Test 2 Review Flashcards
Ideal molar relationship
flush terminal plan, or mesial step. Class I if primate spacing; Class II otherwise
Mesial step
primary second mandibular molar is mesial to the primary maxillary second molar. Class I if slight; Class III if excessive development of mandible
Distal step
(not ideal)- primary second mandibular molar is distal to the primary maxillary second molar. Class II; At best, an end-to-end
How the child occlusion leads to the adult occlusion
When the primary second molars are lost, the first permanent molars will rapidly shift mesially into this leeway space, thereby contributing to an ideal Class I occlusion in the permanent dentition.
This additional space, called the leeway or E space, is on average 5 mm in size in the mandibular arch and 3 mm in size in the maxillary arc.
Class I
mesiobuccal cusp of max first molar occludes mesial with mesiobuccal groove of mand first molar, canine = max canine distal to mand canine/premolar embrasure
Class II
mesiobuccal cusp of max first molar occludes mesial to the buccal groove of mand first molar, canine = max canine mesial to mand canine/premolar embrasure
Class II, div I
mesiobuccal cusp of max first molar occludes mesial to the buccal groove of mand first molar, canine = max canine mesial to mand canine/premolar embrasure BUT max centrals overjet/flare
Class II, div II
mesiobuccal cusp of max first molar occludes mesial to the buccal groove of mand first molar, canine = max canine mesial to mand canine/premolar embrasure BUT max laterals overjet/flare
Class III
mesiobuccal cusp of max first molar occludes distal to the buccal groove of mand first molar, canine = max canine distal to mand canine/premolar embrasure
Interceptive Orthodontics
steps taken to prevent or correct malocclusions as they develop, to prevent a more severe malocclusion
Impacted canines
Maxillary canines is is mostly tooth to be impacted within the bone, if the canine does not erupt properly it should be surgically exposed and bracketed and brought into occlusion (During ortho)
Space Maintainer
Maintains space for tooth to erupt so other teeth don’t take up the space
Nance appliance
prevents max molars from rotating and moving forward while premolars erupt
Tongue Crib
Interrupts finger sucking, tongue thrusting
Herbst
good for those not compliant with headgear
Twin-block appliance
moves Mandible forward and corrects Class II malocclusion
Biteplate
Increase vert. dimension in anteriors while posterior grow into occlusion
Rapid Palatal Expander
Fixes posterior crossbites; palatal shelves on appliance separated by key turn.
Class II corrections
Herbst (fixed), Twin Block Appliance, Frankel I (both removable)
Class III corrections
Chin Cup & Facemask (removable)
Dietary post op instructions
Refrain from using a straw
Refrain from rising 24 hrs after appointment
No heat only ice packs
Use cold wet tea bags if increased bleeding and swelling
The first response to ortho
Compression of the PDL
Different types sutures
Stitches are places to control bleeding and promote healing
Secured with a square knot
Absorbable - plain catgut, chromic catgut and synthetics
Non-absorbable - Silk, polyester fiber, nylon
Removal after 5-7 days after placement
Theory of movement know the process
Equilibrium Theory: All oral forces must be in equilibrium for the teeth to remain in the same position
Primary Eruption Pattern and Age
1s - Centrals (6 months)
2s - Laterals (9 months)
4s - 1st molars (1 year old)
3s - Canines (1 ½ yrs; 18mo)
5s - 2nd molars (2 years old)
Permanent Eruption Pattern and Age
6s - 1st molars (6 yrs old)
1s - Centrals (7 yrs old)
2s - Laterals (8 yrs old)
4s - 1st premolars (10-11 yrs old)
3s - Canines (10-11 yrs old)
5s - 2nd premolar (11 yrs old)
7s - 2nd molars (12 yrs old)
8s - 3rd molars (21 yrs old)
Corrective Ortho
Treatment of malocclusions after they have occurred
Preventative Ortho
Recognition and elimination of malocclusion and irregularities in the developing dentofacial complex prior to permanent alteration
Interceptal Ortho
The steps taken to prevent or correct malocclusions as they develop, to prevent a more severe malocclusion.
Ligatures
Archwires and ligatures are the driving force behind movement of the dentition.
Brackets
Correct placement will reduce unwanted effects: intrusion, extrusion, rotations
Elastic
Adjust bite (overbite/jet) and jaw position
Ortho - Occlusion
Permanent teeth are 2-3 mm larger mesiodistally
Primate Spacing
Maxilla mesial of canine
Mandible is distal of canine
This is so the incisors/canines have room to move so they are no crowded
Overbite
varies from 10-40%
Overjet
commonly excessive
Crowding
less common
DH care and instructions before surgery may improve a patients health and well being by:
- Reduce oral bacterial count
- Reduce inflammation of the gingiva and improve tissue ton
- Remove Calculus Deposits
- Instruct in the use of foods
- Interpret the dentist Directions
Presurgical Instructions
Medications like Aspirin (also increased bleeding) which are not compatible with local anesthesia pts may be instructed to discontinue using before their surgery procedure
Post Surgical Instructions Instruction sheet
Control bleeding keep gauze over the surgical area for 30 mins
When bleeding persists at home place a gauze pad or cold wet tea bag over the area and bite firmly for 30 mins
Rinsing
Do no rinse for 24 hrs after surgical appointment
Then use warm salt water ½ teaspoonful salt in ½ cup after toothbrushing and every 2 hours
Complications include
Uncontrolled pain/bleeding
Temperature of 101 F or higher (indicates infection)
Difficulty open the mouth
Excess swelling
Elevator
uses to leverage against the tooth and loosen the PDL and ease in the extraction - types periosteal (fav one), straight, root tip
Rongeurs
Trim alveolar bone
Surgical curette
cleans and scrapes the interior of the tooth socket to remove disease tissue. Induced bleeding to help create a clot
Bone file
used to smooth bone around the surgical site
Scalpel blade handle
load the blade by picking it up with the hemostat on the bottom edge and sliding it into place
Hemostats
used to hold small tissue specimens as the beak will crush the tissues
Forceps
extract tooth from socket after application of the elevators to loosen the tooth; Designed to be places on and “bite” into the cementum of the tooth
Needle holder
used to hold the suture needle during suturing
Deans scissors
used for trimming soft tissues and to cut sutured
Retractor
used to hold soft tissues make sure it rests on the bone and not the soft tissue
Chisel
Either in a single bevel or bi-bevel designed single bevel type is used for removing bone.
Bi- bevel
is for splitting teeth
Mallet
Source of pressure used on the chisel handle
“Luxate Tooth”
tooth that has been dislodge or displaced from its normal position in the jawbone, often due trauma and can cause pain looseness or angling
Soft Tissue impaction
The tooth is fully or partially impacted by soft tissue or gingival tissue
Hard Tissue impaction
The tooth is fully or partially impacted by bone or gingival tissue
Pericoronitis
infection/abscess of an impacted tooth most commonly found on 8’s
Alveoplasty
surgical preparation of the alveolar ridges for the reception of dentures, reshaping and smoothing of socket margins after extraction of teeth (reshape and smooths the jawbone)
Difference sources of bone graft material
oneself, human cadaver, animal, synthetic bone
Incisional Biopsy
Section removed from within the boundaries of a lesion
At least 1 cm in size
Should include some good tissue
Excisional biopsy
Only part of the lesion is removed for testing
Entire lesion <1m in size excised
Must include all surrounding good tissue
Exfoliative biopsy
cells are scraped
Smear
lesson vaive, sample of cells taken with a brush
Simple fracture
crack line straight down the mandible
Greenstick
fracture of the cortex
Compound fracture
crack in the mandibular bone that is exposed
Simple Comminuted
multiple small cracks of the mandibular
Compound comminuted
multiple many cracks of the mandibular
Signs and symptoms of fractured of the jaw
Painful lump in mand or below the ear
Malocclusion of the dentition
Difficulty opening or TMJ pain
Numbness in the lower chin
Open Reduction
surgery; Surgical flap procedure to expose the feature ends and bring them together for healing
Close Reduction
no surgery; Manipulation of the fragment parts without surgery
Intermaxillary Fixation (IMF)
Follows reduction ( afterwards)
Method of fixation
Uses wires or elastics for the max and mand arches
External Skeletal fixation
Bones screws placed on either side of fracture
Acrylic bar pressed over threads of bone screws and locked
Tinnitus
ringing in the ears
Crepitus
the sound or sensation of grating or clicking
Trismus
Spasms affecting muscles of the jaw
Fremitus
vibration in the teeth caused by trauma from occlusal contact
Oralfacial clefts
failure of lip and or palate tissues to close during development
Cleft lip repair
Lip clefts corrected ASAP
Soft palate clefts 6-18 months
Hard palate postponed 4-5 years
Diastemas
midline is 2mm or less in size; Most children with a maxillary midline diastema at age 9 will have complete closure of diastema by age of 16 without any
