Tutankhamen -1 Flashcards
How many bones are in the skull?
22 Total
8 cranium
14 facial
Purely endochondral bone
SHE II Stapes Hyoid Ethmoid Incus Inferior concha
which bones are mixed?
MOST are Mixed Maleus Occipital Sphenoid Temporal Mandible
Unpaired bones of skull
Vomer
Mandible
Semilunar ganglion is also known as..
Trigeminal, Gasserian, Gasser’s ganglion
Trigeminal n. originates from the…
Pon
Smallest bone in the human body
Stapes
Stapes is derived from which brachial arch?
2nd (aka Reicherts cartilage; also gives rise to CN VII, muscles of facial expression, stapedius, stylohyoid ligament, styloid process, and posterior belly of diagastric muscles
What passes through the foramen ovale?
VALE
V3, Accessory meningeal artery, emissary vein)
Syndesmosis vs synchodrosis
Syndesmosis= suture united by ligaments
Synchondrosis=hyaline cartilage
Bones of Orbit
Floor =
Medial =
Z Pretty MELFS Zygomatic Palatine Maxilla Ethmoid Lacrimal Frontal Sphenoid
Floor = ZPM Medial = MEL
What is the difference btwn frontal resorption vs undermining resorption? Which one is desired?
Frontal- lighter force, desired
Undermining- heavy, causes hyalinization of PDL
What is transitional bone?
resulting bone after tooth has been moved to another place
What is the process of bone formation?
Why Charkas Love Boys
woven-composite-lamellar-bundle
What is another name for cancellous bone?
trabecular
What is the difference btwen primary and secondary osteon?
Secondary- (aka lamellar bone) contains more vessels; formed by remodeling of existing bone
primary (aka composite) less vessels
Cartilage grows by what process?
Interstitial or appositional
Growth site vs Growth center
Growth Center- independent genetic control growth
Growth sites- where growth occurs
When does intersphenoid synchondrosis fuse?
at birth
When does anterior and posterior occipital synchondrosis fuse?
3-5 years
When does Spheno-ethmoidal synchondrosis fuse?
start 7-8 years
When does spheno-occipital synchodrosis fuse?
starts at 15 and finishes at 20
Lesser cornu of hyoid bone is derived from which brachial arch?
2nd (Greater cornu is from 3rd)
Mandibular symphysis fuses at what age?
6-9 months of age
What genes are related to Marfans syndrome?
FBN1 & TGFB-2
Genes of Non-syndromic tooth agenesis?
MSX-1 and PAX9 (3rd olars)
Genes of Treacher-Collins syndrome?
TCOF1
Genes of Turners syndrome?
SHOX
Genes of Dentinogenesis Imprefecta?
DSPP
What is the last bone to complete growth
Clavicle
Tongue reaches adult size at what age?
8 yrs
Maximum width of skull (cranial vault) at what age?
7 yrs
Nasal bone completes growth at what age?
10 yrs
What is Enlow’s V principle?
Complex bones maintain characteristic shape by bone deposition inside the “V” and resorption outside the “V”
What is the first system to form in embryo?
Neural
…Tissue regresses as … tissue develops
Lymphoid; Genital
Skeletal tissue is inversely proportional to the … curve
Lymph
50% of female growth is completed at age?
6
Arch length and perimeter increases or decreases from primary to permanent dentition?
Decreases
What are Bjork’s 7 signs of mandibular rotation
- inclination of condylar head
- curvature of mandibular canal (vertical grower -? more curved lower border)
- Shape of mandibular border (antigonial notching)
- Symphysis inclination (vertical grower -> more prominent chin)
- Interincisal angle
- Interpremolar and intermolar angles
- Lower anterior facial heights
Growth finishes in what order?
Transverse- AP - Vertical
What is the most common salivary gland tumor?
Pleomorphic Adenoma
What is the range of wavelength for curing light?
430-480 nm
What photoinitiator is used in adhesive?
Camphorquinone
What is the most common odontogenic tumor?
It seems Ameloblastoma is correct
Odontoma
What is the most common cephalometic error?
Difficulty in locating landmarks
What force can be placed immediately on TADs?
100-200 g (300 or more will result in failure)
Best achorage device?
Best vertical control device?
Anchorage = TAD Vertical = HG
Agenesis of tooth occurence order?
3rd molars> md. 2nd premolars> mx. lateral incisors
What is the limit of a SARPE expansion?
Zygomatric buttress
Concentration of NaF in mouthwash recommended?
0.05%
Geographic tongue is associated with what conditions?
Psoriasis
Fissured Tongue
Females x3 > males
Munro abscess histologically
Most common finding in HIV patients?
Candidiasis
Most detrimental effect of root resorption?
intrusion and torque
Undermining resorption shows what histologically?
Cell free zone
Growth curve of mandible is btwn which two curves?
General and Neural
Physicians use height/weight chart if there is how much deviation form the norm?
90%
According to functional matrix theory, what causes bone growth?
Periosteal matrix
What part of the face has both endochondral and intramembranous growth?
Upper and Middle
Anterior Pituitary hormones?
FLAT PEG FSH LH ACTH TSH Prolactin Endorphin GH
Posterior Pituitary Hormones?
ADH (vasopressin)
Oxytocin
What does high level of alkaline phosphate indicate?
high level of osteoblastic activity
Paget’s disease
during growth
What are the dental consequences of hypothyroidism(Cretinism)?
root resorption, delayed erruption, incompletely formed roots of permanent teeth, macroglossia, mental retardation
What diseases have Wormian bones?
PORK CHOP Pycnodysotosis Osteogensis imprefecta Ricketts "Kinky hair" Menke's syndrome Cleidocranail dysostosis hypoparathyroidism hypophosphatasia otopalatodigital syndrome primary acro-osteolysis Downs
How does the cranial base growth?
endochondral ossification
synchodrosis
Source of growth of the cranial base?
Spheno-ethmoidal, inter-sphenoidal, spheno-occipital
majority of growth in the mandible is?
Appositional
Normal downward and forward facial growth results from?
Upward and backward growth of maxillary suture and mandibular condyles
Vertical and mesial drift of dentition
Resorption of the anterior border of the ramus allows what kind of growth?
Increase in mandibular corpus length
What suture fuses early in dolicocephalic patients?
Saggital (Coronal in brachy patients)
Which bone ossifies upon termination of growth in the distal phalanges?
Sesamoid
Ossification of Sesamoid bone and growth spurt timing?
occurs 1 year before growth spurt, 70% of growth remains) SMI4
Growth Spurt SMI6-7
What part of maxilla increases arch length and allows for molar eruption?
Mx. Tuberosity
In 11 YO male, lower facial height is expected to increase at what rate?
1mm/year
In a 11 YO male, in a 2 year period, how much are the mandibular molars expected to erupt?
1.5-2mm
Soft tissue vs. skeletal profile changes from teens to adults
Changes in Soft Tissue are greater
According to reviews of UNC database, deviation of the chin in pts w/ deficient or excessive md growth is to what side and what precentage?
left, 90%
Best genetic phenotype for predicting facial growth of child
Same sex sibling
What is the Peak Height Velocity (PHV)
- highest growth rate at any age
- 12 years in girls, 14 in boys
- from puberty for up to 24 months after
In late maturing girl, when does PVH occur?
18-24 months
Best way to determine growth potential?
Hand-wrist film (Serial Ceph shows cessation of growth)
Peak height velocity curve indicates what?
Growth in cm per year
At menarche what is true about growth
most growth is completed
When do primary teeth start calcification in utero?
14 weeks
Calcification of upper and lower 3rd molars…
varies greatly
What is the rate-limiting factor in pre-emergence tooth erruption?
Resorption of primary teeth (formation of permanent teeth stimulate primary tooth resorption)
What time of day does tooth erruption occur?
8PM to midnight of 1am (similar to hormone release)
How long does it take for root to complete following eruption?
2 to 3 years
Mechanism of tooth eruption is best explained by?
Proliferation of cells at the base of the crypt
What are the 3 things that could happen in tight anterior occlusion/late mandibular growth?
- distal displacement of md.
- maxillary incisor flare
- lower anterior crowding
Greatest loss of arch length occur at?
loss of second primary molars @ 6.5 years
What happens to permanent mandibular intercanine width during transition from primary to permanent?
- increases slightly
- 2 mm increase
Narrow arch width vs wider arch weidth, the arch perimeter increases?
greater for the narrow arch
What radiographs should be submitted to the ABO for pt over 18?
FMX
What imaging is the best technique to see TMJ disc perforation?
Arthography
What imaging gives off the most radiation?
Bone Scan
Digital radiograph can produce ___ shades of gray and human eyes can detect ___ shades of gray
256 (8 bit)
16 (4 bit)
You can use a 8 bit monitor to display pictures taken from a camera that has 8 bits and 256 shades of gray (T/F)
True
Most common radiographic error leading to magnification?
increased distance from object to film
What is the ideal distance btwn film to midsagittal plane for lateral ceph?
15 cm (greater will cause magnification)
What is the ideal distance btwn source to midsagittal plane for lateral ceph?
60 in (5 ft)
What is the major source of error in ceph tracing/
Identification of landmarks
In standard ceph, which side of the mandible is lower and more magnified?
Right side
What is the usual cause of double border of mandible in lateral ceph?
Magnification
Why would mandible be smaller on ceph taken 3 years later?
- Pt. too close to the source
- Change in object to film distance
Radiographic film emulsion contains…
Gelatin and silver halide (bromide)
Not including CBCT what is the downfall of digital x-ray?
Resolution
What is the x-ray filter composed of? and why is it used?
- Aluminum
- Reduction of low energy x-rays
What metal is used to produce x-rays? (target)
Tungsten
What is the minimum total filtration that is required by x-ray that can operate in range greater than 70 Kvp
2.5 mm aluminum or equivalent
What is a radiographic filter and intensifying screen used for?
- reduce exposure to patient
- reduce exposure time
- thicker phosphor layer results in faster screens
How long should exposed x-ray film remain in fixing solution?
10 mins (5 for development)
When do primary teeth form in utero?
6 weeks
When do primary teeth begin calcification in utero?
14 weeks
What is the number of teeth related to gemination and its anatomy?
same # of teeth; 2 crowns, 1 root
When does tooth emergence begin related to root completion?
3/4 root completed
When does tooth eruption begin related to root completion?
2/3 root completed
When does apex close after eruption?
2-3 years
What features are associated with tooth eruption?
- occlusal change; root elongation; growth of alveolar bone; resorption of deciduous roots
- NOT RELATED TO MESIAL TOOTH MOVEMENT
What teeth are most common in ectopic eruption?
-mx 1st molars, md laterals, mx canines
What are the most reliable signs of aberrant eruption sequence?
- L7 before L5
- U3 before U4/U5
What is estrogen has what effect on tooth movement?
decreases
What is the most common primary tooth agenesis?
Primary mx lateral incisors
When asymptomatic non-ectopic impacted 3rd molars followed from a mean age of 20-24, what percentage are expected to erupt into a normal position?
33%
What is the most important factor for intra-oral digital photography?
light
Which photography file type loses the most resolution?
JPEG (if GIF is not a choice)
JPEG loses the most information upon compression
What photography tile type loses the least amount of info?
TIF
What do you do when you use a double film packet?
Do nothing
What do you need to do to ensure the film quality when taking extraoral PA?
increase mA or exposure time
What affects penetration the most when taking an X-ray?
kVP
What has no effect on penetrating power of X-ray?
mA and exposure time
How do you decrease an x-ray contrast?
Increase kVP
How do you decrease density of a radiograph?
decrease mA
How do you position a patient’s head when taking a pano?
Frankfort horizontal parallel to the floor
This term is used to describe the area of dental anatomy that is reproduced distinctly on a pano
Focal trough
When evaluating radiograph, which teeth show greatest variation relative to the onset of mineralization of the crowns of permanent teeth?
premolars
Transcranial x-ray good for viewing what structure?
Lateral pole of condyle
What does ABO recommend for scale of photography?
1/4 photo size
Factors that contribute to optimal detail sharpness of a radiograph
- small focal spot area
- short object film distance
Oral tissues that are most sensitive to radiation?
Developing tooth buds and salivary glands
What is mandatory in radiation for protection of patients?
Collimation
Radiation protection guide advocates that x-ray dose to operators of dental machines should not exceed?
100 milliroentgens per week
What type of radiograph is used to view maxillary sinuses?
Waters view
The first clinically observable reaction to radiation is?
Erythema of the skin
Cephalometrics are used to determine…
Dental pattern related to skeletal pattern
ABO, Mandibular Plan is
-constructed gonion to menton
ABO SN-MP range
27-37 degrees
What ceph measures are used in ABO discrepancy index?
SN-MP, ANB but not FMA, IMPA
What two bones meet articulare?
Mandible and temporal (it is a constructed point)
Which point is associated with occipital condyle?
Bolton point (higherst point at posterior condylar notch of occipital bone)
What is the posterior border of foramen magnum called?
Opisthion
Distance between SN and Natural head position?
7 degrees (SN and Frankfort difference -7 degrees)
What are common and stable reference lines when tracing?
FH line
What is level with FH line? and what is Parallel?
level = Zygomatic arch Parallel = Palate
What’s the best structure for superimposition of the cranial base?
Anterior clinoid, cribiform plate, greater wing of sphenoid
At what age can you start to superimpose on SN?
7 yrs
Where is Jugal Point?
Anterior end of upper border of zygomatic arch where it meets the process of zygomatic bone
What is the major limitation of the Witts analysis?
Failure of distinguishing btwn skeletal and dentoalveolar discrepancies
On a ceph, if you change from anatomic porion to machine porion, what will change?
Machine porion is anterior and inferior
FMA and Y-axis increase
FMIA decreases
Where do you superimpose the mandible?
3rd molar crypt, inner cortical part of symphysis, lower border of mandibular canal
(NOT of angle of mandible or mental foramen)
Where do you superimpose to know changes in maxillary dentition?
palate
What’s the percentage of lower anterior facial height?
55%
In 16 YO female, normal ratio of upper facial height to lower facial height?
Upper (nasion to Subnasale): Lower (Subnasale to menton)
43:57
Which ceph line is not an esthetic line?
I line
A good measurement of severity of a malocclusion in the AB line to?
Facial plane (N-Pog)
What 2 lines make up the facial angle?
Facial Plane (N-Pog) and FH Line
What happens to facial angle and mandibular plane angle as a person ages?
Facial Angle Increases
Mandibular Plane decreases
MPA decreases _ degrees per every _ years
1 degree per every 3 years
Angle of Convexity
angle btwn N-A and A-Pog
What is least likely to change from 8-18 yrs? or remains relatively constant with age?
Y-axis; Facial Axis
If the angle of convexity is -5, what type of malocclusion do you expect?
Class III
What can be used as a substitute for porion?
Ear rod
Temporal bone on PA Ceph appears as a line on? Where does petrous bone lie on PA ceph?
Inferior 1/3 of the orbit
Radiopaque line that passes obliquely through the orbits on a PA is which bone?
Sphenoid
Downs analysis used what as a reference plane?
Frankfort Horizontal
Downs used what for superimposition?
Broadbent registration point
Where is Broadbent registration point located?
Intersection btwn the Bolton-Nasion line and perpendicular from sella
Steiner uses what to evaluate lower incisors to chin?
Holdaway Ratio (L1-NB/Pog-NB) 1:1
What is one of the major strengths of McNamara Analysis?
Normative data are based on well defined sample
What is the E line?
Ricketts; Soft tissue Pog to tip of the nose
What is the best point to measure the protrusion of the upper incisors?
SNA
What is the normal range of Nasolabial angle?
94-110
What is the name of the midpoint at the most inferior point of maxillary alveolus?
Supradentale (aka prosthion)
Mandibular one is known as infradentale
Which occlusion is commonly found with interincisal angle of 185 degree?
Class II div II
What anatomic structure is frequently superimposed on periapical or occlusal radiographs of the anterior maxilla?
ANS
The radiopacity that frequently obliterates the apices of maxillary molars when using bisecting principle of intra-oral radiography is?
Zygoma and zygomatic process of maxilla
What structure does the tuberculum impar give rise to?
Tongue
Meckel’s cartilage gives rise?
Malleus, Incus, Sphenomandibular ligament
What brachial arches is hyoid derived from?
2nd and 3rd
lesser-2nd, greater cornu
What bones form lamboidal suture?
2 parietal and 1 occipital
Where does the frontal sinus drain?
Middle meatus
Where does the posterior ethmoidal cells drain?
Superior meatus
What is the lacrimal sac between?
Maxilary and lacrimal bones
What structure is the key ridge?
Zygomatic process of the maxilla
What bone is not a part of the orbit?
Vomer
What bones make up the floor of the orbit?
• Seven bones of the Orbit “Z Pretty MELFS”
o Zygomatic, Palatine, Maxilla, Ethmoid, Lacrimal, Frontal, Sphenoid, ,
o Floor = ZPM Medial = MEL
What bones make up the floor lateral wall of the orbit?
• Seven bones of the Orbit “Z Pretty MELFS”
o Zygomatic, Palatine, Maxilla, Ethmoid, Lacrimal, Frontal, Sphenoid, ,
o Floor = ZPM Medial = MEL
How many cartilages in the inferior 3rd of the nose?
3 cartilages
The nasal septum is usually deviated where?
Inferior 1/3
Which is the largest salivary gland?
- Parotid
- enters though buccinators M2 by Stensen’s duct
Where is the articular tubicle located relative to sigmoid notch?
Posterior
What doesn’t occur when a person swallows?
Supra hyoid relax
Position of the mandibular foramen?
- Above the occlusal plane
- Above and posterior of the mandibular molars
Muscle primarily responsible for smiling?
Zygomaticus major (not Risorius)
Which muscle pulls the lip up when smiling?
Labialis Superioris
Which muscle draws the corner of the mouth laterally when smiling?
Risorius
Temporalis muscles act as?
Periosteal Matrix
Anterior digastic muscle is innervated by what? and posterior by what?
Anterior by trigeminal
Posterior by facial
Origin and insertion of anterior and posterior digastrics
o Anterior origin – close to lingual symphysis; posterior origin – medial surface of mastoid process; a deep groove btwn mastoid process and styloid process called digastric groove o Insertion – both of them into intermediate tendon of hyoid bone(at junction of greater and lesser cornu)
Which muscle inserts into the mandible?
anterior digastric; not hyoglossus, posterior belly of digastric, thyroglossus, superior belly of omohyoid
What muscle protrudes the tongue?
Genioglossus
The hammock ligament is related to…
eruption
What bone bridges the cranial base to facial skeleton
Sphenoid
What is not a part of the sphenoid?
Cribiform (that is ethmoid)
Sphenoid- dosum sellae, anterior clinoid process, hypophyseal fossa
Which paranasal sinus lies beneath the sella turcica?
Sphenoid sinsus
Origin and insertion of Medial pterygoid muscle
Origin: deep head > medial side of lateral pterygoid plate; superficial head > pyramidal process of palatine bone and maxillary tuberosity
Insertion: medial angle of mandible
Origin and insertion of Lateral pterygoid muscle
o Origin: upper head – infratemporal fossa and infratemporal crest of greater wings of sphenoid o Lower head – lateral surface of lateral pterygoid plate o Insertion: inferior head – neck of the condyle; superior – articular disc and condylar capsule
C1 known as the … pivots around the … process of C2
Atlas pivots around the Odontoid process aka dens of Axis (C2)
What is the widest cervical vertebrae (C1-C5)
C1 Atlas
Where is the hyoid bone located relative to the cervical vertebrae?
C3-C4
What is the midpoint at the most inferior point of the maxillary alveolus?
Supradentale (Prosthion)
Foramen that borders the petrous portion of the temporal bone?
- Foramen Lacerum (borders with temporal, sphenoid, occipital)
- most foramina are in sphenoid; jugular foramen border occipital and temporal
- hypoglossal canal in occipital
What nerve is a special sensory to anterior 2/3rd of the tongue?
Facial nerve via chorda tympani
What artery goes into the pterygomaxillary fissure?
Pterygopalatine artery
What are the borders of the Pterygomaxillary fissure?
Anterior border: maxillary tuberosity
Posterior border: lateral pterygoid plate
Where are the Adenoid’s located?
Posterior pharyngeal wall
Nasopharyangeal wall
What is the incubation period for Hep B?
1-6 months (Hep B Antigen is potentially infectious)
What the the most common symptoms of Hep B?
No symptoms
Patient presents with Coloboma and ear tissue?
Treacher Collins
- Downward slanting palpebral fissure
- hyplastic supraorbital rims
- malar hypoplasia
- mandibular hypoplasia
- auricular and middle ear malformations
- lower eyelid coloboma
- may have cleft plate
- normal intelligence
Treacher Collins is not assocaited with…
Mandible prognathism /Md hyperplasia
Hypoplastic maxilla
What are the 5 stages of Craniofacial development?
- germ layer formation
- neural tube formation
- origins, migration and interaction of cell population
- formation of organ systems
- final differentiation of tissues
What stage of craniofacial development does Fetal Alcohol syndrome occur?
1st and 2nd
At what stage of craniofacial development does Mandibular dysostosis occur and what week is that stage completed?
3rd stage (Treacher Collins) and completed at the 4th week
At what stage of craniofacial development does cleft lip and palate occur?
4th stage
At what stage of craniofacial development does Synostosis occur?
5th stage; Synostosis (early closure of sutures btwen cranial and facial bones)
-Crouson, Aperts, Achondroplasia
What syndrome affects both maxilla and mandible and occurs due to a disturbance in the 1st trimester?
Mandibulofacial dystosis (Treacher Collins)
What syndrome has a problem with neural crest cell migration and underformation of the Mx. and Md.?
Treacher Collins
What are the symptoms of Gardner’s syndrome?
- Colon (intestinal) polyps
- Supernumerary teeth
- Multiple Osteomas
- DOES NOT CAUSE CLEFTS
What are the symptoms of Down’s syndrome?
o Trisomy 21 o Brachycephaly o Flat nasal bridge and occiput o Small, low set ears o Macroglossia, glossoptosis o Epicanthal fold o Brushfield spot o Simian crease o Sandal gap deformity of feet o Excessive nuchal feet o Mental retardation o Hypoplastic maxilla o Delayed eruption of teeth o Prevalance 1 in 800
Which syndrome displays syndactyly?
Apert’s
both Crouzon and Apert have premature fusion of coronal and lamboid sutures
What suture fuses prematurely in Apert’s and Crouzon syndrome?
Coronal Suture
What two symptoms are not associated with Cleidocranial dysplasia?
Missing teeth and protrusive maxilla
Cyanosis is common at birth in what syndrome?
(bluish color of skin) Pierre-Robin
-Glossoptosis, micrognathia, U-shaped cleft
Bilateral cleft lip is caused by failure of fusion of what?
Medial nasal process and maxillary
What is the incidence of cleft palate?
1 in 750 worldwide
What facial height is reduced in cleft patient’s?
Upper facial height
What is found in a cleft patient?
Rotated incisors, missing laterals, posterior crossbite
*NOT impacted central incisors
What is the most effective time to surgically close a cleft palate?
1 year after birth
What causes problems in cleft pt’s speech?
- inability to buildup intraoral pressure
- hypernasality
- velopharyangeal insufficiency
When should an alveolar bone graft in a cleft patient be performed?
when the canine root is 2/3rds formed
Infants with repaired cleft palate and lip have what deficiency?
Deficiency in the soft palate
The recent consensus is that grafting of alveolar process in cleft patients should be preformed during which period?
infancy
Effective sources for bone graft for clefts?
Iliac > calvarium > ribs
Best retention for a cleft patient?
retainer with a pontic
Hypertelorism is seen in what type of cleft?
Midline cleft (internasal dysplasia)
What are the symptoms of Eagle Syndrome?
Styloid process elongated; stylohyoid ligament calcification
Kaposi sarcoma in HIV patients is?
Multifocal in origin
What is the most oral manifestation of HIV patients?
Candidiasis
What is seen in osteopetrosis?
Increased radiopacity
The most common location for a Siaolith is?
Submandibular Gland
What is the most common type of salivary gland tumor?
Pleomorphic adenoma
What are the most to least common location for a Pleomorphic adenoma?
Parotid > Posterior lateral hard palate > submandibular > upper lip > buccal mucosa
What is the most common oral malignant tumor?
Mucoepidermoid carcinoma
What is the second most common salivary gland tumor?
Mucoepidermoid Carcinoma
What is the second most common oral malignant tumor?
Adenoid cystic carcinoma
Osteomyelitis is commonly caused by which bacteria?
Staphylococcus aureus
Fibrous dysplasia presents with what radiographic apperance?
ground glass or orange peel
Geographic tongue is associated with…
- Psoriasis
- Fissured Tongue
- more common in female then male
- show abscess histologically
What is the most common odontogenic tumor?
Odontoma or Ameloblastoma ( Dr. Kahn’s suggests Amelo while Neville says Odontoma) so that’s fun
T/F Ameloblastoma metastasize frequently
False
-
Common area for Ameloblastoma
3rd molar/posterior mandible
high recurrence after removal, multiocular, more common in males
A female patient has multiple radiolucencies apical to the lower anteriors. All teeth test vital. What is the probable diagnosis?
Periapical Cementodysplasia (MABF)
How does a mucocele differ from a true cyst?
it lacks an epithelial lining
What is the etiologic agent of the majority of subacute bacterial endocarditis?
Strep viridans
What are the symptoms of hypocalcemia?
-Decreased cardiac output (increase chronotropic, decrease ionotrophic)
-CATs go numb (Convulsion, Arrhythmias, Tetany, numbness/parasthesia around hands, feet, mouth, lips)
Positive Chvostek’s sign (tap angle of the jaw > Massters spasms)
What the the signs/symptoms of Pagets disease?
o Pontential for undergoing “spontaneous” malignant transformation
o Cotton wool appearance
o Alkaline phosphatase is elevated
A patient with achondroplasia in which midfacial structures are most affected is likely to have what malocclusion?
Class III
What is the clinical oral symptom of Peutz-Jegher syndrome?
Melanin pigmentation of lips
What are the signs and symptoms of Ectodermal Dysplasia?
- Missing sweat glands
- Missing teeth/peg shaped
- NOT blue sclera (that is caused by OI)
What are the S+S of Adenoid Facies
- high palate and constricted maxilla
- open bite
- short upper lip
Osteomyelitis is most commonly caused by what bacteria?
Staphloccus Aureus
What can manifest itself as myositis?
Osteomyelitis
Children with what condition have the greatest tendency towards delayed erruption of teeth?
Hypothyroidism
Exam reveals mixed dentition, malocclusion, abnormal resorption pattern of primary teeth, delayed eruption of permanent teeth, incompletely formed roots of permanent and large tongue?
Hypothyroidism
Arthritis changes whatt?
Synovial Fluid
If both parent’s don’t have cleftt but one sibling does, what is the chance the next child will have cleft?
5%
S+S of Taurodontism
- pulp chamber vertically enlarged
- “Bull like” teeth
- associated with amelogenesis imperfecta, ectodermal dysplasia, tricho-dento-osseous syndrome
Banthine’s dental side effect is … and it used to treat …via its MOA, ….
reduced salivary flow
used to treat anticholinesterase poisoning, bradycardia, antispamodic
MOA Muscarinic receptor antagonist
What are the 3 types of drugs that can cause gingival hyperplasia?
- Anticonvulsant (phenytoin)
- Immunosuppressant (cyclosporine)
- Calcium channel blocker (procardia, nifedipine, verapamil, diltiazem)
What effect does prostaglanding have on osteoblasts and osteoblasts?
Arachadonic acid, prostagladin stimulates osteoclastic production
What affect does low doses of analgesics w/ prostaglandin inhibitors for pain control after orthodontic appointments have?
Little of no inhibiting effect on tooth movement
The Arachodontic acid pathway is activated by…
IL-1, IL-6, TNF-alpha
Which cell mediators increase prostaglandin production?
IL-1 and BMP
AHA guideline for banding molars in pt with mitral valve prolapse?
No prophylaxis is needed
How is intramembranous bone formed?
via condensation of mesenchyme
Fetus’s are composed of … bone.
Woven bone
Increasing loading on bone results in …
increased turnover
Histochemically there is no difference btwn basal bone and …..
alveolar bone
If a person has a steep premolar cusps, ortho should finish in what overbite relationship?
Deeper overbite
T/F with tall cusps, a case should finish in a deeper bite to prvent interferences?
True
Nocturnal bruxism is associated with … but it is not associated with …
stress, occlusal interference
With a 3mm OB and an exaggerated Curve of Wilson what is expected?
Non-working interferences
With a edge-edge bite and a severe curve of Wilson what is expected?
Lack of posterior disclusion
How do you finish a 2 mm CO-CR discrepancy?
if = 2 mm equilibrate (MUDL rule: Mesial upper, distal lower) so grind distal inclines on lower
What often prevents attaining Class I posterior occlusion?
Axial inclination of canines
What premanent posterior tooth has a mesial marginal ridge located more cervical than distal margin?
Mandibular first premolar
With what tooth does upper second premolar occlude with in Class III malocclusion?
Mandibular 1st molar only
The non-centric cups in posterior crossbite are?
upper lingual and lower buccal
In response to heavy pressure against a tooth, pain is usually felt after how many seconds?
3-5 seconds
Flush terminal plane in the primary dentition normally results in..
End to end or class I (most of the time)
Distal step in the primary dentition normally results in…
Class II or end to end
What cusp is most likely the cause of balancing interference?
Lingual cusps of maxillary second molars
What changes as a patient shifts from CO to CR?
Vertical dimension increases, OJ increases, OB decreases
T/F a 1mm CO/CR shift is acceptable?
True
The TMJ joint is compose of …
Fibrous CT
The articular surface of the TMJ is lined by …
thin synovial membrane
in the TMJ Translation occurs in the … compartment and Rotation in the … compartment
Upper
Lower
The tooth and cups most likely to cause TMJ are?
Maxillary 2nd molar lingual cusps
The most important single indicator of TMD is…
Reduced amount of maximum opening
What is the cause of TMJ pain that starts from the rights side and radiates to the left?
Psychogenic
- true neuralgia doesn’t radiate across the midline
- psychogenic pain can occur bilaterally
A patient has a bruxing habit with pain and crepitation what should be avoided?
Anterior positioning splint (should use a flat plane orthotic)
If a child is hit in the jaw where would the fracture occur?
Body fractures on the same side
Subcondylar fracture on the contralateral side
How does condylar resorption present?
Facial asymmetry, anterior open bite, decreases ramus height, and progressive mandibular retrusion
What is the most common sign of anterior open bite?
Rheumatoid arthritis
A sudden change in occlusion, pain (parafunction), open bite, internal derangement is associated with…
Rheumatoid arthritis
What age group is condylar hypoplasia most common?
Early adult-late adolescent
Sardowsky and BeGole compared ortho treated group as adolescents 20 years ago and non-ortho malocclusion group and had the following conclusion concerning TMD?
Orthodontic treatment during adolescences did not generally increase or decrease the risk of developing TMD later in life
Pancherz’s study of 22 growing patients with Cl II Div I treated with Herbst had the following findings..
- number of subjects with tenderness to palpation doubled during the initial 3 months of treatment
- after removing the appliances, most muscle symptoms disappeared and 12 months post-tx the number of subjects with symptoms was the same as pre-tx
Smith and Freer’s study of orthodontic tx and TMD concluded…
there was no significant association btwn ortho tx and TMJ disfunction
-but higher rate of clicking in post-orho groups (64% compared to 36%)
Dibbets and Van der Weel’s study of extraction and TMD concluded …
Original growth pattern rather than extraction tx was most likely factor responsible for frequency of TMD reported many years post-tx
When studying Orthodontic tx. and TMD Larsson and Ronnerman concluded?
Extensive orthodontic treatment can be preformed without the fear of creating complications of TMD (suggest tx may possibly prevent TMD)
According to some studies, TMJ sounds are common in __% of the population including patients before orthodontic treatment.
25% (20-30%)
T/F Extraction therapy appears to be an iatrogenic cause of distally positioned condyles
False
A open bite patient with an anterior displaced disc on the left side deviates …
deviated to the same side (left)
If a patient has disc displacement without reduction, what side the deviation will…
be towards the affected side
What sign is not seen in acute closed lock?
Joint sound (ADD without reduction)
The perception of TMJ pain is by which nerves?
Auriculotemporal and masseteric n.
Patient who develops an open bite and low shifting of the mandible to the right has…
right condylar resorption
Dislocation of the mandible can only occur in which direction?
Anterior
A Pt has a prolonged history of internal derangement and develops pain in the TMJ area. What is the assessment?
Posterior capsulitis
A Pt has an open lock. When moving the jaw to the left, she hears a click and is able to close her jaw. What is happening?
Posterior disc displacement on the left
A patient presents with an open lock that occurred when yawning. What is the cause?
Posterior disc displacement
Gorlick states the __% of orthodontic paitents have decalcification and should wait ___ before flouride treatment
50%, wait 2-3 months
Gorlick stated that …% of patients developed WSL when using flouride rinse.
21%
What affect does flouride have on bond strength when applied to teeth prior to bonding?
Decreases bond strength
Research shows that the mean shear bond strength of bracket adhesive using Fluroide releasing etching gel is significantly … than when using non-fluroidated gel
higher
Tarter contorl tooth paste reduces …% of supragingival calculus due to the active ingredient …
50%; pyrophosphate
Cooperation is more likely to be a problem in a patient with…
external motivation for seeking treatment
Adult patient who seeks orthodontic treatment tend to have..
a more positive self image than average
A patient swallows a band and is conscious and coughing, doctor should…
stay with the patient and encourage coughing
What types of occlusion cause speech impairment?
- Anterior open bite (distortion in lingual alveolar sounds - s,z, th)
- Class III (distortion in fricative - f,v)
What sounds can a patient with an anterior openbite not produce?
S, z, th (lingaul alveolar sounds)
Where and when was the first meeting in the ABO?
1929 Estes Park, Colorado
What appliances did Edward Angle invent?
PEER Pin and tube E arch Edgewise Ribbon arch (not univeral)
What are the 4 major causes of malocclusion?
Drugs, habits, hereditary, endocrine imbalances
What is not usually a goal of adjunctive orthodontic treatment?
treating TMD
What is adjunctive orthodontic treatment?
Tooth movement carried out to facilitate other dental procedures
T/F Primary failure of eruption is more frequently seen in the anterior. When orthodontic force is applied, ankylosis often occurs with such teeth when extrusive force is placed on them.
F/T
T/F Hyperdivergence should be treated early. The phenotype is diagnosed early.
T/T
Openbite in primary dentition is predicated on what?
the phenotype doesn’t self correct
What are skeletal characteristics of openbite?
high mandibular plan angle and antegonial notching
What percentage of openbites self correct?
80%
What percentage of young kids with anterior openbite are treated?
20%
The incidence of openbite malocclusion in post-pubertal age group…
decreases
T/F Contemporary research shows that tongue thrust swallow in early permanent dentition is more of an adaptation to openbite then the cause of it. Elimination of tongue thrust leads to spontaneous corrrection of openbite in the age group.
TF
A patient in mixed dentition with no speech problem …
you do nothing
T/F VTO predictors are accurate and can be used in ortho tx planning. VTO soft tissue are accurate.
T/T
Little’s study of relapse in extraction cases found…
- 2/3rd relapse of mandibular teeth within 10 years
- of those cases 30% had acceptable alignment after long term retention; 20% cases had poor crowding after retention stopped
- 1/3rd were clinically acceptable
What is the least likely to relapse?
COS (most stable)
Patient with rotated Mx incisors, deep bite, and large OJ. What is most likely to relapse after tx.
Rotation (order: rotation > deepbite > COS)
What is the normal intermolar width for adolescents and adults/
Adolescents 33-35 mm
Adults 36-39 mm
What is the most important factor in creating a smile arc?
Bracket placement according to case evaluation
What are the soft tissue points for the vertical thirds
Trichion-glabella, glabella-subnasale, subnasale-menton
What is the ratio fo upper lip to soft tissue chin?
1:2
In a compelte nasal obstruction, there is an immediate change of head posture measured by an increase in craniofacial angle of about?
5 degrees
What is most associated with mandibular asymmetry in children?
Trauma
When finishing in class II by extraction of mx. Bi’s, how do you rotate the first molar?
Mesially rotated molars when finishing in class II
A space discrepancy greater then …mm … requires extraction.
10 mm
almost always
A space discrepancy of up to …mm can usually be resolved without extraction of some teeth other then 3rd molars.
4 mm
What are the criteria for serial extractions
- no skeletal disproportion
- class I
- Normal overbite (but NOT mild arch perimeter deficiency)
The goal of serial extraction is…
to transfer incisor crowding posterior to PM extraction site
The key to success of serial extraction is to?
Extract premolars before canines erupt
Consider these criteria for untipping 2nd molars due to loss of first molar with presence of 3rd molars to see if you should extract 3rd molars.
- Presence of 3rd molars
- Pontic space needed
- distance of mandibular 3rd to ramus
Impaction of 3rd molars after orthodontic tx is associated with..
- vertical component of growth
- higher than usual mandibular plane angle
- Excessive ascending rami
- short mandibular body
What is the tooth in the md at age 8?
2nd premolar
What is a viable option when there’s less tooth mass on the upper?
Md incisor extraction
Which arch form would more closely approximate normal position of 2nd and 3rd molars?
Brader arch form
What tooth provides the best anchorage based on bone density?
Mandibular 1st molars
What are possible reasons for a pt to have Class I on one side and Class II on the other side?
Skeletal asymmetry, arch asymmetry, midline discrepancy
Why is the Major cause of class I crowding not the early loss of dental material in the primary dentition?
Because the decrease in primary tooth loss due to fluorination in the US had little to no impact on the prevalence of malocclusion
A diastema less then … mm will probably close spontaneously
2 mm
What is active stabilization?
the ability of the PDL to generate forcee contributing to the equilibrium situation
On an articulator, the chagne in AP is controlled by what?
Change in condylar angulation
What additional piece of information do you gather at a records appointment?
protrusive wax bite
Why would you not articulator mount an ortho cast of preadolescence?
The contour of the TMJ is not fully developed and non adult canine function
When treating a high angle female with cross bite with a bonded RPE when do you extract the supernumerary teeth in the mandible near the canines?
Before treatment
What is the most likely cause of tooth loss in ortho tx?
external root resorption
How long should an extruded tooth be retained?
6 months (due to oblique peridontal fibers)
What is the definition of ankylosis?
two mineralized surfaces fused together
What causes a midline diastema?
tooth size arch length discrepancy
What are the 3 types of arch forms
Bonwill-Hawley: Based on mathetical model
Catenary: based on pendulum swing
Brader trifocal: Based on trifocal eclipse
How does zinc phosphate used for ortho differ than restorative
Zinc phosphate for ortho is mixed thicker
Etching with 37% phosphoric acid for 30 seconds removes how much enamel?
3-10 microns
8-10 for 15 seconds
What is the safest and preferred site of failure when debonding brackets
Interface btwn the brackets and bonding materials
T/F Thermal debond is an alternative method to the usual technique. Ceramic brackets debonded by thermal means both more time and higher temperature required.
T/T
When debonding the force generate should be …
shearing (not torque)
What should be used to sterilize heat sensitive instruments?
Vaporized H2O2 ( best answer if present, if not Ethyl alcohol)
What is the effect on achorage in patient with cermaic brackets 3-3 and metal posterior?
Anchorage loss (higher friction on ceramic vs. metal)
If a patient has a Nickel allergy what AW can be safely used?
TMA (SS and Elgiloy contain 8% nickel)
What are the most common causes of allergic reactions in orthodontic patients?
Nickel or latex
What type of AW shows the least resistance to deformation?
SS (most likely to have permanent deformation)
When comparing TMA to SS, TMA has … the deflection.
double
What is the application of springback?
- ability to deform a wire and return to its original shape
- wires resistance to permanent deformation
Wire Strength =
Strength = stiffness x range
What is wire strength relationship to springiness?
Springiness = 1/stiffness
What are asperities of an AW?
an area that actaully contacts along a wire, resulting in roughness on a wire where it binds
-NiTi > TMA > SS
At what point is permanent deformation first observed in elastic materials?
Proportional or elastic limit
What are the properties of an ideal orthodontic AW?
- high strength
- low stiffness-
- high range
- high formability
A typical SS AW is composed of …% chromium and …% nickel which impart the following properties..
18% chromium-prevents corrosion
8% nickel- flexibility
If you double the diameter of the wire, the strength increases/decreases by…
Increases by 8 times
2 times diameter = 8x strength, 1/16x springness, and 1/2x range
If you double the length of a finger spring, the force it delivers
decreases 1/2
2x length = 1/2 strength, 8x springiness, 4x range
Compared to SS, Ni has a …load/deflection ratio, … springback and …formability
low; greater; low
When wire length is increased, what happens to the load deflection rate?
decrease deflection rate
What gives NiTi its properties?
Phase Transformation
Which AW gives NiTi a soft and gradual force?
Austenitic NiTi
The activation phase of superelastic NiTi involves what state?
SIM (stress induced Martensitic)
Heat treated Elgiloy has the same stiffness as..
SS (Prior to heat treating Elgiloy has greater formability than SS and after heat treating aka precipitation hardening, the strength is increased)
If chromium-cobalt is not heat treated, stiffness is?
same as SS; heat increases strength
What is Young’s modulus of elasticity?
expressed in stress and strain curve, deflection and stiffness
T/F both functional and surgical patients show stable results over time.
True
Twin block therapy results in …% skeletal and …% dental changes.
55-61% skeletal
39-45% dental
What head gear results in the worst/poorest vertical control anchorage?
Cervical pull
How do you counter the effects of molar tip back bend with HPHG?
Use short outer bow, force must be mesial to CR
HPHG is not good for what type of bite?
Deepbite
Cervical HG results in…
- Palatal plane tip
- Mandible rotates backwards
In order to translate the molar how should a cervical HG be adjusted?
Bend outerbow up
Using cervical HG, where is the outerbow placed to prevent distal tipping of the crown?
Above CR (gingival)
How do you prevent molar crown tipping with Kloehn type cervical headgear?
Lifting outbow gingivally
When using Kloehn type cervical headgear what is the affect on the molar with the bow bent lower then the occlusal plane?
produce distal movement with extrusion of the crown by moving the roots to a larger arch
When using asymmetric head-gear what side do you want in order to distalize the molar? (the class II side)
-longer bow and positioned away from the cheek
In order to distalize the Mx. right moalr with asymmetric headgear you must do what?
Cut the left bow short
When using unilateral HG to correct Class II molar on the right side, a possible side effect would be developing crossbite on which side?
Lateral forces are directed towards the short outerbow; right side would have lingual crossbite and left side buccal crossbite)
What is a side effect of asymmetric headgear use?
- Lingual crossbite on the long bow side
- buccal crossbite on the short bow side
What ist the ideal time for facemask therapy?
Early = more orthopedic effect, prior to loss of deciduous molars
What are the effects of facemask therapy?
-Max skeletal protration
-foward movement of max dentition
-set back of bony menton
-lingual tipping of lower incisors
increase in facial height (extruction of upper molars limits the use of face-mask on Class III vertical facial excess pt)
Facemask therapy is contraindicated in patients with …upper incisors
proclined
What occurs as a result of Short class II elastics?
Steeper occlusal plane (more vertical force)
What are the effects of Class II elastics?
- move maxilla back
- erupt lower molars and upper incisors
- position lower jaw forward
- tip occlusal plane
- DO NOT deepen/close bite
What are the effects of Classs III elastics?
- Max incisors procline
- lower incisors retroclined
- counterclockwise
When using a lip bumper …% of expansion is achieved in the frist 100 days, …% in the next 100 and finally …% by day 300.
50%, 40%, and 10%
What are the effects of lip bumper therapy?
- 45-55% incisor proclination
- 35-50% molar distalization and distal tipping
- 5-10% transverse increase in intercanine and decidous molar/premoarl distance
Gingival cleft is seen as a side effect in …
Orthopedic maxillary expansion
A greater incidence of dehiscence in adult patient is seen with …
RPE
What are the effects of maxillary expansion in a patient without crossbite?
- transverse expansion of maxilla and mandible
- significant increase in mandibular arch to correct 3-4 mm of crowding
A 1mm maxillary intermolar width increase results in a …mm intermolar, …mm premolar and ..mm canine increase of he mandible
0.25mm intermolar
0.5 mm premolars
1mm canine
A 1mm maxillary intermolar width increase results in a …mm increase of maxillary premolars and and molars.
0.7 mm
The greatest increase in arch perimeter is achieved by what applicance?
RPE
Where is palatal expansion more pronounced?
anterior and inferior
Following expansion how long does it take to re-establish the midpalatal suture?
4-6 months
What limits the expansion provided by RPE therpy?
-Zygomatic arch
-Coronoid process
-Area of resistance by Suri
+Anterior - periform apeture
+lateral - zygomatic buttress
+posterior - pterygoid juntcion
+Medial - medial palatal synotosed suture
Maximum expansion is limited by?
the Pterygoid plate
Opening an RPE 0.5mm/day, you notice the teeth are moving mesially, what happening?
Normal
When using an RPE whats is its affect on A point?
Move slightly downward and forward
In mixed dentition patients treated with arch length expansion results in
the loss of arch length in the majority of cases until arch length is less then pretreatment arch length
A patient started w/ signification lower crowding, when you remove retention what occurs?
arch length and arch perimeter decrease
What happens following expansion across the canines?
It is prone to relapse
What are the sequela of inadequate mandibular lingal crown torque?
- create crossbite
- elongation of lingual cusps
When the distance between to magnets decreases by 50%, force increases by…
400% (1/d)^2
Pure rotation is a … order bend
1st order (pure rotation, in/out ) 2nd order (vertical) 3rd (torque)
When using a traditional edgewise appliance why are 1st order bends are needed?
compensation for BL thickness of teeth
The duration threshold of a light force capable of producing tooth moment is …
4-6 hrs/day
The physiologic response to sustained pressure against a tooth requires … of force application for tooth movement to begin.
48 hours
IN SWA, what happens to canine roots when the wire is engaged in the brackets?
Move distally
The normal eruptive force of a tooth is estimated at…
2-10 grams
What movements of a canine can be achieved with a force of 35-60 grams?
Tipping, rotation, extrusion
The optimum force to retract a caine is?
100-150 grams (70-120 gr profitt)
The average force to intrude maxillary incisors is…
20 g (10-20 profitt)
In order to have a bodily movement you need…
A force and counter moment
When retracting the canines how do you minimize tipping?
Maximize intrabracket moments
What is a parallel force in the opposite direction?
a couple
What happens to friction in sliding mechanics when forces are parallel to the archwire?
Decrease
Where should a Helices be located in an AW to decrease the force?
area of largest bending moement
What is stationary achorage?
Bodily movement of dental units on one side of the TE site and tipping of dental units on the other sid
What defines the Anchorage value of a tooth?
- root surface area
- PDL area
- tooth inclincation relative to the force
In a 0.022 slot size system, the maximum slot size dimension is?
0.022 x 0.028
What type of resorption is associated with autotransplantation?
External resorption
What Orthognathic surgery most likely to cause post-op TMJ sounds suchas popping and crepitation?
mandibular advancement
How do you minimize the md growth in a 16 yo pt when doing orthognathic surgery?
serial ceph until no growth for 1 year
What surgery is best for mandibular advancement?
BSSO
What must be accomplished presurgically if the pt is to have a mandibular advancement only?
- maximum retraction of lower incisors
- extraction of lower 4’s
According to the Bailey study, what postsurgical change is most likely to be observed in class II pt with mandibular advancement and open bite correction?
Long term increase in OB
What is the most unstable sugical procedure?
Mx. Transverse expansion
Mx. downgragy (according to profitt)
What is the most stable sugical procedure?
Maxillary impaction/superior positioning of the maxilla
According to Bailey, a Highly stable surgical result is less then …% chance of signficant post-treatment change
10%
According to Bailey, a stable surgical result is less then …% chance of signficant post-treatment change
20%
Downward movement of the maxilla is considered … according to Bailey.
Problematic (considerable probaility of major post-treatment change)
According to Bailey Asymmetry surgeries are considered …
Stable if modified in a specific way
According to Bailey superior repostionting of the maxilla is…
highly stable
According to Bailey advancement of the maxilla up to 8mm is considered…
Stable
According to Bailey forward maxilla foward and mandible back is…
stable if modified in a specific way
According to Bailey surgical repositioning of the chin via lower border osteotomy is…
highly stable
According to Bailey a mandibular setback is…
problematic
Most stable surgeries according to Bailey
Mx. impaction > Ms. forward > Mx. Forward
Least stable surgeries according to Bailey
Mx. transverse expansion > Mx. Down > Md. retraction
In surgical tx of class II open bite via bilateral maxillary posterior intrusion, relapse is minimized by…
Passive repositiong of the segments during surgery
What is the surgical treatment for a Class III open bite patient?
Mx. advancement with Mx. Posterior intrusion and Md. set back
Following distraction osteogenesis, how long do you wait prior to activation?
allow 5-7 days (latency period)
how does symphysis distraction affect the condyles?
- buccal tipping of the condlyles (3 degress of distolateral rotation)
- Distraction doesn’t cause bucall tipping of posterior segments
The maxilla can be overimpacted by…
- poor planning
- lack of boney contact
- increase in masticatory function
What are the 2 deletorious effects of maxillary impaction?
- nasal tip goes up
- ala base widens
If planning a Mx. impaction on a hyperdivergent pt. with Class I what else should be considered?
Mx. advancement or Md. reduction
Lefort I osteotomy with Ortho tx. is used to treat?
mx. intrusion, widening of the palate, correction of asymmetry, closing anterior open bite
What procedure is rarely necessary when performing Le Forte I down fracture?
Partial resection of Inf turbinates
What is the ratio of the amount of bony vs soft tissue advancement in an advancement genioplasty?
1:1
When do you not level COS pre-surgically?
- Brachyfacial, short lower facial height, deep bite
- Brachy pt. level COS after surgery
In what type of surgery, is leveling the Mx. and Md. not needed?
3 pieces maxilla
A gingival graft is often required before the genioplasty procedure because?
incision line for genioplasty can stress gingival attachemtn as healing process lead to recession
Which genioplasty is considered the current best approach for chin augmentation?
lower border osteotomy
what is the complication associated with split sagittal osteotomy?
condylar sagging and post surgical trismus
What are the advantages of mandibular setback using BSSO
- excellent control of condylar segments
- osteosynthesis screws can be employed for fixation
- early mobilization of the jaw
What is the extraction pattern in a Class II pt which has mild-moderate crowding in both arches and retruded mandible to prepare them for surgery?
Lower 4’s, upper 5’s and 8’s
What is the advantage of Transoral vertical oblique ramus osteotomy (TVORO)?
required less time than BSSO w/ lower incidence of neurosensory changes
What are the common post-op occlusal problems in patients who have combined surgical and ortho tx. for mandibular excess
-Posterior open bite bilaterally, imediately after removing the fixation
What is one reason not to extract teeth prior to surgery?
a transverse issue
What type of bone cannot be used in ridge augmentation?
Hydroxyapetite?
A Mx. down fracture has what affect on growth?
AP growth is inhibited and vertical continues as normal
What surgical procedure does not require mounted models?
SARPE
What type of radiograph is used to evaulte the perio condition of the posterior teeth?
Vertical bitewing
What ist he function of the fluid of the PDL space?
acts as a shock absorber
What does not cause Periodontal disease?
Occlusion
Amoung the population of adult ortho pts w/ perio disease what percentage of pts show rapid progression of the disease? Show moderate progression? and Show no progression?
10% show rapid progression
89% show moderate progression
10% show no progression
What bacteria cuases bone loss during ortho tx?
Bacteriocides gingivalis
What bacteria causes juvenile periodontitis?
AA (actinobacilus actinomycetemcomitans)
What is released when the PDL is broken down?
IL-1, 2, 6, 8, PGE 2, IFN gamma, TNF alpha = proinflammatory
Why do pts with active periodontitis have more bone loos with ortho treatment?
- osteoblasts cannot function in inflammatory environment
- more osteoclastic activity
T/F Excessive tooth movement doesn’t occur in most ortho tx.
T
Which teeth show the most root resoprtion?
Max Laterals (U2>U1>U3>L1>L2>L3)
Which gingival dibers are most responsible for relapse?
Supracrestal fibers
