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BDS3 - Orthodontics > Treatment planning > Flashcards

Treatment planning Flashcards

1
Q

What are some different causes of an ulcer?

A

Traumatic ulcer, ROU, shetts, stephen johnston, viral, primary or recurrent stomatitis, crohns.

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2
Q

What are the important steps to diagnosing an orthodontic problem?

A

Description of the malocclusion
e.g. class II div I incisor relationship
Determine the causes of the malocclusion
small teeth = spacing,
early loss of deciduous teeth = crowding
digit sucking = proclination and increased OJ
Are the causes dentoalveolar or skeletal?

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3
Q

What does IOTN stand for?

A

Index of orthodontic treatment need.

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4
Q

What does PAR stand for?

A

Peer assessment rating.

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5
Q

What radiograph is used to diagnose orthodontic problems?

A 
Lateral Cephalogram  
-AP skeletal
-Vertical skeletal
-Class III incisors
 Cephalometry.
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6
Q

Why is correct orthodontic diagnosis important?

A

Orthodontic appliances can move teeth very well, but can modify skeletal relationship minimally.
A severe skeletal discrepancy may require surgical intervention.

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7
Q

What are the general principles for orthodontic diagnosis and treatment planning?

A 
History: co/PMH/PDH/SH 
Examination: extra and intra oral
Diff. diagnosis: list of probables  
Special tests: sm’s/rads/photo’s/3D
Diagnosis: description/IOTN
Treatment plan  
Treatment: accept/appliances 
Outcome: PAR index.
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8
Q

What are the three main objectives of orthodontic treatment?

A

Stable
Functional
Aesthetic

and to facilitate other forms of dentistry (crowns, bridges).

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9
Q

What different factors go into a patient’s treatment plan?

A 
Stability
Retention
Patients soft tissue profile
Aetiology of malocclusion
Future growth changes
Patients wishes
Access to treatment
Compliance
Space requirements
Aims of treatment
Prognosis of individual teeth.
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10
Q

What are the aims of treatment for full correction of malocclusion?

A

Class I incisor relationship (OJ/OB normal)
Class I canine relationship
Class I molar relationship (can accept class II)
No rotations, spaces, flat occlusal plane (Andrew’s
six keys).

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11
Q

What are the aims of treatment for compromised treatment of malocclusion?

A

Correct certain aspects accepting others
(e.g. accept buccal crossbite with no displacement)
may have to work within adverse skeletal pattern and leave residual OJ particularly in adults.

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12
Q

What are the stages of treatment planning?

A
  1. Plan around the lower arch (angulation of LLS is stable)
  2. Decide on treatment in lower (ext/nonext)
  3. Build upper arch around lower
    Aim for class I incisor and canine relationship (OJ and OB normal*)
  4. Decide on molar relationship
    Class I or full unit class II molar relationship
    * (if upper and lower incisors normal size, shape and number)
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13
Q

What do you look for when examining the lower arch?

A

Crowding
Angulation of incisors and plane
Curve of spee.

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14
Q

What do you look for when examining the upper arch?

A

Crowding
Angulation of incisors to the maxillary plane
Angulation of the canines/centrelines.

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15
Q

When the teeth are in occlusion (ICP) what do we have to assess?

A 
Incisor relationship  
OJ
OB (curve of Spee)  Centrelines
Canine relationship  
Molar relationship.
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16
Q

What are the two ways of assessing crowding?

A

Measure space available and space required

Overlap technique.

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17
Q

How long does the treatment last to move the upper central incisor forward?

A

6 weeks.

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18
Q

*There is a few case studies on these slides but i cant insert pictures.

A

*

19
Q

What is realistic dentistry?

A

Every patient is not treated as a shopping list.

20
Q

When the patient has an overjet- what percentage is the mandibles fault?

A

80%.

21
Q

How do you estimate the space available when assessing crowding?

A

Measure to see how much space you have there- divide arch into 4 sections (mesial of 6 to distal of 2, distal of 2 to centreline)

  • measuring how much bone we have got there
  • then measure width of every individual tooth
22
Q

What instrument do you use to assess crowding measurements?

A

Callipers.

23
Q

What is stripping?

A

Interproximal enamel reduction (take tiny bit of contact point of both teeth).

24
Q

Why if you take out the lower 5’s for crowding you will have less space than when taking out the 4’s?

A

Take out lower 5’s- much less space because of mesial drift- 6 will come forward and take up space without taking up space- if you take out the 4 this mesial drift wont be as much

  • only take out 5s if you have towards mild end of crowding
  • severe- take out 5’s- wont have enough space- mesial drift and will still get crowding.
25
Q

What teeth do you take out if you have severe crowding (8+mm)?

A

4’s.

26
Q

What teeth or other procedure do you take do if you have mild crowding (0-4mm)?

A

Complete stripping
OR
Take out 5’s.

27
Q

What teeth do you take out if you have moderate crowding (5-8mm)?

A

5mm- extract 5’s

5-8mm- extract 4’s.

28
Q

If your doing a lower arch extraction what do you have to do to the upper arch?

A

Extract in upper arch (MR class 1).

29
Q

If your not doing a lower arch extraction what do you do to the upper arch?

A 
Extract in upper arch
Distalise UBS using headgear (MR class 1).
30
Q

If all the space from extractions will be used what do we need to do?

A

Reinforce anchorage.

31
Q

What does PBR mean?

A

Permanent bonded retainer.

32
Q

What are the disadvantages of a PBR?

A

Time consuming- don’t always work- wire can be bent over time if chewing hard foods- thermoplastic retainer might be better to wear in bed at night, unless spacing/rotations/lls crowding- will relapse so need fixed.

33
Q

What do you need to consider when writing a treatment plan?

A

Diagnosis: orthodontic summary
Problem list: main points
Treatment plan
List successive stages stating tooth movements to be carried out and appliances to be used.
Estimate length of treatment.
If it is not possible to give a detailed plan,
indicate when it will be reviewed (ie following eruption of teeth).

34
Q

What are the different treatment options in orthodontics?

A
  1. Accept malocclusion
  2. Extractions only
  3. URA
  4. Functional appliances +/- extractions
  5. Fixed appliances
  6. Complex treatment involving orthodontics and restorative treatment or orthodontics and orthognathic surgery.
35
Q

What are the limitations of orthodontic treatment?

A

Effects of orthodontic treatment are almost purely dento-alveolar and tooth movement, with little effect on the skeletal pattern

Tooth movements are limited by the shape and size of the alveolar processes

Teeth will only remain stable in a position where there is equilibrium between the forces of the soft tissues, the occlusion and the periodontal structures. All other positions are unstable and will be prone to relapse.

36
Q

Who will do simple orthodontic treatment?

A

Simple treatment may be carried out by the general dental practitioner (relatively straightforward and can be managed by an URA).

37
Q

Who will do complex orthodontic treatment?

A

Complex treatment requires the skill of a specialist practitioner or a hospital specialist.

38
Q

How should orthodontic treatment be timed?

A

Some treatments rely on growth for success and should be used during the adolescent growth spurt for maximal effect (eg overbite reduction, functional appliance therapy).

39
Q

What are temporary anchorage devices?

A

Screws into bone- pulls on that- puts anchorage balance on your side.

40
Q

How long should treatment last with an extraction?

A

24 months.

41
Q

How long should treatment last without an extraction?

A

18 months.

42
Q

How long should treatment last when canines are removed from the palate?

A

2 and a half years.

43
Q

What is the right appliance for patients with a buccally placed canine and have poor oral hygiene?

A

Buccal canine retractor.

BDS3 - Orthodontics (14 decks)

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