Treatment Modalities And orthodontic Appliances Flashcards

1
Q

Which factors to consider type of appliance?

A
  • Patient concern and attitude
  • Patient’s parents expectation
  • Oral hygiene status
  • Medical history
  • Treatment Aims
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2
Q

Primary Dentition

A
  • Removable appliances
  • Expansion appliances
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3
Q

Mixed Dentition

A
  • Removable appliances
  • Functional appliances
  • Fixed appliances
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4
Q

Secondary Dentition

A
  • Removable appliances
  • Functional Appliances
  • Fixed appliances
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5
Q

Adult

A
  • Removable appliances
    _ Fixed appliances
  • Surgery
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6
Q

What moments pre adjusted brackets do?

A
  • 3D controlled tooth movement
  • Bodily movement
  • Intrusion / extrusion
  • Correct rotations
  • Space closure
  • Multiple tooth movements
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7
Q

What’s benefit of pre adjusted brackets?

A
  • Excellent tooth control and finishing as its 3D tooth movement can be achieved.
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8
Q

How tipping movement achieve?

A
  • The round wire permits the tooth to tip around a point known as the root centroid which lies about 1/3 apex of the root
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9
Q

How bodily movement achieve?

A
  • The rectangular wire in rectangular bracket slot produce a force that control position of crown and root. This torque allows us to move teeth bodily.
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10
Q

How torque movement achieve?

A

-Torque allows us to control the position of the crown and root to permit us to control inclination of the tooth

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11
Q

Sliding mechanism?

A
  • A Rigid arch wire usually 0.019x0.025 ss wire allows the teeth to slide along the arch wire and space to close. This space closure referred as Sliding mechanism
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12
Q

Types of fixed appliances

A

1- Standard brackets (SS / Asthetics)
2- Self ligating brackets (SS/ plastic/lingual)
3- Tip edge

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13
Q

Stainless steel brackets

A
  • Pre adjusted edgewise appliance. MBT
    -Slot size usually 0.022x0.028
  • Allow lighter forces in early stages of treatment
  • can also accommodate larger dimension wire with increased stiffness- good for arch co - coordination and sliding mechanism.
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14
Q

Self ligating systems

A
  • Adv- Complete and secure wire engagement.
  • less chair side
  • Reduced friction
  • Better OH

Dis Adv-
- Clips can fracture
- Partial ligation not possible
- Wire can slide
- Cost
- Takes practice

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15
Q

Ceramic Brackets

A
  • Non metallic which are first shaped then hardened by heat
  • Orthdontic Ceramic are made of Alumina
  • Ceramics are harder than SS

Types
- Monocrytalline (machined by synthetic sapphire) e.g Ice (Ormco)

  • Polycrystalline (injection moulding of alumina) e.g Clarity 3M
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16
Q

Problem with Ceramic bracket

A
  • Increased friction
  • Enamel wear - avoid in lower arch deep bite cases
  • Increased bond strength can result enamel fracture at debond
  • Bracket fracture - during tx or at debond
17
Q

Lingual System ( Incognito)

A

Advantages
- Aesthetic
- No labial de calcification
- Easier to reduce an overbite and achieve arch expansion

Dis adv-
- Difficult access
- Small inter bracket span
- Speech issue
- Soft tissue soreness
- Cost

18
Q

Plastic Brackets

A
  • Not used frequently
    -adv - Asthetic

Dis adv-
- Staining
- Lack of strenght
- Permanent deformation reduce 3D tooth control

19
Q

Example of fixed appliance Auxillaries

A
  • Closed coil
  • Push coil
  • Powerchain
  • E-links
  • Niti closing spring ( 12mm and 9mm)
  • TPA (trans palatal arch)
  • BIte turbos
  • Trihelix
20
Q

Slot size of fixed appliances ( pre adjusted edgewise system)

A
  • 0.018 x 0.028 working archwire 0.016x0.022 ss
  • 0.022 x 0.028 working archwire 0.019 x 0.025ss.
21
Q

Removable Appliances
Your role -

A
  • Fitting of activated by orthodontist and passive removable appliances
  • assessing quality of fit and know when to reject and accept appliance
  • Behavioural teaching of advice to patients on appliance management and care
  • Headgear placement, activation and advice to patients
  • Understanding of limitation of removable appliance
  • Familiar with current role of removable appliance in orthodontic
22
Q

Removable appliance
Actions:

A
  • Tip teeth
  • Enable differential tooth eruption
  • Anchorage reinforcement in 3D (vertical /AP/tranverse)
  • Space maintenance
  • retainer
  • bite planes
  • Expansion
  • Support distal movement e.g Nudger appliance +/- HG
  • dissuade digit sucking
  • Extrution of incisors or other teeth
23
Q

Potential problems if Just Tip teeth?

A
  • Aesthetic
  • Dental health
  • Occlusal fit
24
Q

REMOVABLE APPLIANCE in lower arch

A
  • Often used for lower retainer
  • Less use for active tooth movement than URA because:
    • Less undercut for retention
    • less buccal sulcus for spring
    • Tongue limit space for springs
    • not well tolerated by patient
25
Q

REMOVABLE APPLIANCE
Mode of action ? Tipping teeth

A
  • Tip teeth from centroid 1/3 of root or around fulcrum at centre of resistance
  • Centroid (40% from apex ) for single rooted teeth.
  • Trifuration of 6
26
Q

REMOVABLE APPLIANCE
material

A

Base plate- Acrylic
Wire - SS , Elgiloy
Aligners: Polyurethane resins

27
Q

Removable appliance
COMPOENENTS? ACTIVE

A
  • Bite plane ( anterior / posterior)
  • Springs ss Delivers perpendicular force to tooth
  • T- spring 0.6 mm
    -Z- springs 0.5mm
  • Palatal spring 0.5mm ss (1-5 ) 0.6mm 6
  • Buccal spring 0.7mm ,sleeved 0.5mm ss)
  • Robert retractor 0.5mm ss with sleeves
  • Labial bow 0.7mm ss
  • Trim acrylic palatal to incisors if retracting
  • expansion screw (0.25mm per turn)
  • Coffin spring (1.25mmss)
28
Q

Removable appliances components
Retention

A
  • Clasps -
    -Southend (0.8mm Elgiloy, 0.7mm SS)
  • C- Clasps (0.7mm SS)
    -Adam’s Cribs - 0.7mm SS permanent teeth 0.6 primary teeth.
  • Labial bow 0.7 mm ss
29
Q

Removable appliance - Component
Anchorage

A
  • Root surface
  • Palatal Vault
  • Extra oral
30
Q

Removable appliances- Components
Base plate

A
  • Complete
  • Segmented
  • Anterior bite plane
  • Buccal capping
31
Q

Uses of removable appliance

A
  • Tipping of teeth to improve their position
  • Space maintainer
  • Retainers
  • Correcting cross bite
  • Reducing overbite
  • arch expansion
  • Distalising buccal segments +/- with HG
  • Functional appliances
  • Anchorage reinforcement
32
Q

Z spring and T spring task?

A
  • Z spring commonly used to move incisors
  • T spring commonly used to move premolars
33
Q

Why do we correct anterior cross bite?

A
  • To prevent wear to labial surface of upper incisor
  • To limit recession / mobility of lower incisor
  • To limit Possible TMD
34
Q

What anterior bite plan do?

A
  • Enable differential tooth movement eg. Intrusion
  • enable growth
35
Q

How much expansion you get with one turn of key?

A
  • 0.25mm
36
Q

What expansion do?

A
  • Distalisation of 1 or both molars