Stability Flashcards

1
Q

What are the changes in the untreated dentition?

A

*Crowding increases
*Lower arch shortens and narrows with age
*Lower incisors become more irregular
*Overbite increases

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2
Q

What is the post treatment change?

A
  1. Physiological recovery
  2. Unfavourable growth
  3. True relapse
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3
Q

Physiological recovery

A

return to original malocclusion (i.e. spaces or rotations)

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4
Q

Unfavourable growth

A

irrespective of
orthodontic treatment

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5
Q

True relapse

A

changes occurring due
to the placement of teeth in unstable positions

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6
Q

Key issues with stability?

A

How do we ensure maximum stability?

*Recognising where stability will be a problem

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7
Q

How do we ensure maximum stability?

A

Finish case correctly (achieve occlusal and soft tissue balance)

*Use appropriate retention protocol

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8
Q

Correct finishing- how?

A

*Expansion/contraction of arches
*Overjets/overbites
*Crossbites
*Interdigitation

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9
Q

Expansion/contraction of arches- why does it work?

A

*Teeth exist in a zone of balance

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10
Q

How does it work?

A

Avoid expansion/contraction
*Use patient’s original archform as a guide
*Maintain inter-canine and inter-molar widths

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11
Q

Positive/increased overjet (3)

A

*Lower lip control is crucial

*Reduce overjet to 2-4 mm

*Over-treatment to 0 mm recommended

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12
Q

What to note about the lower lip

A

Lower lip often trapped behind upper incisors in Class II/1

Ideally lower lip should cover 1/3 of u

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13
Q

Negative or reverse overjet

Aim of treatment and important considerations?

A

Must achieve positive incisal overbite at the end of treatment

*Remember to allow for the reduction in overbite due to proclination of the upper incisors during treatment

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14
Q

What could be used to create a positive overbite?

A

Surgery

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15
Q

Increased overbite- aims of treatment?

A

*Correct inter-incisal angle

*Correct lower incisal edge/cingulum plateau relationship

*Over-treatment to 0 mm is recommended

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16
Q

Interincisal angle?

A

125-135 degrees

17
Q

Transverse (crossbite) stability (2)

A

Overtreatment
Good buccal overlap

18
Q

Proportional change in transverse (crossbite) from pre to post treatment

A

AB shoud reduce significantly CD should remain the same

19
Q

What’s important about buccal interdigitation?

A

*Ensure good buccal interdigitation

*Poor interdigitation can lead to post-treatment change

20
Q

Poor interdigitation?…

A

Increases
Overbite
Overjet
Crowding

21
Q

Where would stability be a problem?

A

*Lower incisor crowding
*Median diastema
*Generalised spacing

22
Q

Lower incisor crowding- recognise that…

A

lower incisor alignment is rarely maintained

23
Q

With lower incisor crowding tell patient…

A

*Advise patients of the probability of post treatment change (70%)
*Some minor proclination of the lower incisors is possible (1-2mm)
*Permanent retention is the only way to guarantee stability

24
Q

University of Washington study showed that in 600 patients 5 years out of retention
In premolar extraction cases

A

Majority (half) the patients had moderate crowding and 30 percent had satisfactory and 20 percent severe crowding

25
In non extraction cases
Almost everyone (90 percent) had severe crowding
26
University of Illinois 96 patients 20 post years treatment In extraction cases
Post treatment overjet and mandibular crowing reduced with mandibular crowding reducing the most Long term overjet relapsed the least and mandibular crowding relapsed the most
27
In non extraction cases
Overjet and overbite reduced to the same amount post treatment and mandibular crowding reduced to none Long term overbite nad overeat relapsed a similar amount and mandibular crowding relapsed a bit more
28
OHI and lower incisor crowding
Should be able to fit tepe brushes though lower incisors which should have no crowding post treatment
29
Overall in stability and ortho treatment... Patients should be made aware (-)
Of the potential for relapse and the need for retention at the outset of treatment Of the high potential for post treatment change if expansion is used
30
And ...
*Arch width and arch length constriction is a normal physiological process.