PAEDS ORTHO RELATIONSHIP

Question 1

At what age does mixed dentition being?

Answer 1

6 y/o

Question 2

At what age should a child be screened for malocclusion?

Answer 2

8 y/o

Question 3

What comprises of an ortho assessment?

Answer 3

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

Question 4

What is the IOTN?

Answer 4

Index of orthodontic treatment needs - to establish a consensus within the progression as to which malocclusion will gain benefit from having orthodontic treatment.

Question 5

What are the two components of IOTN

Answer 5

Dental health component
Aesthetic component

Question 6

What are the categories of dnetla health component

Answer 6

Grade 1-5

Question 7

What are the characteristics that are assessed in the dental health component?

Answer 7

Missing teeth
Overjet/bite
Crosbites
Contact point displacement

Question 8

What is the aesthetic component?

Answer 8

Using a scale of 10 photos from most dentally attractive to least dentally attractive. However it is subjective.

Question 9

What should you consider for an orthodontist referral?

Answer 9

Age of the pt - too early better than late
Pt and family attitude
Oral hygiene
Prognosis of teeth
Relevant radiographs

Question 10

What is the effect of premature loss of primary incisors?

Answer 10

Loss of primary incisors after 4 is not a concern (as the crowns of successors are formed). Prevents distal teeth from drifting forward

Question 11

What is the effect of premature loss of primary canine?

Answer 11

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.

Question 12

What are the effects of premature loss of first primary molar?

Answer 12

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

Question 13

What are the effects of premature loss of second primary molar?

Answer 13

Results in space loss and mesial drifting of the 6. Thus premolars cant erupted, and causes crowding

Question 14

When is there an increase in dental arch size due to growth?

Answer 14

During the mixed dentition phase (6-12y.o.)

Question 15

Decisions on crowding should be postponed until?

Answer 15

1 yr after the eruption of permanent incisors approx 8.5-9.5

Question 16

If you are going to extract teeth in children what should you always do?

Answer 16

Consult an orthodontic opinion.

Question 17

Should you extract teeth in the primary dentition to relieve crowding?

Answer 17

No, because the permanent teeth are bigger in size and premature loss of primary teeth can cause space loss and contribute to more crowing.

Question 18

Extraction of teeth to relieve severe crowding?

Answer 18

Can be considered 1 yr after the permanent incisors have erupted.

Question 19

Extraction of teeth to relieve mild crowding?

Answer 19

Delay decision until permanent canine and premolars are erupting

Question 20

What are the aims of planned extractions?

Answer 20

• Relive crowding at an early stage so that the permanent teeth can erupt into good alignment
• Reduce the need for appliance therapy

Question 21

What are the disadvantages of planned extractions?

Answer 21

Extractions can be a traumatizing for a child

Question 22

Indications for planned extractions

Answer 22

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

Question 23

Extraction of primary canine?

Answer 23

If done at the correct time can relieve incisor crowding and canine extractions should be balanced on the contralateral side.

Question 24

When would you consider extracting the E?

Answer 24

Never do this ever!!!! Unless deep caries or severe hypomineralisation.

Question 25

Factors to consider for planned extractions?

Answer 25

• Immediate managment of pain
• Long term prognosis of restored teeth
• Dental age of pt

Question 26

When should you seek ortho advice?

Answer 26

Before extraction of all primary teeth, FPM exo, CLP, Class 2 and 3.

Question 27

What is ankylosis?

Answer 27

The fusion of the cementum to the alveolar bone

Question 28

Ankylosis prevalence?

Answer 28

1-9%

Question 29

Most commonly ankylosed tooth?

Answer 29

Mandibular first primary molar (E)

Question 30

What is common with ankylosis?

Answer 30

Congenitally missing premolars

Question 31

Aetiology of ankylosis?

Answer 31

Unclear

Question 32

Ankylosis management?

Answer 32

• 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

Question 32

Ankylosis management?

Answer 32

• 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