orthopedo super review Flashcards
maxillary canine lies between the mandibular canine and 1st premolar
class I / neutrocclusion
other term for class I classification of occlusion
neutrocclusion
mesiobuccal cusp of the maxillary 1st molar falls between the mandibular 1st molar and the 2nd premolar
class II / distocclusion / retrognathism
maxillary canine is mesial to the mandibular canine
class II / distocclusion / retrognathism
other term for class II classification of occlusion
distocclusion/retrognathism
classification of occlusion wherein the maxillary incisor is in extreme labioversion (protruded)
class II division I
classification of occlusion wherein the maxillary incisor is tipped palatally and in retruded position. the maxillary lateral are typically tipped labially or mesially
class II division II
the mesiobuccal cusp of the maxillary 1st molar falls between the mandibular 1st molar and the 2nd molar
class III / mesiocclusion / prognathism
the maxillary canine is distal to the mandibular canine
class III / mesiocclusion / prognathism
the overjet of a class III classification of occlusion is ____ or ____
0mm or negative
other term for class III classification of occlusion
mesiocclusion/ prognathism
situation in which the patient adopts a js position upon closure which is forward to normal
pseudo class III
a pseudoclass III usually exhibits what type of bite
edge-to-edge bite
what is the normal overjet
1-2mm
normal overbite
2-3mm
speech difficulties related to malocclusion wherein there is anterior open bite, large gap between incisors
S, Z
speech difficulties related to malocclusion wherein there are irregular incisors (lingual position of maxillary incisors)
T, D
speech difficulties related to malocclusion wherein skeletal class III is present
F, V
speech difficulties related to malocclusion wherein there is presence of anterior open bite
Th, Sh, Ch
signs of incipient malocclusion
- lack of interdental spacing in th primary dentition
- crowding of permanent incisors the mixed dentition
- premature loss of primary canine (mandibular)
causes tipping, migration, and rotation of adjacent teth into edentulous space
molar uprighting
long term loss of _________ causes molar uprighting
mandibular permanent 1st molar
best treatment for molar uprighting
tipping the crown of 2nd molar distally and opening up space for a pontic to replace 1st molar
bracket slot size for molar uprighting treatment
0.022 inches (0.018inches)
time frame for molar uprighting treatment
6-12 months
used to diagnose tooth-to-tooth, bone-to-bone and tooth-to-bone relationships
cephalometric
used to show the amount and direction of craniofacial growth to analyze treatment results
lateral cephalometric
dentition analysis to predict the size of the unerupted 345 through calculations
MDA (mixed dentition analysis)
dentition analysis for the ratio of total mandibular versus total maxillary tooth size; estimate overbite and overjet
Bolton’s analysis
dentition analysis to determine if crowding is due to inadequate apical bases based on measurement on apical base width at premolar
Howe’s analysis
dentition analysis tests if FL > MD = broader contact areas which will result in more stable and resistant crowding
peck and peck
dentition analysis suggests ideal maxillary 456 arch form based on MD diameter of maxillary 21/12
Pont’s index
dentition analysis classified teeth into small, medium and large
Sanim-Savarra
mesiobuccal cusp of the maxillary 1st molar lines up with the buccal groove of the mandibular 1st molar
class I / neutrocclusion
it is the highest point in the concavity behind the occipital condyle
Bolton (Bo)
the most forward and highest point of the anterior margin of foramen magnum
Basion (Ba)
the point of intersection of the contour of the posterior cranial base and the posterior cranial base and the posterior contour of the condylar process
Articulare (Ar)
outer upper margin of the external auditory canal
Portion (Po)
the midpoint of sella turcica
Sella (S)
lowest point of the inferior margin of the orbit
orbitals
innermost point of contour or premaxilla between the incisor and ANS
point A (subspinale)
innermost on the contour of the mandible between incisor and bony chin
point B (supramentale)
the most anterior point of the contour of the chin
pogonion (Pog)
most inferior part of the manndibular symphysis
mention (Me)
lowest most posterior point on the mandible with the teeth in occlusion
gonion (Go)
plane from porion to orbitale
Frankfurt horizontal plane
best horizontal orientation from which to asses the lateral representation of the skull
Frankfurt horizontal plane
plane from nasion to pogonion
facial plane
plane from gonion and mention
mandibular plane
Angle from the mandibular plane to the sella-nasion line (SN plane)
mandibular plane angle
mandibular plane angle with long vertical dimension and ANTERIOR OPEN BITE
steep mandibular plane angle
mandibular plane angle with short anterior facial vertical dimension and DEEP BITE
flat mandibular plane angle
if the SNA angle is >84 degrees, it indicates
maxillary prognathism
if the SNB angle is
mandibular retrognathism
if the ANB is 2-4 degrees, it indicates
class I skeletal pattern
indications of a removable, functional and fixed appliance
- limited tipping movement
- retention after comprehensive movements
- growth modification during the mixe dentition
major components of removable appliance
- retentive components like Adams clasp, ball clasp, c clasp, and arrow clasp
- framework or baseplate - made up of acrylic and provides anchorage
- active component or tooth moving component - consists of springs, jack screws or elastics
- anchorage component - this resists force of active component
usually used in skeletal class II growing patients to hold growth of maxilla back and to allow mandible to catch up
headgears
how many hours per day should you use a headgear?
10-14 hours/day
treatment length of headgear?
6-18 months
headcap connected to Facebow. DISTAL and INTRUSIVE force on the maxillary molars and maxilla
high pull headgear
neck strap connect to the Facebow. DISTAL and EXTRUSIVE force on maxillary teeth and maxilla
cervical pull headgear
Same as cervical pull headgear. DISTAL direction ONLY
straight pull headgear
skeletal class III malocclusion to protract maxilla
reverse-pull headgear
designed to modify growth during mixed dentition for both dental and skeletal effects
functional appliance
tooth-borne appliance that advances the mandible to an edge-to-edge position to stimulate mandibular growth for class II
bionator
tooth-borne appliance wherein maxillary and mandibular framework are splinted together via pin and tube that holds the mandible forward
herbst
ONLY tissue-borne appliance
frankel functional appliance
it alters both mandibular posture and contour of facial soft tissue
frankel functional appliance
4 basic components of fixed appliance
- bands
- brackets
- archwires
- auxiliaries
it is a horizontally positioned slot
edgewise appliance
double wings for increased rotational and tip control of roots
Siamese twin brackets
vertically positioned slot
Begg appliance
it is a variation of edgewise appliance
straight-wire appliance
bracket thickness should be equal to
thickness of the tooth
angulation of the bracket should be equal to?
long axis of the tooth angulation
the torque in the bracket slot should be equal to
the inclination of facial surface of the teeth
before bonding, tooth should be etched with?
35-50% unbuffered phosphoric acid
______ are used to cement bands because of their fluoride release
GI cements
advantages of bands from brackets
- better resist breakage, especially in areas of heavy mastication
- teeth need both lingual/palatal and buccal attachments
- teeth with short clinical crowns
- teeth with diseases
properties of archwires
- high strength
- low stiffness
- high range
- high formability
alloy composition of archwires
a. stainless and cobalt chromium alloy
b. Ni-Ti
c. beta-Ti
clinically when teeth are on the wrong side of the opposing dentition
it can be skeletal, dental or functional in origin
crossbite
crossbite origin wherein it has a smooth closure to centric occlusion
skeletal
origin of crossbite wherein it demonstrates a deviation in maxillary and mandibular midlines as the patient closes
functional
crossbite may be associated with
a. heredity
b. Max/mand jaw size discrepancies
c. bad oral habits
d. labially situated supernumerary tooth, trauma, or arch length discrepancy
what may result if there is prolonged retention of primary teeth?
anterior crossbite of one or more permanent incisors
anterior crossbite = ???
skeletal or developing class III
posterior crossbite = ???
mandibular shift
tx for anterior crossbite
skeletal - protraction of facemask (if not managed earlier before growth, orthognatic surgery!)
dental - bonded-resin composite slopes and reverses stainless steel crowns
tx for posterior crossbite
palatal expansion 2x a day (0.25mm each turn)
after activation, expander remains in the mouth for 3-6 months = for midpalatal suture region will be formed
opposite arches cannot be brought into occlusion
skeletal or dental in origin
open bite
usually caused by finger habit
maxillary constriction due to pressure on buccinator muscle
anterior open bite
tx for early manifestation of open bite
habit control
orthodontic appliance for open bite
a. tongue crib
b. bluegrass
c. transpalatal bar - to reduce vertical eruption
d. high pull facebows
what is the best space maintainer?
NATURAL TOOTH!
prevents mesial migration of the primary 2nd molar
band and loop
when the primary second molar is lost prior to the eruption of ther permanent 1st molar, this is the space maintainer preferred
distal shoe
this is used after multiple primary teeth are missing and the permanent incisors are erupted
lingual arch
used for bilateral loss of primary maxillary molars
nance appliance
prevents mesial rotation and drift of the permanent maxillary molars
nance appliance
bilateral posterior space maintenance prior to eruption of permanent incisors
partial denture
recommended appliance for thumb/finger sucking
palatal crib
recommended appliance for hyperactive mentalis
lip bumper/ plumber/ Mayne/ Denholtz
recommended appliance for cheek/lip biting
oral screen
recommended appliance for tongue thrusting
tongue crib
recommended appliance for mouth breathing
oral vestibular screen/shield
it determines the future antero-posterior position of the permanent 1st molars
primary molar relationships
normal relationship
cause cusp-to-cusp relation of permanent maxillary and mandibular molars
flush terminal plane
distal step = Angle class ___
Angle class II
mesial step = Angle class ___
Angle class I
primate space in maxillary arch
between lateral and canine
primate space in mandibular arch
between canine and 1st molar
diastema causes:
a. tooth size discrepancy
b. mesiodens
c. abnormal frenal attachment
if diastema is _____ or less the lateral incisors are in good position
2mm
treatment if diastema is caused by abnormal frenal attachment
align the teeth first then frenectomy after canines have erupted
normal change that may result in increase or decrease in size
growth
the change from generalized cells or tissues to more specialized kind
differentiation
means change in position
translocation
means encompasses the normal sequential events between fertilization and death
development
the qualitative change which occurs with aging
maturation
indirect bone formation
endochondral bone formation
endochondral bone formation is due to
hyaline cartilage
direct bone formation
intramembranous bone formation
in intramembranous bone formation, there is constant?
deposition and resorption
means facing the direction of growth
inner side
deposition
means facing away the direction of growth
outer side
resorption
deposition + resorption =
DRIFT
gradual movement of the growing area of the bone
Drift
most of the facial bones are V-shaped
Enlow’s V principle of growth
theory wherein growth is controlled by genetic influence
genetic theory
theory wherein suture growth is the proliferation of the connective tissue between two bones
Sicher’s theory
theory wherein growth depends on the cartilage and periosteum
Scott’s theory
is the major contributor in mandibular growth
condylar growth
is the major contributor in maxillary growth
nasal septum
theory wherein it discussed on functional matrices
Moss’ theory
he supported all of the theories
Van Limborg’s theory
Servosystem theory
Patrovic’s theory
formed directly by intramembranous bone
NO CARTILAGE
cranial vault
primarily cartilage growth; initially cartilage and transformed to bone
cranial base
area of cellular hyperplasia
synchondroses
intraoccipital synchondroses closes _____ years old
3-5 yo
spheno-occipital synchondroses are until ______ years old
20 yo
growth direction of maxilla
DOWNWARD and FORWARD
growth direction of mandible
UPWARD and BACKWARD
major site of growth of mandible
condylar cartilage
at age 6, the greatest increase in size of the mandible occurs _______
distal to the first molar
usual size of the maxillary arch
128 mm
usual size of the mandibular arch
126mm
used in predicting the time of the pubertal growth spurt
can be used to judge physiologic age
hand wrist radiograph
can be used to evaluate whether the growth has stopped or continuing
lateral cephalon ram
most common supernumerary teeth
MESIODENS
conditions associated with supernumerary teeth
a. gardner’s syndrome
b. Down’s syndrome
c. cleidocranial dysplasia
d. Sturge-Weber syndrome
“CD4”
serial extraction
extract _____ before permanent canine erupt
1st PM (serial extraction)
difference between MD width of primary canine + 1st molar + 2nd molar and permanent canine + 1st premolar + 2nd premolar
leeway space
CDE - 245 = _______ for upper and ________ for lower
2-2.5mm for upper
3-4mm for lower
displacement of a tooth from the socket in the direction of eruption
extrusion
displacement of the tooth into the socket
intrusion
the crown moves in one direction; tip of the root in opposite direction
tipping
same direction of force of crown and root
translation
controlled root movement labiolingually or mesiodistally
torque
revolving the tooth around its long axis
rotation
present on the side toward which the tooth is being moved
osteoclast or osteoblasts?
osteoclast
present on the side of the root from which the tooth is moved
osteoclast or osteoblast?
osteoblast
when should you have your first dental visit?
on or after 6 months, no later than first birthday
mandibular incisor region
hypocalcified
natal teeth
teeth present within the first 30 days after birth
hypocalcified
neonatal teeth
characteristics of primary teeth:
- uniform enamel thickness
- short crowns
- exaggerated buccal and lingual cervical ridges
- narrow FACIOLINGUAL from occlusal view
- prominent cervical ridge
only teeth that ha a greater width than height
primary maxillary central incisors
“pot-belly” in appearance
primary mandibular molar
doesn’t resemble any teeth
no central fossa
big MB cervical ridge
primary mandibular molar
all anterior teeth have __ lobes
4
all premolar have 4 lobes EXCEPT ______
mandibular 2nd premolar
first molars have __ lobes
5
second molars have __ lobes
4
stage wherein they are still dependent on parents
infancy
ideal stage for first dental appointment
infancy
shift rapidly from one thing to another
brief attention span
toddlerhood
vocabulary words 500-2000 words
child’s passion runs high
separation anxiety
pre-school year
peer influence
teacher: first significant authoritive adult
asserts independence
school years
“awkward stage”
still immature
adolescence
type of play wherein there is no peer involvement
solitary
type of play wherein you observe others play
on-looking
type of play wherein they play activity alongside
parallel play
type of play with interaction
associative play
this is the highest form of play
cooperative
type of patient that: lack opportunity to meet people outside too little affection only child overcritical parents
timid, shy, bashful
type of patient that has an overprotective parents
defiant
type of patient that overindulge and reject some cases and is spoiled
incorrigible
Frankl behavioral rating scale
Rating 1: ??
- -
Frankl behavioral rating scale
Rating 2: ??
-
Frankl behavioral rating scale
Rating 3: ??
+
Frankl behavioral rating scale
Rating 4: ??
+ +
used for prevention and control of caries
most effective way is systemic
fluoride
use of fluorine ______mg/day can inhibit the important enzyme phosphatase
20-40mg/day
needed for calcium metabolism
phosphatase
recommended dosage of phosphatase for heartburn and pain in extremities
40-70mg/day
will topical fluoride cause fluorosis?
NO
excretion of fluoride is in
kidney
optimal fluoride = _________ for public water
0.7-1.2ppm
adult lethal dose of fluoride
4-5g
child lethal dose of fluoride
15mg/kg
treatment for fluoride toxicity
syrup of ipecac
milk of magnesia
hereditary form of enamel
teeth appear yellow to brown
amelogenesis imperfecta
gray-brown appearance “opalescent hue”
dentinogenesis imperfecta
type of dentinogenesis imperfecta associated with O.I.
type I
most common type of dentinogenesis imperfecta
type II
type of dentinogenesis imperfecta that have multiple pulpal exposure in primary dentition
type III
rampant caries that results from sleeping with feeding bottle
maxillary incisors
ECC (early childhood caries)
aka baby bottle tooth decay
ECC (early childhood caries)
bacteria associated with ANUG
fusiform, spirochetes
its symptoms are:
painful hyperemic gingival punched out erosions covered by gray pseudomembrane, fetid odor
ANUG
achondroplasia will develop to class _____
class III
enlarged tongue, mandibular prognathism, and loner root
gigantism
sorted of mouth and gingiva
gingivostomatitis
sequelae of gingivostomatitis
recurrent herpes labialis
painful white/yellow ulcers with bright red
causes aphthous ulcers
cosxackie virus
rucurrent ulcers are primary on _____ while herpetic lesions on the _____
mucosa; periosteum
recurrent aphthous minor: ____ than 1cm in diameter; lasts for ____ weeks
less; 2
recurrent aphthous major: ____ than 1cm in diameter; lasts for ____ weeks and heal with _____
over; more than 2; healing
frequent recurrences of ulcers should be screened for ___ and ___
DM and Bechet’s syndrome
underdeveloped mandible
enlarged tongue
retained primary teeth
cretinism
cleft palate occurs during ______ weeks in utero
6th-8th
cleft lip occurs during ____ weeks in utero
5th-6th
facial cleft common in females
cleft palate
facial cleft common in males
cleft lip
associated syndromes of facial clefts
- stickler’s
- Vander Woude’s
- DiGeorge syndrome
treatment for facial clefts
rule of 10! cleft lip repair cleft palate repair pharyngloplasty alveolar reconstruction cleft orthognatic surgery cleft rhinoplasty cleft lip revision
cleft lip repair should be done _____ after birth
10weeks
cleft palate repair should be done _____ after birth
9-18 months
pharyngoplasty should be done _____ or later
3-5 years
alveolar reconstruction should be done ______ based on dental development
6-9 years
cleft orthognatic surgery should be done _____ in girls and _____ in boys
14-16 years; 16-18 years
cleft lip revision should be done anytime best after age __
5
in trisomy 21, first primary tooth appear at the age of
2
in trisomy 21, dentition is completed at the age of
5
in trisomy 21, primary teeth are retained up to age __
15
in cleidocranial dysplasia, primary dentition is completed at the age of ___
15
dentition is delayed in all stages
hypothyroidism
delayed eruption of dentition
primary teeth do not resorb
hypopituitarism
most common hemophilia in children
males
hemophilia A
factor VIII deficiency
hemophilia A
no injury of supporting structures
no evidence of displacement
no signs of mobility
clinically, tooth will be tender
concussion
injury to supporting structures
have loosening of tooth
no displacement
sulcular hemorrhage
subluxation
displacement of tooth beside in an axial direction
torn PDL with contusion of alveolar bone
non tender and non mobile
increased PD space
lateral luxation
apical displacement into alveolar bone
compression of PDL
fracture of socket
clinically, tooth appears short
intrusion
partial displacement out of the socket
torn PDL
clinically, elongated tooth and mobile
extrusion
complete displacement out of socket
missing tooth!
avulsion
used drugs to induce a cooperative yet CONSCIOUS state
conscious sedation
patent airway independently maintained
respond to physical stimulation or verbal command
conscious sedation
General anesthesia
deep sedation
incomplete, partial or total loss of reflexes
does not respond to stimulus
deep sedation
mild, odorless, easily irritated and reversible
produces LIMITED analgesia
nitrous oxide
most common adverse effect of nitrous oxide
nausea
maintaining concentration of nitrous oxide
30:70
routes of administration of anesthesia
- oral sedation
- IM
- submucosal
- IV
IM could be done on:
a. vastus lateralis
b. gluteus maximus
c. deltoid
most universally accepted type of administration of anesthesia
oral sedation
most efficient type of administration of anesthesia
IV
onset of oral sedation
30-60 minutes
onset of IV administration of anesthesia
20-25 seconds
submucosal sedation is done on
buccal vestibule
