Risks and Benefits of Orthodontic Treatment

Question 1

What are some benefits of orthodontics?

Answer 1

Improvement in:
- appearance
- function
- dental health

Question 2

How can orthodontics improve function?

Answer 2

Improves
- mastication
- speech

Question 3

What does the MOCDO acronym stand for?

Answer 3

• Missing teeth (impacted or ectopic)
• Overjet
• Crossbites
• Displacement of contact points
• Overbites

Question 4

What issues can impacted teeth cause?

Answer 4

• resorption (root or crown)
• supernumerary teeth can prevent normal eruption
• cyst formation

Question 5

At what length does an overjet pose a big risk for trauma?

Answer 5

> 6mm

Question 6

What negatives are anterior crossbites associated with?

Answer 6

• loss of perio support
• tooth wear

Question 7

What can significant posterior crossbites lead to?

Answer 7

asymmetry

Question 8

What does displacement of contact points refer to?

Answer 8

Crowding

Question 9

What issues can crowded teeth cause?

Answer 9

Difficult to clean
- higher caries incidence
- periodontal disease

Question 10

What problem is associated with deep overbites?

Answer 10

• gingival stripping
• loss of perio support

Question 11

What malocclusions are associated with TMD? (small association)

Answer 11

• crossbite with displacement
• class II with retrusive mandible
• class III
• AOB

Question 12

What risks are associated with Orthodontic Treatment?

Answer 12

• decalcification
• root resorption
• relapse
• soft tissue trauma
• recession
• loss of perio support

Question 13

How can decalcification be prevented in orthodontic patients?

Answer 13

• good case selection
• oral hygiene
• diet advice
• fluoride

Question 14

When selecting patients that are good cases for orthodontics, what factors are included?

Answer 14

• motivated pt
• good OH
• low caries risk

Question 15

What would make a child high risk of decalcification with orthodontic treatment?

Answer 15

• caries history
• pre-existing decalcification
• erosion

Question 16

What dietary advice should you give to patients receiving orthodontic treatment?

Answer 16

• low sugar diary
• avoid snacking between meals
• avoid fizzy drinks
• avoid sweets

Question 17

For patients at higher risk for decalcification during ortho treatment, what can be prescribed?

Answer 17

High fluoride toothpaste
- 2800ppm
- 5000ppm
2x daily

Fluoride varnish application

Question 18

What is the average amount of root resorption that occurs due to ortho treatment?

Answer 18

1mm over 2 years fixed appliances

Question 19

What teeth are more likely to experience root resorption after ortho treatment?

Answer 19

Upper incisors > lower incisors > 6s

Question 20

What are risk factors for root resorption in orthodontic patients?

Answer 20

• prolonged high force tooth movement
• intrusion/large movements/torque
• malformed roots already
• previous trauma

Question 21

What teeth are particularly prone to relapse after orthodontic treatment ?

Answer 21

lower incisors

Question 22

What malocclusion features are particularly prone to relapse after orthodontic treatment?

Answer 22

• lower incisor crowding
• rotations
• instanding 2s
• spaces & diastemas
• class II div 2
• AOB
• reduced perio support

Question 23

How should relapse be managed in orthodontic patients?

Answer 23

1. case selection
2. informed consent
3. retainers (fixed/removable)

Question 24

What benefits are associated with removable retainers?

Answer 24

• remove for OH
• patient control
• easy to spot problems

Question 25

What risks are associated with fixed retainers?

Answer 25

• prone to plaque & calculus build up
• can break & not notice
• requires long term maintenance

Question 26

When might teeth lose vitality because of orthodontic treatment?

Answer 26

• previous trauma
• compromised tooth
• excess force

Question 27

When does orthodontic treatment success increase?

Answer 27

• severe malocclusion
• highly motivated pt
• operator expertise