Space Maintenance and Developing Occlusion

Question 1

Which Baume type has arches with spaces between primary anterior teeth (the more space present, the less chance of crowding in the permanent dentition)?

Answer 1

Baume type I

Question 2

Which Baume type has arches with no space between primary anterior teeth?

Answer 2

Baume type II

Question 3

What is the likelihood there will be permanent dentition crowding if there is primary dentition crowding?

Answer 3

100%

Question 4

What is the term for the space in the maxilla that is between the primary canines and the primary laterals and space in the mandible between the primary canines and the primary 1st molars?

Answer 4

Primate space

Question 5

What is it called if the primate space closes with the eruption of the permanent first molars?

Answer 5

Early mesial shift

Question 6

What is the difference in mesiodistal widths of the primary canine and molar teeth versus the permanent successors (permanent canine and first and second premolars)?

Answer 6

Leeway space

Question 7

What is the mandibular arch leeway space?

Answer 7

1.7 mm / half, 3.4 mm total leeway space mandibular arch

Question 8

What is the maxillary arch leeway space?

Answer 8

0.9mm / half, 1.8 mm total leeway space maxillary

Question 9

Leeway space allows space for the uninterrupted eruption of which teeth?

Answer 9

Permanent canines and the first and second premolars

Question 10

Leeway space relieves what that usually occurs after the eruption of the mandibular permanent incisors?

Answer 10

Mild anterior crowding

Question 11

Leeway space allows for what in the permanent first molars so they can get to an Angle Class I?

Answer 11

Late mesial shift

Question 12

What is the greedist tooth in the mouth with respect to maintenance considerations?

Answer 12

First permanent molar. They eat up any space not taken that is not protected.

Question 13

What is the largest concern with early loss of primary incisors: space maintenance or esthetics?

Answer 13

Esthetics

Question 14

What is the danger with the early loss or removal of primary canine?

Answer 14

Midline shift

Question 15

What is required with the premature loss of primary first molar (B, I, L, S) so the primary 2nd molar will not migrate into space distally and block out the first premolar?

Answer 15

Space maintenance

Question 16

What is the appliance of choice for space maintenance of an early loss primary 1st molar?

Answer 16

Band and loop. Bond on 2nd primary molar, loop transverses space left by 1st primary molar and butts up against the primary canine

Question 17

Losing which tooth early can create the most space loss?

Answer 17

Primary second molar (A, J, K, T)

Question 18

What accounts for the 8mm of space loss that can occur in the maxilla if the 2nd primary molar is lost prematurely?

Answer 18

Maxillary 1st permanent molar will move mesial as well as rotate around its palatal root

Question 19

How much space can be lost in the mandible if the primary 2nd molar is lost prematurely?

Answer 19

4-6mm

Question 20

What is the space maintenance appliance of choice if the 2nd primary molar is lost prematurely?

Answer 20

Distal shoe. Band on 1st primary molar, loop with a gingival pick at the end traverses the open space and is suck down into the gum

Question 21

What must be done after placing a distal shoe to ensure it is not hitting the first permanent molar?

Answer 21

Post placement radiograph

Question 22

What is the most likely reason for premature loss of mandibular primary canine?

Answer 22

Ectopic eruption of permanent lateral incisors

Question 23

What is indicated with early loss of mandibular primary canine?

Answer 23

Extract contralateral canine, place lower lingual holding arch with spurs to engage distal of laterals?

Question 24

What prevents movement of incisors lingually or mesial tipping of permanent molars?

Answer 24

Lower lingual holding arch

Question 25

What teeth are required for a lower lingual holding arch (LLHA)?

Answer 25

Mandibular permanent first molars and mandibular permanent central and lateral incisors

Question 26

What is the space maintainer of choice if permanent 1st molars are in, but 2nd primary molars are lost and there is bone overlaying the succedaneous tooth?

Answer 26

Lower lingual holding arch

Question 27

What are 3 space maintainers used in the mandibular arch?

Answer 27

1. Band and loop
2. Distal shoe
3. Lower Lingual Holding Arch (LLHA)

Question 28

Which space maintainer is indicated for early loss of maxillary primary 2nd molars?

Answer 28

Nance or transpalatal arch. Dr Berry still feels there is tipping with the transpalatal arch

Question 29

What are 3 things not treating an anterior crossbite early can lead to?

Answer 29

1. Gingival stripping
2. Compensatory growth patterns (functional shift)
3. Traumatic occlusion

Question 30

What are the 3 most common ways in VCU pedo for early intervention for anterior crossbite?

Answer 30

1. Hawley retainer with Z-spring
2. Nance arch with Z-spring
3. 2 by 4

Question 31

What is a posterior crossbite that is due to a constricted maxilla, usually bilateral, midlines are coincident and no functional deviations?

Answer 31

Skeletal

Question 32

What is a posterior crossbite that has a lateral shift of the mandible to the crossbite side during closing, usually unilateral, constricted maxillary arch?

Answer 32

Functional

Question 33

Which posterior crossbite is more common, skeletal or functional?

Answer 33

Functional

Question 34

What is key when doing a rapid palatal expander to correct a constricted maxilla and a posterior crossbite?

Answer 34

Overexpand 2-3mm and hold for 6 months

Question 35

One turn in a rapid palatal expander equals how much?

Answer 35

0.25mm

Question 36

What is another means to correct a posterior crossbite, but less sksletal and more dental movement?

Answer 36

Quad Helix

Question 37

If you extract #T (primary 2nd molar), what space maintenance is indicated and why?

Answer 37

Distal shoe off #S planted into the distal of the socket of #T to guide #30 as it erupts

Question 38

If you extract #S (primary 1st molar), what space maintenance is indicated and why?

Answer 38

Band and loop off #T to #R to hold arch space

Question 39

Why would a band and loop be indicated over a lower lingual holding arch (LLHA) for maintenance of space where #S was extracted?

Answer 39

19, #30, and anterior incisors must be erupted to do LLHA

Question 40

What is a primary dentition occlusal scheme where the terminal plane of the mandibular primary second molar is mesial tot he maxillary primary second molar terminal plane?

Answer 40

Mesial step, will normally go Class I or Class III permanent occlusion

Question 41

What is a primary dentition occlusal scheme where the terminal plane of the mandibular primary second molar is distal to the terminal plane of the maxilary primary second molar?

Answer 41

Distal step. The patient will be Class II permanent occlusion

Question 42

What is a primary dentition occlusal scheme where the terminal plane of the mandibular second primary molar is even with the terminal plane of the maxillary primary molar?

Answer 42

Flush terminal plane, mostly Class I permanent

Question 43

What is the ideal occlusion for a 7 year old?

Answer 43

Class I molar (will have permanent molars in)
2mm anterior and posterior overjet
2mm anterior oberbite
Coincident dental midlines

Question 44

What occlusal scheme do you look at once the first permanent molars are in?

Answer 44

Angle class

Question 45

What space maintenance is indicated when #A (maxillary primary 2nd molar) is extracted and #3 and #14 are in?

Answer 45

Nance or TPA