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ABO > Retention > Flashcards

Retention Flashcards

1
Q

Numerous authors have stated that good ___ and ___ may be the key to a stable orthodontic result

A

Intercuspation

Occlusal contacts

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2
Q

What are Andrew’s six keys of occlusion?

A

Molar relationship

Crown angulation

Crown inclination

No rotations

No spaces

Flat occlusal plane

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3
Q

True or false… planning for retention should be carried out after clinical intervention.

A

False.. it should be carried out prior to clinical intervention

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4
Q

What are the three most important factors for why retention is necessary to maintain treatment results?

A

Time is needed for the gingival and PDL fibers to reorganize

Remaining growth, especially in the mandible, may alter occlusal relationships

Pressure from soft tissues surrounding the dentition may lead to a relapse tendency

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5
Q

Growth produces occlusal changes in all three skeletal dimensions. The __ dimension is completed first and has a lesser effect on the occlusion than the other dimension.

A

Transverse

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6
Q

Ideally, an adolescent patient should wear orthodontic retainers indefinitely; however, at minimum, retainers must be worn until growth is completed in ___

A

Adulthood

Even adults show some craniofacial remodeling that can cause alteration of the occlusion. Throughout life, orthodontic retention helps to minimize changes to our occlusion.

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7
Q

What are the retention considerations in extraction vs non-extraction cases?

A

There is not a specific retention philosophy for extraction cases and another for non-extractions cases.

However, excess gingival bunching from closing spaces should be surgically removed to prevent relapse.

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8
Q

If during treatment incisors are proclined, what would relapse do?

A

The lower incisor will upright and crowd, because the equilibrium between lower lip, tongue, and PDL will be altered again once retention is removed

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9
Q

How can lower incisor crowding be prevented in relapse of class 2 cases?

A

Class 2 elastic use should be discontinued at least 2 months prior to debonding. Additionally, overcorreciton of the class 2 treatment may be feasible in cases where expected remaining growth has potential to cause long-term relapse

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10
Q

Correction of treu class 3 malocclusions in adults caused by maxillary hypoplasia, mandibular prognthatism, or a combination of the two most often requires ___

A

Orthognathic surgical correction

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11
Q

What is a consideration for retention of deep bite cases?

A

If the retention is accomplished using a maxillary removable retainer that incorporates a bite plate, the lower incisors and cuspids will have a contact surface to stop the bite from deepening. However, this appliance should not cause the posterior teeth to disocclude.

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12
Q

Removable retainers are effective for retention against ___ relapse. These retainers are made of stainless steel wire and acrylic

A

Intra-arch

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13
Q

The ___ retainer is the most common removable retainer and the type of retainer used to control a deepbite because a biteplane is easily added.

A

Hawley

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14
Q

Why is a lower Hawley retainer much more difficult to insert?

A

Because of undercuts in the premolar and molar region. Thus a bonded lingual retainer is more suitable for the mandibular arch

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15
Q

A second major removable retainer is the ____. It firmly holds each tooth in position and is excellent for maintaining space closure after extractions. There are no wires across the occlusion, so there are no occlusal interferences. However, they are more expensive than Hawley retainers because they are more difficult to fabricate.

A

Wrap-around retainer

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16
Q

What are some possible disadvantages to vacuum-formed retainers?

A

Do not allow settling occlusion

Since they cover the occlusal surfaces, masticatory forces can cause wear and require the retainer to be remade

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17
Q

When would a bonded palatal retainer be necessary?

A

In adult cases with generalized spacing

Large diastema

In cases with a palatal impacted canine (to prevent vertical relapse)

In each of these cases, a vacuum-formed retainer could be used over the bonded retainer to help prevent breakage of the bonded retainer caused by occlusal interference or contact during biting

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18
Q

What is the greatest contributor to late mandibular incisor crowding?

A

Late mandibular growth

19
Q

Most relapse occurs within the first ____ following bracket removal. Thus retainers should be worn full-time for this duration. After, patients can wear on a night-time only basis

A

6 months

20
Q

How long is a positioned typically worn a day for the purpose of finishing/settling?

A

2-4 hours a day

21
Q

Positioners do not retain ___ or ___ as well as standard retainers. However, they are excellent retainers for ___ and ___ malocclusions as well as for ___ malocclusions.

A

Rotations
Incisor irregularities

Class2
Class 3
Open bite

22
Q

The optimum positioner is one that has an articulator mounting that records the paitent’s ___. Why?

A

Hinge axis

Although more expensive, it will prevent the posterior openbite that results when a positioner is made to an incorrect hinge axis

23
Q

Are spring retainers useful for retreatment of mandibular incisor crowding?

A

Recrowding of mandibular incisors is the indication for a spring aligner to correct incisor position.

However, if late mandibular growth is the cause of the crowding, it may be necessary to reduce the interproximal width of the incisors

_most orthodontists find that it is actually much faster and easier to replace brackets on anterior teeth and realign rather than using a spring retainer

24
Q

What is CSF?

A

Circumferential supracrestal fiberotomy

It is a surgical excision of the free gingival fibers and transseptal fibers to reduce rotational relapse

25
Q

True or false… CSF is usually done by a periodontist

A

False.. in most cases, it is done by the orthodontist near the end of the finishing phase of treatment

26
Q

When is CSF indicated?

A

For severely rotated teeth, and it is NOT appropriate for crowding of teeth without rotations

27
Q

What are the seven criteria for the cast radiograph evaluation?

A

Alignment

Marginal ridges

Buccolingual inclination

Occlusal relationship

Overjet

Interproximal contacts

Root angulation

28
Q

The most common mistakes in marginal ridge alignment occur between the ___ and ___. The second most common problem area was between the ___ and ___

A

Maxillary first and second molars

Mandibular first and second molars

29
Q

True or false… extraction cases display signifantly more relapse than non-extraction cases.

A

False. Comparisons of extraction vs. non-extraction cases have shown no significant difference between the two at the postretention phase with regard to the incisor irregularity.

30
Q

True or false… class 1 molar relationship means a healthier TMJ and long term stability

A 
False.   In reality, there is no evidence-based obligation to finish molars in class 1 relationship concerning either TMJ or long-term stability. 
Furthermore, a case-control study indicated that treatment efficiency was greater with the extractions of two maxillary premolars and finishing in class 2 molar relationship as compared to non-extraction treatment of the malocclusion.
31
Q

What are the factors that affect the long-term success of class 2 correction

A

Although maxillary molars do show signs of mesial relapse, the mandible tends to displace forward due to late growth which compensates for the maxillary molar relapse

32
Q

Cut to horizontally directed and often late mandibular growth, __% of class3 cases relapse into reverse overjet

A

30%

33
Q

What is the best way to prevent relapse for class 3 cases?

A

Aggressive overcorrection (perhaps to a degree that a class 2 molar relationship exists)

34
Q

Relapse frequency of anterior openbite in nonsurgical orthodontic cases is between __-__% depending on the treatment mechanics utilized and follow-up time. In surgical cases, the success rate is a little higher and is predicted to be around __%

A

23%-38%

20%

35
Q

Individuals with class ___ malocclusion have significantly deeper pretreatment curve of spee measurements than individuals presenting with class 1 molar relationships

A

2

36
Q

Leveling the curve of spee [is/is not] a relatively stable treatment objective that involves ___ the molars, ___ the premolars, and ___ and/or ___ the incisors.

A

Uprighting

Extruding

Intruding and/or flaring

37
Q

True or false.. relapse of curve of spee in the long term is not correlated with the amount of correction at post treatment. What is it related to?

A

True

However, there seems to be a link between the relapse of the curve of spee and the relapse of both the irregularity index and overbite measurements.

38
Q

It has been shown that the ___ curve of spee that is not completely level ___ has a higher incidence of relapse than one that is completely level ___.

A

Pretreatment

post-treatment

Post treatment

  • in summary, the relapse in the curve of spee is minimal and should be maintained at a high level once properly corrected
39
Q

About ___% of deep bite correction can successfully be retained, and the amount of follow-up does not appear to be related to the amount of relapse

A

71%

40
Q

Patients with ____ pretreatment ____ tend to have deeper initial overbite and a tendency to return to their original relationship throughout the postretention follow-up. In other words, initial severity of the overbite is associated with long-term changes in overbite measurement.

A

Upright pretreatment maxillary and mandibular incisors

41
Q

Growth pattern of the individual seems to affect the long term retention of overbite correction. ___ subjects tend to display less relapse than ___ subjects

A

High-angle

Low-angle and normal angle

42
Q

About half of the relapse occurs in the first ___ following retention therapy

A

2 years

43
Q

typically scores for ___, ___, ___, ___, and ___ all improved after treatment with ___ being the only criterion to actually worsen after treatment.

A 
Occlusal contacts
Marginal ridges
Occlusal relationships
Overjet
Buccolingal inclinations

Alignment

ABO (22 decks)

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