Risks And Benefits Of Ortho Treatment Flashcards
What benefits can ortho have?
Improvement in form and function
Improvement in aesthetics
- can improve psychology of patient
- improve self esteem and their social life
Improvement in dental health
What impact on the dentition can impacted canines have?
Resorption of the roots of permanent teeth
Cyst formation
Prevent normal eruption
What affect on dental health can crowding have?
Harder to clean teeth so increased caries?
More difficult to access all areas so also increase in periodontal disease (greater link)
What are all the potential problems with ‘MOCDO’
Missing / ectopic teeth - root resorption / cyst formation
Oversets - trauma
Cross bites - displacement causing asymmetry, toothwear, gingival recession
Displacement - crowding and threat to caries / perio
Overbite - trauma and gingival stripping
How can patients decrease risk of decalcification?
Maintaining good oral hygiene with minimum twice per day and after every meal
Target gingival margins and margins round brackets
Visit hygienist
Follow diet advice from the GDP with a non cariogenic diet
? High fluoride toothpaste and duraphat varnish
What factors increase risk of root resorption? How much resorption occurs? And where?
1mm / 2 years fixed appliances with mainly U 1’s, 2’s and a;; 6’s being most common
Prolonged high forces,
Rotational forces,
Movement of tooth root - torque
Large movements e.g. space closure
What features are more prone to relapse?
Rotations
Centreline closes / diastema’s
Instanding 2’s
Anterior open bites
CII DII
How can gingival recession be an issue for ortho tx?
Often seen in adults who have space expansion
- more adults given tx so more common now
What must be done in a patient w periodontal disease who needs orthodontic tx?
Perio disease must be stabilised, treated and maintained before any tx as ortho tx increases rate of alveolar bone loss and periodontal destruction
What are the risks of ortho tx?>
Decalcification
Root resorption
Relapse
Soft tissue trauma
Gingival recession
Periodontal health
Loss of vitality
Toothwear / fracture
Allergies
Failed / poor tx
How may toothwear occur in an ortho case?
Maxillary tooth occluding against bracket of mandibular tooth
- greater risk with ceramic brackets
Also enamel fractures during debonding of bracket
When is loss of vitality a greater risk in ortho tx?
Where there has been previous trauma or compromised tooth
- good to warn pt of this and stay tooth could discolour
