
1mm
28
what are advantages of removable ortho
cheaper than fixed shorter chairside time easier to maintain OH non-destructive to tooth surface achieve block movements
29
what are disadvantages of removable ortho
less precise control on tooth movement easily removed by pt rotations very difficult to correct only 1-2 teeth moved at once
30
what is a flat anterior bite plane
used to correct overbite overjet +3mm added to baseplate creates gap between molars which allows for continued eruption
31
what are the steps of fitting a URA
make sure pt details match those on the appliance check appliance meets prescription look for sharp edges check integrity of wire insert in pts mouth and check for blanching of mucosa check posterior retention check anterior retention activate appliance demonstrate insertion and removal book review appt for 4-6 weeks
32
what information should you give a patient after fitting URA
appliance will feel big and bulky excess salivation impinge on speech initial discomfort wear 24/7 including sleep and eating remove after eating to clean do not wear during active sports avoid hard/sticky foods non-compliance lengthens tx time provide emergency contact details
33
what is an ELSAA appliance
expansion and labial segment alignment appliance proclines upper incisors expands posterior dentition reduces overbite
34
what is the function of Z spring
move teeth labially
35
what is the function of T spring
move teeth labially or buccally
36
what is a robert's retractor
move/ tilt incisors palatally
37
what is the FRANKEL appliance
encourages forward posture of mandible in class II patients changes muscular and soft tissue environment of jaws
38
what is the TWIN BLOCK appliance
rapid overjet reduction upper and lower appliances that work in unison lower block occludes in front of upper
39
discuss tx options for class II div 1 malocclusion
accept - if mildly increased or pt not bothered attempt growth modification - twin block, Frankel used during growth periods simple tipping of teeth - with roberts restractor and FABP camouflage - accept skeletal pattern and used fixed appliances orthognathic surgery - combined with ortho tx
40
discuss tx options for class II div 2 malocclusion
accept growth modification - proclination of uppers with modified twin block, ELSAA spring camouflage - accept underlying skeletal aspect and treat with fixed appliances to class I incisors surgery
41
discuss tx options for class II malocclusion
accept simple tipping of teeth growth modification - reverse twin block or chin cup camouflaging - fixed appliaances surgery - with fixed ortho tx
42
what issues can an overjet cause
trauma speech mastication dry mouth
43
what issues can an overbite cause
trauma to palatal gingivae recession
44
what are treatment options for class 2 div 1
accept attempt growth mod during pubertal growth spurt with twin block or headgear URA for mild and favourable overbites camouflage with fixed appliance but accept underlying skeletal discrepancy orthognathic surgery
45
what are treatment options for class 3
accept/ monitor - no displacement intercept with URA - to procline uppers and retrocline lowers growth modification with reverse twin block or RME camouflage with fixed appliance orthognathic surgery
46
what should you tell patients about orthognathic surgery
not done until patient fully grown MDT have to have pre-surgical orthodontics for 12-18 months which can make it look worse at the start post surgical orthodontics for 6 months very lengthy treatment - 36 month all in
47
what are treatment options for class 2 div 2
accept growth modification - twin block with ELSA spring camouflage orthognathic surgery
48
what are the causes of ectopic canines
crowding genetics associated with other dental abnormalities long path of eruption ectopic position of tooth germ
49
what are treatment options for ectopic canines
accept interceptive tx - XLA C in hopes 3 will erupt surgical removal surgical exposure with orthodontic traction gold chain and then fixed appliances autotransplantation
50
what are risks of doing nothing with ectopic canines
resorption of adjacent roots resorption of canine crown ankylosis of unerupted canine eventual loss of C and complex restorative solutions being required for future
51
what are indications for removal of ectopic canines
too high above apical third root of incisors too close to dental midline angle greater than 55 degrees to midsagittal plane
52
what are causes of unerupted 1s
unererupted supernumerary retained primary teeth early loss of primary tooth trauma to primary tooth crowding ectopic position of tooth germ downs syndrome or CLP
53
what are treatment options for unerupted 1s
accept - if patient under 9 tooth may erupt spontaneously surgical exposure and orthodontic traction with gold chain and fixed appliance surgical removal
54
what are features of a digit sucking habit
proclined uppers retroclined lowers narrow maxilla posterior unilateral crossbite AOB
55
how do you prevent digit sucking habit
nail varnish glove over hand at night plasters on fingers fixed habit breaker - palatal archwire with tongue rake removable habit breaker - adams clasps upper 6s, southend clasp, palatal goal posts - could be combined with URA to expand arch
56
what are causes of infraocclusion
trauma infection missing successor
57
what are treatment options for infraoccluded teeth
monitor with photos and study models extract primary and maintain space with URA band and loop retainer retain tooth and build up if no successor
58
what are treatment options for impacted 6s
extract E if not severe disimpact using ortho separator distal discing of E XLA premolars to relieve crowding
59
what are the main risks of orthodontic tx
decalcification (white spots/ decay) root resorption (1mm over 24 months) relapse (retainers must be worn) soft tissue trauma/ ulceration
60
what are the ten steps to fitting a URA
ensure pt details match details for appliance check appliance matches prescription inspect appliance for sharp edges check integrity of wirework inset appliance looking for areas of blanching check posterior retention check anterior retention activate appliance using 65 coil formers demonstrate to patient insertion and removal book review appt for 4-6 weeks
61
what should you tell patients to expect with new URA
will feel big/ bulky mild discomfort impinges on speech excess salivation
62
what 6 instructions should you give to patients after giving them a URA
wear 24/7 - eating and sleeping clean after every meal with soft brush and soapy lukewarm water remove and store in rigid container for contact or active sports avoid hard or sticky foods provide emergency contact number emphasise non-compliance prolongs tx
63
what is the prescription for a URA to retract canines
A - 13 and 23 palatal finger springs R - 16 and 26 adams clasps A - moving only two teeth B - self cure PMMA (if reducing OB too add FABP)
64
what is the prescription for URA to retract buccally placed canines
A - buccal canine retractor on 13 and 23 R - 16 and 26 adams clasps A - only moving 2 teeth B -self cure PMMA
65
what is the prescription for a URA to correct anterior crossbite
A - 12 Z-spring R - 16 and 26 adams clasps A - only moving one tooth B - self cure PMMA with posterior bite plane
66
what is the prescription for a URA to reduce overjet
A - robert's retractor on anterior teeth with ID tubing 0.5mm R - 16 and 26 adams clasps A - moving x teeth B - self cure PMMA FABP (OJ+3mm)
67
68
what is the prescription for URA for expanding upper arch
A - midline palatal scew R - 16 and 26 adams clasps A - reciprocal B - self cure PMMA, posterior bite plane

BDS5 OSCE Revision (16 decks)

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