Special Investigation and Referral

Question 1

Class 3 Malocclusion
How to monitor growth why and how?

Answer 1

• Mandible > maxilla growth (puberty)
  -Height measurement
• Study model
• Lateral Cephalogram
• Hand wrist radiographs

Question 2

Impacted canine

Answer 2

• Palpable at age of 10
• 2-3 % palatal > buccal
• 85% palatal and in arch 15% buccal
• 2D images- Periapical, USO and Orthopantomogram
• 3D - CBCT

Question 3

Trauma

Answer 3

• 45% upper incisors trauma at age of 12 yrs OJ >9mm
• Patient may have trauma before/ during and after tx
• Baseline measurements and regular monitoring (3/12) . Radiographs 6/12 into ortho tx
• Rest before and continue ortho tx after trauma
• length of period of rest depends on type of injury

Question 4

Impacted third molar - Remove when

Answer 4

• unrestorable caries
• Periapical pathology
• Cellulitis
• Abscess
• Resorption of adjacent teeth
• Tooth impeding
• Tumour

Question 5

Cleft lip +/- palate

Answer 5

• Orthodontists part of cleft team
• Incidence 1:700
• UK- Centralised teams
• All cleft patients decrease care of Cleft team
• Routine appointments, Audit appointment with cleft team

Question 6

Why joint clinic

Answer 6

• Joint clinic where different specialities present
• New patient clinic first referred to joint clinic

Question 7

When we need Joint orthodontic clinic

Answer 7

• Orthdontics and oral maxilla facial surgeon
• Patient needs ortho and jaw surgery to correct malocclusion/ facial deformities

Question 8

Process of joint clinic

Answer 8

• New patient clinic
• Join Orthognathic clinic
• Fixed appliance ( pre surgery orthodontic)
• Joint Orthognathic clinic ( OP date)
• Operation
• Post OP review
• Post op orthodontic and debond
• 1,2 and 5 years post op review

Question 9

Hypodontia cases

Answer 9

• Orthodontists and restorative dentist
• Patient with developmental absent teeth (hypodontia)

Question 10

Degree of Hypodontia

Answer 10

• Mild < 2 teeth
• Moderate 2> <6
• Severe >6

Question 11

Joint orthodontics/ Paediatrics

Answer 11

• Hypodontia , Dental trauma, Molar incisor Hypomineralisation, super numaries, Poor prognosis 6’s, Impacted canine, Dental anomalies , Amelognesis imperfecta, Dentinogenesis imperfecta, Megadont

Question 12

Joint clinic / oral surgery

Answer 12

• Orthodontist and maxilla facial surgeon
• Impacted teeth , teeth failed to erupt, Supernumeries