Sweep 1 Flashcards
Effectiveness:
what something can do in the real world.
Efficacy:
what something can do in a controlled environment
Space maintenance for a period of time of
6 months or more - most damage occurs in first six months. Mostly posterior teeth coming forward in upper, anterior going backwards in lower.
Nance is best for when you are missing
multiple upper teeth. Don’t use transpalatals for missing teeth on both sides of arch - they would both tip forward.
Nance are
inactive appliances.
Bilateral max constriction with CO-CR shift ⇒ Tx with
W-arch, Quad helix
Open coil
opens space - need to be compressed to be activated.
Closed coil
holds space
W-arch:
○ Reciprocal anchorage
○ W-configuration → increases wire length ( ↑ flexibility)
○ Force applied near palatal CEJ (not thru Cres)
■ Compression on facial surfaces of molars
■ 50% skeletal & 50% dental
○ Fabrication ⇒ 1rst molars to place band
○ Retention ⇒ ~ 3 months (will relapse into normal occlusion)
Quad Helix
○ Only issue may be
patient compliance → pt may bend lingual wire
Space regaining
more than 3 mm need expansion.
● Pseudo Class III
○ Class I, but interference causes CR-CO shift leading to anterior crossbite
Deep bite use
hawley and bite plate (plastic between front teeth).
Best situation for this? Trauma - palatal tissue irritation
○ Max. removable with double helical cantilever
■ Steel round wire .022
● Double helix →
increases length, thus ↑ range & springiness
○ Max. removable with double helical cantilever
■ Steel round wire .022
● If too small →
deformed by pt; if too big → heavy forces
Double helical cantilever:
● Retention via
● Force applied ——
adams clasps (Lots of retention required; many clasps)
lingually
Double helical cantilever
● No labial bow →
common feature of removables, but labial bow interferes with desired facial movement)
Max removable with double helical cantilever
■ Tx for —— months
● Activate
1-3
2 mm → gives 1 mm of movement in 1 month
○ Fixed appliance for AP bodily movement:
■ Rectangular wire
● 1° dentition w/o successors
○ Ankylosis worsens, so when extracted greater vertical defect (greater periodontal injury & attachment loss)
○ Consider early extraction
○ Elastic bandage ⇒ around elbow; only at night
■ Bulkiness reminds child; not a tight restraint
■ For 6-8 weeks
Treatment options for ankylosed 2nd 1° molars without successors:
● Maintain 1° molars (if no bony defects)
● Extraction before vertical discrepancy too great
● Decoronation - remove crown & leave root tip (facilitates vertical bone growth)
● Don’t treat deep bite in mixed dentition → unless
soft tissue trauma
16 y/o male with Class III
don’t treat till 21 - female at this age can be treated
○ Hawley retainer with finger spring (tipping) →
2 mm activation gets 1 mm movement
■ Adams clasps better for
retention (wraps around teeth; good for kids with short crowns)
TMA preferred over stainless steel for making
bends for extrusion - better flexibility)
○ Retention required when —– manipulated
several teeth
○ Anterior crossbite correction doesn’t require retention if
proper overbite achieved
○ Round wire for —– & —– for finishing
aligning
rectangular
Apnea-Hypopnea Index (AHI) =
total # of apnea + hypopnea / hours of sleep
Metabolic syndrome ⇒
group of risk factors that occur together & ↑ risk of CAD, stroke, DM Type II
● EGG ⇒
monitors brain activity to document sleeps stages
● EOG ⇒
eye movements - determines REM vs. non-REM sleep
● Nasal/oral capnography ⇒
● Nasal/oral capnography ⇒ measures air flow from nose & mouth
● EMG ⇒
muscle activity; bruxism & restless leg syndrome
● ——————— has highest accuracy for invisalign
Lingual constriction
Moderate generalized space discrepancy (—- mm per arch)
<4
Moderate generalized space discrepancy
○ Active Lingual Arch
■ Treats ——–
anterior crowding
Moderate generalized space discrepancy Active lingual arch ● Best for -------- ● ------- of incisors (NOT good for rotations or bodily movement) ○ --------- of molar (anchor tooth) ● Increases risk of ---------
faciolingual discrepancies
Facial tipping
Distal tipping
2nd molar impaction
Moderate generalized space discrepancy
○ Active Lingual Arch
■ Clinical management ⇒
separate teeth for banding; activation every 4-6 weeks
Moderate generalized space discrepancy ○ Lip Bumpers ■ Treats ---------- ● Best for ------- discrepancies ● Possible -------------
lower anterior &/or buccal segment crowding
facial lingual
2nd molar impaction
Moderate generalized space discrepancy
○ Headgear
■ Treats ——— (maxillary arch ONLY)
● Molar movement ———–
○ ———– fibers will pull premolars distally too
● Cervical headgear → also does ———-
● Requires compliance
buccal segment crowding
distally &/or buccally
Interseptal gingival
extrusion
Moderate generalized space discrepancy Headgear ■ Clinical management: ● Adjustment every ----weeks ● Can expect----- mm in a year
6-8
3-4
Serial extractions ⇒ Severe space discrepancy
> 10 mm per arch
● Localized space shortage is an opportunity to regain space if
< 3 mm per quadrant
- Permanent molar ectopic eruption
○ 1rst permanent molar erupts —— → may cause ———-
mesially
1° molar resorption & loss
Moderate localized space discrepancy (
<3mm per quadrant)
○ Space regaining treatment plans:
band and spring
■ BAND & SPRING
● ——- banded and spring pushes——– back
● ——— tip
○ Short roots bc still erupting - very easy to tip
● Fabrication → made by lab, so need to band and separate tooth for impression; wire bend & soldered by lab
○ Activated——-
○ Treatment completed after —- activations
● No ——- required
1° molar
2° molar
Uncontrolled distal crown
3-4 mm
2-3
retention
Moderate localized space discrepancy
● Direct (Intraoral) fabrication with no soldering → tooth banded & bent wire used as spring
■ MODIFIED BAND & SPRING
● Most modern & efficient way → No banding; intraoral fabrication
● Brackets bonded on dentition with spring inbetween
■ BONDED SPRING
Space regaining for posterior tooth loss
○ Max. removable appliance - Hawley finger spring
■ Biomechanics:
● Resistance/anchorage via ———-
● Uncontrolled ——– tip
■ Lab fabrication;—–mm activation; —– movement per month
■ ———– required (with ——–)
adams clasps & anterior palate
distal crown
2-3
1mm
Retention & stabilization
band & loop
Space regaining for posterior tooth loss
○ Banded & bonded appliance with coil spring
■ Open coil spring biomechanics
● Reciprocal force applied ———–
● Distal force & moment produces ——–
○ Mesial rotation of ——— rotation of molar
buccal to C-res
rotation
PM & Distal
Space regaining for posterior tooth loss
○ Banded & bonded appliance with coil spring■ Contralateral 1rst permanent molar banded as well
● Mandibular arch → Anchorage via anteriors with ———
● Maxillary arch → Anchorage via ——- on palate
LLHA
nance button
- Space regaining for anterior & posterior space discrepancy (
<3mm)
- Space regaining for anterior & posterior space discrepancy
○ Treatment with Lower lingual holding appliance (LLHA)
■ Tips ——- (~roughly equal distance)
● Inefficient way to move teeth bc wire is
molars distally & anteriors facially
heavy with little range of movement, but good way to gain space
