Tutankhamen -2 Flashcards
A laser diode works by?
Ablation of tissue
How much bone loss occurs 6 years post extraction? and in the first 6 months? and with guide eruption?
30% (6 years post)
23% (first 6 months)
<1% (with guide eruption)
When is the best time to extract an ankylosed tooth?
as soon as it is identified
When a tooth is ankylosed, the amount of ridge defect depends mainly upon?
the amount of facial growth after ankylosis
What side effect occurs when you move 2nd molars into extracted 1st molars space?
3mm gingival cleft
If the central incisor is located 5mm apical to the CEJ of the other tooth. Do you do closed eruption of apically positioned flap?
Closed eruption
In a patient with palatally impacted canines what surgical exposure technique should be used?
Open eruption
Of impacted canines … are palatal and the primary etiology is…
2/3rds palatal, genetic etiology
Of impacted canines … are labial and the primary etiology is …
1/3rd labially, arch lenth transverse skeletal discrepancy
Orthodontic traction of an unerupted tooth towards the line of the arch should begin … following surgical exposure
no later then 2-3 weeks
A molar has a buccal pocket down to the furcation area, what is the periodontal treatment of choice?
Guided tissue regeneration
If you begin orthodontic treatment in a patient with a 3 wall defect what will happen?
the defect will get worse
A patient presents with a significant crater btwn maxillary premolars what is the recommended periodontal treatment?
Ossesous recontouring
Gingival recession in adult occurs about …% of the time, is more prevalent on which arch?
68% of the time, more prevalent in the mandibular teeth, and occurs more symmetrically
Orthodontic patients with mucogingival problems that require perio tx prior to ortho?
Children …%
Adults …%
5-10% children
20-25% adults
If you find a internal resorption what is the treatment?
Immediate RCT
What are the periodontal indications for controlled orthodontic extrusion?
- one wall vertical defect
- two wall vertical defect
- defect in cervical 3rd of root (not in apical 3rd of root)
How do you treat vertical root fracture?
Extract dat shit
Endodontically treated teeth have what affect on root resorption?
decreased tendency for root resorption
Peak incidence of dental trauma occurs at what age?
8-10 years
With a root fracture 1mm below the CEJ what is the primary thing to evaluate?
Root Length
Tetracycline studies show that implants…
do not move at all
What is the minimum osteointegration required for successful TAD placement?
5% (regular restorative implant 75%)
When 300g of force is applied for 3 months to TAD for anchorage in animals, they are successful …%.
94%
The estimated healing time for implants in the mandible is… and the maxilla is…
Md. 4-6 months
Mx. 6-8 months
When should an implant be placed after extraction of over retained primary?
2 months after extraction
How do you wait for an implant after a bone graft?
9 months
When is the best time to get implants?
when growth ceases
Esthetically how much room do you need for an implant?
7mm
When placing implant the head of the fixture should be how many mm apical to the desired gingival margin?
4mm
When restoring peg laterals, create … space
more space than needed
How much OB is needed for bonded bridge
0.5mm
How much OB is needed for Maryland bridge?
1mm or less
If a patient congenitally missing lateral with retained b and c, how is it managed?
Extract b to guide canine to erupt; then move it distally for a lateral implant. Preserving bone on the lateral Alveolus.
CPR for an adult what is the the compression to breath ratio.
30:2
For adult CPR where do you place your hands for chest compression?
lower half of sternum
How many minutes can the brain survive without oxygen?
4-6 minutes
For an adult CPR, a rescue breath is given every?
5 seconds
What’s the percentage of self-correction of an impacted canine if the tip is distal to the lateral midline?
91%
if mesial to the 2’s > 64%
What is the most common transpositioned tooth?
Maxillary canine
A patient with nasopharyngeal obstruction who undergoes adenoidectomy will go from open mouth breathing to closed mouth brething by what percentage?
80%
What percentage of contemporary US and northern European population exhibit Class II malocclusion?
15-20%
What is the average oral temperature in degree Celsius?
35-37 degrees C (95-99 degrees F)
What statistical test should be used for 3 or more variables?
ANOVA (analysis of variance)
What is the population within one standard deviation? two? three?
68%
96%
99.7%
What is sensitivity?
True positive/pt w/ disease
What statistical test should be used to compare two means?
T-test
What does a Chi-square test measure?
observed vs expected frequency
A statistical correlation is generally expressed as a…
Fraction
What statistically analysis would you use to find relation btwn brushing and gum disease?
Correlation analysis
If there is no correlation btwn two data sets, what is the coefficient?
0 (1 means they are linearly correlated)
What statistically analysis should be used to predict the ceph measurement with mandibular rotation?
Correlation
What is most affected by extreme values? (mean, median, mode)
Mean
What is most affected by a large sample size? (mean, median, mode)
Median
What is the minimum sample size in a ceph study aiming to produce data for a clinical study?
15
A gold standard in clinical research for evaluating a clinical procedure?
Randomized clinical trial
Where is the thyroglossal duct attached to the foramen cecum?
at the posterior of the sulcus terminalis
Is the Nasal floor higher in an adult or a child?
Children
The Lacrimal bone articulate with what bones (4)?
Frontal, inferior concha, maxilla, ethmoid
A Brown tumor is associated with what disease?
Hyperparathyroidism (Stones, bones and abdominal groans)
-loss of lamina dura around multiple teeth
Apertognathia associated with what condition?
Acromegaly
Undermining resorption is characterized by…
- hyalinization
- infiltration of osteoclasts
- infiltration of macrophages
- infiltration of neutrophils
- occurs in medullary space
Most synchondroses fuse at what age?
2-4 years
Wolf-Hirschorn syndrome is associated with what gene?
MSX1
What chromosomes play important role in tooth development?
Chromosome X and Chromosome 4
What disease may develop benign or malignant osteosarcoma?
pagets
Under development of mandible and maxilla (micrognathia) is seen in what syndromes (3)?
- Treacher Collins
- Hemifacial Microsomia
- Marfan Syndrome
What syndrome is due to failure of neural crest migration?
Treacher Colins, Hemifacial
What four syndromes can cause multiple supernumerary teeth?
- Gardners Syndrome
- Cleidocranial dysplasia
- Sturge-Weber syndrome
- Cleft lip and palate
- (Crouzon although rarely)
What condition can cause early exfoliation?
Hyperparathyroidism (also cause loss of lamina dura)
What syndrome can cause early permanent teeth eruption?
Turners (only occurs in females, small permanent teeth, likely root resorption, SHOX gene)
The oral symptoms of Down’s Syndrome are…
- posterior crossbite (97%)
- prognathic mandible (69%)
- Class III molar (65%)
- Open bite (54%)
- freeway space 3 times more than normal 2-3mm)
Down syndrome patient commonly have (caries or periodontal disease)?
Peridontal Disease (90%) Caries are rare
Crouzon Syndrome is associated with the following genes…. and has a … inheritance pattern.
FGFR2 & FGFR3 Mutation
Autosomal Dominat
T/F Crouzon Syndrome is associated with Cleft Palate and supernumerary teeth.
True
also hearing loss, Craniofacial synostosis, midface hypoplasia
Apert Syndrome is associated with the following genes … and has a … inheritance pattern.
FGFR2 and KGFR2
Autosomal dominant
The key clinical presentation differentiating Apert to Crouzon’s is…
Syndactyly
Gardner’s syndrome is associated with multiple … and …, …. cysts, …. of the skin but does not cause….
Gardner’s syndrome is associated with multiple polyposis and osteomas, Epidermoid cysts (slow growing, caused by blockage of sebaceous gland), Fibromas of the skin but does not cause clefting.
Treacher Colins is associated with the … gene.
TCOF1
The presentation of Treacher Colins includes…
Supraorbital hypoplasia, lower eye lip coloboma, retrognathic mandible, normal mental status, ear deformity/absence of ears, Cleft Palate, large mouth, hair extends to cheeks
The classic Triad of Pierre Robin’s Sequence is..
- Retrognathic mandible
- Glossoptosis
- U shaped cleft palate
Marfan Syndrome is associated with the … genes and have a oral presentation of …
FBN1 and TGFB2
Retrognathic Mandible
(prophylaxic antibiotics to prevent endocarditis)
A patient with Cleidocranial dystosis will present with early fontanelle closure resulting in …
Brachycephaly
T/F Cleidocranial dystosis results in absence/incomplete formation of the collar bone. These patients have no oral manifestations.
T, F (primary failure of eruption, delayed eruption, supernumerary teeth, absence of sutural fusion of the mandible, and under-developed maxilla)
Osteogenesis imperfecta is associated with … genes and affects…
COL1A1 and COL1A2
Type 1 collagen defect
The classic symptoms of Osteogensis imperfecta are (3)…
- Blue sclera
- Fragile bones (brittle bone disease)
- early hearing loss
Ectodermal dyplasia has a …inheritance pattern and patients have the following symptoms…
X chromosome (usually affect men)
- lack of sweat glands, skin, sparse hair, sparse hair
- Missing teeth, peg shaped laterals, pointed teeth
Peutz-Jegher syndrome presents with the oral manifestation of …
Pigmentation of the lips, gums, mucous membrane and skin
also intestinal polyps
Cushing’s syndrome is caused by …and presents with …
- Increased corticosteroid and ACTH
- symptoms: Moon face, buffalo hump, central obesity with thin legs
Turners syndrome is associated with the … gene and follows the … inheritance pattern.
SHOX gene Sex chromosome (XO)
The dental presentation of Turner’s syndrome are…
Early eruption of permanent teeth, small teeth, root resorption
The primary palate is formed in week … in utero.
6th week
The secondary palate is formed in week … in utero.
6-8th week
Palatogenesis is completed by week… in utero.
12th week
What structures does the medial nasal process give rise to?
- nasal septum
- bridge of nose
- philitrum
- premaxilla
What structures does the lateral nasal process give rise to?
-Ala of the nose
Cleft lip (chieloschisis) is caused by the failure of the fusion of … and …
Medial nasal process and Maxillary Processes
What dental finding is NOT associated with Cleft Palate?
-Impacted centrals
common findings: rotated incisors, missing laterals, posterior x bite, ectopic eruption, supernumeraries
What is the most common congenital defect of the face and jaw?
Cleft Palate
What is the incidence of Cleft Palate across the following races: Black, asian, white and american indian?
American Indian > Asian > White > black
Cleft lip is more common in (males/females) while cleft palate alone is more common in (males/females).
males = lip females = cleft palate alone
If a sibling/kin is affect by a cleft there is a …% chance an unborn child will be afffected.
4% (also if 1 parent is affected but no sibling)
9% if two siblings are affected
What is the probability of cleft lip/palate when 1 sibling and 1 parent are affected?
17%
What is the cleft “rule of ten”?
First cleft lip surgery (lip repair)
- 10 weeks (~2-4 months)
- 10 lbs
- 10 grams of hemoglobin
The cleft soft/hard palate is normally closed…
within the 1st year of life
When is the alveolar bone graft performed in a cleft patient?
7-10 years, when the canine root is 1/2 or 2/3rd formed (so the U2 and U3 will erupt through the graft)
Following surgery the relapse often seen in cleft patients is caused by…
Scarring tissue “rebound” due to a lack of elasticity
A failure of fusion of the 2nd and 3rd brachial arches results in …
Cervical cyst (brachial cleft cyst) Diverticulum
Hypotelorism is associated with a …. cleft
Oro-ocular cleft
The …. is used to classify case difficulty of cleft patients.
Golson Yardstick (1 best prognosis, no treatment needed, 5 very poor prognosis, surgery and treatment needed)
The nasal bone completes growth as age …
10 (cartilage continues growth for life)
On Scammons curve, the Skeletal curve is inversely proportional to the … curve.
Lymphoid
The limit for transverse expansion of a SARPE is the…
coronoid process
Soft tissue thickness increases more with age in (female/male)
Female
On Scammon’s curve what curve parallels the facial growth curve?
Somatic curve
What are the two growth peaks on on Scammon’s curve?
Early infancy and adolescent
Describe the male growth sequence
Fat spurt > 12 months > Puberty > 8-12 months > PVH > 15-24 months > end of spurt
Describe the female growth sequence
Puberty > 12 months > PVH > 18 months > menarche (end of spurt)
According to Behrent study there is an increase in the following facial dimensions in adults…
All facial dimensions
Palatogensis is completed at what age in utero?
12 weeks
What is the rate of ramal height growth prior to puberty? and following puberty?
Before puberty 1-2 mm/year
After puberty 2-3 mm/year
What are the 3 mandibular growth sites?
- Condylar process
- Posterior border of the Ramus
- Dentoalveoalr process
In a female what direction of mandibular growth is more than what direction?
Vertical more than AP
Mandibular hypplasia/condylar hypoplasia is most common in what age population?
Early childhood
What happens to arch length and perimeter from primary to permanent dentition?
Decreases
Rotation of the Mandible is show by what 2 signs from Bjork?
- Bending of the mandibular canal
- condlyar neck angle
What is the ideal CVMS for functional appliances?
CVMS II (peak growth will occur within one year)
What is a patient’s growth status relative to CVMS III?
Peak growth occurred within one or two years prior
At puberty what SMI is occuring?
SMI 4 = Sesamoid bone ossification
- Occurs 1 year prior to pubertal maximum growth spurt
- 60-70% of growth remaining
At SMI 4 …% of growth is completed in females and …% is completed in males.
33% females (age 11)
29% males (age 12)
At SMI 6..% of growth is completed.
50%
At SMI 7 …% of growth is completed.
75%
What are the most common teeth with ectopic eruption?
Max 1st molars, Md laterals, Max canines
What are the most common signs of aberrant eruption in the Maxilla and Mandible?
U3’s before U4’s and U5’s
L7’s before U5’s
What is the most common tooth agenesis in primary dentition?
Maxillary Laterals
What is the most common ankylosed primary tooth?
Primary Mandibular Second molar
Transposition is more common on the … arch.
Maxillary
What are the most common teeth to transpose?
Maxilary canine with the Maxilary 1st premolar
How long does primary root completion take following eruption?
18 months
What is the ideal time to remove impacted 3rd molars?
Root 2/3rd formed
What are the most common teeth for root resorption in each arch?
- Mx. laterals > centrals > Canines
- Md. centrals > laterals
Root resorption is related to what conditions/syndromes (3)?
hypothyroidism, hypoparathyroidism, Paget’s
In children, incisors that are traumatically intruded have a 5 year survival rate of..
50% for intrusion > 6mm
In children, incisors that are traumatically intruded (< 3 mm) have a survival rate of..
100%
What protein is the major organic component of mature enamel?
Enamelin
The matrix of developing enamel induces what 3 proteins?
Enamelin, amelogenin, tuft
What teeth show the greatest variation in the onset of mineralization besides the 3rd molars?
Maxillary laterals
What ligament is related to the eruption of teeth?
Hammock
In a 11 yo male, over a 2 year period the mandibular molars are expect to erupt how much?
1.5 mm
In a 11 yo male, the lower facial height is expect to increase …mm/year
1 mm/year
What tooth is most likely to be crowded out of the maxillary arch?
Canines
What has a stronger genetic inheritance pattern: Anterior open bite or midline diastema?
Midline diastema (AOB is not an inherited trait)
What is the most common cyst?
Radicular cyst (teeth are non-vital)
What cyst can remain following an extraction?
Residular cyst (maybe of apical or dentigerous origin
What is the most common developmental cyst?
Dentigerous cyst
What is the most common location of an OKC and what is the clinical presentation?
posterior md., symptomatic, 50% jaw swelling
An AOT arises from … and is commonly found…
Adenomatoid odontigenic tumor
- arises from enamel organ or dental lamina
- 2/3 in female, anterior maxilla, impacted canine
Ameloblastoma presents with a … radiographic appearance.
- Multilocular radiolucency
- benign jaw lesion, may result in expansion
- more common in the posterior mandible
- Pathologic origin - odontogenic epithelium
- common recurrence
Cementoblastomas are common in the … and are associated with … teeth.
- usually 2nd or 3rd decades in life before 25
- More often in Caucasian males
- mandible in 1st premolar to molar region
- pain, swelling and expansion of cortical plates
- Teeth are normally vital
A excessive deposit of cementum on the root surface is known as …
Hypercementosis (vital)
A cotton wool radiographic appearance is associated with..
Paget’s disease
- high alkaline phosphatase
- high chance of osteosarcoma
- bone pain, Hat and Denture don’t fit anymore; mx. enlargement
Fibrous dysplasia has a … radiographic appearance.
- Ground glass
- aysmptomatic regional alteration of bone by replacing fibrous tissue, monostotic or polystotic
- most often in young adults and juveniles
- singular, slow growing and painless swelling of the jaws
- Increase in akaline phosphatase
Periapical Cemento-osseous dysplasia is associated with …teeth and common in…
Vital md. anterior
MABF
3 stages (osteolytic, cementoblastic, mature inactive)
Osteopetrosis results in…
- fragile bones
- abnormal calcified cartilage
- highly radiopaque
- high alkaline phosphatase
What is the recommend treatment for Condensing Osteitis?
- RCT or EXT
- usually associated with non-vital tooth
Eagles syndrome results in …. ligament calcification.
Syloid ligament (also elongation of the styloid process)
HBsAg indicates…
infectious person, high during acute or chronic hepatitis
Anti-HBs indicates
recovery and immunity
Anti-HBc indicates
a previous or ongoing infection;appears at the onset in acute infection and persists for life
IgM anti-HBc indicates
an acute or recent HBV; present for about 6 months
The symptoms of Hep b are… following a …. incubation period
jaundice, dark brown urine
4wks - 6mos
What is the radiographic appearance of osteomylitis?
Moth-eaten
The radiographic appearance of a Osteocarcoma is…
- sunburst, codman’s triangle
- can manifest as myositis
- Most common malignancy in children
The radiographic appearance of Ewing Sarcoma is… and it is most common in… (sex).
Onion skin
Boys (<15 years old)
What is the most common malignant salivary tumor?
Mucoepidermoid carcinoma
What are the systemic symptoms of rheumatoid arthritis?
Fever, fatigue, pericarditis
Active pain is associated with Osteoarthritis or osteoarthrosis?
Osteoarthritis
Multiple myelomas has what clinical feature?
- punched-out bone
- most common maliganancy
What is the blood glucose level of a Diabetes meliltus patient?
> 160 mg/dl
A 5 yo patient presents with symmetric bilateral enlargement of the posterior mandible. The radiograph reveals large, multiocular radiolucencies. What is the diagnosis?
Cherubism
What are the symptoms of Velopharyngeal insufficiency?
- hypernasality
- sleep apnea
Osteomyelitis is caused by what bacteria?
Staph aureus
What systemic antibiotic is least effective for periodontal disease?
Metronidazole
Place the following tumors from most to least common: Monomorphic adenoma, Pleomorphic adenoma, Warthin’s tumor, and Oncocytoma.
Pleomorphic adenoma > monomorphic adenoma > Oncocytoma > Warthin’s tumor
The clinical sign of traumatic occlusion is..
Mobility
What are the most common to least common malignant tumors (4)?
Mucoepidermoid carcinoma > adenoid cystic carcinoma > Carcinoma EX Pleomorphic adenoma > polymorphous low grade adenoma
A protrusive wax bite provides information on…
condylar inclination
What is the force of swallowing?
70-150 N (7-14 lbs)
Bennett angle is formed by a …. plane and the path of advancing the condyle during … movement
angle formed by horizontal plane and the path of advancing condyle during lateral moment (during lateral movement)
The articular tubercle is a part of the …. bone and found…
Part of the temporal bone, located at the base of the zygomatic arch
-anterior to the condyle, posterior to coronoid notch
Condylar hyperplasia usually presents during the … decade of life.
2nd (early adult/ late adolescent)
What is a latent radiographic image?
Image produced after exposure but prior to development
Why is radiographic filtration needed?
To remove low energy radiation, increase penetration
What thickness of aluminum is needed for filtration of radiographs above 70 kVp and below 70 kVp?
> 70 kVp = 2.5 mm
< 70 kVp = 1.5 mm
What is mandatory for patient protection in radiography?
Collimation
What does a using a Intensifying screen accomplish?
To reduce radiation needed to exposure film, thicker film -> less sharp
Using a double intensifying screen to reduce what?
Exposure time
What is the earliest sign of radition?
Erythema
What oral tissue is most sensitive to radiation?
Developing tooth buds, salivary glands
Increasing kVP has what affect on density?
increases density
In order to radiograph a root fracture what should be done to kVP?
increase
Double mA has what effect on exposure time?
halves it
Density =
= kVp x mA x T/L
What are the possible causes of a light radiograph?
- under exposed
- excessive fixation
- long distance
- film pack reversed
What are the possible causes of a dark radiograph?
- over exposure
- over development
- inadequate fixation
- short distance
A panorex is not useful in determining…
Arch perimeter/length deficiency and caries
What imaging technique would be useful to diagnose internal derangement and anterior displaced disc?
MRI
Arthrogram for perforated disc
What imaging technique is used to diagnose a perforated disk?
Atrhogram
A submentovertex radiograph is good to view what structure?
Zygomatic arch
A Towne’s view radiograph is good to view what structures?
occipital bone, petrous bone, and condylar fracture
A Water’s view radiograph is useful to view what structures?
Maxillary sinus
A Cauldwell’s view radiograph is useful to view what structures?
frontal sinus, ethmoid sinus and orbital margins
A Transcranial view radiograph is useful to view what structures?
- lateral poles of condyles
- least reliable for condylar shape
- taken in open and closed postion
T/F increasing voxel size will increase magnification. A decrease in voxel size increases resolution.
TT
What are the Class II indicators on the Ceph cranial base landmarks?
- Large anterior cranial base (S-N)
- Large posterior cranial base (S-Ba)
- Large cranial base angle (S-N-Ba)
A significantly short posterior cranial base indicates..
Mandibular prognathism
CBCT has (better or worse) resolution than medical CT?
Better
Where is the Jugal Process located?
Intersection btwn maxilla and zygomatic buttress
What the the midline structures on a ceph?
OMG MidBase
Opisthion
Menton
crista Galli
Midagittal sture
Basion
What is Bolton point and broad bent triangle?
- Bolton point inferior aspect of occipital bone
- Bo-N-S
What does a holdaway ratio of 2:1 mean?
Lower incisor more proclined compared to chin
Where is PT point on a lateral ceph?
Foramen rotundum
What is the major/most common source of error in ceph tracing?
Landmark identification
The frankfort horizonatal plane is most level with …
Zygomatic arch
The frankfort horizontal plane is most parallel with…
the palatal plane
What is not an ABO ceph measurement?
FMA
Mandibular plane angle for the ABO?
Constucted gonion to menton
The external acoustic meatus location compared to internal?
External is located anterior and inferior to internal
What is the ratio btwn AFH:PFH?
60:40
How is the Z angle drawn?
Chin to most anterior upper/lower lip to FH line, 78 degrees
How is holdaway angle formed?
Facial plane (N-Pg) and Chin to upper lip; should 7-15 degrees
The AB plane to facial plane is a part of what analysis?
Down’s, relate denture bases to each other
Negative value -> Class II
Positive value -> class III
What lines form the angle of convexity?
N-A and A-Pog
- relate upper jaw to lower jaw
- Positive value -> Class II
- Negative value -> Class III
According to Steiner analysis, U1 to NA in mm and angle?
U1-NA: 22 degrees, 4mm
L1-NB: 25 degrees, 4mm
In relation to the S line the lips…
touch
In the Tweed Triangle
FMA =
IMPA =
FMIA =
FMA = 25 IMPA = 87 FMIA = 68
Low angle ( FMA <20) High angle (FMA >30)
What is Sassouni’s analysis?
- demonstrates vertical relationship
- all 4 lines in balanced face should merge posterior at center point
- more parallel plane, greater tendency for deepbite
What is the occlusal reference plane for the Wits analysis?
Functional occlusal plane
( Downs uses—-bisecting occlusal plane: bisects incisor overbite and passes over the distal cusps of the most posterior teeth)
Where do you superimpose for the mandible?
- 3rd molar crypt
- mandibular canal
- inner cortical plate of cortical plate of symphysis
What is the most stable reference plane?
FH plane
Cephalic index =
Weigh/Height x 100 (transverse view)
Dolico < 76
Brachy > 81
Meso - 76-81
Facial Index =
Length/Width x 100 (frontal view)
- Dolico = leptoproscopic
- Meso = mesoproscopic
- Brachy = Euryproscopic
Craniofacial composite superimposition
- planum sphenoidum
- cribiform plate
- greater wing of sphenoid
- anterior clinoidale
Maxillary superimposition
- vertical legs of keyridge (anterior/posterior contours of zygomatic arches)
- Align key ridge AP and vertical and best fit of internal structures of maxillary bony complex
Mandibular superimpostion
- internal cortical outline of symphysis
- best fit on mandibular canal
What two drugs can inhibit tooth movement?
- bisphosphanates (Alondronate~fosamax, risedronate~actonel)
- Steroids and NSAIDS
- Indomethacin (more potent) inhibit tooth moment at normal level
What is the MOA of NSAIDS that leads to reduced tooth movment?
inhibit conversion of arachondonic acid to prostaglandins
What is the MOA of Steroids that leads to reduced tooth movement?
inhibit formation of arachondonic acid by blocking phospholipase A2
What is Prostaglandin E (PGE) affect on tooth movement?
- cause appearance of osteoclasts and bone resorption
- detected in gingival fluid during ortho tx.
What is pro-banthine?
- parasympathetic antagonist
- Anti-cholinergic (by blocking muscarinic Ach receptor)
Non-selective NSAIDS act on …. and have the following side effects…
-Both COX 1 & 2
-Rental toxcity, GI bleeding
(Aspirin, ibuprofen, naproxen, ketoprofen)
Selective NSAIDS act on… and have the following side effects…
- target COX2
- less GI bleeding and platelet inhibition
- Celebrex (Celecoxib) not effective in actue post op pain
- Vioxx (Rofecoxib) long lasting up to 24 horus
Calcium will increase/decrease tooth movement?
Decrease
Vitamin D will increase/decease tooth movement?
increase
Where and when was the first meeting of the AAO?
1900 St. Louis
Where and when was the ABO formed and by whom?
1929, Estes park, CO by Dr. Alber Ketcham
Who was the first editor of the AJO?
Dewey
Preceptorship was abolished by the ADA in what year?
1969
The CDABO was formed in…
1979
The stress/strain curve shows..
elastic behavior/property of a material
In relation to an arch wire what is stress?
Force/area
In relation to an arch wire what is strain?
Deflection/unit length
What is the elastic limit/proportional limit of an arch wire?
The point at which it becomes permanently deformed
What is the yield strength of an arch wire?
0.1% deformation if observed (yield point)
What is the ultimate yield strength of an arch wire?
- max load wire can sustain after some permanent deformation
- greater than yield strength
What is the energy storage capacity of an archwire?
Resilience (area of the curve up to the proportional limit range)
What is formability of an arch wire?
amount of permanent bending a wire can sustain before breaking
What is range of an arch wire?
Distance that a wire can bend before permanent defromation
What is the Modulus of elasticity?
Stiffness; slope of stress-strain curve
Asperities of arch wire in order by different materials?
NiTi > TMA > SS
Rank friction of arch wire materials during sliding mechanics
TMA > NiTi > SS
No superelastic or phase changes are observed in what type of arch wire?
Nitinol
What is the superelastic property of an AW?
Wire has the ability to change molecular structure
NiTi wires have a low or high load deflection rate?
Low
What are the two possible ways to induce a phase change in NiTi?
Pseudoelasticity (a -> m more specifically stress induced martensic)
Thermoelasticity (a -> m when cool, then m - > a when deactivated)
What is the ideal temperature for phase change in NiTi?
35 degrees C
What is the advantage of Copper Niti arch wires?
resistant to deformation, guaranteed TTR, aka Beta-NiTi
When is the appropriate time in treatment to use a M-NiTi?
Later stage (when flexible but larger and somewhat stiffer wire is needed) -Small round NiTi are better for A-NiTi and large rectangular AW are better with M-NiTi
What is the composition of TMA (Titanium Molybdenum)?
80% Ti
11.5% Molebdenum
6% zircornium
4.5% tin
At what stage of treatment is a TMA an appropriate choice?
- intermediate and finishing wires
- excellent choice for auxillary springs
The center of resistance of a single rooted tooth is located…and a multi-rooted tooth is…
Single: 1/2-1/3 root length
Multi: btwn roots/furcation, 2mm apical
How do you counter molar tip by using maxillary incisors intrusion?
HPHG with short outer bow
If distance is decreased by half what is the resulting force?
Force = 1/(distance)^2
Force is increased 4 times
Of untreated subjects about …% have no mandibular incisor irregularity, …% have moderate crowding, …% have severe crowding.
50% no crowding
23% moderate
17% severe
Mandibular crowding is more prevalent in (males/females) and (white/black).
Male > Female
White > Black
For every 1 mm increase in intercanine width, … mm are gained in arch perimeter.
1mm
For every 1mm increase in interpremolar with, … mm are gained in arch perimeter.
0.75mm
For every 1mm increase in intermolar width, … are gained in arch perimeter.
0.25mm
The greatest arch perimeter is achieved by…
incisor advancement
Mandibular expansion is achieved by …% expansion and …% incisor flaring.
50% expansion
50% incisor flaring
When expanding the maxilla 10 mm you would expect a gain of …mm.
7mm (70% Mx expansion percentage)
By flaring an incisor 1mm how much arch perimeter space is gained?
2mm (every 1 degree proclination = 0.8 mm space)
Flaring the maxillary 1 mm results in the upper lip moving … mm and when the mandibular incisors are flared 1 mm the lower lip moves …mm.
Upper lip 0.3 mm
Lower lip 1 mm
In the transition from the primary to permanent dentition space is recaptured in 3 ways.
- slight increase in arch width across canines
- slight labial position of permanent incisors
- distal shift of L3’s when primary molars are exfoliated
What the indications for a canine substitution?
- Class II molar
- Anterior tooth size relationship
- length, shape and color of canine
What are the three exposure techniques for labial canine impaction and their indications?
Close eruption- most labial impacted teeth, mid alveolar impaction, mimics natural eruption (best esthetics)
Apically Positioned Flap- simple labial impaction, cases where canine is displaced mesiodistally or inadequate gingiva
Excisional (open)- when there’s adequate gingiva, when tooth is 2 mm below MGJ
Describe the sequence and timing of serial extraction.
Extract C’s as soon as lower incisors erupt, D’s when 2/3 of premolar root is formed, and the 4’s as soon as they emerge
T/F The Eruption follicle is not absolutely necessary for eruption. If a crown is dragged against bone the result is resorption.
F/T
What are the 7 indications for interceptive treatment in mixed dentition?
- space maintenance
- Posterior crossbite
- psychosocial issues
- skeletal vertical excess
- extopic eruption
- myofunctional habits
- Skeletal AP Class III
Bond strength is increased by …% adhesive filler for cremic brackets.
80%
Bond strength is (increased/decreased) by fluoride application prior to bonding.
decreased
What type of tooth movement is the most prone to relapse?
Rotation
Following treatment of a Class II Div 2 patient what is most likely to relapse?
Deep bite
What fibers are important in stability/relapse?
transeptal
What is the most retentive clasp design for a Hawley retainer?
Adams
The ratio of dental to skeletal expansion for an RPE is…
50:50
What are the circummaxillary sutures (5)?
Frontonasal Zygomaticomaxillary Intermaxillary Transpalatal Midpalatal
What is the appropriate force for headgear?
500-1000g (1-2 lbs) total or 400-800 g/side
What is the appropriate force for a facemask?
1000g total or 500g/side
When using HPHG a long bow bent … and a short bow bent… produce the same effect.
Long bow up
short bow down
The Bionator is a Class … corrector and its main advantage is…
Class II Corrector
Extremely useful in controlling vertical dimension
(acrylic stops in incisal/occlusal and facial surface)
What is the cause of OJ and sagittal molar relationship relapse following Herbst appliance therapy?
Anterior movement of Maxillary molars and incisors
The Herbst and Mara class II correctors tend to …
- Deepen the bite
- increase ramus height/ anterior facial height
A Mara appliance tends to deepen the bite because…
its allows for anterior teeth extrusion
What are the undesired side effects of Sleep Apnea appliances?
- Lateral open bite
- Flaring of mandibular incisors
- Mandibular posterior rotation
In general, what type of surgery is used to increase facial height?
BSSO
In general, what type of surgery is used to decrease facial height?
Maxillary Impaction
The most stable surgical changes are…(3)
Maxilla up (impaction) > Mandible forward> maxilla forward
The least stable surgical changes are…(3)
Mx. Transverse expansion > maxilla down > mandible back
What surgery is associated with condylar saggin?
BSSO
Following BSSO surgery diminished sensations occur in … and after a year postop …
Almost all have diminished sensation following surgery, 2/3rds have some deficit in sensation 1 year post-op
The most common occlusal complications of BSSO sugery are…
midline discrepancy, posterior openbite, edge to edge incisors
A … is the most likely surgical procedure to produce TMJ popping or crepitation sounds.
BSSO
What is a common complication of a mandibular setback?
Condyles located posteriorly and causes anterior open bite
What are the implications for a Leforte II?
retrusive nose and maxilla
Traction in distraction osteogenesis should follow a …
5-7 day latency period, a soft tissue callus is converted into fibrous connective tissue
Slow traction during Distraction osteogenesis can produce …mm of traction without associated pain.
20 mm
According to Burstone, the upper occlusal plane should be … and no more than …mm of incisal show should occur at rest.
Flat, 3mm
Reorganization of the PDL occurs after…
3-4 months
What is the suggested treatment for a asymptomtic horizontal root fracture?
2 years observation post orthodontic treatment
With gingival inflammation there is great breakdown of bone due to an increase in…
prostaglanding, IL-1, IL-6 and MMP
Biologic width is…
2.01mm
The gingival margin should be ..mm coronal to the CEJ
1 mm
What are the 5 types of PDL fibers?
- alveolar crest
- Horizontal
- Oblique
- Apical
- Interradicular
What the 3 types of gingival fibers?
- Dentogingival
- Transepttal
- Circumferential
PDL fibers reorganize in … months and Gingival fibers in …months.
PDL fibers ~3 months
Gingival fiber 4-6 months
How long should orthodontic treatment be delayed for a stable 3 wall defect?
3-6 months
What is the treatment of 3 wall periodontonal defect?
GTR (guided tissue regenertation)
What is the treatment for a 2 wall peridontal defect?
Osseous recontour/resetion
What is the treatment for a 1 wall peridontal defect?
Ortho can correct it by extraction, intrusion and uprighting
If the bone is level and a ther is marginal ridge discrepancy, leveling may result in..
a hemiseptal defect
An orthodontist treating a patient with a horizontal/circumferential periodontal defect should avoid …
vertical movement
The classification ,description and treatment of furcation defects.
o Class I – just the tip of the probe; tx – membrane graft; osseous recontour
o Class II – half way through; tx – GTR
o Class III – through and through; hemisection, TE, open flap curettage
Pre-orthodontic peridontal records of a patient >18 yo for the ABO should include..
- full mouth perio probing by examinee
- written documentation from GP, Perio, Pedo
- Pretreatment pano, BW, Md/mx PAs
- FMX
What are the causes of a gummy smile (4)?
- excessive Mx. Growth
- Short upper lip
- Increased eruption of Mx. Teeth
- Delayed apical migration of gingival margin
Apexification vs. Apexogenesis
Apexification- necrotic pulp; immediate ortho ok; can be done concurrently
Apexogensis- vital pulp
What is the minimal OJ needed for PCF crowns/bridges and maryland bridges?
0.5-0.75 mm (avoid additional prep on lingual)
When preparing for a venner, how much OJ is needed?
No OJ needed
The width to length ratio for a Maxillary Central is …%
65-75%
What is the CPR chest compression and breath ratio for 2 rescuers?
15:2 (one rescurer - 30:2)
According to Kokich what is the best time for implants
-No change in vertical facial development from serial cephs 12 months apart (Girls: 17 years; Boys: 21 years)
Bone on which side of the implant is thicker?
Compression
What is the worst type of bone to use for bone graft when planning for a later implant?
Hydroxyapetite
The proper width of a pilot drill for an implant should be..
0.2 to 0.5 mm smaller than the implant diameter
What affects implant stability between length and width?
Width
TAD failure is more prevalent in which arch?
Mandible
In order to prove/disprove a hypothesis, what kind of statistical test should be preformed?
Chi-square test (observed vs. expected)
When should a multiple regression test be used?
When several factors need to be evaluated simultaneously
When should a correlation test be used?
When you want to find out the association btwn 2 variables
When should a Wilcoxon test be used?
When you want to compare two paired groups
Incidence is … why prevalence is…
New case; total amount of disease at a certain time
What is standard error and how is it calculated?
Variation in mean from sample (SE = SD/square root of N)
According to federal law, how long should the records on the staff be kept?
30 years
According to federal law, how long should an employee needle stick record be kept?
5 years
According to federal law, how quickly should a newly employed person should Hep B shots be made available?
ASAP
What borders the petrous portion of the temporal bone?
Foramen lacerum
Machine porion is where related to anatomical porion? and how does if affect FMA, FMIA and Y-axis?
Anterior and inferior
Increases Y axis & FMA
Decrease FMIA
What is the most reliable dental land mark in a PA ceph? and most reliable skeletal landmark?
Dental: mandibular canine
Skeletal: Menton and B point
What is the least reliable dental landmark in a PA ceph? and the least reliable skeletal land mark?
Dental: mandibular 1st molar
Skeletal: Zygomatic-frontal suture
Where does the petrous portion of the temporal bone lie in a PA ceph?
inferior 1/3rd of the orbit
What are the suprahyoid muscles?
Dig My Style, it Genius Digastric Myohyoid Stylohyoid Geniohyoid
What muscles form the floor of the mouth?
Mylohyoid and Geniohyoid
The Geniohyoid muscle is innervated by what CN?
C1 via Hypoglossal (CN XII)
The Mylohoid muscle is innervated by what CN?
Inferior alveolar branch of the Mandibular nerve (V3)
What are the Infrahyoid muscles (4)?
TOSS Thyrohyoid Omohyoid Sternohyoid Sternothyroid
The Thyrohyoid is innervated by what nerve?
C1 via CNXII
What are the extrinsic tongue muscles?
PSGH Paltaoglossus Styloglossus Genioglossus Hyoglossus
What the the intrinsic muscles fo the tongue?
Vertical, transverse, and longitudinal
The Palatoglossus is innervated by what nerve?
CN X
What structures lie between the Mylohyoid and Hyoglosus muscles?
- Hypoglossal n.
- lingual n. carrying chorda tympani
- Submandibular ganglion suspended from V3
- Submandibular duct
- deep lingual, sublingual vein
The …gland is located above the mylohyoid muscle.
Sublingual
The … gland is located below the Mylohyoid muscle and wraps around toward the superior at the posterior end of the muscle.
Submandibular
What are the three pharyngeal msucles?
palatopharyngeus, stylopharyngeus, salpingopharyngeus
All Pharyngeal muscles are innervated by the … nerve except the … muscle which is innervated by the… nerve.
CNX
Stylopharyngeus CNIX
All the muscles of the soft palate are innervated by the … nerve except fot the … muscle which is innervated by the … nerve.
CNX
tensor veli palatini V3
The … muscle is the primary elevator of the soft palate and found on the … wall of the eustachian tube.
Leveator veli palatini
Medial wall of the eustachian tube
The … muscle is the dilator of the Eustachian tube and found on the …wall of the tube.
Tensor veli palatini
Lateral wall of eustachian tube
The … muscle forms the anterior faucial pillar and the … muscle forms the posterior pillar.
Palatoglossus
Palatopharyngeus
The submental space is found … the mylohyoid muscle and drains the …
Below mylohyoid m.
Drains incisors
The Sublingual space is found … the mylohyoid muscle and drains the …
Above mylohyoid
Drains 1st premolar and 1st molars
The submandibular space is found … the mylohyoid muscle and drains…
Below mylohyoid
drains 2nd and 3rd molars
What are the three maxillary spaces?
Canine, buccal and Infra-termporal
What are the contects of the the Cavernous sinus?
-CN III, IV, V1, V2, VI, internal carotid; (Abducens CNVI and carotid are not in the wall)
A lesion in CNVII and XII results on the …
affected side (XII tongue deviation, VII Bells Palsy)
A lesion in CNXI results in head movement … the affected side
Head turns toward the affected side
A lesion in CNX results in the Uvula deviating…
Away from the lesion side
General sensation of the anterior 2/3rds of the tongue is provided by..
Lingual n. (CNV3)
Taste sensation of the anterior 2/3rds of the tongue is provided by..
Chorda tympani (CNVII)
General sensation of the posterior 1/3rd of the tongue is provided by..
CN IX (Glossopharyngeal) also provides gag reflex)
The general sensation and taste sensation of the Epiglottis are provided by…
CNX (vagus)
What are the 5 major branches of the Maxillary artery?
Men In Black Private Investigators Middle meningeal artery Inferior Alveolar Buccal PSA Infraorbital
What vitamins are involved in production dentin and enamel?
CAD
C more for dentin
A more for enamel
Hemophilia A shows a .. inheritance pattern and results in a …deficiency.
- x linked, recessive
- Factor 8 deficiency
Hemophilia A results in a … PTT, …PT and …bleeding time.
increased PTT
Normal PT and Bleeding time
* no contraindication for orthodontic treatment
Superior Oblique Capitis
Origin:…
Insertion:…
Invervation:…
Origin - atlas
Insertion- nuchal line of occipital bone
Innervation- Suboccipital n. of C1
Growth of the Orbit is compensated by a change in what bone?
Frontal
Where does mandibular remodeling occur?
Resorption of the Anterior Ramus Deposition of the Posterior Ramus Resorption at B point Deposition at external surface of lingual cortical symphysis Deposition at alveolus
Chin prominence is common in what syndrome?
Cleidocranial dysotosis
…mg of folic acid can reduce the incidence of cleft by …%
0.4 mg folic acid
33%
What is the appropriate situation to use a LLHA?
Premature exfoliation of the primary molar with succedaneous eruption > 6 months, Scheduled exfoliation
What muscle is responsible for the flaring of the nose?
Nasalis
The Semilunar ganglion is location on what bone?
Sphenoid
Orthodotnic treatment of a endodontically treated tooth results in ..
less resorption
What is the calculation and assessment of the ionizing radiation dose recieved by the human body>
Dosimetry
What is the most common Pimary molar occlusion?
Flush Terminal Plane
What percentage of Class II are due to a retrognathic mandible?
75%
What are the two types of “play” at the wire bracket interface? and which one can be minimized and how?
Torquing and Rotation play; rotation play can be minimized by ligation (play can never be eliminated and is required for the wire to be removed and reinserted)
ABO DI Score ANB
> 6 and
ABO DI Score IMPA
IMPA > 98, 1 point increment
What structures are used to superimpose the maxilla?
Lingual contour of the palate and PT fissure
When adjusting a twin block where is the acrylic removed?
Posterior
An ameloblastoma is commonly seen in… and located …
Black, Males
Posterior mndible, show growing and agressive
After a 6 month serial ceph to monitor growth may an impalnt be placed in a 19 year old?
No, need a year without growth
What is the primary reason for an impacted canine?
Over-retained C or genetics
..% of Anterior open bite is successfully corrected surgically and …% non-surgical
82% surgical
75% non-surgical
When treating a Class II for phase I treatment, what % will have a reasonable correction?
75%
What bone contains the carotid canal?
Temporal
Geniohyoid vs. Anterior Digastric
- geniohyoid is deeper dissection from submentovertex position
- after removing the mylohyoid you will see the geniohyoid
- digastrics are mor superficial
What is amphetiamine used to treat and what are its side effects?
- ADHD
- reduced appetite, pupil dilation, constricted blood vessels, increased heart reate, feeling of happiness and power
What blood vessel is found in the pterygomaxillary fissure?
Sphenopalatine a.
T/F the Frontonasal process form the lateral lip?
False, maxillary process
What muscle is least likely to be associated with smiling?
Obicularis oris
What muscle is the agonist of the medial pterygoid muscle?
Masseter muscle
What are has all 3 types of bone grwoth: intramembranous, endochondrous and sutral?
Neurocranium and midface
What side of the jaw moves during disclocation?
affected side
What factors contribute to TAD stablity?
- Tight pitch (threads clsoe to one another)
- Diameter (length, surface, and taper do not help)
What is the risk when moving a tooth that underwent apexification?
Fracture
IF you have maxillary impaction, how do you evaluate about incisors?
Incisors at rest and 3mm of incior display at rest
What is the origin of Osteoclasts?
hematopoietic stem cell
If you decrease voxel size what must be adjusted for the photon?
increase exposure time due to needing more photons
What is the most readily noticeable symptom of pharyngeal insufficiency?
Hypernasality
If you have a a unilateral crossbite and no functional shift what needs to be done?
flat plane to evaluate if there is a shift in CO to CR
Which is more destructive a unilocular or multilocular ameloblastoma?
Multilocular
Congenitally missing tooh. Cyst arising from the dental lamina. What is the most likey lesion?
Primordial Cyst
Where is basion?
Most anterior postion of the foramen magnum
Historically what is the best way to study mandibular changes?
Implant studies
A female patient undergoes a setback surgery, would it be fixated?
Yes
What kind of patients would you not want to level the COS?
- Brachy surgery patient
- short lower face height
- deep bite
- 3 piece maxilla
How do you reduce the curve of Wilson?
- lingual root torque on the lower
- Buccal root torque on upper
What is the difference between sterilization and disinfection?
Sterilization kills everything including spores
What is hooke’s law?
stress and strain havea a linear relationship
Clinically useful springback occurs if the wire is deflected beyond?
yield point
The ..dose is how much the body absorbs and … is the total radiation.
Effective; equivalent
There is (deposition/resorption) on the lingual border of the mandibular symphysis and (deposition/resorption) at the b point.
Deposition; resoprtion
Tylenol acts more (peripherally/centrally?
Centrally
When placing a Maryland bridge, where you want the incisors in relation to the occlusal plane?
10-15 degrees
T/F: TPA has no vertical or AP effect on maxillary first molars during extraction treatment.
T it controls
- molar roation and uprighting
- transverse posterior dimension
- maintains leeway spaces
Of Class II correctors the … shows 2mm more correction
Twin block have 2mm more correction than a herbst
- also increased mandibular ramus height
- most effective in controlling mandibular plane angle
- most flaring of mandibular incisors
Both the Herbst and Mara singificantly restrict… and cause…
Maxillary growth, and cause a steeper occlusal plane
What happens to the hyoid bone follwoing a setback?
Moves downward
T/F VTO are accurate in adult extraction cases.
T
WHen restoring a black triangle, what do you consider with a good bone level?
tooth Width
What is Hystereiss of an archwire?
Phase transformation
How long should orthodontic treatment be delayed following ceasing bisphosphante use?
3 months
The crowding limits for Invisalign is…mm
1-5mm
What results in Gingival recession with orthopedic effects in adults?
RPE
According to profitt, vertical … in males and … in females as they have
decrease in males and slightly increases in females
T/F symphyisal distraction causes TMJ problems.
False, but it can result in devitalization of lower incisors, incisors eruption into the distraction site, and it is a risky procedure
T/F Early fusion of the maxillary sutures is seen in Crouzon syndrome
False
What is the primary cause of impacted canines?
Genetics
The … muscles retrude the tongue.
Styloglossus and hyoglossus
The … sinuses drain into the middle meatus.
Ethmoid, maxillary, temporal
What are the paired bones of the facial skeleton?
Maxilla Nasal Lacrimal Palatine Zygomatic Inferior nasal concha
What bones form the cranial vault?
PEST OF 6 Parietal Ethmoid Sphenoid Temporal Occipital Frontal
What bones form the face?
Virgil Can Not Make My Prt Zebra Laugh Vomer Conchae(inferior) Nasal Maxilla Palatine Zygomatic Lacrimal
Which Arachodonic acids metabolite plays a role in tooth movement?
Leukotriene
What teeth only contact one other tooth in the opposing arch?
Maxillary 8s and Mandibular 1s
Wits used the … occlusal plane while downs uses…
Functional - line thru occlusal surface of 1st molars and premolars
Bisected - bisects incisor overbite and passes overal distal cusps of most posterior teeth
What are the primate spaces?
Mesial of U3 and distal of L3
What applicable adidas Edward Angle invent?
Only his PEERs Pin and tube E-arch Edgewise Ribbon arch
3-3 Bolton
77
Spontaneous correction of a childhood diastema is most likely when its width is not more than..
2mm
On an articulator, the change in A-P is controlled by… and what additional information is needed at records to establish that setting?
Condylar Inclination, protrusive bite
A TMA arch wire contains…
80% Titanium 11.5% Molybdenum 6% Zirconium 4.5% Tin -these are safe to use nickel sensitive patient
SS archwires have the … stiffness, … springiness and therefore … resistant to permanent deformation.
Highest stiffness, lowest springiness and least resistance to permanent deformation
The point at which any permanent deformation is first observed in an elastic material upon receiving a load is?
Proportional limit
2x the wire diameter = … strength, … springiness, and … range
2x diameter = 8x strength, 1/16 springiness and 1/2 range
2x wire length = … strength, … springiness, … range
2x wire length = 1/2 strength, 8x springiness, and 4x range
In order to produce a counter clockwise rotation of the maxilla with HPGH the force must be… to the center of resistance?
Counter clockwise rotation = force mesial to Crot
Clockwise rotation = force distal to Crot
When using asymmetric HG to correct a unilateral Class II molar relationship, a … cross bite is a side effect on the Class II side and a … cross bite is a side effect on the Class I side.
Lingual crossbite of the Class II side with the long outer bow
Buccal crossbite of the Class I side with the short outer bow
Tipping force
35-60 gm
Bodily movement (translation)
70-120
Root uprighting force
50-100 gm
Rotation force
35-60
Extrusion force
35-60
Intrusion force
10-30 gm
What is the best surgery for a class 3 prognathic Md. patient with TMD?
IVRO (vertical ramus osteotomy)
What are undesirable effects of Lefort 1 maxillary impaction?
- rotation of the nasal tip upwards
- widening of alar base
What surgical procedure is likely to require a graft for stabilization?
Lefort 1 down fracture
The sagittal split osteotomy is the procedure of choice for the advancement of the mandible. What complications are often associated with this procedure?
Condylar sagging and post surgical trismus
Dental Decompensation prior to Orthognathic Surgery
Class II
Class III
Class II - upper 5s / lower 4s
Class III - upper 4s / lower 5s
Which is an advantage to mandibular set back using transoral vertical oblique ramus osteotomy (TOVRO)?
- relatively less time than a BSSO
- lower incidence of neurosensory changes
Which sutures are spilt with an RME?
Palatal
Circummaxillary
Circumzygomatic
Following maxillary down fracture/Lefort I what growth potential remains?
Maxilla continues to grow vertically as normal
What does HIPPA stand for?
Health Insurance Portability and Accountability Act
Specificity is…
The probability of a negative new test result when there is truly no disease present
The growth centers are…(3)
Epiphyseal plates
Synchondrosis
Nasal septum
Which part of the face has both intramembranous and endochondral growth?
Upper and middle
Sutural growth, endochondral, and intramembranous growth are seen in…
Neurocrainium and midface
The cranial base growths by what mechanism?
Endochondral
The source of growth at the cranial base is where?
Synchondroses
The cranial base develops by…
Proliferation at the synchondroses
The lateral wall of the orbit is made up of which bones?
Frontal process of zygomatic bone
Greater wing of sphenoid
What should not be used in the treatment of a TMD patient?
Class III elastics (can worsen an anterior displaced disc)
The lingual cusps of the maxillary second molars can cause
- balancing side contacts
- TMD
A flat plane occlusal splint should be use for…. patients while a Anterior positioning splint would be used for…
Flat Plane for symptomatic bruxism/TMD patients
Anterior positioning splint only used to recapture an anteriorly displaced disc
Gorlick found the highest incidence of WSL on the …(what teeth)
Maxillary Laterals
Gorelick stated that fluoride administered throughout treatment would result in continuous remineralization up to the depth of …. however if the lesions have progressed beyond that depth immediate fluoride treatment following debond will result in …
~0.5 mm and arrest the lesion and prevent further repair
Flouride remineralization penetrates ~0.5 mm so immediate treatment will essentially seal the deeper demineralization by surface remineralization
When an anterior open bite is associated with a speech difficultly in a child, the speech sound most likely to be affected is ..
Lisp with “s”, “z” sibilants (th, sh, ch)
When an Class III bite is associated with a speech difficultly in a child, the speech sound most likely to be affected is ..
Distortion of labiodental fricatives (f and v)
When an Class II Div II bite is associated with a speech difficultly in a child, the speech sound most likely to be affected is ..
(Lingual position of mx. Incisors) difficulty in producing linguoalveolar stops “t” “d”
Skeletal open bite will usually have …(4)
- excessive eruption of posterior teeth
- downward rotation of Md. and Mx.
- normal (or even excessive) eruption of anterior teeth
- upper incisors below stomion superioris
In .022 slot system, what is the maximum slot measurement? And in .18?
22 slot = 22 x 28
18 slot = 18 x 25
What is not an indication for extraction prior to surgery?
Transverse issue
The following indicate pre surgical ext. crowding, dental decompensation, overjet, excessive protrusion
If upper 7’s are removed what happens to the 8’s?
Careful use of headgear to distalize first molars after second molar extraction there is a 75-80% chance the 3rd molars erupt into an acceptable position to replace the second molars
What imaging is useful in diagnosis of condylar hyperplasia?
Tech 99 (bone scan)
What type of AW is less effective in anterior tooth root torque/ torque control?
Martensitic NiTi
When treating a class II patient, the goal is to … the OP-SN angle in because … that angle increases the tendency for relapse.
Smaller
Increasing
The greatest indicator of root resorption is…
Previous history of root resorption
Fusion of what synchondrosis indicates completion of the cranial base?
Sphenoid-occipital synchondrosis
In a patient with acromegaly, which sinus gets larger?
Frontal (Total volume)
Sphenoid (AP change)
Hypertelorism is associated with ? (2)
Midline cleft
Aperts
(Trisomy 21 HYPOtelorism)
What genes are associated with maxillary lateral incisor agenesis?
PAX9, EDA, SPRY2, SPRY4 and WNT10A
