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Ortho II > Transverse Problems > Flashcards

Transverse Problems Flashcards

1
Q

what is the prevalence of anterior crossbites

A

2.2%-11.9%

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2
Q

when is the anterior crossbite manifested

A

in the mixed dentition

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3
Q

what is the result of no tx of an anterior crossbite

A
  • esthetic problem
  • damage to the teeth in crossbite through attrition
  • gingival recession
  • loss of alveolar bone on lower incisors
  • excess mobility of lower incisors affected by the crossbite
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4
Q

what is the DDX for anterior crossbite

A
  • cepahlometric evaluation
  • dental assessment: class III molar relationship
  • negative overjet or end to end relationship with retroclined mandibular incisors (compensated class III malocclusion)
  • if negative overjet, proceed to functional assessment
  • functional assessment: determine whether a centric relation/centric occlusion discrepancy exists
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5
Q

what might an anterior crossbite DDX patient have in the functional assessment of CR and CO

A
  • at CR, patient may have a class I skeletal pattern, normal facial profile and class I molar relationship
  • at CO, patient may have a class III skeletal and dental pattern
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6
Q

what is examined in the DDX for anterior crossbite

A
  • cephalometric evaluation
  • dental assessment
  • functional assessment
  • profile analysis
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7
Q

if the pt has a class III molar relationship with negative overjet what do you need to do

A

a functional assessment- see if there is a CR CO discrepancy
- if no CR CO discrepancy -> true class III malocclusion
- if there is a CR-CO shift -> pseudo class III maloclussion

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8
Q

what do you do if a pt is in a pseudo class III relationship

A

eliminate CR CO shift

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9
Q

what happens if you eliminate a CR CO shift in pseudo class III

A

you get a class I molar relationship -> class I malocclusion or a class III molar and you get a compensated class III malocclusion

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10
Q

what is a class III molar with positive overjet and retroclined mandibular incisors

A

compensated class III malocclusion

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11
Q

in an anterior cross bite what should the ceph show you in the skeletal

A

class III maxillo mandidular relationships

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12
Q

in an anterior cross bite what would the ceph show you in the dental

A

class I or II maxillo-mandibular relationships

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13
Q

in an anterior crossbite what would the dental eval show you about the skeletal

A
  • severe proclination of upper incisors
  • severe retroclination of lower incisors
  • class III molar relationships
  • may or may not be present in class III skeletal
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14
Q

in an anterior crossbite what would the dental exam show you about dental relationship

A
  • normal inclination/position or severe retroclination/retrusion of upper incisors
  • severe proclination/protrusion of lower incisors
  • class I or II molar relationship
  • presence of anterior functional shift
  • may or may not be present in class III dental
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15
Q

what would the profile exam tell you about the skeletal relationship in an anterior crossbite

A

concave or straight
- may or may not be present in class III skeletal

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16
Q

what would the profile exam tell you about the dental in an anterior crossbite

A

straight or convex

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17
Q

what is the most common etiologic factor for nonskeletal anterior crossbites

A

lack of space for the permanent incisors

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18
Q

what should the tx plan be focused on for the early treatment of dental anterior crossbite

A

on management of the total space situation, not just the crossbite

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19
Q

what is the management of early tx of dental anterior crossbite

A
  • extraction of adjacent primary teeth to provide necessary space
  • disking of teeth
  • opening space for tooth movement
  • determine whether tipping will provide appropriate correction
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20
Q

what are the treatment modalities for anterior crossbite

A
  • fixed inclined planes
  • reverse crown
  • maxillary lingual holding arch with springs
  • removable appliance with jackscrew
  • 2x4 appliance
21
Q

what is a reverse crown

A

a large permanent anterior tooth crown is reverse cemented

22
Q

what is the purpose of a maxillary lingual holding arch with springs

A

lingual eruption of maxillary lateral incisors in a crowded arch

23
Q

what should the general dentist do for an anterior crossbite

A

refer to orthodontist

24
Q

what is the objective of anterior crossbite tx

A

reduce the amount of dental compensation to skeletal; discrepancy that are often associated with a more severe malocclusion in late adolescence

25
Q

where are abutments for the 2x4 appliance placed

A

on first molars and maxillary incisors

26
Q

what is the prevalence of the posterior crossbite

A
  • 7.3% of hispanic population
  • 9.6% in african american populations
  • 9.1% among caucasians
27
Q

what is a cause of the posterior crossbite and what is it

A
  • transverse maxillary deficiency: narrow maxilla relative to the rest of the face
28
Q

what happens in the hidden posterior crossbite

A
  • compensatory changes in dentoalveolar processes
  • tipping of maxillary teeth to the buccal
  • tipping of mandibular teeth to the lingual
  • uprighting teeth creates a dental crossbite
29
Q

a unilateral posterior crossbite may be:

A

a bilateral crossbite with a functional lateral jaw shift as the teeth from centric relation to centric occlusion

30
Q

what is the key sign of unilateral posterior crossbites

A
  • deviation of the mandibular dental midline, relative to the maxillary dental and skeletal midlines, toward the side of the crossbite when the teeth are in MI
31
Q

what are the sequelae to posterior crossbites due to functional shifts not being treated

A
  • compensatory changes in the TMJ - no strong evidence
  • modifications of soft tissue growth - no strong evidence
  • development of skeletal asymmetries - no strong evidence
  • attrition of teeth
32
Q

do posterior crossbites due to functional shifts self correct

A

no

33
Q

what needs to be considered for posterior crossbite management?

A
  • is the crossbite skeletal or dental
  • is the crossbite unilateral or bilateral
  • is there a functional shift
  • if dental, which teeth are tipped and in which jaws
  • should the treatment be initated at this time or deferred to a later date
  • should the problems be corrected
  • can the problem be corrected or masked by treatment
34
Q

how is a posterior cross bite managed

A
  • simple dentoalveolar unilateral posterior cross bite: fixed or removable appliances to move teeth
  • W-arch, quadhelix
  • jackscrew
35
Q

what ages do you use the W-arch, quadhelix for

A

up to age 9 or 10

36
Q

what does the jackscrew do for the posterior cross bite

A

relatively heavy force that separates the partially interlocked suture

37
Q

where is the anchorage and rate of expansion for rapid palatal expansion

A
  • posterior teeth
  • 0.5-1.0mm/day
38
Q

where is the anchorage and rate of expansion for slow palatal expansion

A
  • posterior teeth
  • 1.0mm per week
39
Q

where is the anchorage and what is the rate of expansion for implant supported expansion

A
  • maxilla- bone screws
  • slow or rapid
40
Q

what expansion do you use in the early mixed dentition

A

slow expansion

41
Q

suture can be separated in females up to age:

A

16

42
Q

suture can be separated in males up to age:

A

18

43
Q

what radiograph is used to assess the midpalatal suture patency

A

an occlusal radiograph

44
Q

what is another name for the buccal crossbite

A

scissor bite

45
Q

what is a scissor bite

A

buccal displacement of a maxillary posterior tooth, with or without contact between the lingual surface of the maxillary lingual cusp and the buccal surface of the mandibular antagonist’s buccal cusp

46
Q

what is a complete buccal crossbite and what isa another name for it

A
  • Brodie bite
  • a combination of excessive maxillary width and a narrow mandibular alveolar process, although the width of the mandibular base is usually normal
47
Q

what is a scissor bite treated with

A
  • elastics
  • mandibular appliance to upright posterior teeth
  • lip bumber
48
Q
A

Ortho II (11 decks)

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