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DS4102 > W2 - Ortho Relapse / Retention - Abdalla > Flashcards

W2 - Ortho Relapse / Retention - Abdalla Flashcards

1
Q

What are the different orientations of gingival connective tissue collagen fibre bundles?

A
  1. Periosteogingival fibres
  2. Inter-papillary fibres
  3. Transgingival fibres
  4. Circular and semicircular fibers
  5. Transseptal fibers
  6. Intercircular fibers
  7. Intergingival fibres
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2
Q

Gingival tissue reorganisation

What is it?

Role in ortho?

A

Connective tissue fibers are twisted/stretched after ortho

  • Need time to re-organise
  • Otherwise, teeth will relapse
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3
Q

How long does it take for periodontal fibers to reorganise

A

3-4 months

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4
Q

How long does it take for gingival fibers to reorganise

A

4-6 months

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5
Q

How long does it take for trans-septal fibers to reorganise

A

12 months

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6
Q

What ortho movements are more prone to relapse?

A

rotations

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7
Q

What is pericision aka circumferential supracrestal fiberotomy

A

Incision of supracrestal fibers around ortho treated teeth

  • By cutting fibers, you speed up the rate of periodontal reorganisation
  • Reduced rate of relapse in theory
  • Not commonly done
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8
Q

4 factors that affect retention

A

Periodontal / gingival anatomy

Soft Tisses

Occlusal balance

Growth / development

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9
Q

How do the soft tissues affect occlusal positioning/balance

A

Must be equal force between tongue and cheek

  • Teeth should be in the “neutral” area
  • If not positioned neutrally → relapse due to force from cheek/tongue
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10
Q
A

Extraction of premolars necessary

otherwise → soft tissues will press against teeth (relapse)

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11
Q

What must be addressed first in these cases with lip incompetence / lip trap?

A

Lip trap must be addressed

otherwise will have soft tissue imbalance affecting ortho

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12
Q

How do you measure mandibular incisor extrusion?

A

Compare mandibular occlusal plane angle to mandibular plane angle

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13
Q

How does the maxillary arch change and develop over time?

A

Intercanine width increases (1.7mm btw 13-45yo)

Intermolar width decreases by 1mm by 45

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14
Q

How does the mandibular arch change over time?

A

Intercanine width decreases 1.2mm (13-45 yrs)

Intermolar width decreases by 1mm (by 45 yrs)

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15
Q

Why is it common to see mandibular teeth become crowded as people age

A

Intercanine width slowly decreases 1.2 mm

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16
Q

Maxilla termination of growth

A

Girls - 15

Boys - 17

17
Q

Mandible termination of growth

A

girls - 17

boys - 19

18
Q

Why does the mandible keep growing after the maxilla stops?

A

Cephalo-caudal gradient of growth

  • Maxilla closer to top of head, thus stops earlier
19
Q

Pros and cons of removable retainers (2 and 2)

A

Pros

  • Can be worn part-time
  • Can remove for cleaning

Cons

  • Relies on compliance
  • More intrusive
20
Q

Pro and con of fixed retainers

A

Pro

Doesnt rely on compliance

Con

More difficult to clean

21
Q

Advantages of acrylic retainers with labial bow (3)

A
  • Robust- can eat without them getting damaged
  • Allows posterior occlusal settling
  • Anterior bite plane can be incorporated to retain corrected deep bites
22
Q

Advantages of vacuum formed retainers (5)

A
  • Cheap
  • Aesthetic
  • Decreased speech interference
  • Nighttime only
  • Prosthetic teeth can be incorporated
23
Q

Pros (2) and cons (3) of bonded/fixed retainers

A
  • Discreet
  • Doesn’t rely on compliance

Cons

  • Affects OH
  • Can become active and cause mvmt
  • Upper retainers can cause occlusal contact
24
Q

What happened here?

A

Stainless steel bonded retainer became active

25
Q

Which ortho treatments have limited retention (low risk of relapse)

A
  • Corrected crossbites
  • Impacted canines treated with extraction
  • Dentitions where teeth have been separated to allow for eruption (Dahl)
26
Q

risk of relapse?

A

Low

Limited retention

27
Q

Which ortho treatments have moderate retention (medium risk of relapse)

A

Class 1 cases

Class 2 Exo cases

Corrected class 1 and 2 deep bites

Corrected class 2 div 1

28
Q

Risk of relapse after tx?

A

Moderate

29
Q

Which ortho treatments have high retention (high risk of relapse) (5)

A
  1. Lower arch expansion
  2. Rotation
  3. Considerable spacing
  4. Midline diastemas
  5. Teeth that are placed in position outside of soft tissue envelope (think lip/cheek balance)
30
Q

Risk of relapse after tx?

A

High

31
Q

Adjunct methods to assist with retention (3)

A

Pericision

Extraction of wizzies

Eliminate parafunctional habits (thumb suck)

32
Q

Why is lifelong retention unlikely?

A

Dentition naturally changes with age - relapse is very likely

Pts should be advised of this

  • Pts should only undergo ortho if they are willing and capable of following prescribed retention regimen following treatment (wearing retainers)

DS4102 (37 decks)

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