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Ortho > Problems In The Mixed Dentition (Resident) > Flashcards

Problems In The Mixed Dentition (Resident) Flashcards

1
Q

What are the two major causes of irregular and misaligned teeth in the early mixed dentition?

A

Interferences
Lack of space

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2
Q

_______ with eruption, which prevent a permanent tooth from erupting on a normal schedule and secondarily can lead to space problems because other teeth drift to improper positions

A

Interferences

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3
Q

__________ for adequate alignment, which causes an erupting tooth to be deflected from its normal position in the arch

A

Lack of space

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4
Q

Space analysis

A

Amount of space available vs amount of space needed

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5
Q

Space available

A

Measure the arch length

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6
Q

Space needed

A

Add together widths of each tooth

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7
Q

What if tooth is unerupted?

A

Estimate width by radiographs, proportionality tables (Moyers and Tanaka and Johnston), combo of both

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8
Q

Leeway space

A

Difference between the size of the larger primary molars and the smaller permanent premolars
sometimes called e space

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9
Q

Leeway space for maxilla

A

1.5 mm per side

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10
Q

Leeway space for mandible

A

2.5 per side

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11
Q

Space regaining

A

Required not enough space or if Succedaneous teeth are missing (space maintenance alone is inadequate)

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12
Q

How much space can be re-established in a localized area with relative simple appliances and a good prognosis?

A

Up to 3 mm

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13
Q

How much space is a discrepancy between the amount of space available for the teeth and the amount of space required a severe problem?

A

More than 3-4 mm

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14
Q

Maxillary space regaining

A

Easier than mandible bc increase anchorage for removable appliances afforded by the palatal vault and possibility for use of extra oral force (headgear)

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15
Q

What can tip permanent maxillary first molars distally to regain space

A

Fixed appliance or removable appliance

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16
Q

What can molars be bodily moved with to regain space

A

Fixed appliances only

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17
Q

Because molars tend to tip ______ and rotate ___________, distal tipping for ___________ of space regaining is often satisfactory.

A

Forward, mesio-lingually, 2-3 mm

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18
Q

Appliances that help regain space in maxilla

A

Hawley retainer with finger spring
Pendulum appliance
Distal jet appliance
Headgear

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19
Q

Hawley retainer with finger spring

A

Removable retainer worn to regain space by tipping the permanent first molar distally
After regaining, space should be maintained with a band and loop or lingual arch

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20
Q

Pendulum appliance

A

Fixed appliance used to distalize molars bilaterally
Gains anchorage from the palate but uses helical springs to supply the distalizing force

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21
Q

Distal jet appliance

A

Fixed appliance used to distalize unilaterally or bilaterally
Uses palate as anchorage

22
Q

Headgear

A

Most effective and straightforward method to move molars distally

23
Q

Headgear advantage

A

No reciprocal incisor protrusion

24
Q

Headgear disadvantage

A

Compliance (minimal 14 to 16 hours per day)

25
Q

Once space is regained what is required in maxillary space regaining?

A

A space maintainer
Fixed is preferred

26
Q

Mandibular space regaining

A

Not as effective as maxillary space bc appliances are more fragile and prone to breakage
Do not fit as well and lack the palatal anchorage support
Bone dentistry

27
Q

How to regain space in the mandible

A

Lip bumpers

28
Q

Lip bumper indications

A

Minimal space regaining
Arch development
Unraveling of mildly crowded incisors

29
Q

Lip bumper location

A

2-5 mm from the facial surfaces of the lower incisors
Lip pushes back and creates distal force to tip

30
Q

Lip bumper purpose

A

Lip pushes back and creates distal force to tip molars poseirorly

31
Q

Lip bumper side effect

A

Forward movement of incisors

32
Q

Lip bumper follow up

A

Monthly to maintain 2-5 mm clearance of incisors, monitor progress

33
Q

Do you use a lip bumper to maintain space?

A

No it should be replaced with a LLHA once space is gained

34
Q

Children with moderate crowding and inadequate space in early mixed dentition

A

-arch will need to be expanded to accommodate the permanent teeth
-some permanent teeth will need to be extracted

35
Q

Severe crowding

A

Limited tx of problem will not be sufficient and permanent tooth extraction is most likely the best alternative

36
Q

Two major symptoms of severe crowding in the early mixed dentition

A

1 severe irregularity of the erupting permanent incisors
2 early loss of primary canines caused by eruption of the permanent lateral incisors

37
Q

Serial extractions

A

Timed extraction of primary and ultimately permanent teeth to relieve severe crowding

38
Q

Indications for serial extractions

A

No skeletal problems exists
Large space discrepancy (greater than 10 mm per arch)

39
Q

Typical extraction pattern - cd4

A

Primary canine, primary first molar, permanent first premolar

40
Q

Maxillary midline diastema

A

-Usually close spontaneously when canines erupt and incisor root and crown positions change

41
Q

What do you do if a diastema is due to a large frenum attachment?

A

Frenectomy performed after space closure

42
Q

When a larger diastema (>2mm) is present what should you suspect?

A

Midline supernumerary tooth or intrabony lesion (look at radiographs)

43
Q

Frenum attachments

A

Insertion of labial frenum into a notch in the alveolar bone
Band of heavy fibrous tissue lies between the central incisors

44
Q

Frenectomy

A

-Frenum is removed while there is still space, scar tissue forms between the teeth, making closure more difficult and increasing relapse potential
-Best to align teeth before

45
Q

Retention of diastemas

A

Best retainer- bonded section of flexible wire, wire contoured lies near cingulum keep out of occlusal contact, hold teeth together while allowing some ability to move independently during function

46
Q

Ugly duckling stage

A

-Spacing and mesial root position of max incisors (diastemas) results from position of unerupted permanent canines
-space decrease/disappear when canines erupt

47
Q

What happens with the greater amount of space in the ugly duckling stage?

A

The less likely the diastema will close on its own
-2 mm or less will probably close spontaneous
-greater 2mm need ortho

48
Q

Other spacing etiology

A

Obstruction
Insufficient tooth mass

49
Q

Obstruction

A

Supernumerary teeth (mesiodens)
Frenum attachment
Large mandibular incisors (occlusion)
Macroglossia
Habits - thumb, fingers, tongue

50
Q

Insufficient tooth mass

A

Microdontia
Hypotonia
Peg laterals
Missing teeth

Ortho (19 decks)

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