Week 3 Abdalla: Iatrogenic Problems Ortho Flashcards

1
Q

What are benefits of ortho tx?

A
  • Prevents dental trauma in patients with inc overjet (however, most traumatic dental injuries take place in mixed dentition (before ortho)
  • Improve aesthetics and self esteem
  • No strong evidence for benefits to unerupted teeth, treatment of severe functional occlusal problems and speech.
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2
Q

What are some risks of ortho tx?

A
  • White spot lesions
  • Root resorption
  • Periodontal and soft tissue lesions (indentations, gingivitis, ulcers from wires)
  • Gingival recession
  • Enamel loss when removing ortho brackets
  • Eye injuries (head gear)
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3
Q

What are white spot lesions?

A
  • Most common problem with ortho tx
  • Decalcification of enamel
  • Cyclical process of remin and demin
  • Can progress to cavitated lesion
  • Clinically appears as white or brown spot on tooth surface
  • Ortho appliances can retain plaque
  • Risk factors: pre-existing WSL, poor pre-tx OH
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4
Q

How common are white spot lesions with ortho? Which teeth are most susceptible?

A
  • At least 50%
  • Maxillary lat incisors most commonly affected
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5
Q

How can WSL be prevented?

A
  • Professional application of fluoride foam every 6-8 weeks
  • High fluoride toothpaste
  • Avoid ortho tx in pts with poor OH
  • Insufficient evidence to recommend fluoride releasing products attached to braces
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6
Q

How to treat WSL?

A

MI varnish remineralises the surface layer but makes it impermeable to underlying demineralisation. Instead advocate for:

  • Brush F toothpaste 2x daily
  • Sugar free chewing gum
  • Tooth mousse (CPP-ACP)
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7
Q

What should you do if WSL are still present after 2 months?

A
  • Microabrasion
  • Bleaching
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8
Q

What are risk factors for root resorption with ortho?

A
  • Less than <5% of ortho pts suffer severe RR
  • Less common in Asian pts
  • Age/gender not associated
  • Intrusion more risky tooth movement
  • Possible association with nail biting
  • Endo treated teeth are less susceptible
  • Tx time
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9
Q

What patients are suscepatble to gingival recession from ortho?

A

Thin gingival biotype

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