Risks of Ortho txt Flashcards
What are the 3 main benefits of Orthodontic txt?
- Improvement in appearance (dental and facial)
- Improvement in function (mastication and speech(rarely))
- Improvement in dental health
What severe malocclusion are associated with improvement of function after ortho txt?
- Large AOB
- Severe increased OJ
- Marked reverse OJ
What do the numbers mean in terms of txt in the IOTN dental health component?
1&2 - No need or Low need (min benefit)
3 - Borderline need (some benefit)
4&5 - Need/high need (sig benefit)
What does the MOCDO acroynm stand for?
Missing teeth
Overjet
Crossbites
Displacements of contact points (ie crowding)
Overbites
What are the risks of impacted teeth?
- Root resorption of adjacent
- Supernumerary can prevent normal eruption
- Can be ass with cyst formation
What measurement of an OJ is at increased risk of trauma? What makes this problem worse?
> 6mm OJ risk of trauma to upper incisors
- Greater the OJ greater the risk
- Worse with incompetent lips
What are some risks with having an Anterior crossbite?
- Loss of perio support
- Tooth wear
What risk ass with posterior crossbites?
- A sig displacement may lead to asymmetry and requiring early correction
Crowding can make what more difficult to do?
- more difficult to clean
- surfaces less accessible
What is a negative impact from deep traumatic overbite?
- Gingival stripping
- Loss of perio support
If a pt has TMJ dysfunction , what advice would you give them if they wanted ortho txt?
- Ortho in isolation should not be offered to impropve TMD
- Conservative txt must be offered before any ortho
- Ortho txt may aggravte TMD e.g. using intermaxillary elastics
What are some risk ass with ortho txt?
- Decalcification (weakens the enamel to caries - etch and bond)
- Root resorption
- Relapse
- Soft tissue trauma
less common
- Recession
- Loss of perio support
- Headgear injuries
- Enamel fracture and tooth wear
- Loss of vitality
- Allergy
- Poor or failed txt
How can you prevent decalcification?
- Good case selection of motivated pt , low caries risk and good OH pre txtx
- Oral hygiene
- Diet advice
- Fluoride
What OHI advice would you give pt?
- Toothbrushing
- Inter dental brushing
- Min twices per day throughoughly
- After meals
- Disclosing tablet
- Target gingival margins and around each bracket
What diet advice would you give the pt?
- Encourage low cariogenic diet
- Reduce sugar intake and frequency
- Use sugar free gum as this stimulates salivary buffer
What fluoride can help prevent decalcoification?
- Toothpaste with F
- High risk 2800ppm or 5000ppm twice daily
- Mouthwash 0.05% fluoride mouthwash (225ppm)
- Duraphat fluoride varnish 22,600ppm
Root resorption is an inevitable consequence of ortho txt. What is the average over 2 yrs fixed appliance. What is the most common teeth affected?
- approx 1mm 2yrs fixed
- Any teeth but UI>LI>6s
What are the risk factors for root resorption?
Type of tooth movement
- Prolonged high force
- Intrusioin
- Large movements
- Torque root movements
Root form
- Blunt
- Pipette
- Resorbed already
Previous trauma
Nailing biting?
What is meant by the term relapse?
- return of features of the original malocclusion following correction
What features are more prone to relapse?
- Lower incisor crowding
- rotations
- Instanding 2s
- Spaces and diastemes
- Class II div 2
- AOB
How do you manage relapse?
- Good case selection
- informed consent
- Life long retention either fixed or removable
What is the management of recession after ortho txt?
- Correct txt planning (teeth within bone avoid overexpansion
- Thing biotype
- Warn pt
- Gingival graft
What should you do if pt has active perio disease and wants ortho?
- Must be treated, stabilsed and maintained before ortho txt starts
What allergys can a person have related to ortho?
- Latex
- Nickel
- Adhesive - colophony
Why might a txt have a poor or even failed outcome?
The clinician
- Poor diagnosis
- Poor txt planning
- Operator techniw error i.e. poor mechanics
The Patient
- Unfavourable growth
- Poor coop with either appliance wear, repeated breakages or poor attendance
What factors does txt succes increase with?
- Severity of malocclusion
- motivation of pt
- Operator expertise
