Week 5 Adjunctive therapy Flashcards
What is the primary goal of adjuntive therapy?
Not to correct malocclusion
to reposition teeth facilitate other dental procedures: restore function, control/eliminate disease process
True or False?
Goal is not always ideal occlusion and alignment
True
What is the fastest growing area in ortho?
Adult treatment
Age of patients for adjunctive therapy?
typically in 40-50s
Duration of adjunctive therapy
a few months
rarely more than a year
Long term retention is supplied by _____ in adjunctive therapy?
Restorations
True or False?
TMD is considered as adjunctive therapy?
False
TMD is not considered as adjunctive therapy?
True or False?
Adjunctive orthodontic treatment is almost always inter-disciplinary in nature
True
Best determinant of timing for placement of a dental implant is when?
on completion of vertical alveolar growth
in younger patients
How do you upright the tooth?
- Distal crown tip
2. Mesial root tip
What is distal crown tip?
By merely tipping, comparatively easier tooth movement, space is opened (pseudopocket due to an extraction or a missing tooth)
The space is maintained for restoration of tooth (Implant or bridge)
True or False?
Uprighting multiple molars is easier than uprighting a single molar.
False
Uprighting a single molar is much easier!
What is mesial root tip?
Need to move root by mesial movement.
it is significantly more difficult than distal crown tip because it requires root movement through alveolar bone of significant distance space is closed mesially.
To do this, you need to use the skeletal anchorage. It needs to be done very slowly (takes upto 3 years)
It requires a long time since it is a cortical bone remodeling.
What is one thing you need to consider when tipping a tooth?
Extrusion!
When tipping a tooth to distal, it is common for a tooth to be extruded. if there is an antagonist, it is easy to control the extrusion. If there is no antagonist, the case becomes more complex and you need to apply the force to fix it.
What do you use to prevent extrusion to tip the tooth?
T-loop spring mechanic or Helical mechanic
These springs tip the crown and also move roots mesially little bit to prevent extrusion of molar.
so it produces some intrusive movement
so crown tip with intrusion to prevent extrusion
Intrusion rate?
0.5mm per month
0.5 mm intrusion of Max posterior translates into about _____ closure of anterior open bite.
1 mm
Intrusion upto ____ can be obtained.
4 mm
True or False?
Relapse can occur with intrusion. Reasonably good short/medium term stability.
True
True or False?
Controlled space closure is enhanced by using Temporary Anchorage Device (TAD) and auxiliary helical spring.
True
Indications of Forced eruption?
Tooth fracture (subgingival): This gives no room to restore, if the patient wants restoration instead of implant… you would have to extrude that tooth
Periodontal disease and vertical bony defect
Treatment options for forced eruption?
Perio crown lengthening - limitation is Crown-root ratio
Orthodontic rapid extursion
What is the orthodontic extrusion (Extrusion)?
uses orthodontic forces.
the PDL including alveolar bone follows the extruding tooth.
What is the Rapid Extrusion?
uses heavier forces, more frequent activation and results in extruding the tooth beyond the PDL (lengthen clinical crown without PDL and Bone involvement).
Long retention period!: important because the tooth can reintrude back for a significant time period.
When do you intrude the teeth?
Supra-erupted teeth eg. missing occlusal conterpart (antagonist)
Anterior tooth intrusion can be done… how?
it is difficult but possible with
conventional orthodontic technique
Posterior teeth intrusion can be done.. how?
Only possible with reinforced anchorage systems (eg. TADs or Implants)
What is the most difficult orthodontic tooth movement to accomplish?
INTRUSION!!!
TADs is placed how to apply the force to intrude the tooth without tipping?
Placed both facially and lingually
What is the orthodontic anchorage?
Resistance to undesirable tooth movement
What is the skeletal anchorage?
utilizes either osseo-integration (implants) or metal to bone mechanical resistance Temporary Anchorage Devices (TADs)
Applications of TADs?
Makes previously difficult tooth movements possible (intrusion of posterior teeth)
Simplifies orthodontic bio-mechanics
Speeds up ortho treatment
Most commonly missing teeth?
- 3rd molars
2. Max lateral incisors
