Risks Of Orthodontic Treatment

Question 1

Permanent stains of various shades (yellow, white, brown) due to loss of minerals from enamel, can progress to caries, can appear very early in orthodontic treatment, mainly in association with fixed appliances

Answer 1

Decalcification (associated with inadequate patient oral hygiene)

Question 2

Generally found at bond margins in a patient with very poor oral hygiene

Answer 2

Caries

Question 3

_________ and __________ may both resorb during application of orthodontic force

Answer 3

Cementum and dentin

Question 4

Resorbed areas will fill in with ———

Answer 4

New cementum

Question 5

Certain factors may be associated with significant amounts of root resorption (8)

Answer 5

1. root morphology (pointed apices, dilaceration)
2. position of tooth in arch
3. history of severe trauma
4. excessive orthodontic force
5. type of orthodontic force
6. prolonged orthodontic treatment
7. pre-exsisting root resorption
8. metabolic/hormonal factors

Question 6

It is rare for pulp to devitalize during orthodontic treatment.

Give 3 instances where this may occur

Answer 6

• excessive forces
• devitalization may occur of the impacted due to the excessive distance in which the cuspid has to move
• the adjunct lateral incisor may devitalize if extreme root resorption is inflicted upon tooth by cuspid prior to treatment

Question 7

Alveolar bone can be perforated when:

Answer 7

By a root that is moved too far
Forces are applied rapidly or when a non-surgical case is being treated aggressively.

Gingival recession or increased risk of such may be associated with alveolar perforation

Question 8

Gingivae may bunch in extraction sites after space closure.

Answer 8

Some patients require periodontal surgery to revise the gingival anatomy during or after orthodontics

Question 9

Ischemic

Answer 9

Restriction in blood supply

Question 10

Orthodontic forces may produce ischemic areas within the periodontal ligament.

This can cause?

Answer 10

Which are the source of discomfort to patients. Mild aching and tenderness to occlusal pressure start several hours after insert/activation and may last for several hours. Response varies from patient

Question 11

During opening movements, the jaw joint moves down and forwards and clicks onto the disk (r____) and the opening is normal.

When the patient closes their mouth the jaw joint will “slip off” the distal aspect of the disk

Answer 11

Displacement with reduction

Question 12

A ____ ______ ______ _______ occurs when the jaw joint moves down and forward but does not slip into the disk.

The disk is “locked” forward and limits the amount of mandibular opening

Answer 12

Disk displacement without reduction