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4th Year Revision > Orthodontics > Flashcards

Orthodontics Flashcards

1
Q

What are the skeletal classifications? (3)

A
  • class I maxilla lies 2-4mm in front of mandible
  • class II maxilla lies >4mm in front of mandible
  • class III mandible lies <2mm behind the maxilla
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2
Q

What is the vertical assessment of the patient? (2)

A
  • frankfort mandibular plane angle

- lower facial height

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3
Q

What points does the frankfort plane intersect? (2)

A
  • inferior margin of orbit

- superior margin of external acoustic meatus

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4
Q

What is class II div I incisors?

A

Upper central incisors are proclined. Lower incisor edges lie posteriorly to cingulum plateau of upper incisors

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5
Q

What are the types of overbite? (3)

A
  • complete
  • incomplete
  • traumatic
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6
Q

What is the nasion?

A

The most anterior point of the fronto nasal suture in the median plane

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7
Q

What is the pogonion?

A

The most anterior point of the bony chin

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8
Q

What is the menton?

A

The most anterior inferior midline point on the mandibular symphysis

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9
Q

What is the gonion?

A

The constructed point of intersection of the ramus plane and the mandibular plane

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10
Q

What is the E plane angle?

A

Ricketts aesthetic plane

In a balanced force the lower lip is +2mm and the upper lip is -2mm

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11
Q

What materials do we use for fixed appliances? (5)

A
  • brackets
  • wires
  • elastomers
  • coil springs
  • mini implants/screws
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12
Q

What materials do we use for removable appliances? (3)

A
  • wires
  • acrylic
  • thermoplastic
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13
Q

What are the ideal material properties of orthodontic brackets? (5)

A
  • strong
  • bio compatible
  • bondable
  • aesthetic
  • low friction
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14
Q

What are the types of ceramic brackets? (2)

A
  • mono crystalline

- poly crystalline

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15
Q

What are the stages of fixed appliances? (2)

A
  • aligning and levelling

- space closure/major tooth movements

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16
Q

What are the different shapes of orthodontic arch wires? (3)

A
  • round
  • rectangular
  • square
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17
Q

What are the characteristics of nickel titanium wires? (2)

A
  • shape memory

- super elasticity

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18
Q

What is resilience?

A

The amount of energy absorbed by a structure when it is stressed to its proportional limits

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19
Q

What is formability?

A

The amount of permanent deformation that a wire can withstand before failing

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20
Q

What are the ideal properties of aligning arch wires? (4)

A
  • formable
  • cheap
  • low friction
  • flexible
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21
Q

What is another name for heat treating?

A

Annealing

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22
Q

How do you heat treat SS? (2)

A
  • removes stress

- increases elastic limit/resilience

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23
Q

What are the types of coil springs? (2)

A
  • open

- closed

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24
Q

What materials are elastomeric made out of?

A

Polyurethane

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25
Q

What are the properties of polyurethane? (4)

A
  • elongates on stretching
  • contracts
  • full recovery to original shape
  • quick force degradation
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26
Q

What are the uses of thermoplastics? (2)

A
  • retainers

- aligners

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27
Q

What are miniscrews?

A

Temporary anchorage devices that provide temporary mechanical retention

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28
Q

What are miniscrews made out of?

A

Titanium alloy

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29
Q

What are the comments types of fixed appliances?

A

Variations on the pre adjusted edgewise system

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30
Q

What are the indications for fixed appliances? (5)

A
  • rotations
  • multiple tooth movements
  • bodily movement
  • space closure
  • lower arch treatment
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31
Q

What are the contraindications for fixed appliances? (4)

A
  • poor oral hygiene
  • active caries
  • poor motivation
  • mild malocclusions
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32
Q

What are the risks of fixed appliances? (6)

A
  • decalcification
  • root resorption
  • loss of periodontal support
  • TMJ dysfunction
  • failed treatment and relapse
  • pain, ulceration etc
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33
Q

What are the types of attachment to the tooth? (2)

A
  • bands

- bonds

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34
Q

What teeth would you usually use bands on?

A

Molars or premolars or teeth with ceramic crowns

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35
Q

What are bonds?

A

Perforated or mesh bases held on to the teeth by acid etch composite

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36
Q

What are the types of brackets? (3)

A
  • modules and wire ties
  • self ligating
  • ceramic brackets
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37
Q

What are the phases to active treatment? (3)

A
  • alignment and levelling
  • major tooth movement
  • finishing
38
Q

What types of wire would you use in the alignment phase?

A

Light flexible

39
Q

What is the alignment phase? (4)

A
  • usually arch wires changed each visit
  • wires of increasing stiffness
  • deformation energy dissipates as wires straighten and pull teeth into alignment
  • each new wire is deformed less but has a higher deformation energy
40
Q

What occurs in the major tooth movement stage? (2)

A
  • usually left unchanged each visit

- sliding mechanics is when teeth are pushed or pulled along the arch wire by power chain, coil springs or elastic bands

41
Q

What occurs in the finishing stage? (3)

A
  • detailing of alignment and interdigitation
  • fine adjustments to bracket position
  • some bends to arch wire
42
Q

What is intra membranous bone formation?

A

When mesenchymal cells differentiate into osteoblasts which calcify into bone

43
Q

What is the location of intra membranous bone formation? (2)

A
  • maxilla

- mandible

44
Q

What is endo chondrial bone formation?

A

When cartilage cells hypertrophy into a calcified matrix and osteogenic invasion creates bone

45
Q

What is the best age for treatment using a growth modifying appliance in females and males? (2)

A
  • 12-14 for males

- 11-14 for females

46
Q

What is the treatment for a class III occlusion maxillary deficiency?

A

Face mask

47
Q

What is the definition for a functional appliance?

A

An appliance that utilises or redirects the forces of masticatory and/or circum oral muscles to produce or permit tooth movement and may modify facial growth

48
Q

How do non functional appliances work? (3)

A
  • stretch the muscles of mastication
  • posture mandible
  • differential tooth eruption
49
Q

What are the skeletal effects of functional appliances? (4)

A
  • causes forward displacement of the mandible
  • places a backward force on the maxillary arch
  • accelerates condylar growth
  • redirects condylar growth
50
Q

What functional appliance can you use if the patient is not very compliant?

A

Herbst appliance

51
Q

When should you prescribe a functional appliance? (4)

A
  • mild to moderate increase in overjet
  • increase in overbite
  • active facial growth
  • willingness to comply
52
Q

What are the indications for functional appliances? (6)

A
  • motivated patient
  • pre adolescent growth phase
  • skeletal discrepancy mild or moderate
  • increased overjet/overbite
  • procaines maxillary incisors
  • well aligned arches
53
Q

What are the contraindications for functional appliances? (5)

A
  • poor motivation
  • age>14
  • poor dental health
  • condylar disease
  • proclaimed lower incisors
54
Q

What are the advantages of functional appliances?(5)

A
  • removable and easy to clean
  • may avoid extractions
  • accelerates skeletal growth
  • early treatment
  • less damage to tooth tissue
55
Q

Why do functional appliances have less damage to tooth tissue? (3)

A
  • less root resorption
  • less chance of decalcification
  • less effect on bone levels
56
Q

What are the disadvantages of functional appliances? (3)

A
  • compliance
  • lack of detailed tooth movement
  • candidosis
57
Q

What are the types of functional appliances? (5)

A
  • anderson
  • twin block
  • frankel
  • bass
  • herbst
58
Q

What are the examples of removable appliances? (4)

A
  • an active plate
  • functional appliance
  • space maintainer
  • retainer
59
Q

What are the drawbacks of removable appliances? (5)

A
  • can tip teeth only
  • can only move a few teeth at a time
  • can be taken out by the patient
  • adverse effects on speech
  • poorly tolerated in lower arch
60
Q

What are the advantages of removable appliances? (4)

A
  • relatively simple to use
  • difficult to over activate
  • good anchorage
  • less chair side time and low cost
61
Q

What are the components of removable appliances? (4)

A
  • active components
  • retentive components
  • anchorage
  • baseplate
62
Q

What is the value of forces required to move teeth?

A

No more than 24-40grams per teeth

63
Q

What kind of clasps can you get? (3)

A
  • adams or delta clasps
  • southend clasps
  • ball hooks
64
Q

What is the definition for anchorage? (2)

A
  • the area from which the force is applied to move the teeth

- for every action there is an equal and opposite reaction

65
Q

How do you increase anchorage? (5)

A
  • clasp more teeth
  • move only one or two teeth at a time
  • use lighter forces
  • occlusal capping
  • add headgear
66
Q

What is the role of the baseplate? (4)

A
  • connects all components
  • vehicle for transmission of force from anchorage to active components
  • supports anchorage through palatal coverage
  • can incorporate bite planes
67
Q

What are the uses of anterior bite planes? (2)

A
  • reduce deep overbites

- rarely used to free occlusal interferences

68
Q

How do anterior bite planes work? (2)

A
  • work by allowing posterior teeth to erupt

- temporary increase in face height accommodated by facial growth

69
Q

What are the additional claimed effects on an anterior inclined bite plane? (2)

A
  • proclamation of lower incisors

- functional effect

70
Q

What are posterior bite planes used for?

A

To free occlusal interferences

71
Q

What are the advantages of removable appliances? (3)

A
  • removed for cleaning
  • excessive forces cannot be applied
  • little clinical time needed
72
Q

What are the disadvantages of removable appliances? (4)

A
  • limited to tipping movements only
  • limited rotational movement on incisors only
  • problems with retention
  • not well tolerated in lower arch
73
Q

What are the indications for removable appliances? (4)

A
  • minor tooth movements in mixed dentition as first phase of 2 phase treatment
  • to prevent damage to dentition and periodontium whilst permanent dentition established
  • to establish normal function
  • to reduce deep overbites in growing patients
74
Q

What are the active components? (2)

A
  • springs

- screws

75
Q

What are the advantages of springs? (2)

A
  • cheap

- less pt compliance

76
Q

What are the disadvantages of screws? (2)

A
  • expensive

- bulky

77
Q

What are the advantages of screws? (4)

A
  • effective speech more
  • ease of insertion
  • minimal operator skill
  • retention on teeth being moved
78
Q

What are the alternative sources of space? (4)

A
  • extractions
  • increased arch length
  • increased arch width
  • inter proximal reduction
79
Q

What factors should you consider for borderline extractions? (4)

A
  • profile
  • skeletal pattern
  • class II div 2
  • MH
80
Q

When should you extract upper central incisors? (3)

A
  • trauma
  • dilaceration
  • ectopic
81
Q

When should you extract 2 lower incisors? (2)

A
  • severe lower incisor crowding

- severe displacement of incisors

82
Q

When would you extract one lower incisor? (4)

A
  • class 3 malocclusion
  • lower incisor crowding
  • severe rotation
  • severe displacement
83
Q

Why are premolars the favourite choice for orthodontic extraction? (4)

A
  • no aesthetic impact on smile
  • space near to crowding
  • straightforward extraction
  • molars provide good anchorage for appliances
84
Q

When would you extract second permanent molars? (3)

A
  • only provides a very little space to relieve crowding
  • can help with moving upper posterior teeth distally
  • may dis impact 3rd molar
85
Q

What non orthodontic factors would you consider for tooth extractions? (5)

A
  • tooth quality
  • pathology
  • congenitally absent teeth
  • abnormal tooth shape
  • difficult extractions
86
Q

What factors should you consider when choosing the retention regimen? (5)

A
  • likely stability of result
  • initial malocclusion
  • oral hygiene
  • compliance of patient
  • pt preference
87
Q

What are the types of retainers? (3)

A
  • essex retainer
  • hawley retainer
  • bonded retainer
88
Q

What is the overjet normally?

A

2-4mm

89
Q

What features of the lip do we assess? (4)

A
  • lip competence
  • lip fullness
  • nasolabial angle
  • method of achieving an anterior seal
90
Q

What is the nasolabial angle?

A

Formed between the base of nose and the upper lip and should be 90-110*

91
Q

What factors indicate that a low fraenal attachment is causing a midline diastema? (3)

A
  • when the frenum is placed under tension there is blanching of the incisive papilla
  • radiographically a notch can be seen at the crest of the interdental bone between upper central incisors
  • anterior teeth may be crowded

4th Year Revision (12 decks)

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