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Prof Abdalla > Week 5- Space Management > Flashcards

Week 5- Space Management Flashcards

1
Q

What is the difference between balancing and compensating extractions?

A
  • Balancing: extraction of contralateral tooth (opposite tooth of same arch)
  • Compensating: extraction of opposing tooth in opposite arch
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2
Q

What can happen if a deciduous canine is lost before the other canine? What can you do to avoid this issue?

A

Midline can shift. Consider balancing exo (extract the other deciduous canine in same arch)

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3
Q

What is the issue with timing of crown formation and timing of eruption for 6’s?

A
  • 6’s crowns form around birth and are susceptible to hypomineralisation/hypoplasia.
  • Timing of eruption makes teeth vulnerable to caries as they are in the mouth before children establish good OH
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4
Q

What is a treatment option if the first permanent molar has poor prognosis in children?

A

Aim to get 2nd molar to erupt as replacement for 1st molar and 3rd molar to erupt as replacement for 2nd molar. (2 functioning molar teeth each side of arch)

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5
Q

What should be considered if you are extracting 6 due to poor prognosis?

A

Consider compensation extraction. Otherwise tooth could over erupt.

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6
Q

When should a 6 be extracted if it has poor prognosis to allow the 7 to fill its space?

A

Mx: timing not as important (8-10)

Md: extract 6 immediately after calcification of bifurcation of md 2nd molar.

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7
Q

Where is primate/anthropoid spaces for upper and lower arch?

A

M to upper deciduous canine and D to lower deciduous canine

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8
Q

What is the incisor liability for upper and lower arches?

A

Upper: 7.5mm

Lower: 6mm

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9
Q

How can you overcome incisor liability in maxilla?

A
  • Anterior interdental space
  • Primate space
  • Labial eruption of incisors increasing arch length and circumference
  • Increased inter-canine width
  • Reduced inter-incisal angle (more proclined, making more space)
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10
Q

How can you overcome incisor liability in mandible?

A
  • Anterior interdental space
  • Increased inter-canine width
  • Reduced inter-incisal angle
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11
Q

Can you use Angles classification in the primary dentition?

A

No

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12
Q

What are the 3 deciduous molar relationships?

A
  • Flush terminal plane: distal surface of md and mx molars are in same vertical plane
  • Mesial step: distal surface of md second molar is mesial to distal surface of mx molar.
  • Distal step: distal surface of md second molar is distal to distal surface of maxillary second molar.
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13
Q

What is the most common molar relationship in deciduous dentition?

A

Fulsh terminal plane

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14
Q

How do we transition from flush terminal plane to class I occlusion?

A
  • Early shift
  • Late shift
  • Differential jaw growth

(or combination)

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15
Q

What is early shift?

A

If md primate space is available during eruption of permanent molars, the lower permanent molar move forward into a class I relationship.

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16
Q

What is late shift?

A

Uses leeway space. There is space difference between posterior primary teeth and permanent teeth which replaces them.

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17
Q

What is differential jaw growth?

A

If lower jaw grows more forwards (than mx) the lower jaw carries the lower teeth further forward relative to upper teeth.

18
Q

If you see distal step in deciduous dentition what molar relationship is likely in permanent dentition?

A

Class II

19
Q

If you see flush terminal in deciduous dentition what molar relationship is likely in permanent dentition?

A

Class I (or end to end)

20
Q

If you see mesial step in deciduous dentition what molar relationship is likely in permanent dentition?

A

Class I (or class III)

21
Q

What is leeway space for upper vs lower arch?

A

Upper: 1.5mm per side

Lower: 2.5mm per side

22
Q

When are lingual arches contraindicated?

A

Until all permanent incisors have erupted

23
Q

If you lose primary incisors at a young age, what can you use?

A

No tx necessary. Replacement is for aesthetic concerns mainly. Can make fixed lingual arch off deciduous second molars.

24
Q

What should you do if you have premature loss of primary canines?

A
  • Balance extractions
  • Lower lingual arch can prevent space loss caused by retraction of incisors.
25
Q

What appliances can be used if you have premature loss of primary molars?

A

Lingual arch resting against incisors

Band and loop appliance (used for single tooth)

26
Q

What are the pros and cons of band and loop appliance?

A
  • Pros: Can be used prior to eruption of permanent incisors & can be fabricated and placed chairside at same visit
  • Con: if abutment tooth is lost, the appliance fails.
27
Q

Why is space maintenance not appropriate for all children?

A

If pt has decay and high caries risk, can be difficult to clean

28
Q

What is the issue with the following pic?

A

E’s lost early and 6’s moved forwards

29
Q

What is the most important thing to pick up as general dentist?

A

Ectopic mx canine

30
Q

Is compensation indicted in primary dentition?

A

No, rather fit a space maintainer.

31
Q

What is happening in this picture?

A

LHS deciduous canine lost before RHS side, causing shift in midline. Should have balanced earlier.

32
Q

What can you do if pt has congenitally missing premolars?

A

Role of E’s is to hold 6 back in position to give space for 5 to erupt. If 5 is missing, it might be appropriate to extract the E and allow mesial drift of 6 to close the space. CONSULT ORTHO.

33
Q

What can you do if pt has congenitally missing premolars?

A

Role of E’s is to hold 6 back in position to give space for 5 to erupt. If 5 is missing, it might be appropriate to extract the E and allow mesial drift of 6 to close the space. CONSULT ORTHO.

34
Q

What is incisor liability?

A

Difference between combined widths of permanent and deciduous incisors

35
Q

Can primate spaces be utilised to allow room for incisors in upper or lower arch?

A

Primate spaces in upper arch can be used to allow us to fit permanent incisors.

In lower, primate spaces are distal to deciduous canine.

36
Q

What are the 3 approaches to managing transition from primary to permanent dentition in terms of space?

A
  • Space management: hold space before primary teeth lost (proactive)
  • Space maintenance: maintain space after premature loss of primary tooth (reactive)
  • Space regaining: regaining space after early loss of primary tooth once space has been used (retroactive)
37
Q

What is a lingual holding arch?

A
  • Bands on 6’s
  • Wire rests on lingual surface of anterior teeth
38
Q

What are space management strategies?

A
  • Lingual arch
  • TPA
  • Nance
39
Q

What is a simple space maintenance strategy?

A

Restoring primary teeth

40
Q

What is wrong with this tx option?

A

Already lost space of E. Needed to place earlier.

41
Q

What is incisor liability?

A

Difference between the combined widths of the permanent and deciduous incisors

Prof Abdalla (6 decks)

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