Week 3 Generalized space shortage Flashcards
Generalized space shortage
True shortage of space including leeway
tooth movement methods will create the space
prognosis and stability are unknown (retention is mandatory)
Generalized space shortage
True shortage of space including leeway
tooth movement methods will create the space
prognosis and stability are unknown (retention is mandatory)
Moderate generalized space discrepancy is when _________
First thing to consider with moderate generalized space discrepancy
arch expansion; this is NOT palatal expansion, but expanding the circumference of the arch
creating up to 4-5mm of space
Alternative to arch expansion
take out 2 permanent teeth. premolars average about 7mm M-D width, so if you take out 2 premolars, you’d free up 14mm of space
so if you’re looking for creation of 4-5mm of space, that means you’d have to close 9-10mm of space if you extract!
Perform arch expansion based on:
- Lips and incisors ap position: WNL or retrusive
- Facial keratinized tissue: Adequate
- Overbite
- Overjet
Consider arch expansion if….
Skeletal class 1 (best candidate)
Dental class 1 or E-E molar
All teeth present
Treatment options for moderate generalized space discrepancy
- Active lingual arch
- Lip bumpers
- Banded/Bonded appliance
- Headgear
Active lingual arch for..
lower anterior crowding
Best for FL discrepancies
Facial tipping of incisors (best for tipping facially), distal tip of molar
NO good for rotation
MAY increase the possibility of second molar impaction
Stability unknown.
Lip bumpers for….
Lower anterior and/or buccal segment crowding
Best for FL discrepancies
Facial tipping of incisors / migration
Distal tipping of molar
NO good for rotation
May increase possibility of 2nd molar impaction
Without lip pressure, teeth migrate in facial direction
Banded and Bonded fixed appliance for…
Lower anterior and/or buccal segment crowding.
Tipping and bodily movements are possible
Rotations can be treated
Headgear for….
Max arch only
Buccal segment crowding
Only molar movement control
Require cooperation
True or False?
With headgear alone, only teeth you have control over are the molars.
True
With long face - use high pull
short to normal face - use cervical pull
Severe generalized space discrepancy of >4-5 mm per arch. What do you do?
Extraction based on crowding and protrusion.
What do you do when severe generalized space discrepancy ≥ 10 mm per arch?
Serial extraction
Indications for serial extraction
Class 1 Good facial form Severe space shortage Early loss of primary canines Gingival defects Impaction imminent (close by)
Advantages of serial extraction?
spontaneous incisor alignment improved gingiva improved hygiene improved psych better canine position reduce treatment/retention time better stability
Disadvantages of serial extraction
Incisor lingual tipping
deep bite
reduced vertical growth and alveolar development
poor facial esthetics
requires future treatment
remaining teeth may not erupt or have poor form
tongue habits develop
Usual extraction sequence for serial extraction
- Primary canine (for ant crowding and alignment)
- Primary first molar (when 1/2 to 2/3 of premolar root is formed to expedite eruption)
- First premolar (to provide space in the permanent dentition)
Moderate generalized space discrepancy is when _________
First thing to consider with moderate generalized space discrepancy
arch expansion; this is NOT palatal expansion, but expanding the circumference of the arch
creating up to 4-5mm of space
Alternative to arch expansion
take out 2 permanent teeth. premolars average about 7mm M-D width, so if you take out 2 premolars, you’d free up 14mm of space
so if you’re looking for creation of 4-5mm of space, that means you’d have to close 9-10mm of space if you extract!
Perform arch expansion based on:
- Lips and incisors ap position: WNL or retrusive
- Facial keratinized tissue: Adequate
- Overbite
- Overjet
Consider arch expansion if….
Skeletal class 1 (best candidate)
Dental class 1 or E-E molar
All teeth present
