Treatment of Class I Malocclusion Flashcards

1
Q

Define class I

A

Lower incisor occludes at or below the upper incisor cingulum plateau

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2
Q

What causes crowding?

A

Imbalance in jaw size, tooth size, arch perimeter

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3
Q

How to treat crowding?

A

Expansion
Distal movement
Enamel stripping
Extraction

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4
Q

Problems of expansion?

A

Relapse (average expansion = 3.7mm, average relapse = 2mm)
Fenestration of labial plate
Aesthetics

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5
Q

What appliance is used to expand the upper arch?

A

Quad helix

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6
Q

What are the limits of expansion in mm?

A

Central incisors = 2mm outwards/buccally
Posteriors outwards/buccally = 3mm
Canines outwards = 0mm

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7
Q

How to cause distal movement of the upper arch?

A

Headgear (plus URA, TB or FA)
Non-compliance appliances
Temporary anchorage devices

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8
Q

How to cause distal movement of the lower arch?

A

Lip bumper

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9
Q

Name the non-compliance appliances

A

Pendulum appliance

Distal jet

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10
Q

Give an example of a TAD (Temporary anchorage device)

A

Mid-palatal implants

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11
Q

When to do distal movement of upper buccal segments?

A

Well aligned lower arch
Half unit class II molars
Co-operative patient

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12
Q

Does a lip bumper work?

A

No - very difficult to move lower arch distally - relapse will happen

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13
Q

What is enamel stripping?

A

Remove up to 0.25mm enamel from contact points by abrasive metal strips and air-rotor stripping
Usually done after the teeth are aligned (sometimes proclined) rather than crooked

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14
Q

How is space created in class I incisors?

A

Upper midline diastema
Generalised spacing
Missing teeth

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15
Q

Options for missing lateral incisors

A

Open space = restorative replacement

Close the space

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16
Q

What to consider when opening or closing the space?

A

Malocclusion
Molar relationship
Space present

17
Q

What to do for missing upper lateral incisors for class II incisors and class III incisors?

A

Class II incisors = close space

Class III incisors = open space

18
Q

Name the most common displaced tooth

A

Upper permanent canine

- palatal impaction 85% or buccal impaction 15%

19
Q

What to do when a displaced canine is palatally impacted?

A

Leave in situ, monitor
Extract
Expose and align
Transplant

20
Q

What to do when a displaced canine is buccally impacted?

A
Open exposure (apically repositioned flap)
Closed exposure (attach gold chain)