ORTHODONTICS Flashcards
What is orthodontics?
- Growth and development of the teeth, face and jaws.
- Diagnosis, prevention and correction of dental and facial irregularities.
What Andrew’s 6 keys.
- Correct incisor relationship (class I)
- Correct angulation- The root is angulated distally to the crown.
- Correct inclination
- Upper incisors crown is labial to root.
- All other teeth- the occlusal part is lingual to the gingival part.
- Tight approximal contact with no rotations
- Correct molar relationship (class I)
- Flat occlusal plane.
What are the risks of orthodontic treatment?
- Decalcification- the begining of caries around the bracket.
- Relaspe (patient needs to wear their retainer)
- Pain/ discomfort
- Root resorption
- Soft tissue trauma
- Loss of tooth vitality
- Candida infections
- failure to complete treatment.
What is the frankfort plane?
A line from the earhole (porion) to the orbital rim of the eye socket (orbitale)
Classify and discuss this jaw relationship
Class I-
The mandible is 2-3mm behind the maxillary basal bone.
This is the normal relationship.
There can be bimaxillary protrusion/ retrusion when both jaws are set forward or back
Classify and discuss this jaw relationship.
This is the class II.
This is when the maxilla is positioned >3mm infront of the mandible.
This can be caused by:
Mandibular hypoplasia (smaller mandible)
Maxilla being too large
Mandibular Retrognathia (a normal sized mandible which is positioned too far back)
Classify and discuss this jaw relationship
Class III.
This is when the mandible is positioned further forward than the maxilla.
This can be caused by:
Maxillary hypoplasia- maxilla is too small.
Mandibular prognathism- mandible is too far forward
Mandible is too big.
How does a class II affect the way the patient bites?
The patient has an overjet.
How does a class III affect the way a patient bites ?
Reverse overjet.
What class is commonly found in a cleft lip and palate patient and why
Class III due to scar tissue preventing maxilla growth.
What is this abnormality?
Crowding
What is this abnormality?
Spacing
What is this abnormality?
Increased overjet
What is this abnormality?
Reverse overjet
What is this abnormality?
Hypodontia
What is this abnormality?
Anterior open bite.
The teeth do not overlap at all.
What is this abnormality?
Deep bite.
The upper teeth overlap alot.
**also known as an overbite**
what is this abnormality?
Ectopic teeth (teeth are in the wrong place)
What is this abnormality?
Anterior crossbite
What is this abnormality?
Posterior crossbite.
Classifiy this incisor relationship.
Class I.
The lower incisor edge contacts at or below the cingulum of the upper central incisor.
Classifiy this incisor relationship.
Class II division 1
The lower incisors lie posterior to the cingulum of the upper incisors.
The upper centrals are proclined (or increased overjet)
Classifiy this incisor relationship.
Class II division 2.
The lower incisors contact posterior to the cingulum.
Theupper central incisors are retroclined.
(minimal overjet)
Classifiy this incisor relationship.
Class III
Lower incisal edges lie anterior to the cingulum of the upper incisors.
Upper incisors proclined. Lower incisors retroclined.
Name and compare the 4 types of occlusion?
Ideal occlusion (all 6 of andrew’s keys have been achieved)
Normal occlusion- most common
minor deviations -no aesthetic or functional problem.
Malocclusion- Significant deviations from the ideal that can be considered unsatisfactory aesthetically or functionally.
What do we use to vertically assess the patient?
The frankfort plane and the mandibular plane angle
What occlusal relationship are we expecting if the Frankfort line and FMPA meet before the back of the head?
The planes meet before the External occipital protuberance causing an Open bite
What occlusal relationship are we expecting if the Frankfort line and FMPA meet after the back of the head?
A deep overbite
Due to the tendency of parallel jaws resulting in the planes not meeting.
What is the mid sagital reference line?
The line from between the eyes down to the cupid’s bow of the lips.
Describe this lip relationship.
Competent lips- the lips meet at rest. The mentalis muscle is relaxed.
Describe this lip relationship.
Incompetent lips- the lips don’t meet at rest.
Describe this lip relationship
This is a lip trap.
The central incisor gets trapped infront of the lower lip.
Describe this lip relationship
Tight lower lip- The hyperactive lower lip can cause retroclination of the lower incisors.
Compare the two types of tongue thrust?
Adaptive- will stop when you treat the AOB
Endogeneous- this will just relapse again.
Compare the problem caused by thumb sucking to digit sucking?
Thumb sucking causes assymetrical problems.
Digit sucking causes symmetrical problems
What are the occlusal features of a thumb sucking habit?
- proclination of upper anteriors
- retroclination of lower anteriors.
- AOB or incomplete open bite.
- Narrow upper arch.
How do we measure an overjet?
measure the biggest gap you can get with the 4 incisors when the patient is occluding.
Describe this bite
An increased and complete overbite contacting the tooth. .
The upper incisors overlaps 1/3 to 1/2 of the lower incisor.
Describe this bite
Increased and Complete overbite contacting the palate.
Describe this bite
Incomplete overbite.
Describe this bite
Average bite.
Describe this bite
Anterior open bite.
Describe this bite
reduced open bite.
What are the parts of an orthdontic examination?
- History
- Extra-oral examination:
- Anterior posterior skeletal assessment
- Vertical assessment
- Lateral assessment
- Soft tissues
- Intra-oral examination
- Teeth
- Oral hygine and periodontal risk
- Lower arch
- Upper arch
- Occlusion.
What is lateral cephalometry?
Standardised lateral radiographs of the face head and skull
How is a lateral cephalometry reproducable?
Because the patient is positioned in a cephalostat. This is a set distance away from the cone and film.
What is the SNA?
This relates the maxilla to the SN line.
What is SNB?
This relates the mandible to the SN line.
What is ANB?
The differnce between the SNB and SNA.
Give the SNA, SNB and ANB of a class I
SNA- 81
SNB-78
ANB-3
Give the SNA, SNB and ANB of a class II
SNA- average
SNB- decreased.
ANB >5
Give the SNA, SNB and ANB of a class iii
SNA- decreased if maxilla is deificent.
SNB- normally average
ANB <1
What is the FMPA
Frankford mandibular plane angle.
The angle between the frankford and the mandibular plane.
What is the TAFH and what is this measuring.
this is the upper anterior face height, This measures from the nasion to the anterior nasal spine.
What is the LAFH and what does it measure?
The lower anterior facial height. This measures from the anterior nasal spine to the menton ?
What are the average FMPA and LAFH: TAFH.
FMPA- 27* +/- 4*
LAFH: TAFH= 55%
What values of FMPA AND LAFH:TAFH constitute long face syndrome.
FMPA >31*
LAFH:LAFH= >55%
What values of FMPA and LAFH:TFAH cause a short facial type.
FMPA <23 *
LAFH:TFAH <55%
Discuss the impact of an arch width discrepancy?
This causes the upper and lower cusps to be occluding. As a result the mandible deviate to occlude in ICP causing mandibular displacement of the jaw. (resulting in crossbite)
What is transverse dento-alveolar compensation ?
When the tongue and cheeks mould the alveolar pocess to maintain the occlusal relationship affected by the arch discrepancy/
What causes crowding?
small jaws with normally sized teeth.
macrodontia. (large teeth)
What causes spacing?
Large jaws with normally sized teeth
Microdontia.
Discuss this clinical image?
This is a conical/ peg shaped tooth.
It is known as a mesodens when close to the midline.
Effect- this displaces the adjacent teeth.
What is the SN line?
The anterior cranial base.
Discuss this clinical image.
This is a tuberculate supernumerary
which is an extra tooth which does not erupt.
Effect- this commonly blocks the permanent tooth eruption e.g. incisor.