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MCQ 1.2 > Tooth Movement > Flashcards

Tooth Movement Flashcards

1
Q

What are 7 factors for tooth positioning

A

Tooth size
Size of jaw
Presence of predecessor
Loss of predecessor
Tooth wear
Physiological mesial drift
Periodontal disease

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2
Q

What are the 3 phases of tooth movement

A

Pre eruptive phase
Eruptive pre functional phase
Post eruptive phase

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3
Q

What is the pre eruptive phase

A

The movement of the tooth germ - an aggregate of embryonic cells that will eventually form tooth

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4
Q

During eruption what type of tooth movement is it

A

Axial movement mainly hormone control

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5
Q

What can erupting teeth be affected by

A

Light intermittent forces such as muscular or soft tissue contact
Digit sucking or tongue thrusting

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6
Q

How do teeth move

A

Remodelling of bone and periodontal ligament take place
Bone resorbs on pressure side of tooth and is deposited on tension side
Usually as remodelling of PDL and bone occur tooth remains intact but some root resorption occurs

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7
Q

What do osteoblasts do

A

Deposit bone

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8
Q

What do osteoclasts do

A

Resorb bone

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9
Q

What do osteoblasts remove

A

Un mineralised collagen/osteoid that lines bone surface which acts as physical barrier to osteoclasts

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10
Q

What do osteoblasts release

A

Soluble activating factor which has direct action on osteoclasts

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11
Q

What is the pressure tension theory

A

Forced applied to tooth - bone laid down on tension side or bone resorbed on pressure side - tooth moves

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12
Q

What happens to tooth movement with light pressure side

A

Multinucleate cells resorb bone directly

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13
Q

What happens to tooth movement with light tension side

A

Blood flow is activated where PDL is stretched
Promotes osteoblastic activity and osteoid deposition
Osteoid mineralises to form new bone

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14
Q

What happens to tooth movement with heavy pressure side

A

Compression of PDL
Disturbance of blood flow in compressed PDL
Cell death in compressed area of PDL (hyalinisation)
Resorption of hyalinised tissue by macrophages
Undermining bone resorption by osteoclasts adjacent to hyalinised tissue
Tooth movement

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15
Q

What happens to tooth movement in heavy tension side

A

Blood flow is activated where PDL is stretched
Promotes osteoblastic activity and osteoid deposition
Osteoid mineralises to form new bone

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16
Q

What is the piezoelectric theory

A

When a force is applied to a tooth it will move within PDL but some deflection of bone also occurs producing stress generated electric potentials at bone surface
These forces are short lived and are unlikely to play an active role in bone remodelling

17
Q

What does cell shape change have to do with tooth movement

A

Relationship between cell shape and metabolic activity
When a cell is distorted receptors are activated which initiates a cascade of chemical events

18
Q

What happens as a result of mechanical stimulus in tooth movement

A

Acute inflammatory response in periodontal tissues
Triggers a cascade of biological events

19
Q

What 7 biological responses are released and responsible for initiating bone remodelling and tooth movement

A

Neurotransmitters
Arachidonic acid
Growth factors
Metabolites
Cytokines
Colony stimulating factors
Enzymes

20
Q

What are the 3 categories for post eruptive tooth movement

A

Accommodates tooth position within growing jaw, especially height
Compensates for occlusal wear
Accommodates interproximal wear

21
Q

What does it mean to accommodate tooth position within growing jaws, especially height

A

Readjustment of position of tooth socket by bone remodelling

22
Q

What does it mean to compensate for occlusal wear

A

Continues cementum formation at root apical site

23
Q

What does it mean to accommodate interproximal wear

A

Mesial drift by occlusal forces and ligament contraction as well as pressures of cheeks/tongue

24
Q

Why is tooth growth said to occur earlier in girls than boys

A

Related to burst of condylar growth that separates jaws and teeth
Apices of teeth move 2-3mm away from IDC

25
Q

What are 7 affects of tooth wear

A

Reduction in anatomical/clinical crown height
Over closure
Reduction in vertical facial height
Denture difficulties
Mesial/distal wearing continuously
Increase in contact point
Reduction in length of arch

26
Q

What is a factor of mesial drift of teeth

A

Impaction of 3rd molar arch unable to accommodate all teeth
If a tooth is lost
Osteoblastic/osteoclastic

27
Q

What are 4 hypotheses to mesial drift of teeth

A

Mesial inclination of teeth produces resultant force during biting that favours mesial drift
Actions of certain jaw muscles, particularly Buccinator ‘propel’ teeth forwards
Bone deposited preferentially on distal surface of sockets pushes teeth mesially
Contraction of gingival connective tissues (especially transseptal collagen fibres in gingiva) brings about mesial drift

28
Q

What does periodontal disease cause teeth to move

A

Buccal flaring of anterior teeth
Creation of median diastema
Apical movement of fulcrum point
Loss of PDL
Loss of supporting bone - resorption

29
Q

What is ankylosis

A

Direct union of tooth to bone

30
Q

What is extrusion

A

When a tooth is missing opposing tooth will move in an axial direction towards edentulous space eruptive force
More common with missing lower teeth

31
Q

What is a result of mesial inclination of most teeth

A

Dentoalveolar compensation when teeth erupt vertically they encounter an opposing force equal to eruptive force to move them forward elongating dentoalveolar process

32
Q

What do transseptal fibres do

A

Run between adjacent teeth across alveolar process draw neighbouring teeth together and maintain them in contact

33
Q

What does soft tissue pressure influence

A

Tooth position as teeth will still drift mesial even without soft tissue pressure

34
Q

What was the Dahl principle designed to create

A

Anterior space by separating posterior teeth through an anterior bite plane for 4-6 months
A combination of posterior passive eruption and anterior intrusion created the space leads to re establishment of posterior occlusion and anterior space

35
Q

What is the anterior intrusion for the Dahl principle

A

Av = 1.05mm

36
Q

What is the posterior eruption for the Dahl principle

A

Av = 1.47mm

37
Q

What is the space creation in the Dahl principle

A

2mm

38
Q

What is now done instead of the Dahl principle

A

Direct/indirect adhesive materials
For full mouth rehabilitation cases removable splints are often used to assess a patients ability to tolerate the planned change in their occlusion

MCQ 1.2 (34 decks)

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