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BDS4 Ortho > Fixed Ortho > Flashcards

Fixed Ortho Flashcards

1
Q

What is the definition of Fixed appliances?

A
  • Appliance which is fixed to teeth and can’t be removed by pt
  • Consists of brackets, bands, archwires and auxillaries
  • They are precision tooth movers
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2
Q

Compare fixed appliances and removable appliances

A

Fixed
- 3D control
- Complex tooth movements
- Control of root
- Less dependent on compliance
- Requires excellent oral hygiene
- Risk of iatrogenic damage
- Poor intrinsic anchorage

Removable appliances
- Simple tooth movements, tipping
- No control over root movement
- Greater compliance required
- Less risk of iatrogenic damage
- Good intrinsic anchorage
- Can be lost

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3
Q

When do we use fixed appliances?

A
  • Correction of mild to mod skeletal discrepancies (camoflauge)
  • Alignment of teeth
  • Correction of rotations
  • Centreline correction
  • Overbite and overjet reduction
  • Vertical movement of teeth
  • Closure of spaces / creating spaces
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4
Q

What are out treatment goals? Andrews Six Keys

A
  • Tight approximal contacts with no rotations
  • Class I incisors
  • Class I molars
  • Flat occlusal plane or slight curve of spee
  • Long axis of teeth have slight mesial inclination except lower incisors
  • Crowns of canines back to molar have lingual inlcination
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5
Q

What are the fixed appliance components?

A
  • Bracket / tube
  • Band
  • Archwire
  • Elastomeric Modules
  • Auxillaries (little springs or elastomerics)
  • Anchorage components
  • Force generating components
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6
Q

What are the brackets made of? What are its components

A
  • Stainless steel most common
  • Polymers or ceramics can also be used
  • Consist of
    • bracket slot
    • Tie wings
    • Bracket base
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7
Q

What are the bands? What is needed prior placement?

A
  • Stainless steel with pre welded attachments
  • Can also include tubes or cleats
  • Require space before placement
  • Need a separator 1-2 weeks before band placement - gives 1mm space around contact point
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8
Q

What does torque movement do?

A
  • Buccal lingual tipping (angulation) of root of tooth
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9
Q

How are the brackets bonded to teeth? What material is used? What reaction is it? What type of retention is it?

A
  • Composite via acid etch technique
  • Used for brackets and tubes not bands
  • Photo initiation reaction using light cure 440-480nm wavelength of light
  • Micromechanical retention
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10
Q

What material are the molar bands bonded to teeth with?

A
  • Glass ionomer
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11
Q

What materials of archwires are there?

A
  • Stainless steel used after NT working up the way hardest
  • Nickel titanium (shape memory) - gives light continuous force
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12
Q

What are some properties of Nickel Titanium wire?

A
  • Flexible
  • Light continuous force
  • Shape memory so returns to original shapes and cannot bend
  • Higher friction than SS but using this small of a diamter doesnt usually create issues
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13
Q

What is meant by cannot bend ?

A
  • Cannot form a loop within the wire
  • bend will not stay
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14
Q

What are some properties of stainless steel wire?

A
  • Lower friction so tends to slide teeth easier
  • Formable so archwire can bend and loops
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15
Q

Why is bumper tubing used?

A
  • To protect flimsy wire that could be knocked out of place if tooth contacts it
  • Gives more rigidity
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16
Q

Give some force generating components ? How do the teeth move using these?

A

Sliding mechanics
- Elastic power chain
- NiTi coils
- IO elastics
- Active ligature

  • Teeth move by utilising energy stored in the elastic or spring
  • Need to be seen frequently to continue elastomeric changes
17
Q

What are NiTi coil springs used for?

A
  • Push teeth apart
18
Q

What are the anchorage considerations?

A
  • Resistance to unwanted tooth movement
  • Newtons 3rd La : Every forces has equal but opposite reactionary force
19
Q

What is compound anchorage

A
  • Use long ligatures over more than one tooth, this increase in root surface allows for more favourable tooth movement
20
Q

What is absolute anchorage?

A
  • Temporary anchorage devices (non osseointegrating mini screw)
  • Gives anchorage control
  • Can be buccal or palatal
21
Q

What is reciprocal anchorage?

A
  • Type of anchorage when two units of teeth move towards each other with equal distance
22
Q

What is Cortical anchorage

A
  • Cortical plates provide increased resistance to tooth movement
  • Maintains intermolar width
23
Q

How is intermaxillary anchorage utilised?

A
  • Class 3 or Class 2 elastics
24
Q

What is function of retainers?

A
  • Maintain final tooth pos with a passive orthodontic appliance
25
Q

What features have a higher relapse potential?

A
  • Diastema / space closure
  • Rotations
  • Palatally ectopic canines
  • Proclination of lower incisors
  • AOB
  • Instanding upper lateral incisors
26
Q

Give a different option of retainer other than thermoplastic?

A
  • Hawley retainer
27
Q

What are the variety of clinical situations where you would chose a fixed retainer?

A
  • Spaced closure
  • Diastema
  • Proclination of lower labial segment
  • Periodontal cases
  • Ectopic canines’
  • Instanding upper 2s
28
Q

What can go wrong with fixed reatiners?

A
  • Comp can debond and tooth can move
  • Caries
  • Poor oral hygiene
  • If become active can cause teeth excluded from arch
29
Q

3 Main risks with fixed appliances
How to prevent

A
  • Decalcification
  • Root resorption
  • Relapse

Careful case selection
Monitoring
Pt compliance and motivation

30
Q

What initial problems can a pt encounter at start of ortho?

A
  • Pain
  • Mucosal irritation
  • Ulceration
  • Appliance breakage
31
Q

Role as GDP in ortho pts

A
  • OHI
  • Diet advice
  • Prevention
  • Liase with orthodontist if concerns
  • Make appliance safe
32
Q

What does the bracket prescription determine?

A
  • The tip, torque and in/out control
33
Q
A

BDS4 Ortho (9 decks)

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