space maintenance

Question 1

skeletal and dental structures during “golden age of dentition”?

Answer 1

During the mixed dentition, the “Golden Stage of Dentition”, both skeletal and dental structures change concurrently

Question 2

For a child with all developmental spaces, prediction goes towards? what if there are disturbances?

Answer 2

For a child with all developmental spaces, prediction goes towards a well aligned permanent dentition
On the other hand, any disturbance in these spaces, either increased or decreased, can potentially altered the outcome.

Question 3

Space analysis quantifies what?

Answer 3

the amount of needed space (crowding/ spacing) within the arches estimating the severity of space discrepancy

Question 4

what does space analysis compare?

Answer 4

comparison between the amount of space
available for the alignment of the teeth and the amount of space
required to align them adequately.

Question 5

results of space analysis

Answer 5

• Space Available and Space Required Comparison has 3 results:
• Excess
• OK
• Deficiency

Question 6

which is more common lack of space or excess

Answer 6

lack of space, but do not ignore excess space

Question 7

crowding divisions

Answer 7

1. Mild
2. Moderate
3. Severe

Question 8

categories of excessive space?

Answer 8

or excess space there is not such a category. Each case will
be assessed based on its etiology and other factors.

Question 9

What is Spacing?
* Spaced dentition is characterized by?
* esthetic problems?
* boys vs girls?
* localized vs generalized?

Answer 9

• Spaced dentition is characterized by interdental spaces and lack
  of contact points between the teeth.
• It is a common esthetic problem for many patients.
• In studies related to young populations, it was found that
  spacing in both arches was more common in boys than girls.
• Spacing can be localized or generalized due to the number of teeth
  included.

Question 10

potetnial etiologies of spacing

Answer 10

• The causes of generalized spacing
  may be:
• Hereditary
• Acquired
• Functional

Question 11

Hereditary causes of spacing include
* Tooth size-arch size?
* angulation?
* Congenitally?
* tongue?
* Supernumeraries?
* tooth size?
* frenum?

Answer 11

Hereditary causes include
* Tooth size-arch size discrepancies
* Protrusive teeth
* Congenitally missing teeth
* Macroglossia
* Supernumerary teeth
* Small teeth
* Hypertrophic frenum

Question 12

Acquired problems for spacing can be
classified as:
* Pathologic conditions increasing?
* Missing?
* Delayed eruption?
* Perio?

Answer 12

• Pathologic conditions increasing tongue size
• Missing teeth
• Delayed eruption of permanent teeth
• Periodontal disease

Question 13

functional causes of spacing

Answer 13

oral habits

Question 14

What can we do for spacing?
* Orthodontics plays an important role in the management of spaced
dentition, often in cooperation with?
* To achieve the most esthetic and functional result, orthodontists must evaluate what?
* Diagnostic set-up of dental casts may be useful in?

Answer 14

What can we do?
* Orthodontics plays an important role in the management of spaced
dentition, often in cooperation with other dental departments such
as oral surgery, periodontology, esthetic dentistry, and
prosthodontics.
* To achieve the most esthetic and functional result,
orthodontists must carefully evaluate the etiologic factors.
* Diagnostic set-up of dental casts may be useful in treatment
planning and informing the patient.

Question 15

Why should we correct spacing?
* Spacing should be corrected because it can:

Answer 15

1. Result in gum problems due to the lack of protection by the teeth.
2. Prevent proper functioning of the teeth.
3. Make the smile less attractive.

Question 16

tx options for generalized spacing

Answer 16

1. Esthetic intervention using composite resin, Veneer, Crowns,…
2. Orthodontic space closure.
3. Closure of anterior spaces and opening posterior spaces

Question 17

what is necessary after tx of generalized spacing?

Answer 17

fixed retention due to high relapse rate
Can make oral hygiene difficult

Question 18

What is a Diastema?
* The midline diastema?
* The space can be a? when?

Answer 18

• The midline diastema is a space (or gap) between the maxillary central incisors.
• The space can be a normal growth characteristic during the primary and mixed dentition.

Question 19

Prevalence of diastema in 10 to 12 years old children:
* more in which arch?
* African American %
* Caucasians %

Answer 19

• More in maxilla. Between central incisors.
• African American 19%
• Caucasians 8%

Question 20

• Diastemas may also be caused by:
• • Tooth size ?
• Missing?
• Oversized?
• Over?
• angulation of the teeth?

Answer 20

• Tooth size discrepancy
• Missing teeth
• Oversized labial frenum.
• Overjet
• Protrusion of the teeth

Question 21

tx options for diastemas

Answer 21

Once the reason has determined. Options may include:
* Keep the diastema.
* Orthodontic treatment.
* Composite/Porcelain veneers
* Crown and bridge work or replacement of teeth with implants (adults only).

Question 22

oversized labial frenum tx

child vs adult tx

Answer 22

If oversized labial frenum is the reason, pt may be referred for a frenectomy.
* If the frenectomy is conducted on a child, the space may close by itself.
* If it is a teenager or adult, the space may need to be closed with braces prior to frenectomy. It is due to scar tissue which may prevent space closure by orthodontic forces

Question 23

when could diastemas close spontaneously in development, what is the implication of this?

Answer 23

• In most cases, diastemas will close spontaneously as the canines
  erupt due to their M inclination applying forces on the incisiors
• Little disagreement can be found that intervention to close the diastema should be deferred until the canines have fully erupted

Question 24

what size of diastemas req active intervention

removable vs fixed appliances?

Answer 24

Generally diastemas more than 2 mm require active intervention.
* Removable appliances generally close diastemas by tipping the crowns of incisors vs fixed appliances provide better control of dental alignment.

Question 25

mixed dentition caution when tx diastemas

Answer 25

In the mixed dentition, caution is necessary to avoid tipping the roots of lateral incisors distally such that they interfere with the erupting path of the canines.

Question 26

diastema relapse

Answer 26

There is a strong tendency toward relapse, hence a fixed retainer is nessecary

Question 27

crowding

Answer 27

Crowding is the lack of space for all the teeth to fit normally within the jaws.

Question 28

Crowding could be as the result of: * Twisted or displaced? * Disharmony in the? * Early or late loss of? * Improper?

Answer 28

* Twisted or displaced teeth. * Disharmony in the tooth to jaw size relationship. * Early or late loss of primary teeth * Improper eruption of teeth.

Question 29

Crowding etiology

Answer 29

* The exact cause of crowding or malocclusion in general is unknown. * Several researchers have suggested that the problem is hereditary and is associated with the evolutionary development of modern humans. * These investigators attributed the main cause of crowding to a progressive reduction in the jaw size as compared with tooth size. * Another author believed there are true signs of hereditary and environmentally induced tooth size/jaw-size discrepancy “Signs of a True Hereditary Tooth-Size/Jaw-Size Discrepancy” and “Environmental Factors Causing Crowding.” * Given the size of these lists, the etiology of crowding must be **considered multifactorial.**

Question 30

Why should we treat Crowding? * Prevents? * Promotes? * Increase the chances of? * Prevents? * Make your smile?

Answer 30

* Prevent proper cleaning of all the surfaces of your teeth. * Promote dental decay. * Increase the chances of gum disease. * Prevent proper functioning of teeth. * Make your smile less attractive

Question 31

classes of crowding

Answer 31

Mild crowding less than 4.5 mm Moderate 5mm to 9mm Severe 10mm or more

Question 32

Mild crowding less than 4.5 mm can be resolved through;

Answer 32

* Preservation of the leeway space, * Regaining space * Limited expansion in the late mixed dentition.

Question 33

Moderate crowding 5 to 9 mm can be approached with:

Answer 33

* Expansion * Some of these cases may require extraction of permanent teeth

Question 34

Severe crowding >10mm will need:

Answer 34

* Extraction * Serial extraction or guidance of eruption is reserved for treatment of severe tooth-size/arch-size discrepancies

Question 35

serial extractions

Answer 35

extraction of primary toth and successor (generally 1st PM)

Question 36

Eruption guidance

Answer 36

extraction of primary tooth but successor remains

Question 37

Bolton Analysis * It determines the ratio of? * It shows whether there is any? * It is recommended for? when? * Bolton analysis determines:

Answer 37

* It determines the ratio of the MD widths of the Max teeth to Man teeth. * It shows whether there is any tooth size discrepancy between the upper and lower teeth. * It is recommended for permanent dentition, after eruption of all permanent teeth from 1 st molar to 1 st molar. * Bolton analysis determines: * Overall ratio. * Anterior ratio.

Question 38

bolton analysis overall ration calculation

Answer 38

sum of man MD width from 1st molar to 1st molar divided by the same sum of maxillary

Question 39

interpreting overall bolton analysis

Answer 39

* If the overall ratio is** less than 91.3%**, it **indicates maxillary tooth materials excess**. (vice versa) * The maxillary teeth are relatively too large compared to the mandibular teeth. (vice versa) | more than 91.3=man excess

Question 40

anterior bolton analysis

Answer 40

Question 41

interpreting ant bolotn analysis

Answer 41

* If the overall ratio is **less than 77.2%, it indicates maxillary tooth materials excess. (vice versa)** * The maxillary teeth are relatively too large compared to the mandibular teeth. (vice versa) | more than 77.2= man excess

Question 42

what is done after calculating the bolton ratios

Answer 42

* After calculation of the Bolton ratio (Overall and Anterior), the arch with the relatively smaller tooth material is determined and the actual figure/value corresponding to the arch tooth size is located in the table. * The ideal value for the size of the opposing teeth is read off from the accompanying column. * The difference between the actual value and the ideal value (according to the table) for the relatively enlarged tooth material represents in mm the amount of excess tooth size in the arch.