Space management-Dr. V Flashcards

1
Q

List complications of premature loss of primary teeth

A
  • Supraeruption
  • Mesial Drift
  • Distal Drift
  • Change in arch dimension (L & Circumference)
  • Ectopic or blocked eruption of perm teeth
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2
Q

What are some considerations to consider prior to placement of space maintainer

A
  • OH
  • Caries Risk
  • teeth lost
  • Teeth present or remaining
  • Motivation
  • Dental Hx
  • Space Available
  • Occlusion or malocclusion
  • Timing & stage of development
  • Bone Condition
  • Potential & direction of space closure
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3
Q

Loss of Primary Incisor

A
  • cosmetic issue
  • rarely space issue when permanent teeth erupt
  • closes more w/early loss
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4
Q

Loss of Primary 1st molar

A
  • M/D drifting
  • More pronounced in 3-5 y.o.
  • Delayed & ectopic eruption of 2nd bicuspid
  • Tx:
    • early=Band & Loop
    • Late= Lingual Arch
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5
Q

Los of Primary 2nd Molar

A
  • devastating
  • difficult to tx
  • Before 6 year molar erupts
    • tx:
      1. distal shoe→once 6 yr molars are in, switch to:
        • reverse band & loop
        • lingual arch
        • Transpalatal Arch (TPA)
          • aka Nance appliance
        • Nance Appliance
      2. Let teeth erupt, distalize, and create space
  • After 6 yr. molars erupt
    • Lingual arch
      • lower arch if incisors have erupted
      • hold leeway space (E space)
      • hold multiple spaces unilateral or bilateral
    • TPA/Nance
      • Upper arch if incisors have not erupted
      • passive
      • hygienic
      • not impinge on soft tissues
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6
Q

Loss of Primary Canines

A
  • Midline Shift
  • Increase OJ & OB
  • loss of arch dimensions
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7
Q

Space Maintainer Appliances Protocol

A
  • Must check at all recalls for:
    • tooth movement, not passive
    • loose or broken appliance
    • decay
    • gingival issue
    • dental development
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8
Q

What is the importance of space in primary dentition?

A
  • Allows room for permanent dentition
  • Decreases risk of decay
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9
Q

What are the 4 D’s of ortho?

A
  • Description
  • Development
  • Dimensions
  • Diagnosis
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10
Q

What are the stages of development in dentate individuals

A
  • Primary
  • Mixed
    • early
    • late
  • Permanent
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11
Q

How should development be evaluated?

A
  • advanced or delayed based on norms
    • age, race etc
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12
Q

What terms are used to describe occlusion in mixed or permanent dentition?

A
  • Angles Classification
  • Overjet & Overbite
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13
Q

Angles Classification:

A
  • Normal:
    • Maxillary 1st molar cusp→ Buccal groove of Lower 1st molar
  • Class 1:
    • normal molars
    • other alignment irregularities
      • crowding
      • misalignment
      • rotations
      • crossbites
  • Class 2:
    • MB cusp anterior to buccal groove
  • Class 3:
    • MB cusp posterior to Buccal groove
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14
Q

Overjet vs Overbite

A
  • Overjet:
    • horizontal misalignment
    • upper front teeth protrude out
    • aka Buck Teeth
  • Overbite:
    • Vertical Misalignment
      • vertical distance b/w upper and lower front teeth
    • aka deep bite or overbite
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15
Q

Terms to describe primary dentition

A
  • Primate Spaces
  • Baume Classification
  • Terminal Plane
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16
Q

Primate spaces

A
  • naturally occurring
  • primary teeth
  • Upper arch
    • lateral incisor & canine
  • Lower arch
    • 1st molar & canine
17
Q

Baume Classification

A
  • primary teeth
  • Type 1:
    • 3-6 mm of space
    • all space in all teeth
  • Type 2
    • crowded
    • some rotated teeth due to limit space in anterior
18
Q

Leeway Space

A
  • space b/w canine & 2nd molar
    • maintains area for:
      • permanent canine, 1st & 2nd premolar
  • Maxilla
    • needs 1.5mm on each side
  • Mandibular:
    • needs 2.5 on each side
19
Q

Terminal Plane

A
  • primary teeth
  • 2nd molar relationship
  • Determines potential occlusion of permanent teeth
  • Types:
    • Straight Flush
      • normal
    • Distal Step
    • Mesial Step
20
Q

What terms are used to describe arch dimensions?

A
  • Arch length
    • Central incisors→distal 1st perm molar
  • arch width
  • arch perimeter/circumference
21
Q

What are the trends in arch development:

A
  • arch circumference differs
22
Q

Tanaka-Johnston space analysis

A
  • based on lower incisor widths
  • ½ with of lower incisors
    • +11.0 mm=width of 1 quad of unerupted bicuspids & canine in maxillary
    • +10.5mm=” “ in mandibular
23
Q

Moyers Space Analysis

A

Mixed Dentition

  • Add widths of lower 4 incisors=width of unerupted bicuspids/canine from a table
    • use 75%
24
Q

Pacifier Habit: Prevalence

A
  • most children use
  • prolonged use is rare
  • thumb or finer habit might replace
25
Q

Pacifier habit: associated malocclusion

A
  • anterior open bite
  • maxillary arch constriction w/posterior crossbite
  • Labial movement of teeth
26
Q

Pacifier habit impact on teeth

A
  • Minimal if stopped by 18 months
    • More pronounced 36+ months
27
Q

Thumb and Finger Habits: Prevalence

A
  • Most common
  • Starts at birth
  • ⅔ of it disappears by 5
    • incidence:
      • 30% @ 12 months
      • 10% @ 5 y.o.
28
Q

Thumb and Finger Habits: Associated Malocclusion

A
  • Posterior cross bite
  • Anterior Open bite
  • Increased overjet
29
Q

Thumb and Finger Habits: Impact on teeth

A
  • Force magnitude
  • Force direction
  • Frequency in hrs/day
  • Duration in years
30
Q

Thumb and Finger habits: Treatment

A
  • attempt before eruption of perm incisors
  • emotional development
  • counseling
    • effective w/older children
  • reminder therapy
  • reward therapy
  • adjunctive therapy
31
Q

Tongue Thrust

A
  • hard to define what is normal vs abnormal
  • Passive vs active posture of tongue
32
Q

What is an abnormal swallow

A
  • aka atypical swallow
  • active thrust during swallowing
33
Q

Why is there anterior positioning of the tongue?

A
  • development is anterior-posterior
  • tonsils & adenoids
  • need to seal off oral cavity
34
Q

Lip habits : Types & describe

A
  • Types:
    • Lip Licking
      • benign habit
      • produces dermatitis
      • Tx: palliative care
    • Lip Biting:
      • Body-focused repetitive behavior
      • Tx: palliative care & cognitive behavior therapy
      • Severe=radical action
    • Lip sucking:
      • aka trapped lip
      • produces malocclusion
      • tx:
        • myofunctional therapy
        • Lip appliance
        • Functional appliance
        • Fulll ortho care
        • Periodontal tx: recession
35
Q

Lip Habits: Impact on teeth

A
  • Maxillary Incisors-Proclination
  • Mandibular Incisors:
    • retrclination
  • contributes to increased:
    • overjet
    • Class 2 malocclusion