Space Management Flashcards

1
Q

During the mixed dentition, the “______ ______ __ _______”, both skeletal and dental structures change ________.

A

Golden Stage of Dentition
concurrently

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2
Q

For a child with ____ developmental spaces, prediction goes towards a well aligned permanent dentition.

A

all

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3
Q

On the other hand, any disturbance in these spaces, either ______ __ ______, can potentially altered the outcome.

A

increase or decrease

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4
Q

Space analysis -

A

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

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5
Q

Space analysis requires a comparison between

A

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

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6
Q

what are the 3 results when comparing the space available and the space required?

A

Excess
OK
Deficiency

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7
Q

Is lack or space or excess space in arches more common?

A

Lack of space, but should not ignore excess space

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8
Q

What are the 3 groups of space deficiency?

A

Mild: 0-4mm
Moderate: 4-8mm
Severe: >8

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9
Q

For excess space there is not categories, each case is assessed based on its _______ and ____ _____

A

Etiology and other factors

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10
Q

What is Spacing?

A

Spaced dentition is characterized by interdental spaces and lack of contact points between the teeth.
Common esthetic problem.

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11
Q

In young populations, is spacing more common in boys or girls & which ethnicity is more common?

A

Boys and African Americans

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12
Q

Spacing can be localized or generalized due to the number of teeth included, which is more common?

A

Generalized

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13
Q

The 3 causes of spacing are

A

Hereditary
Acquired
Functional

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14
Q

Hereditary causes include

A
  • Tooth size-arch size discrepancies
  • Protrusive teeth
  • Congenitally missing teeth
  • Macroglossia
  • Supernumerary teeth
  • Small teeth
  • Hypertrophic frenum.
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15
Q

Acquired problems can be classified as:

A
  • Pathologic conditions increasing tongue size
  • Missing teeth
  • Delayed eruption of permanent teeth
  • Periodontal disease
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16
Q

Functional causes include:

A

Oral habits
*easiest to dx but hardest to fix

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17
Q

To achieve the most esthetic and functional result, orthodontists must carefully evaluate the _____ _____

A

etiology factors

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18
Q

Spacing should be corrected because it can:

A
  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.
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19
Q

Three treatment options are available for generalized spacing:

A
  1. Esthetic intervention using composite resin, Veneer, Crowns,…
  2. Orthodontic space closure.
  3. Closure of anterior spaces and opening posterior spaces
20
Q

After orthodontic treatment, it is frequently necessary to apply ______ ________ as these cases have a high risk of relapse.

A

fixed retention

21
Q

What is a diastema?

A

a space (or gap) between the maxillary central incisors.
Can be a normal growth characteristic during primary and mixed dentition

22
Q

Prevalence of diastema in 10 to 12 years old children:

A
  • More in maxilla. Between central incisors.
  • African American 19%
  • Caucasians 8%
23
Q

Diastemas may also be caused by:

A
  • Tooth size discrepancy
  • Missing teeth
  • Oversized labial frenum. * Overjet
  • Protrusion of the teeth.
24
Q

Treatment options for a diastema?

A
  • Keep the diastema.
  • Orthodontic treatment.
  • Composite/Porcelain veneers
  • Crown and bridge work or replacement of teeth with implants (adults only).
25
Q

If oversized labial frenum is the reason causing a diastema, pt may be referred for a ________

A

frenectomy

26
Q

If it is a teenager or adult with diastema, the space may need to be closed with braces prior to frenectomy because

A

It is due to scar tissue which may prevent space closure by orthodontic forces.

27
Q

In most cases, diastemas will close spontaneously as the ______ ____

A

canines erupt

28
Q

Generally diastemas more than ____ require active intervention.

A

2mm

29
Q

Removable appliances generally close diastemas by tipping the crowns of incisors vs fixed appliances provide better control of dental alignment.

A
30
Q

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 _______

A

canines

31
Q

what is crowding?

A

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

32
Q

Crowding could be as the result of:

A
  • Twisted or displaced teeth.
  • Disharmony in the tooth to jaw size relationship. * Early or late loss of primary teeth
  • Improper eruption of teeth.
33
Q

what is the etiology of crowding?

A

exact cause of crowding or malocclusion in general is unknown.

34
Q

Several researchers have suggested that the problem is

A

Hereditary
- maybe reduction in jaw sizes over the years
- must be considered multifactorial

35
Q

Crowding should be corrected because it can:

A
  • 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.
36
Q

Mild crowding less than 4.5 mm can be resolved through;

A
  • Preservationoftheleewayspace,
  • Regaining space
  • Limited expansion in the late mixed dentition.
37
Q

Moderate crowding 5 to 9 mm can be approached with:

A

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

38
Q

Severe crowding >10mm will need:

A
  • Extraction
  • Serial extraction or guidance of eruption is reserved for treatment of severe tooth-size/arch-size discrepancies
39
Q

What is Bolton Analysis

A

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

40
Q

Bolton analysis determines:

A

Overall ratio
Anterior ratio

41
Q

Step 1 of calculating Bolton analysis

A

Sum of Mand 12 and Max 12 by The M-D 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)

42
Q

Step 2 of bolton analysis

A

Overall ratio: Sum mand 12/Sum of max 12 X 100 = 91.3%

43
Q

Step 3 of bolton analysis is

A

Interpretation of overall ratio -
If the overall ratio is less than 91.3%, it indicates maxillary tooth materials excess.
(vice versa)

44
Q

Step 4 of bolton analysis is

A

Anterior ratio:
Sum of Mand (anteriors)/Sum of Max (anteriors) X100 = 77.2%

45
Q

Step 5 of bolton analysis : interpretation of Anterior ratio

A

If the overall ratio is less than 77.2%, it indicates maxillary tooth materials
excess. (vice versa)

46
Q

Step 6 in bolton analysis

A
  • 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.
  • 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.
47
Q

review bolton analysis summary

A