Skeletal Changes

Question 1

The maxilla is attached to the cranium via what

Answer 1

numerous sutures

Question 2

What are the three major clinical problems of maxillary growth

Answer 2

maxillary hypoplasia (class III)
maxillary prognathism (classII)
transverse deficiency (posterior crossbite)

Question 3

This can be used to restrain maxillary growth

Answer 3

headgear

Question 4

What is the distribution of forces involving headgear retraining maxillary growth

Answer 4

500-1000g (orthopedic) distributed over large bone areas and number of teeth

Question 5

What is the force duration involving headgear retraining maxillary growth

Answer 5

12-16 hours/day

Question 6

What is the force frequency involving headgear retraining maxillary growth

Answer 6

intermittent, not continuous

Question 7

What are the common headgear variations

Answer 7

high-pull
cervical pull
combination

Question 8

Where are the intraoral components anchored involving maxillary protraction-face mask and reverse pull headgear

Answer 8

maxillary molars (sometimes premolars)

Question 9

These can be used for maxillary protraction to minimize unwanted dental movement

Answer 9

temporary implants or ankylosed teeth

Question 10

When is maxillary protraction-face mask and reverse pull headgear typically done

Answer 10

before the age 9-10 (when sutures close)

Question 11

How long does maxillary protraction-face mask and reverse pull headgear last

Answer 11

6-8/9-12 months

Question 12

How much skeletal movement can be achieved involving maxillary protraction-face mask and reverse pull headgear

Answer 12

generally not more than 3mm

Question 13

In which patients are you likely to see a maxillary transverse deficiency

Answer 13

in patients with class III, class II vertical problems and as an isolated problem

Question 14

This is a common treatment to correct maxillary transverse deficiency

Answer 14

palatal expansion

Question 15

This suture is targeted during palatal expansion

Answer 15

midpalatal suture

Question 16

How much expansion can you achieve with rapid palatal expansion

Answer 16

1mm/day; mostly in adolescents

takes 2-3 weeks

Question 17

Which is the most common type of palatal expanders

Answer 17

Jackscrew-type expanders

Question 18

What type of palatal expanders are used in preschool and preadolescent patients

Answer 18

W-arch
Quad helix
1mm/week
3-6 months

Question 19

This regarding the mid palatal suture increases with age, which increases the difficulty of suture expansion

Answer 19

interdigitation

Question 20

RPE is mostly done in adolescents and pre-adolescents, which produces what movements

Answer 20

50% skeletal

50% dental

Question 21

In adults, the mid palatal suture is either fused or highly interdigitated, a palatal expansion would produce what

Answer 21

mostly (if not entirely) dental movements

large movements may require surgically assisted RPE

Question 22

The mandible grows mainly at which two locations

Answer 22

the condyles (endochondral)
posterior and lateral surfaces (intramembraneous)

Question 23

What are the three common clinical problems of mandibular growth

Answer 23

mandibular hypoplasia/retrognathism (class II)
mandibular prognathism (class III)
transverse constriction (brodie bite)

Question 24

Functional appliances can accelerate mandibular growth, but may not what

Answer 24

increase the final size of the mandible

Question 25

This partly accounts for the inconsistent skeletal effect

Answer 25

the loading pattern

Question 26

What are the two common unwanted dental effects of functional appliances

Answer 26

lower incisor proclination

upper incisor retroclination

Question 27

Functional appliances may reduce what, which is acceptable for some patients

Answer 27

overjet

Question 28

Why is the retraining mandibular growth-chin cup headgear no longer used

Answer 28

it reduces mandibular protrusion primarily by increasing anterior face height rather than shortening its size

Question 29

This is the most common treatment for mandibular prognathism

Answer 29

mandibular surgical setback after the cessation of mandibular growth

Question 30

Why is widening of the mandible difficult to achieve

Answer 30

the symphisis fuses at 7-8 months in most humans

Question 31

Mandibular expansion appliances expand what

Answer 31

dento-alveolus but not basal bone

Question 32

Expansion of the mandible basal bone requires what

Answer 32

surgical procedure; distraction osteogenesis

Question 33

This is a surgically and mechanically induced bone regeneration process, which has been used commonly to lengthen limb and craniofacial bones

Answer 33

distraction osteogenesis

Question 34

How does distraction osteogenesis work

Answer 34

two bone fragments are gradually opened by the distractor to create a gap which induces new bone formation, consolidation, and remodeling

Question 35

This is a term used to describe the adaptation of the soft tissues which include the blood vessels, ligaments, muscles, and nerves, etc.

Answer 35

distraction histogenesis

Question 36

This is the interval between osteotomy operation and the start of distraction

Answer 36

latency

Question 37

This is the period that distractor activation takes place

Answer 37

distraction

Question 38

This is the post distraction period (appliance is still in place) to allow for new bone formation

Answer 38

consolidation

Question 39

This is the period that the regenerated bone continues to remodel (after appliance removal)

Answer 39

remodeling

Question 40

How much should you over-expand so consolidation can occur

Answer 40

30%