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FINALS - Orthodontics > Risks and Benefits of Orthodontic Treatment > Flashcards

Risks and Benefits of Orthodontic Treatment Flashcards

1
Q

What are the potential benefits of orthodontic treatment?

A

Improvement in dental/facial appearance
Improvement in function
Improvement in overal dental health

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2
Q

What are the psychological impacts of severe malocclusion?

A

Affect facial attractiveness

People with unattractive faces perceived unfavourably

Correction may improve self esteem and psychological wellbeing

Improvement in quality of life

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3
Q

Outline some of the stereotypes noted by those with a ‘normal’ dental appearance.

A

Judged as:

More intelligent
More friendly
More desirable as a friend
Less aggressive

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4
Q

Outline the functional benefits of orthodontic treatment.

A

Mastication
Speech

Improvement more pronounced in severe malocclusions, particularly AOB, increased OJ and reversed OJ.

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5
Q

What is the MOCDO acronym?

A

Missing teeth
Overjet
Crossbites
Displacement of contact points
Overbite

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6
Q

What possible complications can impacted teeth lead to?

A

Can cause resorption
Can be associated with cyst formation
Supernumerary teeth can prevent normal eruption.

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7
Q

What risk is associated with an increased overjet of >6mm?

A

Risk of trauma to upper incisors
Worse with incompetent lips

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8
Q

What risks are associated with anterior crossbites?

A

Loss of periodontal support
Toothwear

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9
Q

What risks are associated with posterior crossbites?

A

A significant displacement which may lead to asymmetry and early correction.

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10
Q

What risk does crowding pose?

A

Makes the teeth more difficult to clean, or make it take longer to clean them.

This can have an impact on maintaining good oral hygiene.

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11
Q

What risks can deep traumatic overbites have?

A

Can cause gingival stripping and loss of peril support.

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12
Q

What is the relationship between malocclusions and TMJ disfunction?

A

Small association between TMD and some malocclusions such as:

Crossbite with functional shifts
Class II with recursive mandible
Class III
AOB

Treatment does not guarantee correction or improvement of TMD.

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13
Q

What is the possible risk of ortho in a patient with TMD?

A

Ortho should never be used in isolation to treat TMD.

Intermaxillary elastics may aggravate existing TMD.

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14
Q

What are the main four risks of orthodontic treatment?

A

Decalcification
Root resorption
Relapse
Soft tissue trauma

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15
Q

Other than the four main risks of orthodontic treatment, what less common risks are there?

A

Recession
Loss of periodontal support
Headgear injuries
Enamel fracture and toothier
Loss of vitality
Allergy
Poor/failed treatment

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16
Q

What can the impacts of decalcification due to ortho treatment?

A

Unsightly staining
Frank cavitation
Gross caries

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17
Q

What steps can be taken to prevent decalcification?

A

Case selection
Oral hygiene
Diet advice
Fluoride

18
Q

What patients are determined to be ‘good patients’ for ortho treatment?

A

Motivated patient
Good OH pre-treatment
Low caries risk
No other risk of decal indicated

19
Q

What factors in a patients history may indicate a higher risk of decalcification?

A

Pre-existing decalcification
Erosion
Caries history

20
Q

What specific OH should be given to a patient to prevent decalcification from orthodontic treatment?

A

Toothbrushing and interdental brushes
Twice a day very thoroughly
After every meal
Disclosing tablets
Target gingival margins and around each bracket.

21
Q

When should duraphat toothpaste be prescribed for patients?

A

For patients with an established higher risk.

22
Q

What is root resorption in relation to orthodontic treatment?

A

An inevitable consequence of tooth movement

Average approximately 1mm lost over 2 years with fixed appliances.

Mostly unnoticed but severe in 1-5% of cases.

23
Q

Which teeth are most at risk of root resorption?

A

UI > LI > 6s

24
Q

Which factors can impact the severity of root resorption?

A

Type of tooth movement:
- Prolonged high force
- Intrusion
- Large movements
- Torque

Root form:
- Blunt
- Pipette
- Resorbed already

Previous trauma

Nail biting

25
Q

What is orthodontic relapse?

A

The return of the features of the original malocclusion following correction.

26
Q

Which teeth are particularly prone to relapse?

A

Lower incisors

27
Q

Which types of misalignment are more likely to relapse?

A

Crowding, rotations, instanding laterals, AOB, spaces and diastemas, teeth with reduced periods support.

Class II d2 are also at a higher risk

28
Q

What are the benefits and drawbacks of removable retainers?

A

BENEFITS
Can remove for OH
Can wear part time
Patient controlled
Easy to spot problem/replace

DRAWBACKS
Requires patient compliance
Can be worn and broken by parafunctional habit.

29
Q

What types of removable retainer are available?

A

Clear occlusal retainer
Pressure/vacuum formed retainer
Essix retainer
Hawyley type retainer

30
Q

What are the benefits and drawbacks of fixed retainers?

A

BENEFITS
Does not require patient compliance

DRAWBACKS
Prone to plaque and calculus build up
Can break without patient noticing
Needs excellent OH
Requires more care/long term maintenance

31
Q

What steps can be taken to manage soft tissue trauma from orthodontic work?

A

Analgesia
Orthowax/babybel cheese wax over sharp components

32
Q

Explain the nature of recession from orthodontic treatment?

A

An increasing problem, more common in adult patients.

It may not manifest until years after treatment.

33
Q

How can you manage the risk of recession from orthodontic treatment?

A

Correct Tx planning
Avoid overexpansion
Thin biotype
Warn patient
Gingival graft/surgery

34
Q

What is the risk to gingival health from orthodontic treatment?

A

Gingivitis is common

Recession can happen

Active periodontal disease must be treated, stabilized, and maintained before ortho Tx

During orthodontic treatment, alveolar bone loss and periodontal destruction is accelerated.

35
Q

What mechanisms are in place to prevent headgear trauma?

A

Snap away traction spring
Nitom facebow

36
Q

How can tooth wear/enamel fracture occur during orthodontic treatment?

A

Tooth versus bracket

Greater risk with ceramic brackets

Ceramic harder than enamel

Enamel fracture from debond

37
Q

Describe the risk of vitality loss from orthodontic treatment?

A

Rare

More risk if previous trauma/compromised tooth

Warn patient

Can be idiopathic

38
Q

What allergies are relevant to note for orthodontic treatment?

A

Latex

Nickel

Adhesive - colophony

39
Q

What factors lead to poor/failed orthodontic treatment?

A

From the clinician:
- Poor diagnosis
- Poor Tx planning
- Operator technique error

The patient
- Unfavorable growth
- Poor co-operation

Also consider:
- Severity of malocclusion
- Motivation of patient
- Operator expertise

40
Q

What are some potential drawbacks of cosmetic quick ortho (also known as six month smiles)?

A

Only can fix mild problems
Unrealistic patient expectations
Informed choice
Relapse
Litigation prone in hands of inexperienced operators

41
Q

What type of patients have the most to gain, and least to loose from orthodontic treatment?

A

Patients with severe malocclusion treated by experts.

42
Q

What type of patients have the least to gain, and the most to loose from orthodontic treatment?

A

Patients with mild malocclusions.

FINALS - Orthodontics (19 decks)

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