PAEDS ORTHO RELATIONSHIP Flashcards
At what age does mixed dentition being?
6 y/o
At what age should a child be screened for malocclusion?
8 y/o
What comprises of an ortho assessment?
Pt-Carer awareness of malocclusion
Extraoral of facial forms (skeletal pattern/soft tissue)
General oral health and hygiene
Presence/Absence of teeth
Alignment and form of each arch
Occlusion of teeth
Radiographs
Study models
Clinical photographs
What is the IOTN?
Index of orthodontic treatment needs - to establish a consensus within the progression as to which malocclusion will gain benefit from having orthodontic treatment.
What are the two components of IOTN
Dental health component
Aesthetic component
What are the categories of dnetla health component
Grade 1-5
What are the characteristics that are assessed in the dental health component?
Missing teeth
Overjet/bite
Crosbites
Contact point displacement
What is the aesthetic component?
Using a scale of 10 photos from most dentally attractive to least dentally attractive. However it is subjective.
What should you consider for an orthodontist referral?
Age of the pt - too early better than late
Pt and family attitude
Oral hygiene
Prognosis of teeth
Relevant radiographs
What is the effect of premature loss of primary incisors?
Loss of primary incisors after 4 is not a concern (as the crowns of successors are formed). Prevents distal teeth from drifting forward
What is the effect of premature loss of primary canine?
VERY BAD!
- Maxilla: if C is removed before incisors have closed their gap, can lead to incisor spacing and labioversion of permanent canine.
- Mandible: if C is lost, this is very serious, leads to lingual tipping of 4 md incisors, and blocking out the 3.
What are the effects of premature loss of first primary molar?
If lost prior to eruption of 6: it would cause the mesial shift of the E’s
If lost after eruption of 6: less likely to cause space loss
If lost during eruption of 6: little chance of space loss
What are the effects of premature loss of second primary molar?
Results in space loss and mesial drifting of the 6. Thus premolars cant erupted, and causes crowding
When is there an increase in dental arch size due to growth?
During the mixed dentition phase (6-12y.o.)
Decisions on crowding should be postponed until?
1 yr after the eruption of permanent incisors approx 8.5-9.5
If you are going to extract teeth in children what should you always do?
Consult an orthodontic opinion.
Should you extract teeth in the primary dentition to relieve crowding?
No, because the permanent teeth are bigger in size and premature loss of primary teeth can cause space loss and contribute to more crowing.
Extraction of teeth to relieve severe crowding?
Can be considered 1 yr after the permanent incisors have erupted.
Extraction of teeth to relieve mild crowding?
Delay decision until permanent canine and premolars are erupting
What are the aims of planned extractions?
- Relive crowding at an early stage so that the permanent teeth can erupt into good alignment
- Reduce the need for appliance therapy
What are the disadvantages of planned extractions?
Extractions can be a traumatizing for a child
Indications for planned extractions
Significant permanent incisor crowding
Patient aged around 9 years
Class I without a bite overbite
All permanent teeth present
First perm molars in good condition
Extraction of primary canine?
If done at the correct time can relieve incisor crowding and canine extractions should be balanced on the contralateral side.
When would you consider extracting the E?
Never do this ever!!!! Unless deep caries or severe hypomineralisation.
Factors to consider for planned extractions?
- Immediate managment of pain
- Long term prognosis of restored teeth
- Dental age of pt
When should you seek ortho advice?
Before extraction of all primary teeth, FPM exo, CLP, Class 2 and 3.
What is ankylosis?
The fusion of the cementum to the alveolar bone
Ankylosis prevalence?
1-9%
Most commonly ankylosed tooth?
Mandibular first primary molar (E)
What is common with ankylosis?
Congenitally missing premolars
Aetiology of ankylosis?
Unclear
Ankylosis management?
- Retain them as long as they are not causing any issues: caries.
- Try not to surgically remove them if possible, if root resorption is evident then leave them alone, they should resorb entirely. It is hard to surgically remove
Ankylosis management?
- Retain them as long as they are not causing any issues: caries.
- Try not to surgically remove them if possible, if root resorption is evident then leave them alone, they should resorb entirely. It is hard to surgically remove
