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Pedo/Ortho II > Principles & Techniques 2 > Flashcards

Principles & Techniques 2 Flashcards

1
Q

What forces oppose eruption of teeth?

A

chewing and soft tissue forces

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2
Q

______ pressures of ______ duration are more significant in producing tooth movement than heavy intermittent pressures like chewing.

A

light pressures of long duration

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3
Q

Teeth that are in function erupt at a rate that parallels the rate of what?

A

the rate of vertical growth of the mandibular ramus

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4
Q

As the _____ grows longer it creates space between the maxillary arch and mandibular arch.

A

ramus

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5
Q

Before the tooth is in occlusion, it’s primarily effected by forces _________ eruption.

A

promoting

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6
Q

After the tooth is in occlusion, it’s primarily effected by forces _________ eruption.

A

opposing

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7
Q

The total eruption path of a first permanent molar is about _____ cm.

A

2.5 cm

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8
Q

Why do ankylosed teeth appear “sunken” down compared to adjacent teeth?

A

Because half of the eruption path (i.e. 1.25 of 2.5cm) is achieved after tooth is on occlusal level. Ankylosed tooth will stop at the halfway point.

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9
Q

How can a lateral tongue thrust affect eruption of teeth?

A

It can prevent teeth from fully erupting to fill the space created by ramus growth. Causes a posterior open bite.

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10
Q

What treatment options do we have for ankylosed permanent teeth?

A

Extraction, crowns, or surgery (i.e. distraction osteogenesis)

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11
Q

When is extraction of an ankylosed primary tooth recommended?

A

When it drops below the height of contour and there is not an adult tooth to replace it.

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12
Q

For ankylosed primary teeth without an adult tooth replacement, what options are there for treatment?

A

extraction, build-up of primary tooth, or leave as is

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13
Q

During adult life, teeth continue to _______ at an extremely slow rate.

A

erupt

opposing forces required to keep teeth from hyper eruption

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14
Q

How does wear of teeth affect vertical dimension?

A

Vertical dimension is maintained by further eruption of teeth

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15
Q

The bone remodeling involved in orthodontic treatment is mediated by the _____.

A

PDL

PDL phenomenon

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16
Q

What happens if the PDL is destroyed during orthodontic treatment?

A

ankylosis

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17
Q

Under normal circumstances, how wide is the PDL?

A

0.5mm

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18
Q

What constantly remodels the collagens of the PDL?

A

fibroblasts and fibroclasts

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19
Q

What remodels and recontours the alveolar bone and cementum?

A

osteoclasts and cementoclasts, respectively

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20
Q

What kind of nerve endings are in the PDL?

A

unmyelinated free nerve endings for proprioception and pain

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21
Q

What does the fluid function as in the PDL?

A

A shock absorber for the tooth

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22
Q

If pressure is maintained on the tooth, what happens to the PDL fluid?

A

It is rapidly expressed to create more fluid pressure in the PDL (pain is felt)

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23
Q

On mandibular anterior teeth, does the lip or tongue put more pressure on the teeth?

A

tongue

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24
Q

Is lip or tongue pressure greater on maxillary incisors?

A

lip

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25
Q

______ ___________ of the PDL implies that there is a threshold for orthodontic force, and any force less than this wouldn’t move the tooth.

A

active stabilization of the PDL

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26
Q

What is the threshold for orthodontic force (in g/square cm)

A

5-10 grams/square cm

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27
Q

Active stabilization produced by _________ _______ in the PDL explains why teeth are stable in the presence of imbalanced (natural) pressures.

A

metabolic effects

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28
Q

What is a lip bumper?

A

Appliance that holds the lip away from the anterior teeth to allow for maximum forward movement of teeth

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29
Q

What is the envelope of stability?

A

Teeth occupy a space where soft tissue pressures are in equilibrium (but remember it isn’t balanced pressure)

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30
Q

After a tooth emerges into the mouth further eruption depends on metabolic events within the PDL including…

A

formation of cross-linkages and maturational shortening of collagen fibers.

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31
Q

If a tooth is moved, does the bone and gingiva follow the tooth?

A

Yes

32
Q

When the alveolar bone socket bends (acting as shock absorber) it generates a ___________ _______.

A

Piezoelectric current

33
Q

What do piezoelectric currents do?

A

They stimulate skeletal regeneration and repair, which is how bone adapts to functional demands

34
Q

What two unusual characteristics do piezoelectric signals have?

A

An initial “quick decay rate” that quickly reduces to zero within a second. An equal signal of opposite direction when the force is released.

35
Q

Piezoelectric signals are the migration of ________ when the crystal structure of bone is deformed.

A

electrons

36
Q

When a maintained force bends the alveolar bone, what happens to electrons in the crystal structure?

A

structure is stable and electrons don’t move

37
Q

When a maintained force on the alveolar bone is released, what happens to the electrons in the bone’s crystals?

A

crystal returns to original shape and electrons reverse direction back toward the original position

38
Q

Small voltages seen in fluid ions of the bone fluid are called a ________ _________, and have a rapid onset and alteration (like piezoelectric signals)

A

streaming potential

39
Q

Without streaming potentials or piezoelectric currents, what happens to bone?

A

skeletal atrophy

40
Q

What does the AcceleDent appliance claim?

A

That vibration of teeth will shorten length of orthodontic treatment. (but it’s a lie!)

41
Q

The classic theory of orthodontic tooth movement relies on ________ rather than electrical signals to stimulate cellular differentiation.

A

chemical signals

42
Q

What two things are necessary for chemical signal release to cause differentiation seen in orthodontics?

A

mechanical compression of tissues, and change in blood flow

43
Q

Mechanical effect on the PDL causes the release of what?

A

cytokines, prostaglandins, and other chemical messengers

44
Q

Will there be more blood flow to the compressed or stretched PDL?

A

stretched

45
Q

What chemical messengers are important in cellular differentiation?

A

PG-E, IL-1beta, cAMP

46
Q

Is release of prostaglandins a primary or secondary response to pressure?

A

primary

47
Q

How long of sustained pressure does it take for cAMP levels to increase?

A

4-6 hours (therefore, orthodontic appliance must be worn for 6+ hours to facilitate tooth movement)

48
Q

What happens to the PDL if too much pressure is placed on the tooth in orthodontics?

A

sterile necrosis of PDL (aka hyalinized) due to ischemia

49
Q

Differentiation of _________ isn’t possible without adequate blood flow to the PDL.

A

osteoclasts

50
Q

When blood flow to the PDL is cut off, what kind of resorption happens?

A

undermining resorption

51
Q

Where do osteoclasts come from during undermining resorption?

A

adjacent marrow spaces outside the alveolar socket

52
Q

Undermining resorption causes tooth movement to take ____ time.

A

more time

53
Q

_______ resorption happens when light, continuous force is applied and blood flow to PDL is maintained.

A

frontal resorption

54
Q

Frontal resorption causes tooth movement to take ____ time.

A

less

55
Q

During frontal resorption, bone is ______ on the tension side of PDL and ________ on the pressure side.

A

formed, remodeled

56
Q

What kind of resorption results in smooth continuous tooth movement?

A

frontal resorption

57
Q

What kind of resorption causes more pain?

A

undermining resorption

58
Q

Which kind of resorption is the rate limiting step in tooth movement?

A

undermining resorption

59
Q

clinically, what kind of resorption happens during tooth movement?

A

both frontal and undermining

60
Q

Is there evidence to suggest self-ligating brackets accelerate tooth movement?

A

Nope.

61
Q

Does lateral expansion of the dental arch by self-ligating brackets “grow” buccal alveolar bone?

A

No

62
Q

Is lateral expansion of the dental arch by self-ligating bracket systems comparable with lateral expansion gained by rapid maxillary expansion (RME) followed by conventional edgewise treatment?

A

No

63
Q

Is lateral expansion of the dental arch gained by self-ligating bracket systems stable in the long term?

A

No

64
Q

Do self-ligating bracket systems provide lower clinical forces compared with conventional brackets?

A

No, they may even cause more forces

65
Q

Do patients treated with self-ligating bracket systems experience less pain during treatment?

A

No

66
Q

In what age range and which teeth are likely experience dental trauma?

A

7-10 years old, and the anterior incisor region

67
Q

What do we worry about happening to replanted avulsed teeth?

A
  • periodical abscess
  • internal root resorption
  • ankylosis
68
Q

Should you replant primary teeth?

A

No, you fool

69
Q

What are some good things to transport an avulsed tooth?

A

Saline, milk, saliva, water

70
Q

If the tooth has been out for less than an hour, what should you do?

A

Replant immediately, clean with water or saline the root off but do NOT touch the root surface

71
Q

If the tooth has been avulsed for more than an hour, what should you do?

A

Soak tooth in fluoride solution for 20 min, rinse with saline, and replant

72
Q

How do you treat the socket of an avulsed tooth?

A

Do NOT curette, do NOT vent, do NOT make flap, gently aspirate without entering socket

73
Q

What should you do to manage soft tissues?

A

tightly suture, especially if in cervical region

74
Q

How long should you leave a splint in place to treat an avulsed tooth?

A

7-10 days

75
Q

What are possible drug considerations in conjunction with treating avulsed teeth?

A

systemic antibiotics, refer to physician for tetanus, chlorhexidine rinse, analgesics

Pedo/Ortho II (2 decks)

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