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Module 5 exam > Orthodontics > Flashcards

Orthodontics Flashcards

1
Q

What does “ortho” mean?

A

Greek word meaning straight or upright

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2
Q

What does dontics mean?

A

Teeth

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3
Q

What does orthodontics do?

A

The development, prevention and correction of irregularities of the teeth, bite and jaw

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4
Q

Examples of when orthodontics is used?

A
  1. Interceptive
  2. Ectopic / impacted teeth
  3. Hypodontia
  4. Cleft, lip and palate
  5. Craniofacial disharmony
  6. Misaligned teeth
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5
Q

What needs to be considered when thinking of orthodontic treatment?

A

Risk VS Benefit

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6
Q

What is the role of a dental therapist in terms of orthodontics?

A

Gatekeepers of orthodontic treatment and it is crucial that they can identity the patient’s occlusion problem and refer

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7
Q

What are we listening for when examining a patient for orthodontic treatment?

A
  1. Patient concerns
  2. Family concerns
  3. Social concerns
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8
Q

What are we looking for in terms of teeth when considering ortho treatment?

A
  1. Missing teeth
  2. Teeth of poor prognosis
  3. Tooth positioning
  4. Traumatic occlusion
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9
Q

What are we looking for in terms of soft tissues when considering ortho treatment?

A
  1. Lip trap
  2. Gingival recessiom
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10
Q

What are we looking for in terms of facial bones when considering ortho treatment?

A
  1. What is the jaw relationship
  2. Are the jaws symmetrical
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11
Q

What is the most important thing that needs to be good for a referral to ortho?

A

Oral hygiene

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12
Q

What happens during an orthodontic examination?

A
  1. Listen to concerns
  2. Assess facial skeleton
  3. Assess gingival health
  4. Assess oral hygiene
  5. Assess teeth
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13
Q

How to measure skeleton pattern?

A
  1. Upright natural head position
  2. 90 degrees in dental chair
  3. Resting position
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14
Q

What are the 3 planes in which Skelton patters should be measured?

A
  1. Anteroposterior
  2. Vertical
  3. Transverse
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15
Q

How to measure anteroposterior?

A
  1. View patient from the side
  2. Look at the relative position of maxilla and the mandible
  3. Palpate tissue A and B point
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16
Q

What is a class 1 pattern?

A

Mandible is in 2-3mm posterior to maxilla (normal)

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17
Q

What is class 2 pattern?

A

Mandible is retruded relative to the maxilla (underbite)

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18
Q

What is class 3 pattern?

A

Mandible is protruded relative to the maxilla (overbite)

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19
Q

What are the 2 assessments for vertical plane?

A
  1. Lower facial height
  2. Frankfort mandibular plane angle
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20
Q

What is the lower facial height?

A

Distance from the eyebrow to the base of the nose should be equal the distance from the base of the nose to the lowermost point of chin

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21
Q

What is the frankfort mandibular plane angle?

A

Point of intersection between the mandibular plane and frankfort plane - intercept at occiput

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22
Q

What are vertical measurements classed as?

A
  1. Average
  2. Increased
  3. Reduced
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23
Q

How to measure transverse pattern?

A
  1. View from above and the front
  2. Tongue spatula
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24
Q

What radiographs are used for ortho treatment?

A
  1. DPT
  2. Lateral Ceph
  3. Upper anterior occlusal
  4. CBCT scan
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25
Q

What should you consider medically when referring for ortho?

A

Treatment choice
Gingivae
Extraction haemophilia
Co operation
Infection risk - diabetes
Candida risk - asthma

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26
Q

What in the social history would you consider when referring for ortho?

A

Motivation
Habits - thumb sucking
Hobbies - contact sport
Attendance

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27
Q

What is IOTN?

A

Does the patient qualify for treatment on the NHS

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28
Q

What does IOTN stand for?

A

The index of orthodontic treatment need

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29
Q

What are the two elements of IOTN?

A

Dental health
Aesthetic

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30
Q

What score does dental health need to be for NHS treatment?

A

4 or 5

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31
Q

What is the dental health based on?

A

worst feature of malocclusion

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32
Q

What does MOCDO stand for?

A

Missing teeth
Overjet
Crossbites
Displacement of contact points
Overbites

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33
Q

How is aesthetics measured?

A

10 standard colour photographs

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34
Q

What is classed as a normal occlusion?

A

All teeth well aligned
No crowding
Class 1 incisor relationship
Class 1 molar relationship

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35
Q

What is malocclusion?

A

An irregularity in the occlusion beyond the accepted range of normal

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36
Q

Causes of malocclusion?

A

Skeletal pattern
Size of jaw and teeth
Syndromes

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37
Q

What causes crowding?

A

Big teeth
Small jaws

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38
Q

What causes spacing?

A

Small teeth
Big jaws

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39
Q

What is a removable appliance?

A

Not attached to the teeth and can be removed for cleaning and sports

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40
Q

What are the components of conventional removable appliances?

A

BARA
B - baseplate
A - active component
R - Retentive component
A - Anchorage

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41
Q

What are active components?

A

Springs - Z springs
Screws - Midpalatal screw
Bows - Labial bows

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42
Q

What is the force produced by the component dependent on?

A

Length of wire
Radius of wire
Elastic modulus (stiffness)

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43
Q

Size 0.7mm spring requires what activation?

A

1mm

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44
Q

Size 0.5mm spring requires what activation?

A

3mm

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45
Q

What degrees does a palatal finger spring require?

A

90 degrees

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46
Q

What degrees does a z spring need for movement?

A

45 degrees

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47
Q

What are retentive factors?

A

Southend clasp
Adams clasp
Delta clasp
Ball ended clasp

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48
Q

What is a baseplate?

A

Acrylic
Holds components together
Can incorporate bite planes
Provides anchorage for the appliance

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49
Q

What is anchorage?

A

Resistance to unwanted tooth movements

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50
Q

Advantages of removable appliances?

A

Can be removed for cleaning and sport
Good anchorage
Can move blocks of teeth
Cheap
Less chairside time
Easy to adjust

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51
Q

Disadvantages of removal appliance?

A

Temp affect on speech
No bodily tooth movement
Retention post correction difficult
Requires good technical support

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52
Q

What is a removable appliance used for?

A

Anterior cross bite

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53
Q

What is a functional appliance?

A

Alter the muscle forces against the teeth and craniofacial skeleton

54
Q

What are functional appliances used for?

A

Class 2

55
Q

What is a fixed functional appliance?

A

The energy is stored within the appliance and forces are applied to teeth, soft tissue and bone

56
Q

What is a removable functional appliance?

A

The energy is stored within the muscle and ligament

57
Q

What’s an example of fixed functional appliance?

A

Herbst appliance

58
Q

What’s an example of removable functional appliance?

A

Twinblock

59
Q

Advantages of twin block?

A

Good for dental health
May avoid extractions
May accelerate growth
May reduce trauma

60
Q

Disadvantages of twin block?

A

Bulky appliance
Herbst known to fracture
Can affect speech
Cause soft tissue trauma
Lack of detailed tooth movement

61
Q

What to expect after functional appliance?

A

Overjet of 2mm
Edge to edge malocclusion
Partial success

62
Q

Why do functional appliances fail?

A

Not worn enough
Not been made properly
Wrong treatment (adverse growth changes)

63
Q

What is a fixed appliance?

A

Attached to the teeth by bands or bonds and brackets

64
Q

How does a fixed appliance move the teeth?

A

Using a wire and it’s interaction with the brackets and bands

65
Q

What 2 wires are used in fixed appliance?

A

Nickel titanium
Stainless steel

66
Q

What 2 sizes are orthodontic wires?

A

Round
Rectangular

67
Q

What are the 5 types of tooth movement?

A

Tipping
Bodily movement
Extrusion and intrusion
Rotation
Torque

68
Q

What appliance will cause tipping?

A

Removable and fixed

69
Q

What appliance will cause bodily movement?

A

Fixed only

70
Q

What appliance will cause extrusion and intrusion?

A

Removable and fixed

71
Q

What appliance will cause rotation?

A

Fixed only

72
Q

What appliance will cause torque?

A

Fixed only

73
Q

Risks of fixed appliance?

A

Caries
Gingivitis
Periodontal destruction
Soft tissue trauma
Pulpal necrosis
Root resorption
Recession

74
Q

Advantages of fixed appliance?

A

Full range of tooth movement

75
Q

What types of fixed appliances is there?

A

Labial + Lingual
TPA
Quad helix
RME
Mini screws

76
Q

What are the 2 phases of ortho treatment

A

Active treatment
Retention phase

77
Q

What is the biggest risk of all ortho treatment

A

Relapse

78
Q

What is the current advice for retainers

A

Worn 7 nights a week
Worn for life

79
Q

What are the 2 main types of removable retainer

A

Hawley retainer
Clear plastic

80
Q

What is good about the hawley

A

Can add a pontic

81
Q

What are the 3 types of fixed retainer?

A

Twist - Flex
Ortho - Flex
Memotain

82
Q

As a therapist we might have situations of ortho emergencies, if someone has a problem with removable appliance what should we do?

A

URA - Refer
Functional - Refer
Retainer - make in house

83
Q

As a therapist we might have situations of ortho emergencies, if someone has a problem with fixed appliance what should we do?

A

Bracket off - Refer
Band loose - Refer
Wire out causing trauma - Can cut

84
Q

What are some abnormalities that ortho can fix?

A

Crown root dilaceration
Supernumerary
Peg shaped incisors
Hypodontia

85
Q

What is crown root dilaceration?

A

Trauma causes displacement of un erupted permanent teeth and causes the crown and root to form in another direction

86
Q

Where does crown tooth dilaceration occur?

A

Any point of the root

87
Q

What do peg shaped incisors increase the risk of?

A

ectopic canine

88
Q

What is neonatal teeth?

A

Primary teeth that have already erupted at birth and can cause feeding problems

89
Q

What is the treatment for neonatal teeth?

A

If very mobile then extract however if in situ then leave as is

90
Q

What is an eruption cyst?

A

Appears as a blue mucosa overlying an unerupred tooth

91
Q

Where is it common to see an eruption cyst?

A

Over the Es and 6s

92
Q

What symptoms does an eruption cyst have?

A

They are asymptomatic

93
Q

What’s the treatment for an eruption cyst?

A

Resolves on its own when the tooth erupts

94
Q

What are impacted teeth?

A

When primary or permanent teeth do not erupt fully, can be partially erupted

95
Q

What caused impacted teeth?

A

An obstruction

96
Q

What is infra occluded and retained teeth?

A

Causes by ankylosis adjacent teeth erupt and and ankyloses teeth remained unchanged

97
Q

What is the treatment for infra occluded or retained teeth?

A

Usually extraction but if missing permanent successor then leave in situ

98
Q

What 3 things most commonly cause premature loss of primary teeth?

A

Caries
Balancing and compensating
Serial extractions

99
Q

Where is most commonly affected by caries in primary teeth?

A

Mesial drifting of the 6s resulting in premolar crowding

100
Q

How does trauma affect the developing dentition?

A

Avulsion of incisors can cause a midline shift
Delayed eruption of permanent successor
Intrusion of incisors can causing deflection in permanent successor

101
Q

What teeth are most likely to cause an affect with balancing extractions?

A

Cs and Ds

102
Q

What are serial extractions?

A

Kjellgren 1948 – planned sequence of extractions to relieve incisor crowding of mixed dentition

103
Q

What teeth to cross bites most commonly affect?

A

Incisors and molars

104
Q

What can a cross bite cause?

A

Displacement of the jaw and tooth

105
Q

When is a cross bite most easily corrected?

A

Mixed dentition

106
Q

What can having a sucking habit cause?

A

Proclined upper anterior
Retroclined lower incisors
Buccal segment cross bite
Reduced overbite or anterior open bite

107
Q

How to stop sucking habits?

A

Deterrent devices
Plaster on finger
Encouragement
Nail varnish

108
Q

What 2 ways is bone laid down?

A

Endochondral - In cartilage
Intramembranous - In membrane

109
Q

How does bone remodel?

A

lays down or removes bone from the surface

110
Q

How to bones connect?

A

via sutures which are non movable

111
Q

What is the only bone structure that is movable?

A

TMJ

112
Q

What way is the calvarium laid down?

A

Intramembranous

113
Q

What do the 6 fontanelles allow for?

A

Compression of head during birth

114
Q

When do the fontanelles close?

A

By 18 months

115
Q

What does the calvarium grow in response to?

A

Brain growth

116
Q

How are the 2 main areas of cartilage within the cranial base laid down by?

A

Endochondrial

117
Q

When does the primary dentition start to erupt?

A

6 months

118
Q

When is the primary dentition complete?

A

3 years old

119
Q

When is root formation complete in the primary dentition?

A

Complete by 18 months after eruption

120
Q

When do primary teeth start to exfoliate?

A

6 years old

121
Q

When is the permanent dentition finished?

A

Around 13 years old except 8s

122
Q

When is root formation complete in permanent teeth?

A

3 years after eruption

123
Q

What is leeway space?

A

Buccal primary teeth are wider than permanent

124
Q

What is craniosynostosis?

A

Premature fusing of the sutures on the calvarium causing an abnormal shaped head

125
Q

What is the most common craniofacial birth defect?

A

Cleft lip and palate

126
Q

What side is cleft lip most common on?

A

Left side

127
Q

How is CLP diagnosed?

A

Ultrasound scan at 20 weeks

128
Q

What happens if there is a delay in diagnosis for CLP?

A

Difficulty feeding and unsettled infant

129
Q

Cleft services in Scotland?

A

MCN
CleftSIS
CLAPA
Changing faces

130
Q

General problems with CLP?

A

Breathing
Hearing
Speech
Feeding
Psychological

131
Q

Dental problems with CLP?

A

Facial appearance
Hypodontia
Supernumerary
Ectopic
Hypoplastic
High caries rate

132
Q
A

Module 5 exam (11 decks)

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