Ortho- ortho & oral surgery

Question 1

What soft tissue procedures would an orthodontist refer to an oral surgeon for?

Answer 1

frenectomy
Frenoplasty
Extraction of impacted teeth

Question 2

What is a frenoplasty?

Answer 2

Modification of the frenum

Question 3

What is a fraenectomy?

Answer 3

Surgical removal of the frenum.

Question 4

Name some hard tissue procedures an orthodontist would refer to an oral surgeon for?

Answer 4

Impacted canines
submerged retained primary teeth
Implants to be used as achorage.
Extractions.
Orthognathic surgery.

Question 5

What are the orthodontic and surgical treatment options for impacted canines?

Answer 5

Accept
Extract
Surgical exposure.
Tooth transplant.

Question 6

When would you leave & monitor an impacted canine

Answer 6

If it is not affecting the aesthetic
If Patient has bilateral impaction (still has symmetry)
Tooth is not doing any harm to adjacent teeth/ affecting ortho treatment.

Question 7

What are the risks of leaving an impacted canine ?

Answer 7

Infection.
Cyst formation
Eruption of the tooth at a later date.

Question 8

In what situations would you extract an impacted canine?

Answer 8

• If it is difficult to align/bring down
• Is affecting the aesthetic .

Question 9

Compare the different surgical exposure options for an impacted canine?

Answer 9

Minimal surgical exposure (extract the primary tooth, remove the overlying mucosa and follicle/ and clip away some bone to expose the canine )
Open exposure (a window of gum is left over the exposed tooth and packed to allow healing but prevent the mucosa growing over it)
Closed exposure (Attach the gold chain to it and sew a flap over it. This chain allows you to guide the tooth through keratinised mucosa.

Question 10

How do we achieve a good aesthetic around a surgically exposed tooth?

Answer 10

We want to ensure we keep the attached mucosa when we expose the canine. So we replace the attached mucosa apically so that when the exposed canine erupts the attached mucosa will be brought down with it.

Question 11

What is a tooth transplant?

Answer 11

When an ectopic tooth is extracted and transplanted back into the correct position .

Question 12

What are the indications for a tooth transplant?

Answer 12

When we cannot reasonably get a result by exposure or traction.
If there is the potential for damage to other teeth by alignment.

Question 13

What are the disadvantages of a tooth transplant?

Answer 13

It will eventually akylose.
Ankylosed teeth results in resorption of the root (replacement resorption) & result in the tooth becoming non vital.