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Orthodontics > Risks and Benefits of Orthodontic Treatment > Flashcards

Risks and Benefits of Orthodontic Treatment Flashcards

1
Q

What are the benefits of ortho treatment?

A

Improvement in appearance, function and dental health.

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2
Q

What are the psychological benefits of ortho treatment?

A

improve self esteem and psychological wellbeing

Quality of life improvement.

Children with “normal” dental appearances are judged to be
- less attractive
- Less intelligent
- less friendly
- more aggressive.

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3
Q

What are the functional benefits of ortho treatment?

A

Improved mastication and (potentially) speech

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4
Q

What type of malocclusions are likely to benefit from ortho treatment in terms of function?

A

Large AOB
Severe increased OJ
Marked reverse OJ

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5
Q

In terms of IOTN, what determines treatment need?

A

1 and 2- no treatment need/little treatment need.

3- borderline need

4 and 5- High treatment need

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6
Q

What are the potential consequences of impacted teeth?

A

Resorption of neighbouring teeth and the impacted tooth

Cyst formation

Prevent normal eruption of other teeth

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7
Q

What are the potential consequences of an increased overjet greater than 6mm?

A

Risk of trauma to upper incisors
- worse with incompetent lips.

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8
Q

What are the potential consequences of anterior crossbites?

A

Loss of perio support
Tooth wear
Gingival recession

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9
Q

What are the potential consequences of posterior crossbites?

A

A significant displacement may lead to asymmetry.

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10
Q

What are the potential consequences of crowding?

A

Crowded teeth are more difficult to clean- but not directly linked to caries.

Weak association between irregular teeth and periodontal disease.

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11
Q

What are the potential consequences of a deep traumatic overbite?

A

Gingival stripping

Less perio support

Trauma to the palate

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12
Q

What is the association between TMJ dysfunction and malocclusion?

A

Crossbite with displacement
Class II with recursive mandible
Class III
AOB

But no guarantee correction will improve TMD- multifactorial disorder.

Advise conservative treatment first for TMD.

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13
Q

What are the main risks of ortho treatment?

A

Decalcification
Root resorption
Relapse
Soft tissue trauma
Recession
Loss of perio support
Headgear inuuries
Enamel fracture and tooth wear
Loss of vitality
Allergy
Poor/failed treatment

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14
Q

How is decalcification a risk associated with ortho treatment?

A

The ortho appliance is a plaque retentive factor.
If plaque not brushed away, leads to decalcification and eventually calcification.

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15
Q

What is the role of the GDP in preventing decalcification in ortho patients?

A

Case selection- motivated patient, good OH pre-treatment, low caries risk.
Regular OHI
Diet advice
Fluoride

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16
Q

What would make a patient high risk for decalcification?

A

Pre-existing decalcification
Erosion
Caries history

17
Q

What OHI would you give a patient with ortho appliances?

A

Brush a minimum of twice a day for 2 minutes with fluoride toothpaste- spit don’t rinse.
Brush after every meal
Use disclosing tablets to see the areas you are missing
Target gingival margins around each bracket
Interdental brushes to get in between the brackets and the teeth
Fluoride- toothpaste, duraphat, mouthwash, fluoride varnish

18
Q

What diet advice would you give a patient with ortho appliances?

A

Encourage a non-cariogenic diet

Avoid snacks between meals- if you are going to snack eat things like crackers, crisps, savoury sandwiches.

Avoid fizzy drinks and diluting juice, sports drinks.

Avoid sticky sweeties.

Can use sugar free gum- stimulates salivary buffers.

19
Q

What can you give high risk patients in terms of fluoride?

A

Duraphat toothpaste- 2800ppm if they are over 10, 5000ppm toothpaste if they’re over 16.

Use twice a day- use normal toothpaste other times during the day.

0.05% fluoride mouthwash (225ppm)- in between brushing and not after.

Duraphat varnish- 22,600ppm, applied up to 4 times a year.

20
Q

How is root resorption a risk factor associated with ortho treatment?

A

Inevitable consequence of tooth movement.

21
Q

How much root resorption would be considered normal during ortho treatment?

A

Average is approximately 1mm over 2 years.

22
Q

Which teeth are most susceptible to root resorption?

A

Any teeth but most common in
- upper incisors
- lower incisors
- 6’s

23
Q

What factors make a patient at increased risk of root resorption?

A

Type of tooth movement- prolonged high forces, intrusion, large movements, torque.

Root form- blunt, pipette, resorbed already

Previous trauma

Nail biting

24
Q

What is relapse?

A

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

25
Q

Which teeth/malocclusions are most prone to relapse?

A

Lower incisal crowding
Rotations
Crowding
In-standing lateral
AOB, diastemas
Class II div 2
Reduced perio support/short roots

26
Q

How do you prevent relapse?

A

Retention- removable or fixed.
- See ortho lab flashcards for more info.

27
Q

How is soft tissue trauma a risk of ortho treatment?

A

Pain/discomfort from the tooth movement- give analgesia advice.

Ulceration- ortho wax/babybel cheese wax.

28
Q

What is the management of recession cased by ortho treatment?

A

Correct treatment planning- teeth within bone, avoid over expansion.

Warn patient if they are at risk- thin biotype

Could potentially do a gingival graft.

29
Q

How does periodontal health influence ortho treatment?

A

Must be treated, stabilised and maintained before ortho treatment starts.

Ortho treatment will accelerate alveolar bone loss and perio destruction.

Loss of perio support.

30
Q

How can you prevent headgear trauma?

A

Safety mechanisms- must have 2 minimum.
- Snap away traction spring.
- Nitom facebow.

31
Q

What increases risk of toothwear/enamel fracture during ortho treatment?

A

Ceramic brackets- ceramic is harder than enamel.

Need to make sure that the bracket is not interfering with the occlusion in any way.

32
Q

What increases the chance of loss of vitality?

A

Previous trauma
Excessive forces
Idiopathic cause

Warn the patient of this risk

33
Q

What might someone be allergic to in ortho appliances?

A

Latex
Nickel
Adhesive- colophony

34
Q

What factors increase the success of treatment?

A

Severity of malocclusion
Motivation of patient
Operator expertise

Orthodontics (15 decks)

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