Interceptive Orthodontics Flashcards
Additional space if required to accommodate the larger anterior teeth of the permanent dentition. How is this achieved?
Leeway space
Increased in the inter canine width through lateral growth of the jaws.
Upper incisors eruption onto a wider arc- more prolined.
What width of diastema is likely to close naturally?
Less than 2.5mm.
AT 6 years old, 96% of children will have a diastema.
This reduced to 7% by 12 years old.
When would you expect the contralateral tooth to erupt?
Within 6 months, if not, then investigate further.
What are the management options for an impacted first permanent molar?
If less than 7 years old- leave it (90% self correct).
Extract e.
Ortho separator between 6 and e- leave for 1 week and then review.
Attempt to distalise the first molar.
What are the common reasons for unerupted central incisors?
Supernumeraries.
Trauma to primary tooth which has caused dilaceration of the permanent tooth.
What aspects of history and examination would you want to undertake for someone who has an unerupted central incisor?
Ask patient and child if there is any history of trauma.
E/O and I/O- feel buccally and palatally for a bulge.
If retained primary incisor- look at the colour, mobility, and inclination of a’s.
How would you manage a patient with unerupted central incisors that are caused by supernumeraries?
If patient less than 9 years old
- Extract primary tooth and supernumeraries.
Maintain space and monitor for 12 months.
If older than 9 years old or still fails to erupt
- expose and bond gold chain and apply orthodontic traction.
Which teeth are required to have balancing extractions?
c’s and d’s
If a patient loses their e’s prematurely, what is required to be done?
Maintain the space, otherwise the 6 will drift into the 5’s place and prevent it from reaching full occlusal height.
If a patient loses their e’s prematurely, what space maintainer might you prescribe?
Passive URA- Labial bow or Southend clasp 3-3. Adams clasps on the 6’s.
Fixed- palatal and lingual arches or band and loop.
When should first permanent molars be assessed for long term prognosis?
8/9 years old.
When should 6’s be extracted, if required?
Calcification of the bifurcation of lower 7’s.
8’s present
Class 1 with an average or reduced OB
Moderate lower crowding
Mild/moderate upper crowding
Do 6’s require compensating extractions?
If extracting a lower 6- also extract the upper 6 in the same side.
If extracting an upper 6, you do not need to extract the lower.
Don’t balance with sound tooth and don’t balance if well aligned or spaced.
If you extracted a lower 6 and did not extract the upper 6, what is likely to happen?
Upper 6 would overerupt and prevent the lower 7 from moving medially into the space of where the 6 was.
What are the dangers if a patient displaces their mandible during closure?
TMJ problems.
Permanent dentition will erupt into a unilateral cross bite.
What is a patient’s IOTN if their mandibular displacement is greater than 2mm?
4c- needs treatment.
What is a patient’s IOTN if their mandibular displacement is 1-2mm?
3c.
