Test 3 Flashcards
1
Q
Label A
A
Bracket
2
Q
Label B
A
Archwire
3
Q
Label C
A
Elastic ligature
4
Q
Label D
A
Self ligating brackets
5
Q
Label A
A
Archwire
6
Q
Label B
A
Ligature wire
7
Q
Label C
A
Band
8
Q
Label D
A
Headgear tube
9
Q
Label E
A
Buccal tube
10
Q
Label F
A
Elastic
11
Q
Label A
A
Archwire
12
Q
Label B
A
Coil
13
Q
Label C
A
Wire ligature
14
Q
Label D
A
Bracket
15
Q
Label E
A
Crimpable hook
16
Q
Label F
A
Elastic ligature
17
Q
Label G
A
Chain elastic
18
Q
Label H
A
Elastic
19
Q
Label I
A
K hook
20
Q
Label J
A
Bracket hook
21
Q
Label K
A
Separator
22
Q
What are placed to create space for orthodontic band placement?
A
Separators
23
Q
Are separators required if there is adequate space for bands?
A
No
24
Q
How long do separators need to be in place for prior to band placement?
A
1 week
25
What are the characteristics of the ideal separator?
Painless
Easy to insert
Separates adequately
Remains in place until removed
26
How do separators work?
They provide gentle persistent pressure by encircling the contacts where space is required for banding
27
How to determine the size of elastic separators needed? (Small, medium or large)
Floss contacts and determine if the contact is tight enough to warrant separation/size of separators needed
28
What does the client education include for separators?
Notify the office if one falls out
They must remain in place for 1 week
Do not floss the area and brush gently
If it is out for more than 1 day before the next appt the procedure will likely have to be done again and postpone the banding appointment
29
What are the two methods for inserting elastic separators?
Separating pliers
Looping floss
30
How to remove separators?
Sickle scaler to hook the elastics and pull out, leave on shank to move onto the next one and discard all at the end
31
What other type of separator is there other than elastic?
Brass
32
When is brass separation used?
When the contact is too tight to get an elastic separator through
33
True or False: Brass separators apply full immediate pressure and is therefore more tender than elastics
True
34
Is the brass end of a brass separator irritating to the tissues?
Yes
35
How to place brass separating wire?
Cut length of wire and feed under the contact with ligature pliers
Draw one end up over the contact
Twist the ends toegther fromt the facial side until pressure is felt on the contact
Cut the end leaving a short, controlled pigtail and tuck that gingivally
36
What is the red arrow pointing to?
Buccal tube
37
Define the function of a fitted band.
Anchors and directs the forces created by the archwire or appliance to the band
38
What is the limitation for seating bands in the RHPA?
No person shall design, construct, repair or alter a dental prosthetic, restorative or ortho device unless the technical aspects of the design construction, repair or alteration are supervised by a member of the RCDSO or CDTO, or are themselves a memebr
39
What is the limitation of a dental hygienist in relation to bands in lay terms?
Dental hyenists may cement bands and must recognize when a band is not fitting properly when they seat it
40
What is the tray set up for banding?
Band cement
Spatula and mixing pad
Pumice
Prophy head
Bands
Cotton rolls
Band seater
Sickle scaler
Saliva ejector
A/W syringe
Mirror
Explorer
Cotton pliers
41
What is this?
Bite stick band seater
42
What is this?
Band seater - operator applies force
43
What is this?
Band remover
44
What teeth are banded?
Usually the 6's but can be anywhere a firm anchorage is required
45
How to choose the correct size band?
The mesial and distal and facial to lingual size must be large enough to encompss the tooth without overseating into the gingival area
You can use callipers or visual cues
46
What is band crimping and contouring?
The band must be contoured by compressing the soft metal band into all grooves with no voids or gaps
47
What to do with tried in bands that don't fit?
Sterilize and return to dispenser
48
How to know which band goes where?
Identification marks on the band
49
What is the banding method for the lower posteriors?
Place the lingual first, then push down the mesial and distal sides of the band, ending with seating the buccal
50
What is banding method for the upper posteriors?
Place the buccal first, then push down the mesial and distal sides of the band, ending with seating the lingual
51
What is a snap fit of bands?
Occlusal edges must be slightly gingival, or at the mesial and distal marginal ridges
52
Where should the bracket or buccal tube be once the band is seated?
Centrally aligned from mesial - distal and occlusal - gingival
53
What happens if the band or buccal tube is twisted?
It will cause the bracket or buccal tube to be malaligned
54
What must be recorded about the bands in the ROC?
Band size for each tooth being banded
55
How to cement bands?
Place band on a piece of tape or wax and apply cement coating the entire inside for the band with a little excess
Ensure the tooth being banded is clean, dry and well isolated
Seat band unsing band seater
Inspect for proper fit
Have client bite on wet cotton roll
Remove excess cement with scaler
56
What are all the steps for placing bands?
1. Try in
2. Removal
3. Place cement on band
4. Place bands
57
What is this pointing to?
1st dimension, incisal to gingival
58
What is this pointing to?
2nd dimension, depth, facial to lingual
59
What are the bracket slot sizes?
.018 x .025 or .022 x .028
60
What do distogingival dots and colour do?
Indicate the orientation of the bracket on the tooth
61
What are the two types of bracket slot shapes?
Angled
Straight
62
Which type of slot shape has straight archwires placed into slots that can activate torque during the final phase of treatment?
Angeled slots
63
Which type of slot shape requires bending the wires to place curves into the archwire, prior to placing the archwire into the slots?
Straight slots
64
Angled slots use what type of archwire?
Flat
65
Straight slots use what type of archwire?
Curved
66
What is the shape of the bracket pad?
The gingival side if contoured, narrower than the incisal
67
Auxillary hooks placement
Can be either mesial or distal but always go to the gingival
68
What is the purpose of hooks on bands and brackets?
To hold elastics
69
A single wing bracket has how many wings?
Two
70
True or False: Each single wing bracket is indentical for each tooth?
True
71
How many wings do twin bracketes have?
Four
72
What type of bracket is this?
Single
73
What type of bracket is this?
Twin
74
What type of bracket is this?
Self-ligating
75
What are self ligating brackets also known as?
Speed brackets
76
What are the types of material used for brackets?
Metal
Plastic
Porcelain and ceramic
77
What are the benefits of metal brackets?
Easier to clean
Strong
Cost effective
78
What are the disadvantages of metal brackets?
Esthetics
79
What are the advantages of plastic brackets?
Esthetics
80
What are the disadvantages of plastic brackets?
Food stains
Not as strong
81
What are the advantages of porcelain and ceramic brackets?
Esthetics
Easy to clean
82
What are the disadvantages of porcelain and ceramic brackets?
Not as strong as metal
83
What is the criteria when placing brackets?
1. Centered mesio-distally for rotational control
2. Edge of th bracket parallel to the incisal edge (crown tip)
3. Vertical slot between the bracket wings must be parallel along the long axis of the tooth
4. Placement of brackets on the height of contour
84
What should the horizontal dimension be in regards to bracket placement?
Center the bracker incisal to gingival
85
How to visualize the long axis of the tooth?
Look directly through from the apex of the root to the middle section of the crown
86
What is the point where the tooth has its greatest bulge?
The height of contour
87
If a bracket is placed to gingival it will cause the tooth to
Extrude
88
If a bracket is placed to incisal it will cause the tooth to
Intrude
89
If a bracket is placed too mesial it will
Rotate the tooth distally
90
If a bracket is placed too distal it will
Rotate the tooth mesially
91
Paralleling and axial errors in bracket placement will result in
Tilting of the tooth
92
What operator clock position allows for best visualization of the horizontal dimension?
8 to 10:00
93
Parallel/axial placement is best visualized from what operator clock position?
12 to 8:00 going back and forth while assessing
94
What to do is a tooth is partially erupted when placing brackets?
May need to reposition bracket as tooth erupts
95
What to do if the teeth are severely crowded when placing brackets?
Reposition brackets as teeth unravel to centre of labial surface
96
What to do if teeth are severely rotated when placing brackets?
Reposition brackets as full facial surface of crown is more accessible
97
Vertical error in band/bracket placement results in
Intrusion or extrusion
98
Horizontal error in band/bracket placement results in
Rotation mesial or distal
99
Combination vertical and horizontal error in band/bracket placement results in
Tipping or tilting
100
Overseated bands result in
Possible periodontal conditions
101
Indequate contouring or voids in cement of bands/brackets results in
Caries
102
What are the steps in the bracketing procedure?
1. Polish teeth with pumice
2. Etch tooth surface
3. Apply thin layer of primer/bond to etch area and bracket pad
4. Bracket is placed with dot disto-gingivally with the bracket holder pressing bracket firmly to tooth
5. Remove any excess bond and chech that wings are not bonded
6. Light cure
103
What is the bonding technique where brackets are held in a pliable mold during bonding and then when set the mold is carefully peeled away?
Indirect bonding
104
What are the steps for indirect bonding?
1. Impressions and send to lab
2. Lab will position brackets using a water soluble bonding agent
3. Flexible plastic mold is made over the bonded model and the brackets are adapted into the mold
4. Model is placed in hot wate to dissolve bond
5, Mold arrives at office for trial fit in client's mouth
6. Once placement is established, primer and bond is placed all at once and immediately positioned into the mouth to set/be light cured
7. Once bond is set the mold is peeled away
105
How are lingual brackets placed?
Indirect technique made in lab
106
Label A
Bracket holder
107
Label B
Elastic ligature hemostat
108
Label C
Ligature holder (twister)
109
Label D
Bracket remover
110
Label E
Ligature tucker
111
What is the difference between a bracket remover and a band remover?
Bracket remover has a sharper edge than a band remover
112
How long are intital archwires used for?
The first few months
113
What are the characteristics of the initial archwires?
Stainless steel or Nitonol/Titonal
Twisted or braided wire
Round
Very flexible
Applies light continuous pressure
114
What is the most common gauge of initial archwire?
.0175 or .016
115
The intital archwire usually has a memory and is use to start loosening the teeth by
Initiating hyalinization
116
What types of intitial archwire is popular?
Braided or co-axial
Nitonol or titonol (NiTI)
117
What is the disadvantage of a braided or co-axial initial archwire?
May kink if bent
118
What is the advantage of a NiTI initial archwire?
Extremely good memory and doesn't kink
119
How long are mid-treatment wires used for?
6 months - 3 years or more
120
What type of wire is used a mid-treatment wire?
Stainless steel or NiTi
121
What gauge of wire is used for mid treatment?
.016 or .020 round or
.016 x .016 square or rectangular
122
The heavier the gauge wire the more tenstion is
Exerted, since it fits into the bracket slot tighter
123
Can stainless steel arches be bent, curved, and sodered as needed?
Yes
124
How long are finalizing arch wires used for?
The last 3-6 months of treatment
125
What type of archwires are used for finalizing wires?
Square or rectangular that fit exactly in the slot size of the bracket
126
How does the finalizing arch wire work?
It will interpret the built-in torque of the brackets as a finishing movement
127
To use a finalizing arch wire, why must the teeth be well aligned, almost perfectly?
Otherwise the wire will pop off the brackets due to the tension exerted
128
What gauge of wire is used for finalizing arch wires?
.019 x .025
129
What tool must be used to cut archwires?
Heavy duty wire cutters / distal end cutters
130
How to fit archwires?
Determine size by using client model and cut with distal end cutters or heavy wire cutters
131
Before cutting the archwire length you must take into account
The labial placement of the archwire into the brackets
Any ins and outs the wire may be coursing due to mal-aligned teeth
132
Where to ligate first?
Midline first and work posteriorly
133
Why would stainless steel wire ligatures be used?
More secure engagement of arch wire into bracket slot than elastics
134
How to insert ligature wires?
Insert so that the wire slides under the bracket wings then pull tightly across towards the mesial of the tooth and twist on the opposite side using the needle driver not the hemostat approximately 7mm away
Cut the ligature to about 3mm
Tuck up ginigivally
135
When twisting the wire ligature the maxilla twists starts
Below the archwire (incisally)
136
When twisting the wire ligature the mandible twists starts
Above the archwire (incisially)
137
How to remove wire ligatures?
Clip loops (distal side of bracket) with light wire cutter
Use hemostat or cotton pliers to grasp the twisted end and pull away from the bracket
Carefully place each ligature on the bracket tray
138
How to apply elastic ligatures?
With a ligature plier (hemostat with a metal tooth on the end)
Stretch it over the bracket
139
How to remove elastic ligatures?
Use an explorer and hook through them sliding them off
140
What are elastic ligatures often refered to as?
"o"s o "donuts"
141
Advatanges of elastic ligatures?
Easy to use
Faster
Not technique sensitive
142
Disadvantages of elastic ligatures?
Difficult to clean
Tend to trap food debris
Lose elasticity over time
143
POI for clients after bracketing?
Brush, floss, waterpik, proxy brushes
What to do if ligation comes off or comes loose
What to do if ligature wire is poking/uncomfortable
144
How to remove brackets?
Bracket removing pliers paced next to the tooth, and the edge of the bracket pad with the cutting edge of the beaks under the resin if possible.
Squeeze handle slowly without twisting or torquing.
Scale or cavitron excess cement from tooth. May use highspeed if needed
145
What is chain elastic?
Runs from tooth to tooth closing spaces and/or keeping a unit of teeth together
146
What is a chain elastic also known as?
Power chain
C chain
147
Can metal ligatures also be used as a chain?
Yes
148
Where are open or closed coils placed?
Over a round .020 archwire
149
What are open coils for?
To gain space
150
What are closed coils used for?
To maintain space
151
What can be part of the bracket, or added to the archwire with soder or a tube the two arches?
Hooks
152
What is an auxiallary aid that may be added to an archwire anywhere, at any time during treatment?
Crimpabe archwire hook
153
What would crimpable archwire hooks likely be used for?
Fixation after surgery
154
What auxillary are used to rotate teeth and help teeth erupt into the arch?
Buttons
155
How do buttons work?
Elastics are hooked up to the button
156
What auxillary are rubber pads that are added to the archwire on the opposite side of a rotation to provide leverage for movement?
Rotation wedges
157
What auxillary is available on a spool, allowing the operator to cut the length required for each case?
Elastic thread
158
What is the function of elastics?
To activate the ortho appliance
159
What are the sizes of elastics?
Light - 3/8", 6oz pressure
Heavy - 1/4", 8oz pressure
160
How are class II elastics placed?
13 - 46
23 - 36
161
How are class III elastics placed?
43 - 16
33 - 26
162
With class II regular hook, what else is placed with elastics to avoid extrusion of the cuspid or lateral?
Power chain from max 3-3
163
What do class II regular hook elastics do?
Distalize max anterior segment and extrude and move mand posteriors forward
164
What do class II mid placement elastics do?
Provide slight retraction of the anteriors only with power chain in place. Acts primarily as a control mechanism and to close down the bite.
165
What do class III hook or sliding hook elastics do?
Moves the lower anterior segment back
Moves the max molars forward
166
What do vertical hook elastics do?
Acts to close anterior open bite
167
What do vertical mid elastics do?
Acts to close the mid arch area down
168
What are cross elastics for?
To correct posterior crossbites only
169
Where are cross elasics placed?
Man lingual to mand buccal
Max buccal to mand lingual
170
Why should anterior cross elastics never be used?
The plan of occlusion will be thrown off
171
How to correct midline problems in the anterior?
Class II elastics on one side
Class III elastics on the other
172
When are triangular and box elastics used?
Near the end of treatment to help close dwn the bite
173
When is it a box elastic?
Whe stretched over 4 hooks
174
Why must retainers be worn?
To avoid relapse and stabilize the teeth/bone relationship
175
When is ortho treatment ended?
Final position of dentition has been acheived
Clinician and client are both satisfied
Dentition has been in final wire for 3-6 months
176
Proper occlusion will help hold the teeth in the
Cusp of the fossa relation, in the posterior, and the labial to lingual contact in the anterior
177
What teeth have an increased risk of moving?
Mand incisors
178
What are the reasons for relapse?
Age, natural lingual collapse
Fibrous frenum tissue (diastema)
Memory
Teeth that are not locked in occlusion have higher risk of relapse
179
What type of retain is used for the max and mand when full retention is required that has an adjustable labial archwire and possible springs?
Hawley retainers
180
How long must hawley retainers be worn for?
24 hours for 6-7 months
Nightly 1-2 years
Then 2 nights per week forever
181
What are finger springs for in Hawley retainers?
To put pressure on specific teeth for localized movement such as tipping, and minor rotations
182
What type of retainer is used for minor tooth movement to finish off a case?
Tooth positioner
183
How long to wear a tooth positioner for?
3 hours per day - client bites down for 15 seconds and releases continuously while wearing it
184
What type of retainer is use for max and mand retention and is vacuum formed?
Essix
185
How long must an essix be worn?
24 hours a day for 6-7 months
Nightly forever
186
Where are fixed retainers bonded?
Lower wire 3-3 or 4-4
Upper wire 3-3
Full arch with bands 6-6
187
Why is long-term mandibular retention recommended?
Holds against movement due to growth
Incisor is kept upright
Intercanine width is held
Holds against forces of 3rd molar eruption
188
Force is a push or pull that includes
Magnitude
Duration
Direction
Point of application
189
What is the amout of force?
Magnitude
190
What is how long the force is applied and is there a recovery period?
Duration
191
What is how the movement going to be directed?
Direction
192
What is determined by the operator considering their personal preference and the direction of movement required?
Point of application
193
Excessive force can result in
Discomfort
Mobility
Root resorption
194
True or False: For duration, a light continuous force is better than a heavy force for a short duration.
False. For duration, a heavy force for short duration is better than light continuous force.
195
What ways can force be applied?
Continuous
Dissipating
Intermitten
Functional
196
What is an example of continuous force?
Open coil
197
What is an example of dissipating force?
Monthly archwire adjustments
198
What is an example of intermitten force?
Removeable appliances
199
What is an example of functional force?
Bionator - activated by the muscle function of the tongue and cheek
200
Is tipping an easy or difficulty movement to achieve?
Easy
201
What force is best for tipping movement?
Light continuous forces
202
What is the bodily movement of crown and root at the same time in the same direction?
Translation
203
What type of force is best for translation?
Light dissipating force
204
What type of bracketing technique must be used for translation?
One that prevents tipping
205
What is the movement around a tooth's long axis with a high risk of relapse?
Rotation
206
What force is best for rotation?
Disspiating forces with periods of recovery or light continuous forces
207
What is the risk with translation?
Apical resorption
208
What is the risk with intrusion?
Tooth dying - oblique fibers resist, compressions of the periodontal ligament results in decreased blood supply
209
What type of force is best for intrusion?
VERY light forces
210
What type of force should be used for extrusion?
Light continuous forces during rapid growth periods
211
What phase is root torque?
Final phase movement
212
How is root torque achieved?
By fulcrum designed in brackets allowing a pivot of the root only, a buccal to lingual movement.
Using a square or rectangular wires which fit into bracket slots exactly
213
What is imbalances or interferences in intercuspation which will result in jiggling and mobilization of the teeth?
Occlusal malfunction
214
For occlusal malfunction, what are often receommended to reduce stress on the teeth and periodontium?
Bite planes
215
How are forces related to age?
The older a person is, the lighter the force should be for movement to occur. Longer periods of rest are also advised
216
Tissue responses affect movement intially by
Compression of the periodontial ligament results in osteoclasts developing and the removal of tissue
217
Tissue responses affect movement secondarily by
Direct resorption of the bone and apposition of bone on the tension side
218
What are the root resorption influencing factors?
1. Tipping motion
2. Biologic factors - age, metabolic influence
3. Environmental factors - asthma, allergies, hyperthyroidism
4. Nutrition, age, habits, trauma
219
When to use a removable appliance?
1. Patient is responsible and cooperative
2. When esthetics is important
3. OHI is easier to maintain
4. Appropriate anchor teeth present
220
When to use a fixed appliance?
1. Patient is too young or unable to handle a removable appliance
2. Does not object to esthetics
3. Motivated to maintain good OH
4. Permits bodily movement to occur
221
Parts of a removeable appliancce
Baseplate: acrylic
Retention: adams clasp
Active component: springs, wires, screws
Anchorage: clasps on 6s or headgear
222
What is a Hawley multi spring appliance?
Active components such as springs can be added to any appliance for localized tooth movement. Springs can be embedded in the acrylic.
223
What are the parts of a Hawley retainer?
Labial bow
Spring
Adjustment loop
Clasp
Acrylic
224
What is the most common of the many designed for a space maintainer?
Band and loop
225
What appliance has spring loaded bars designed so that pressure can be applied between teeth to create more space?
Space regainer
226
What is a thumb sucking appliance?
Various crib designs are fabricated to restrict thumb placement, and break the seal, taking away the satisfacton from sucking
227
When are thumb sucking appliances used?
Only after all avenues have been exhausted and the patient is still sucking their thumb when of school age
228
What is an oral screen appliance?
Appliance to stop habits such as thumb, finger, and lip sucking, tongue thrusting, habitual mouth breathing, and use of pacifiers
229
How does a night guard work?
Maintains freeway space between teeth
230
What is a NTI appliance?
Small appliance to fit lower teeth to stop clenching/grinding and can be worn during the day
231
What are bite plates?
Acyrlic splints used to reduce stress on muscles by holding them in a more relaxed position. Assists with TMJ problems
232
When is a fixed palatal expander used?
When rapid substantial expanison is desired
233
When is a removable palatal expander used?
Where slower movement is desired and a little expansion is required
234
How often is the key in an expander turned?
¼ turn 2-3x daily (rapid) or
2-3 times per week (regular)
235
How long of retention is required for bone to fill in stabilizing the palate?
90 days
236
What does the Schwarts appliance do?
Encourages premaxillary arch development to create anterior space
Encourages lateral arch development to correct a posterior crossbite
237
The Schwart appliances contains
Embedded screws which are turned to activate the appliance, forcing a segment of the bone with teeth to move facially
238
What are the causes of crossbites?
Dental related - localized tipping of tooth/teeth
Muscular related - function adjustment needed to remove tooth interferences
Asynnetric growth of the maxilla or mandible
Lack of agreement in widths of the maxilla and mandible
239
What appliance may be used to correct an anterior crossbite?
Guide plane or add a finger spring to a Hawley archwire
240
What appliance is a muscle anchorage appliance used for lip habits?
Lip bumper
241
How does a lip bumper work?
Uses the light continuous forces of the lip muscle pressing against the bumper pad located labial to the anterior teeth
Serves to gain space by forcing molars distally and may be used to upright molars
242
What appliance is used to reposition the mandible forward as required for clients with a class II?
Incline plane
243
How does an incline plane appliance work?
Each time the client closes, it forces the lower jaw to thrust forward
244
When is a bionator used?
For skeletal class II div I
Closing anterior open bites
245
Action achieved by the bionator?
Directs mand growth by forcing the jaw to close in a predetermined position at the same time it is retraining the muscles that guide jaw closure
246
Important factors for making a bionator?
Proper wax bite
Mandible must be brought forward until the mand anterior teeth are labial to the max anterior teeth by 1-2mm
Opening closed bites or overbites, an opening of 3-6mm is recorded in wax
247
What is an orthopedic corrector?
Appliance with posterior screws to advance the mand
248
What appliance is an alternative to the bionator?
Twin blocks
249
Twin blocks correct what occlusions
Class II Div I
Class I
Class II Div II
250
What are the factors for success with the twin blocks?
Accurate wax bite in centric occlusion leaving 1-1.5mm of space between the molars
251
When is a Frankel appliance used?
To influence arch development laterally, also allow for forward growth of mandible
252
What actions are achieved from the Frankel?
Cheek pads and lip pads remove the those forces allowing the tongue to dominate
Results in lateral development of the jaws
Acrylic pressing into the vestibular areas stimulates bone development laterally
253
What is the Herbst appliance used for?
CLass II Div I cases with lack of client co-operation. Appliance is fixed to the occlusal surfaces of the posterior teeth
254
What are the types of headgear?
Cervical Gear
High-pull
Combination Headgear
255
What type of headgear either keeps the upper jaw from growing, or pulls the upper teeth back?
Cervical Gear
256
What type of headgear pulls the upper jaw and teeth up and back so they align with the lower jaw and teeth?
High-Pull
257
What type of headgear had the 6's distalized while the intrusion and extrusion forces are balanced out?
Combination Headgear
258
Which type of head gear creates pressure to the anterior area where the headgear inserts into buccal tubes resulting in an intrusion of the anterior segment and opens an anterior deep overbite?
High-Pull
259
What headgear is used for skeletal class III cases?
Reverse-Pull
260
Reverse-Pull headgear uses rubber bands which
Attach to upper braces or holding arch
261
What does a cephalometric radiograph show?
Profile view of the client that allows for study of the relationships between bony and soft tissue landmarks
262
How can a ceph be used?
To diagnose facial growth abnormalities prior to treatment, evaluate progress mid-treatment or at post-treatment
263
What is a cephalmetric analysis?
Analysis of the dental and skeletal relationship in th head
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How is a cephalometric analysis done?
THe ceph is traced on to tracing paper or done with a computer program
Skeletal and soft tissue land marks are plotted
Measurements are made and compared against a standard to determine the effects of ortho treatment
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Label N
Nasion
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Label S
Sella Turcica
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Label A
Subspinale
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Label B
Supramentale
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Label Po
Pognion
270
Label M
Menton
271
Label ANS
Anterior Nasal Spine
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Label P
Porion
273
Label O
Orbitale
274
Label Pn
Pronasal
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Label Po'
Soft tissue prognion
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Label N'
Soft tissue nasion
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How to compare upper facial height to the lower?
Upper = nasion in mm minus anterior nasal spine in mm
lower = anterior nasal spine in mm minus menton
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What should a child's upper to lower facial height be?
50% upper and 50% lower
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What should an adults upper and lower facial height be?
45% upper to 55% lower
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What is the frontonasal structure, or junction f the front an nasal bones seen in the profile as an irregular notch?
Nasion
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What is the centre of the bony crypt occupied by the hyphophysis cerebri?
Sella turcica
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What is the most anterior point on the symphysis of the mandible?
Pogonion
283
What the most anterior oint of the nasal bone?
Anterior Nasal Spine
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Wht is an arbitrary measure point taken at the innermost curvature from the anterior nasal spine to the crest of the maxillary alveolar process, signifying the approximate junction of the basal or supporting maxillary bone and the alveolar bone?
Point A (Subspinale)
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What is an arbitrary measure point of the anterior profile curvature from the mandibular landmark Pogonion to the crest of the alveolar process?
Point B (Supramentale)
286
What is the most inferior point on the symphysis of the mandible?
Menton
287
What is the most superior point of the external auditory meatus?
Porion
288
What is the lowest point on the inferior bony margin of the orbit?
Orbitale
289
What is directly across fom the frontalnasal structure on the corresponding soft tissue?
Soft tissue nasion
290
What is the most prominent point of the nose soft tissue?
Pronasale
291
What is the most prominent or anterior point on the soft tissue chin in the midsaggital plane?
Soft tissue pogonion
292
What is the esthetic line?
A line drawn from Pronsale to soft tissue pogonion
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What are the average lips in an esthetic line?
Upper lip 1 mm behind the line
Lower lip on the line
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Class II Dv I will often demonstrate a _____ with the lips ___ of the esthetic line
Convex
Ahead
295
Class II Div II and Class III will often demonstrate a ____ profile with the lips ___ the esthetic line.
Concave
Beyond
296
what can skew esthetic line results?
Large nose or oversized chin
297
What is the cranial line between the centre of the sella turcica and the anterior point of the frontonasal suture representing the aterior cranial base?
S-N line
298
What facial plane connects the lowest points of the orbits and the superior points of the external auditory measutus?
Frankfort Horizontal Plane
299
What denture plane bisects the posterior occlusion of the permanent molars and premolars and extends anteriorly?
Occlusal plane
300
What angle indicates whether the maxilla is normal, prognathic or retrognathic?
SNA
301
What is the average SNA?
80 degrees
302
What angle indicates whether the mandible is normal, prognathic or retrognnathic?
SNB
303
What is the average SNB angle?
78 degrees
304
What angle indicates whether the skeletal relationship between the maxilla and mandible is a normal skeletal class I, a skeletal Class II, or a skeletal Class III?
ANB
305
What angle reveals the inclination of the central incisor as related to the cranial base line?
Upper incisor to SN
306
What is the average upper incisor to SN angle?
104 degrees
307
What measurement indicates the anteroposterior position of the incisial edge of the upper central incisor with reference to the NA line?
Upper incisor to NA
308
What is the average measure of the upper incisor to the NA?
4mm
309
What angle reveals the inclination of the lower central incisor?
Lower incisor to NB
310
What is the average angle of the lower incisor to NB?
25 degrees
311
What measurement gives an indication of the anteroposterior linear relationship of the lower incisor with reference to the vertical NB line?
Lower incisor to NB
312
What is the average measurement of the lower incisor to the NB?
4mm
313
What is a mixed dentition analysis?
Analysis done when permanent mand and max incisors and first premolars have erupted to determine if there will be insufficient space for permanent cuspids and premolars.
314
How to do mixed dentition analysis?
Ortho study models may be uesd to quantify the amount of crowding or spacing present
Comparing the space available with the space required for all teeth to fit
315
What are the two major assumptions made during mixed dentition analysis?
The anterior-posterior position of the incisors is correct and the space available will not change because of growth
316
How to measure the space required in mixed denition analysis?
It is the sum of the mesiodistal widths of all individual teeth measures from contact point to contact point
317
How to measure space available in mixed dentition assessment?
Measure the length of dental floss over the top of the alveolar process from the mesial right 6 to the mesial left 6 or measure the dental arch in four straight segments and add each to total a length
318
How to quanitfy crowding/spacing in the adult dentition?
mm of space available minus m of space required = mm crowding/spacing
- Negative number indicates crowding
- Positive number indicates spacing
319
Space supervision protocol is based on
Results of the mixed dentition analysis
320
Removal of primary canines provides space for
Incisors to align
321
Removal of primary first molars and slicing mesial of second primary molars results in
Space available for permanent molars
322
Removal of 2nd primary molar and placement of a lingual archwire preserves space until
The permanent premolar erupts
323
With gross space discrepencies what are general rules to provide a reasonable chance for success and a minimum chance for trouble?
Class I occlusion
Balanced facial skeleton
At least 5mm to little in each quad
Midlines must match
No open or deep bite present
324
What is corrective jaw surgery which involves both jaws and the accompanying teeth?
Orthognathic surgery
325
What is the correction and establishment of a stable functional balance among the teeth, jaws and surrounding facial structure?
The goal of combined orthodontic and orthognathic surgical treatment
326
What is the timing of surgery during the course of ortho treatment?
Orthodontist and surgeon work together
Often teeth are aligned first which may result in temporary underbite
Surgery then done to correct relationship
Final ortho movement is done after healing takes place
327
Osteotomy can be done on the
Maxilla or the mandible
328
What is the surgical cutting of bone on an angle and subsequent sliding of bone sections forwards, or backwards, by overlapping ends?
Osteotomy
329
How does an osteotomy slide the bone sections fowards?
Lengthening of the section, the narrower areas will fill in with healing
330
How does an osteotomy move bone sections backwards?
Shortening the section, the bulk caused by overlapping will reduce with healing
331
What is the surgical removal of a section of bone to shorten the mand and or max length?
Ostectomy
332
How is an ostectomy done?
The cuts were straight and parallel to each other, excising a section of bone, then placing the two cuts so they would abut to each other. The bone is then wired and or plated to secure together
333
Which has a higher success rate, osteotomies or ostecomies?
Osteotomoies
334
What is a surgical soft tissue augmentation done when the occlusion is corrected but the chin is not esthetically pleasing?
Genioplasty
335
What is an oblique osteotomy?
The ramus is exposed and a bone cut is made, a bevelled cut is made to bypass mand arterty and inferior alveolar nerve to faciliate sliding of the segment.
336
What [surgical procedure is the overlapping of bone to reduce length?
Sliding osteotomy
337
What is the Laforte 1 osteotomy?
Basic procedure for mid face deficiencies.
338
It is possible to segment the maxilla into as many as __ pieces without the loss of tissue/
9
339
What are the different types of genioplasty?
Single section
Double section
Length reduction
Height reduction
340
POI for ortho surgery
Liquid only for first few days
First day nse may be stuffy and throat irritated
First 24 hours speak slowly and concentrate on enunciation
Carry lip moisturizer for frequent application
First 3-4 days rinse and swab with chlorhexidine or 50/50 water/hydorogen peroxide. Then gentle brushing of accessible facial surfaces
Use waterpik after 2-3 weeks
Mild pain reliever for a few days
341
What is the third molar controversy?
Some believe that if left they will cause a lingual collapse/crowding in the mand anterior teeth
If the premolars were extracted the third molars may drift forward tipping, promoting molar impaction
342
Maxillary cuspids are most frequently _____ impacted
Palatally
343
Supernumerary teeth will be either removed or left depending on
Their position as seen in x-rays
344
An SNA angle larger than normal indicates
Skeletal Class II malocclusion
345
A small SNB angle indicates ____ while a large angle indicates ___
Class II
Class II
346
Upper incisor to SN is important in
Torque control when retracting or advancing upper incisors
347
A larger than normal upper incisor to SN angle indicates
Skeletal Class II dic I and Class III malocclusion
348
The clinician would use the ______ to decide whether the incisor has to be retruded or protruded by tiping mechanics, bodily movement, or by a combination of thw two.
Upper incisor to NA
349
A larger than normal lower incisor to the NA angle indicates ____ while a larger indicates _____.
Class II div I
Class III
350
A larger than normal lower incisor to NB measurement means a ____ profile and a Class ___ Div ____ malocclusion.
Convex profile
Class II Div I
351
A smaller than normal lower incisor to NB measurement means a ____ profile and a Class ___ Div ____ malocclusion.
Straight or concave profile
Class II Div I
