Phase 1

Question 1

In the most common serial extraction protocol, the first teeth to be removed are the ___. The removal of these teeth allows for the eruption, posterior movement, and spontaneous improvement in the algintment of the ___. In about 6-12 months, ___ are extracted, followed later by the extraction of ___.

Answer 1

Primary canines

Permanent lateral incisors

Four primary first molars

First premolars

It is common to observe that the adjacent teeth erupt toward the extraction sites, with the lower incisors often uprighted as well . As soon as the second molars near emergence, fixed appliances can be used to align and detail the dentition.

Question 2

When is serial extraction indicated?

Answer 2

When there is a predicted tooth size/arch size discrepancy of 7-10mm

Also, in cases where tooth sizes are abnormally large (as indicated by the width of an erupted maxillary central incisor), serial extraction protocols may be appropriate.

Question 3

A central incisor width of __mm or greater indicates that the patient may have larger than average teeth

Answer 3

10mm

Question 4

True or false… serial extraction protocols are not recommended in instances of full-blown class 2 or 3 malocclusions because of the imbalance in the interarch relationship along with emerging intraarch problems.

Answer 4

True

Question 5

Rapid maxillary expansion not only separates the midpalatal suture, but also affects the ___ and ___ sutural systems

Answer 5

Circumzygomatic

Circummaxillary

Question 6

The optimal time for beginning treatment for class 3 malocclusions is when?

Answer 6

Coincident with the loss of the maxillary deciduous incisors and the eruption of the permanent central central incisors

Question 7

In corrected class 3, Pts should be overcorrected during phase 1 with an overjet of at least ___-___mm achieved. Maximizing the ___ overlap of the anterior teeth is also a major treatment objective.

Answer 7

4-5mm

Vertical

Question 8

The most predicatable and effective orthopedic appliance that can be used for the correction of class 2 malocclusion is the ___ appliance. How does it work?

Answer 8

Herbst

The mandible is brought forward by the Herbst bite-jumping mechanism, bilateral devices that are attached to the maxillary first molars and mandibular first premolars by bands or SSCs.

Question 9

True or false.. an interesting phenomenon that occurs in some class 2 patients who undergo RME in the mixed dentition is spontaneous improvements of the underlying Sagittarius relationship.

Answer 9

True

As long as the maxilla is maintained in a widened relationship relative to the mandible during the transition from the mixed to permanent dentition, it appears that the patient tend to posture the mandible forward to achieve a better dental interdigitation. In some instances, the class 2 relationship improves over time, a phenomenon not observed in untreated class 2 individuals. If there is a residual class 2 problem at the beginning of phase 2, definitive class 2 treatment (herbst appliance) is initiated.

Question 10

The time between the initial phase of treatment and the second phase of fixed appliances is termed the ____ period. What happens here?

Answer 10

Interim

Patients typically are given a removable palatal plate usually without a labial wire

They are seen every 4-6 months until the end of the transition to the permanent dentition when the second deciduous molars become loose. At this point, a TPA is used in about 90% of the patients.