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.
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)
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
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
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
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)
7
Q
What should you do if WSL are still present after 2 months?
A
- Microabrasion
- Bleaching
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
9
Q
What patients are suscepatble to gingival recession from ortho?
A
Thin gingival biotype
