Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS4 > Orthodontics - Note questions > Flashcards

Orthodontics - Note questions Flashcards

1
Q

During an orthodontic assessment what kind of questions should you ask the patient to gather infomation on them?

Motivation etc

A
  • What they are they concerned about with their mouth and the way they look
  • How motivated are they for tx
  • Do they want tx
  • Enquire about past Ex, truama to any teeth and previous ortho
  • MH
  • Assess growth stage
  • Do they have good OH habits
  • Do they have any habits like thumb sucking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

During an E/O ortho assessment what are you assessing?

A

AP - paplate skeletal base and visual assessment
vertical - FMPA and LAFH ratio
Transverse - asymmetry
Lips - incompetent or competent
Smile line
Habits - thumb sicking etc
Displacement of mandible on closure (important as can suggest more mild class 3 or class 1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why is it important to check the resting position of the mandible and if it displaces on closure?

A

As this can make you think that the patient is a class 3 when they have a skeletal class 1. This is due to the mandible moving more anterior from RCP to ICP making it seem like they have a more severe class 3. This is called a pseudo class 3.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are you looking for on an I/O examination for ortho?

A
  • Record the patients OH
  • BPE for perio health
  • Charting of the teeth and teeth with poor prognosis
  • Incisor inclination
  • Crowding
  • Spacing
  • Missing teeth (presense or absence of canines)
  • Rotations
  • Displaced teeth
  • OB which is complete or incomplete, increased or decreased +/- traumatic
  • OJ
  • Centre lines
  • Cross bites
  • Molar and canine relationship and buccal segments
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the measurements for crowding?

A

Mild <4mm
Moderate 4-8mm
Severe >8mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why is a diagnostic record important?

A
  • Tx planning
  • Show progress and outcome of tx
  • Medical legal
  • Audit and research
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some examples of diagnostic records in ortho?

A

Radiographs
Clinical photos
Study models

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some rreasons for taking radiographs in orthodontics?

A
  • Locating U/E or missing teeth
  • Look at size of roots to assess risk of root resorption
  • Look for supernumery
  • Pathology
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What two radiographs would you take for locating a ectopic canine?

A

OPT and Occlusal
Two PA’s from different positions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the problems list sub divided into?

A

Pathological and developmental problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does MOCDO stand for?

A
  • Missing teeth
  • OJ
  • Crossbite
  • Displacement of teeth
  • OB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When tx planning which arch should you keep the same and why?

A

Try and keep the lower arch the same
This is because it lies in an area od relative stability due to the tongue lips and the cheeks.
This gives you a good starting point

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How can space for the upper arch be achieved? (3)

A
  • Distal movement of the buccal segments
  • Extraction
  • Arch expansion (only for crossbites)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

In what specific case would you expand the upper arch to create space?

A

If the patient had a crossbite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

If you are extracting only upper or lower teeth do you still want to achieve a class I buccal segment relationship?

A

No you do not need a class 1 buccal segment relationship as Extracting upper teeth will leave a class 2 and extracting only lower will leave a class 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is anchorage?

A

The resistance to unwanted tooth movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

To gain valid consent from the patient what must you do?

A
  • Present all the treatment options to the patient
  • Explain the risks and benefits for each
  • Make sure the patient understands
  • Should get written consent and document risks in notes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

The primary dention is usually spread and upright. If a patient does not have much space what should you warn them could happen in the permenant dention?

A

Crowding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why do the 2’s tip distally during the ugly duckling phase?

A

As the 3’s develop they push on the roots of the 2’s causing them to tilt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the Leeway space?

A

Difference in width between C,D,E and 3,4,5
N.B greater in the lower arch than the upper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is an infra-occluded molar and how should you treat them?

A

These are retained primary teeth. Which may be anklyosed and therefore prevent the eruption of the permenant successor or cause it to erupt ectopically
Ex these teeth if there is a successor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How would you deal with an impacted upper first molar?

A

Try dislodging the molar by a peiece of brass wire round the contact point of the E over several visits
If this doesnt work then Ex E and deal with crowding later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are some ways of breaking a digit sucking habit?

A

Habit breaking appliance, removable or fixed
Bad tasting nail polish

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the effects of premature loss of primary teeth?

A
  • Localised crowding
  • Centre line shifts (if it is unilateral loss of C and to degree D)
  • Early extraction of E’s before 6’s are through will cause mesial drfit of 6’s and effect occlusion
  • Prevent Xbite by timely Ex of C’s when 2’s are erupting palatally
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

If you have to Ex one C, should you balance by Ex the other C and why?

A

Yes
To prevent centre line shift

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are balancing Ex?

A

This is when you take out the same tooth on the same arch but on the opposite side
Example 13 and 23

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is a compensating Ex?

A

When you take out the same tooth on the opposing arch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

In ortho why are Ex done?

A
  • To create space
  • Reduce crowding
  • Level and align
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What teeth are preferred for Ex if the arch is moderate to severe crowding?

A

4’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What teeth are preferred to be Ex for mild crowding

A

5’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are some indications for early Ex of 6’s

A
  • Hypoplastic
  • Poor prognosis
  • Large restoration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

If the 16 is needed to be extracted due to poor prognosis, what other teeth in the mouth should you Ex and why?

A

46
- Should compensate the Ex but not balance
- This is to prevent over eruption of the 46

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

When is the best time to Ex 6’s of poor prognosis to allow for 7’s to fill the space?

A
  • around 9 years of age
  • At the bifurcation of the 7’s radiographically
  • Patient should also have pre-molars
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are some causes of congenital spacing?

A
  • Hypodontia
  • Small teeth (microdontia)
  • Large jaws
35
Q

In severe cases of spacing how should these cases be approached?

A

With an orthodontic and restorative combined approach

36
Q

What can midline diastemas be commonly assoociated with?

A

Supernumerys
large muscle attachments (labial frenum)

37
Q

Do midline diastemas have a high tendancy for relapse? is so what can you do to minimise this?

A

Yes
Need prolonged retention
Recommend fixed and removable retainers for life

38
Q

What are 2 tx options for buccally placed canines?

A
  • Ex of 4’s
  • Transposition of 3
39
Q

From what age should you palpate for canines?

A

9

40
Q

What is a key clinical sign that the maxillary canine may be palatally impacted?

A
  • Inclination of the 2’s
41
Q

Interceptive orthodontics is used to treat palatally placed maxillary canines. What are the tx options?

A

1) Early Ex of the C’s to allow spawntaneous eruption (mild)
2) Maintain C’s, Review 3’s to look for root resorption and cystic changes. Then Ex 3 and replace with prothesis
2) Accept position if 2-4 are close then Ex 3
3) Exposure of 3 and ortho alignment
4) Autotransplantation

42
Q

What are some criteria that have to be met in order for you to expose palatally placed maxillary canines and realign?

A
  • Canine has to be in favourable position
  • Has to be enough space in the arch for the canine to move into
  • patient has to be willing to have the surgery and then have 2+ years of FA. Patient needs to be motivated
43
Q

Explain how the exposure and ortho alignment of a palatally placed maxillary canine works?

A
  • The canine is exposed
  • It is given 3 months to spawntaneously erupt
  • If it doesnt spawntaneously erupt, then gold chain can be attached to pull it
  • Then carry out FA work to move the canine into position within the arch
44
Q

For autotransplantation of maxillary canine that has closed apex. What has to be done after it is repostioned?

A
  • Has to be RCT’d <10days
  • Must have space for it
  • Revascularisation can take place if open apex
45
Q

Root resorption can happen to adjacent maxillary laterals as a result of impacted canines. This should be refered to a specialist who will either do what?

A
  • Ex the canine
  • Ex the lateral if there is significant resorption
  • Then FA
46
Q

What is a normal OJ?

A

2-4mm

47
Q

With an increase in OJ there is also an increase in what risk?

A

Trauma risk

This is excenuated by incompetent lips

48
Q

What effects does a digit sucking habit have on the mouth and teeth? 4

A
  • Proclincation of upper incisors
  • Retroclined lower incisors
  • AOB
  • Posterior Xbite
  • Small maxilla

Should always fix a habit before tring to correct OJ as will just cause relapse

49
Q

Management of Increased OJ in a class 1 or mild class 2

A
  • Ex to create space and FA
50
Q

Managment of Increased OJ in moderate to severe class 2 cases?

A

1) growth modification with either headgear (to reduce maxillary growth) or function appliance to promote mandibular growth. Then orthodontic camoflague with Ex’s in upper arch and FA for bodily movements of the teeth
2) Surgical correction in severe cases

51
Q

During what period would growth modifcation obtain the best results?

A

Puberty
Period of greatest growth

52
Q

Which class is an increased OB closely associated with?

A

Class II div 2

Where the 1’s are proclined and the 2’s are retroclined. This relates to the realtionship with the lip

53
Q

In what class can an increased OB be advantageous? and why?

A

Class 3
As it prevents relapse relapse and helps maintain the incisor position

54
Q

What are some reasons that an increased OB can occur?

A
  • Increased LAFH
  • Increased inter-incisal angle
  • Increased lower lip line
  • Retroclined incisors
55
Q

Treatment for an Increased OB?

A
  • URA with FABP to allow the posterior teeth to over erupt
  • Intrusion of incisors
  • Proclination of lower incisors
  • Surgery
56
Q

What are some criteria for the stability of OB reduction?

A
  • Reduce the inter incisal angle
  • Favourable growth
  • Elimination or reducing ateiological factors such as LAFH and high lower lip line
57
Q

What can cause an AOB (skeletal and enviromental)

A

Skeletal - patients with increase LAFH and Increased FMPA
Enviromental - Digit sucking habit and tongue thrusting
CLP

58
Q

How to treat an AOB

A
  • Its very hard to treat so refer to a specialist
  • Stop habit with habit breaker
  • Surgery
  • What to intrude the molars so headgear can be used in restrain extrusion of the maxillary molars. TAD can be used to intrude the molars
59
Q

Reversed OJ is associated with a Class III. What is the aetiology of a reversed OJ?

A
  • Large mandible
  • Small maxilla (overcrowding)
  • Forward position of the glenoid fossa

Xbites are commonly assocaited

60
Q

With a reversed OJ the soft tissues Over compensate to try and achieved a anterior oral seal. What affect does this have on the inclination of the U and L incisors?

A

retroclines lowers
Proclination of the upper (as the lips are forced away from the teeth to achieve seal this gives space to the uppers to procline)

This can mask a more severe underlying skeletal pattern

61
Q

What should you assess for patients with reversed OJ?

A
  • pt opinion on their facial appearance
  • Severity of the skeletal discrepancy
  • The amount of dento-alveolar compensation, as this will tell you how much orthodontic camoflague you can carry out.
  • Amount of anticipated facial growth
  • Check OB need good level to prevent relapse
  • Can pt achieve edge to edge when retrudes. This increases the chances of good prognosis of tx
    N.B
    Rember proclination of U will decrease the OB
    And retroclination of L will increase OB
62
Q

Tx options for reversed OJ

A
  • Accept and align
  • Reversed twin block
  • Camoflague with FA procline the uppers and retrocline lowers
  • Surgery
  • Early orthopeadic referral for enhanced growth of maxilla
63
Q

How can crossbite be described?

A

Should be described relative to the upper arch
- Unilateral or bilateral
- Anterior or posterior
- WIth displacement or without displacement

64
Q

Displacement of a crossbite can be due to?

A

Premature contacts which cause the mandible to slip either anteriorly or laterally to achieve ICP

65
Q

How is an anterior crossbite associated with displacement treated?

A
  • interceptively in mixed dentition (as long as there is enough of an OB to prevent relapse)
  • Can treat with FA in permenant dentition if not enough of an OB
66
Q

Posterior Xbites tx?

A
  • URA for rapid maxillary expansion (with mid palatal screw)
  • Done in younger patients (utilise mid palatal suture)
  • Quad helix looks like a W
67
Q

Describe a quad helix, what is it used for, what size of wire is used?

A
  • Looks like a W
  • Has bands on the 6’s
  • Used to fix posterior Xbites
  • 1mm HSSW
68
Q

What is a TAD

A

Temporary anchorage device
- Screws in maxilla, most commonly non-osteointegrating screws

69
Q

What factors would you consider for site selection of a TAD?

A
  • Bone width and thickness of the cortical plate
  • Bone quality
  • Access position of roots and anatomy in area
  • Good OH of patient
  • Good gingival health
  • Access for placement
  • Good radiographs
  • Tx mechanics including direction and force required
70
Q

Indications for a URA can be passive or active. GIve examples for both?

A

Active
- Expand the upper arch
- Tip and tilt and teeth (decrease OJ)
- Correction of Anterior Xbite
- Decrease OB (flat anterior bite plane allows molars to over erupt and decrease OB)
- Distal movement of the molars facilitate by headgear

Passive
- Habit breaker
- Space maintainer
- Retention

71
Q

FIxed appliances are used to move teeth in all of the 3 D planes. What can FA do to teeth?

A
  • Tip and tilt
  • Rotate
  • Intrude and extruce
  • Bodily movements
72
Q

What is anchorage?

A

The resistance to unwanted tooth movement

73
Q

What are some ways that you can reduce anchorage?

A
  • Good treatment planning, know how much force is required for movement and have enough anchorage. Include the maximum number of teeth in the anchorage unit
  • Class 2 and 3 elastics spread load across both arches
  • Move less teeth, reduces anchorage
  • Transpalatal arch wire
74
Q

What does headgear require to be safe?

A

2 safety mechanisms to prevent damage to the eyes

75
Q

Anchorage reasons for failure?

A
  • Poor planning. Moved to many teeth with not enough anchorage
  • Poor patien compliance(dont ware the elastics)
76
Q

What are functional appliances used for?

A

Growth modification

Ineffective for tooth movement

77
Q

What type of skeletal class is a function best suited for and why?

A

Class 2 (especially class II div 1)
as restricts maxilla
And promotes mandibular growth

Similar effect as class 2 elastics

78
Q

What skeletal and dental changes does a functional cause?

A

Skeletal
- Maxillary restriction
- Mandibular growth
- Forward movement of the glenoid fossa
- Increased LAFH (as mandible moves down and forward as it grows)
Dental
- ULS retrocline
- LLS procline

79
Q

Keys to success of functional appliance?

A
  • Good co-operation. Patient wears all the time including when eating
  • Give during biggest growth spurt
80
Q

What does a twin block comprise of and what does it look like?

A

Comprised of two removable appliances. WIth a slope on each of the buccal blocks to protude the mandible.
They are well tolerated and patient can wear while eating

81
Q

3 Types of functional

A
  • Twin block
  • MOA (medium opening activator)
  • Herbst (cant eat with this in)

A one-piece functional orthodontic appliance used to reduce a deep overbite. The upper and lower sections are joined by two rigid acrylic resin posts and only the lower anterior teeth are covered with acrylic allowing the lower molars freedom to erupt. This is MOA

82
Q

How much of a reduction of the OJ should you expect per month from functional?

A

1mm

83
Q

If there are no changes in OJ after a few months of wearing a fucntional. What could be some possible explainations for this?

A
  • Patient not wearing
  • Poorly designed and made
  • Poor growth in general

BDS4 (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions