Risks and Benefits of Orthodontic Treatment Flashcards
What are some benefits of orthodontics?
Improvement in:
- appearance
- function
- dental health
How can orthodontics improve function?
Improves
- mastication
- speech
What does the MOCDO acronym stand for?
- Missing teeth (impacted or ectopic)
- Overjet
- Crossbites
- Displacement of contact points
- Overbites
What issues can impacted teeth cause?
- resorption (root or crown)
- supernumerary teeth can prevent normal eruption
- cyst formation
At what length does an overjet pose a big risk for trauma?
> 6mm
What negatives are anterior crossbites associated with?
- loss of perio support
- tooth wear
What can significant posterior crossbites lead to?
asymmetry
What does displacement of contact points refer to?
Crowding
What issues can crowded teeth cause?
Difficult to clean
- higher caries incidence
- periodontal disease
What problem is associated with deep overbites?
- gingival stripping
- loss of perio support
What malocclusions are associated with TMD? (small association)
- crossbite with displacement
- class II with retrusive mandible
- class III
- AOB
What risks are associated with Orthodontic Treatment?
- decalcification
- root resorption
- relapse
- soft tissue trauma
- recession
- loss of perio support
How can decalcification be prevented in orthodontic patients?
- good case selection
- oral hygiene
- diet advice
- fluoride
When selecting patients that are good cases for orthodontics, what factors are included?
- motivated pt
- good OH
- low caries risk
What would make a child high risk of decalcification with orthodontic treatment?
- caries history
- pre-existing decalcification
- erosion
What dietary advice should you give to patients receiving orthodontic treatment?
- low sugar diary
- avoid snacking between meals
- avoid fizzy drinks
- avoid sweets
For patients at higher risk for decalcification during ortho treatment, what can be prescribed?
High fluoride toothpaste
- 2800ppm
- 5000ppm
2x daily
Fluoride varnish application
What is the average amount of root resorption that occurs due to ortho treatment?
1mm over 2 years fixed appliances
What teeth are more likely to experience root resorption after ortho treatment?
Upper incisors > lower incisors > 6s
What are risk factors for root resorption in orthodontic patients?
- prolonged high force tooth movement
- intrusion/large movements/torque
- malformed roots already
- previous trauma
What teeth are particularly prone to relapse after orthodontic treatment ?
lower incisors
What malocclusion features are particularly prone to relapse after orthodontic treatment?
- lower incisor crowding
- rotations
- instanding 2s
- spaces & diastemas
- class II div 2
- AOB
- reduced perio support
How should relapse be managed in orthodontic patients?
- case selection
- informed consent
- retainers (fixed/removable)
What benefits are associated with removable retainers?
- remove for OH
- patient control
- easy to spot problems
What risks are associated with fixed retainers?
- prone to plaque & calculus build up
- can break & not notice
- requires long term maintenance
When might teeth lose vitality because of orthodontic treatment?
- previous trauma
- compromised tooth
- excess force
When does orthodontic treatment success increase?
- severe malocclusion
- highly motivated pt
- operator expertise
