Space Maintenance Flashcards
when does the golden stage of dentition occur and what happens
- during mixed dentition
- both skeletal and dental structures change concurrently
for a child with all development spaces prediction goes towards:
a well aligned permanent dentition
any disturbances in primate spaces means:
either increased or decreased spacing can potentially alter the outcome
what does space analysis do
it quantifies the amount of needed space (crowding/spacing) within the arches estimating the severity of space discrepancy
what does space analysis require
a comparison between the amount of space available for the alignment of the teeth and the amount of space required to align them adequately
space available and space required comparison has 3 results:
- excess
- OK
- deficiency
which is more common: excess spacing or not enough
not enough
what are the 3 categories of crowding
- mild
- moderate
- severe
what are the categories for excess space
there are no categories- each case is assessed based on etiology and other factors
what is spacing
interdental spaces and lack of contact points between the teeth
what is mild crowding
4mm
what is moderate crowding
5-8mm
what is severe crowding
greater than 8 mm
is spacing common
yes
is spacing more common in both arches in girls or boys
boys
spacing can be ______ or _____ due to the number of teeth included
localized or generalized
what is the etiology of spacing
- hereditary
- acquired
- functional
what are the hereditary causes
-tooth size arch size discrepancies
- protrusive teeth
- congenitally missing teeth
- macroglossia
- supernumerary teeth
- small teeth
- hypertrophic frenum
what are the functional causes of spacing
- oral habits
what can the acquired problems be classified as
- pathologic conditions increasing tongue size
- missing teeth
- delayed eruption of permanent teeth
- periodontal disease
orthodontics play a role in management of spaces often in cooperation with:
oral surgery, perio, esthetic dentistry and prosthodontics
to achieve the most esthetic and functional result, orthodontists must:
carefully evaluate the etiologic factors
why should we correct spacing
- result in gum problems due to the lack of protection by the teeth
- prevent proper functioning of the teeth
- make the smile less attractive
what are the 3 options to treat generalized spacing
- esthetic intervention using composite resin, veneer, crowns
- orthodontic space closure
- closure of anterior spaces and opening of posterior sapces
after orthodontic treatment it is frequently necessary to apply:
fixed retention
why is fixed retention necessary
these cases have a high risk of relapse
what is a diastema
the midline diastema is a space or gap between the maxillary central incisors
a diastema can be a ____ growth characteristic during the:
normal; primary and mixed dentition
what is the prevalence of diastema in 10-12 year old children
- more in maxilla, between central incisors
- african americans 19%
- caucasians 8%
what is the etiology of a diastema
- tooth size discrepancy
- missing teeth
- oversized labial frenum
- overjet
- protrusion of the teeth
what are the treatment options for a diastema
- keep the diastema
- orthodontic treatment
- composite/porcelain veneers
- crown and bridge work or replacement of teeth with implants (adults only)
if oversized labial frenum is the reason for a diastema:
pt may be referred for a frenectomy
if the frenectomy is done on a child the space may:
close by itself
if the frenectomy is done on a teenager or adult the space_______ because
may need to be closed with braces prior to frenectomy; scar tissue which may prevent space closure by orthodontic forces
what happens in most cases of diastemas
diastemas will close spontaneously as the canines erupt
generally diastemas more than ____ require intervention
2mm
when should treatment of diastemas be deferred until
until the canines have fully erupted
how do removable appliances close diastemas vs fixed appliances
they close by tipping the crowns of incisors vs fixed appliances provide better control of dental alignment
what do you need to be careful of in closing diastemas in the mixed dentition
avoid tipping the roots of lateral incisors distally such that they interfere with the erupting path of the canines
there is a ______ towards relapse with diastemas, hence a ____ is necessary
strong tendency; fixed retainer
what is crowding
the lack of space for all the teeth to fit normally within the jaws
crowding could be the result of:
- twisted or displaced teeth
- disharmony in the tooth to jaw size relationship
- early or late loss of primary teeth
- improper eruption of teeth
what is the cause of crowding or malocclusion
generally unknown
several researchers suggest that the etiology of malocclusion is:
hereditary and associated with the evolutionary development of modern humans due to a progressive reduction in jaw size as compared with tooth size
the etiology of crowding must be considered:
multifactorial
why should we treat crowding
- 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
what are the treatment options for mild crowding less than 4.5mm
- preservation of the leeway space
- regaining space
- limited expansion in the late mixed dentition
proper management of space in the primary and mixed dentitions can:
prevent unnecessary loss in arch length
what are the treatment options for moderate crowding between 5-9mm
- expansion
- some of these cases may require extraction of permanent teeth
what are the treatment options for severe crowding greater than 10mm
- extraction
- serial extraction or guidance is reserved for treatment of severe tooth size/arch size discrepancies
what does the bolton analysis determine
- the ratio of the MD widths of the max teeth to mand teeth
- whether there is any tooth size discrepancy between the upper and lower teeth
when is the bolton analysis recommended
for the permanent dentition after eruption of all permanent teeth from 1st molar to 1st molar
what ratios does the bolton analysis determine
- overall ratio
- anterior ratio
what is step 1 of calculating the bolton analysis
- sum of mandibular 12: the MD width of all permanent teeth from 1st molar on one side to the 1st molar on the other side, is measured and summed up - 2nd and 3rd molars are excluded
- sum of maxillary 12: the MD width of all permanent teeth from 1st molar on one side to the 1st molar on the other side, is measured and summed up - 2nd and 3rd molars are excluded
what is step 2 in calculating the bolton analysis
- overall ratio: the sum of the MD width of the mandibular teeth to maxillary teeth (12 teeth, 6-6) is 91.3%
what is step 3 in calculating the bolton analysis
- interpretation (overall ratio)
- if the overall ratio is less than 91.3% it indicates maxillary tooth materials excess and vice versa
- maxillary teeth are relatively too large compared to the mandibular teeth and vice versa
what is step 4 of calculating the bolton analyssi
- anterior ratio: according the bolton, the sum of the MD width of the anterior mandibular teeth to the anterior maxillary teeth ( 6 teeth 3-3) is 77.2%
what is step 5 in calculating the bolton analysis
- interpretation (anterior ratio): if the overall ratio is less than 77.2% it indicates maxillary tooth materials excess and vice versa
the maxillary teeth are _____ compared to the mandibular teeth
relatively large
what is step 6 in calculation of bolton analyssi
- calculation in mm
- 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 for the relatively enlarged tooth material represnets:
in mm the amount of excess tooth size in the arch
