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module 8 > ortho > Flashcards

ortho Flashcards

1
Q

what can you use to get retention on a removable appliance

A
  • adams, delta clasps
  • labial bow
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2
Q

what elements must be included in the upper removable appliance design

A
  • retention
  • active components
  • anchorage
  • base plate modifications
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3
Q

what are removable appliances mainly made of

A

acrylic and wire

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4
Q

what are removable appliances often used with

A

adjunct to fixed appliance

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5
Q

name 4 active components of removable appliances

A
  • springs
  • biteplanes
  • screws
  • bows
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6
Q

when is a removable appliance passive

A

for retention

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7
Q

name 6 types of removable appliances

A
  • interceptive appliance
  • space maintainer
  • pre-surgical orthopaedics
  • active plate
  • retainer
  • functional appliances
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8
Q

what why is there less iatrogenic damage with removable appliances

A

pt can remove to brush teeth

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9
Q

what is needed from the pt to place removable appliances

A

good compliance

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10
Q

what ortho disadvantage is there to removable appliances

A

restricting to tipping movements - very difficult to get bodily movement

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11
Q

how many teeth can be moved at one time with removable appliances

A

ideally only a couple at a time

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12
Q

what are the four components of removable appliances

A
  • active components
  • retentive components
  • anchorage
  • baseplate
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13
Q

what is the acronym for remembering the components of removable appliances

A

ARAB

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14
Q

what width of wire is used for stainless steel springs in removable appliances`

A

0.5-0.7mm

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15
Q

what type of stainless steel is used for springs in removable appliances

A

18/8 austenitic stainless steel

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16
Q

what increases with the amount of wire used in a spring

A

greater range of the spring

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17
Q

what decreases as the amount and range of the spring increases

A

forces exerted

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18
Q

what is the equation for force and deflection in stainless steel springs

A

F = d.r⁴/ l³

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19
Q

what does r stand for in the equation for force and deflection in stainless steel springs

A

radius of the wire

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20
Q

what does d stand for in equation for force and deflection in stainless steel springs

A

deflection of the wire

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21
Q

what is deflection of the wire

A

how far away we are moving from the original shape of the wire

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22
Q

what does l stand for in the equation for force and deflection in stainless steel springs

A

length of the spring

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23
Q

what does increasing the radius of the wire for stainless steel springs in removable appliances by 2 do?

A

increases the forces applied by 16x

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24
Q

what does reducing the length of the stainless steel spring in removable appliances by 2 do

A

reduces force applied by 8 times

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25
Q

how is the length of the spring reduced in removable appliances

A

introducing loops

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26
Q

what does a thicker wire in removable appliance springs result in

A

more force

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27
Q

what is the max force that can be applied to one tooth

A

25-40grams

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28
Q

where should the force be applied to in removable appliances to reduce the tipping of the tooth

A

as close as possible to the gingival margin

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29
Q

name 4 springs of removable appliances

A
  • z springs
  • t springs
  • buccal canine retractors
  • palatal finger springs
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30
Q

what active components can be embedded into the baseplate of removable appliances

A

screws

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31
Q

how are screws in removable appliances activated

A

by turning a key

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32
Q

what can expansion or distalisation help with in removable appliances

A

correct cross bites and create space

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33
Q

what does one quarter turn of a key in screw of removable appliances equate to

A

0.25mm of separation

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34
Q

how often would a pt usually turn the key for a removable appliance screw

A

once per week

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35
Q

why might the pt not tolerate screws in removable appliances

A

quite bulky

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36
Q

what can also be done to teeth being moved by removable appliances

A

clasped for retention

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37
Q

how many ways can removable appliances expand

A

2-3

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38
Q

what can a pt use to turn the screw in their removable appliance if they lose their key

A

paper clip

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39
Q

why might you not activate a screw in removable appliances until the second visit

A

to get the pt used to wearing it first

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40
Q

what is retention of removable appliances mainly achieved from

A

clasping of molar/ premolars

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41
Q

why are cribs less effective on primary teeth

A

less undercuts to engage

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42
Q

what clasps are used for retention in incisors in removable appliances

A

south end/ C clasp

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43
Q

name 4 types of claps used in removable appliances

A
  • ball hook
  • c clasp/ southend
  • adams
  • delta
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44
Q

what are ball hook clasps good for in removable appliances

A

keeping twinblocks on

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45
Q

how thick would an adam/delta SS clasp around a molar be

A

0.7mm

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46
Q

how thick would an adam/delta SS clasp around a premolar be

A

0.6mm

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47
Q

how thick are southend clasps

A

0.6-0.7mm

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48
Q

how thick are ball hooks on removable appliances

A

0.7mm

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49
Q

how do adams clasps work

A

engage undercuts at mesal and distal aspects

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50
Q

how much undercut can adams cribs engage in

A

1mm

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51
Q

what can be soldered onto an adams clasp

A
  • double cribs
  • head gear attachment
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52
Q

how are adams clasps adjusted

A

adams pliers

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53
Q

what ideology is used when considering anchorage for removable appliances

A

for every action there is an equal and opposite reaction

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54
Q

name 5 ways to increase anchorage of removable appliances

A
  1. clasp more teeth
  2. only move 1-2 teeth at a time
  3. lighter forces
  4. occlusal capping
  5. headgear
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55
Q

what should you bear in mind if using occlusal capping in removable appliances

A

if teeth are covered then are difficult to move

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56
Q

what should you consider before giving a pt headgear with removable appliances

A

theoretical risks

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57
Q

what does the baseplate of the removable appliance do

A

connects the components of the appliance

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58
Q

what is the the baseplate made from in removable appliances

A

acrylic

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59
Q

how does the baseplate support anchorage in removable appliances

A

palatal coverage

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60
Q

what does a flat anterior bite plane on baseplate allow for

A

over-eruption posteriorly

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61
Q

what does buccal capping do

A

over-eruption anteriorly

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62
Q

what should you tell the lab when prescribing for removable appliances

A
  • what you are trying to do
  • retention components
  • active components
  • baseplate modifications
  • pt details
  • draw design
  • when its required
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63
Q

what is the first thing you should do when fitting a removable appliance

A

check its for the right pt

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64
Q

what should you check the labwork for before fitting a removable appliance

A

any sharp acrylic

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65
Q

where does sharp acrylic tend to be in removable appliances

A

rugae area

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66
Q

what might you need to do when fitting a removable appliance

A

acrylic burs to trim to get it to fit

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67
Q

what do you need to decide at the fit appt of removable appliances

A

whether to activate the clasps and springs at that appt or the next one

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68
Q

what should you get the pt to do once fitted the removable appliance

A

speak to make sure its not dislodging

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69
Q

what should you make sure the pt is able to do before leaving with a removable appliance

A

take it in and out

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70
Q

what time frame should you review the pt after fitting a removable appliance

A

8 weeks

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71
Q

why is there a longer time after fitting a removable appliance for the first time than normal review appts

A

takes longer to act from the fit appt

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72
Q

when should you ask the pt to take their removable appliance out

A

when cleaning and playing sports

73
Q

what should you warn the pt not to do when cleaning their removable appliance

A

use boiling water - will change shape

74
Q

what will a pt lisping at the review appt of a removable appliance make you think

A

theyve not been wearing it

75
Q

what should you check the removable appliance for at review appt

A

wear, tooth imps on bite planes

76
Q

what should you check the mouth for at review appt of removable appliance

A
  • redness of palate
  • indentation of appliance on palate
  • trauma from springs
77
Q

what should you check aside from the removable appliance at review appt

A

teeth that are being moved and anchor teeth

78
Q

what will happen if the pt has had XLA and not been wearing removable appliance

A

anchorage will be lost - wont fit very well

79
Q

how might you know that teeth are moving from pt wearing removable appliance

A

teeth may be slightly mobile

80
Q

what may be stopping teeth from moving in removable appliance

A
  • acrylic in the way
  • insufficient activation of springs
  • unerupted teeth
  • retained roots
81
Q

how much should you reactivate springs by in removable appliance at review appt

A

1-2mm

82
Q

how much tooth movement should happen each month with removable appliance

A

1mm

83
Q

how is tooth movement achieved in aligners

A

deformation of aligner

84
Q

how many hours a day does a pt need to wear aligners

A

22 hrs

85
Q

when would fixed ortho be used for primary teeth

A

interceptive Tx

86
Q

what control do you have with fixed ortho

A

3D movement

87
Q

what are fixed ortho in comparison to removable appliances

A

more anchorage demanding

88
Q

what is tipping in fixed ortho

A

root stays in place but crown placement is altered

89
Q

what is torque in fixed ortho

A

whole tooth movement

90
Q

which type of movement has the greatest need for anchorage

A

torque

91
Q

name 5 indications for fixed ortho

A
  • multiple tooth movements needed
  • rotations
  • bodily movements
  • space closure
  • lower arch Tx
92
Q

what does fixed ortho do to a pt in terms of oral health impact

A

high caries risk

93
Q

name 6 risks of fixed ortho

A
  • decalcification
  • root resorption
  • loss of periodontal support
  • TMJ dysfunction
  • fail Tx and relapse
  • reversible risks
94
Q

who is in a higher risk bracket for root resorption in fixed ortho

A

trauma pts

95
Q

what should you do for trauma pts undergoing fixed ortho

A

take Pa every 6 months

96
Q

what should you do if a pt with fixed ortho has trauma mid-Tx

A

pause Tx for a while

97
Q

what pt is at risk of loss of periodontal support with fixed ortho

A

thin biotype

98
Q

where does loss of periodontal support tend to happen with fixed ortho

A

lower incisors

99
Q

what type of movements may cause loss of periodontal support in fixed ortho

A

lots of expansion

100
Q

what opinion should you get before going ahead with fixed ortho if there is existing TMJ issues

A

OS/ OM

101
Q

what should you bear in mind before giving fixed ortho to a pt with parafunctional habits

A

clenching and grinding will be very painful during fixed ortho

102
Q

what is there mild evidence to support with regards to TMj dysfunction and fixed ortho

A

cross bite being improved with fixed ortho will improve TMJ dysfucntion

103
Q

how might fixed ortho Tx fail or relapse

A
  • ankylosis
  • poor Tx planning
  • poor compliance
104
Q

name 2 types of fixed attachments

A

bands
brackets

105
Q

where are bands for fixed ortho ususally used

A

molars/ premolars or teeth with ceramic crowns

106
Q

what might you warn a pt undergoing fixed ortho who has crowns before Tx

A

damage to crowns

107
Q

when might bands be placed over molars or premolars

A

if crowned

108
Q

what do you need to do before you place a band for fixed ortho

A

separator first to free up contact points

109
Q

what are bands placed with in fixed ortho

A

GIC

110
Q

what extra benefit migth fixed ortho bands have

A

GIC fluoride release

111
Q

where do bands go usually if there is orthognathic surgery

A

last molar

112
Q

what is fixed ortho made up of

A

brackets, wire, modules

113
Q

what type of bands will be placed for rotated teeth

A

figure of 8

114
Q

how do figure of 8 bands work

A

create alot of friction between module, wire and bracket

115
Q

why dont we use figure of 8 bands for closing gaps in fixed ortho

A

too much friction so teeth are held too tight and wont move

116
Q

what is a long ligature in fixed ortho

A

tied together to keep the teeth closed

117
Q

what can ceramic brackets on the palatal/lingual aspect of the tooth cause - particularly on lower incisors

A

wear

118
Q

when would a gold chain be used

A

impacted teeth eg canine to guide teeth in

119
Q

what are buttons and power chain good for

A

de-rotating teeth

120
Q

what are self-ligating brackets

A

have a clip on them so modules arent needed

121
Q

what are self ligating brackets good for

A

expanding the arch

122
Q

why are self ligating brackets good for expanding the arch

A

lighter forces, as less friction between modules and bracket/wire

123
Q

what stops the wire sliding out of place in self ligating brackets

A

little stops between the brackets

124
Q

when might you not use self ligating brackets

A

if pt prone to calculus - if builds up over the clips then may struggle to get them off

125
Q

what are the white wires used with ceramic brackets made of

A

metal - coated in ceramic

126
Q

what do ceramic brackets take longer to do

A

close gaps

127
Q

why do ceramic brackets take longer to close gaps

A

more friction

128
Q

what must you consider as a dentist when placing lingual brackets

A

back

129
Q

why is there less wire bending with lingual brackets

A

custom made to teeth

130
Q

why ortho advantage might lingual brackets have

A

prop pt open if deep over bite

131
Q

what fixed ortho system do DDH use

A

NBT system

132
Q

what size of round wire can be used with NBT system

A

014, 016, 018

133
Q

when do the teeth start to move more in fixed ortho

A

whe rectangular wire is placed as fully fills the slot

134
Q

what size slot is there for NBT system

A

022

135
Q

what does every single bracket have for fixed ortho

A

prescription built into it

136
Q

what does the prescription built into the bracket decide for fixed ortho

A

what tip and torque we want

137
Q

what does the prescription built into bracket save us

A

time putting bends into wire

138
Q

which brackets have a prescription built into them

A

straightwire

139
Q

what do standard archwire brackets require

A

arch wire bends to produce ideal tip

140
Q

what are the in and out movements of teeth usually caused by in fixed ortho

A

the base of the bracket

141
Q

why might the base of the bracket have an angle built into it

A

to keep the wire straight

142
Q

without offset bends, what do standard edgewise brackets not do

A

align contact points labio-lingually

143
Q

what is it about straightwire brackets that aligns contact points labio-lingually

A

variation in thickness of bracket bases

144
Q

what provides the torque control for straightwire brackets

A

bracket slot cut at an angle to base

145
Q

what are the 3 phases of fixed ortho Tx

A
  • levelling and aligning
  • major tooth movement
  • finishing
146
Q

what is used for the levelling and aligning stage of fixed ortho

A

round wire and flexible wire NiTi

147
Q

what does the major tooth movement stage of fixed ortho Tx and what does it correct

A

SS wire to correct overjet/bite and centreline correction

148
Q

what is done in finishing stage of fixed ortho Tx

A

detailed alignment

149
Q

what does the wire do as the teeth align more

A

becomes more passive

150
Q

what wires are used in the alignment phase of fixed ortho for initial straightening

A

014 wire

151
Q

which wire does the hard work in fixed ortho

A

thinner wire

152
Q

what does the thicker wire NOT having to do much moving mean in fixed ortho

A

forces dont increase

153
Q

what happens as the wires straighten up and pull teeth into alignment

A

deformation energy dissipates

154
Q

what does each new wire have more and less of in fixed ortho

A
  • more deformation energy
  • less deformation
155
Q

how do you permanently bend NiTi wire

A

heat it up

156
Q

what properties do NiTi wires have

A
  • high flexibility
  • low force over long range
  • shape memory
157
Q

which wire is used to do major tooth movements

A

rigid wires - 1925 SS wire

158
Q

what do rigid SS wires do to the bracket

A

fill it as much as possible

159
Q

what happens to the wire at each visit when its rigid SS wire

A

left unchanged

160
Q

what cause sliding of teeth

A

powerchain

161
Q

what is powerchain used for

A

close any gaps in teeth

162
Q

what are coil springs used for in fixed ortho

A

retraction of teeth

163
Q

what are coil springs made out of

A

NiTi

164
Q

what are coil springs attached to

A

button in alveolar bone

165
Q

why is only the gingivae numb when placing buttons in alveolar bone

A

so we know if we’ve hit the PDL of a tooth

166
Q

what method replaced alot of headgear

A

coil springs

167
Q

what do you need from the pt to use elastic bands

A

compliance

168
Q

how can elastic bands be used in fixed ortho

A

change things anterioposteriorly

169
Q

what alloy makes up SS wires

A

iron, chromium and nickel

170
Q

what properties do SS wires have

A

stiff, resist deformation, no memory

171
Q

how can you tell SS and NiTi apart

A

SS alot more shiny

172
Q

what kind of wires are used in the finishing stage of fixed ortho

A

lighter wires

173
Q

why are lighter wires used in the finishing stage of fixed ortho

A

allows settling of occlusion

174
Q

what is done at finishing stage of fixed ortho

A

detailing of alignment and interdigitation

175
Q

what might the orthodontist do during the finishing stage of fixed ortho

A
  • fine adjustments to brackets
  • bends to arch wire
  • elastics
176
Q

what instructions are given to pts with fixed ortho

A
  • told how sore teeth will be
  • cleaning instructions
  • retainer instructions
177
Q

what would you do as a GDP for a broken bracket

A

remove and make safe

178
Q

what would you do as a GDP for a lost module

A

replace if available

179
Q

what would you do as a GDP for a protruding archwire

A
  • brace wax
  • cut short with a distal end cutter

module 8 (9 decks)

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