Adult Orthodontics Flashcards
Why do adults seek ortho treatment?
Relapse from treatment done previously.
Refused treatment as a child
Lack of earlier opportunity
Adjunctive
- facilitate restorative treatment
- After periodontal drift
- Part of surgical correction of jaw discrepancy.
How is treatment in adults different to treatment in children?
Adults aren’t growing anymore- limits treatment options.
Periodontal health- careful periodontal assessment required in patients.
Missing/heavily restored teeth
Physiological factors
Adult motivation- usually very motivated.
How does the fact that adults aren’t growing, influence treatment?
Growth modification is not an option- either accept the skeletal discrepancy or surgery.
Overbite correction more difficult to correct- may need tooth intrusion- cannot use a FABP in an adult because you would get over-eruption of posterior teeth.
Midpalatal suture is closed- can only expand maxillary bas with surgery.
How would periodontal condition affect ortho treatment in adults?
More likely to have periodontal disease and loss of attachment.
Previous support loss does not preclude ortho treatment but active periodontal disease does.
Loss of supped leads to
- tooth centre of rotation moving apically
- anchorage value reducing.
How does missing teeth/restorations influence ortho treatment?
Tooth loss leading to drifting/tilting
Restorations may complicate bonding of brackets
RCT okay if obturated correctly and symptomless
What physiological factors may influence ortho treatment in adults?
Decreased cell turnover, initial movement can be slower
Use lighter forces
Why might ortho treatment be indicated as an adjunctive treatment to restorative?
Upright abutments to aid restoration
Intrusion of over-erupted teeth
Extrusion to increase crown length
Why might ortho treatment be indicated as an adjunctive to perio treatment?
Disclaiemr- perso must be stabilised first.
May have tooth migration as a result of perio- proclaimed incisors, spacing, increase overbite.
Why is ortho treatment needed prior to orthographic surgery?
Align and co-ordinate the arches.
Decompensate the incisors.
Then post-surgery orthodontics.
What are Andrews six keys?
Ideal treatment goals.
Tight approximate contacts with no rotations
Class I incisors
Class I molars
Flat occlusal plate or slight curve of spee.
Long axis of the teeth have a slight mesial inclination except the lower incisors.
The crowns of the canines back to the molars have a lingual inclination.
What appliance options are available for adults?
Fixed appliances- metal brackets, ceramic brackets
Lingual appliances
Aligner technology
What are the pros and cons of ceramic brackets?
More aesthetic appliance but the wire is still metal.
Why must you have metal brackets on lower teeth, if you have ceramic brackets on upper teeth?
Ceramic brackets are harder than enamel- if you put them on the lower incisors there can be notching of the incisal edges of the upper incisors.
What are the pros and cons of lingual appliances?
Con- technically very demanding
Pros- aesthetics, if any decalcification occurs it will be palatally and not visible.
What are the pros and cons of removable aligners?
Good aesthetics
Simple to make- made using software.
Best cases tend to be relapse cases.
Aligners engage the attachments and put force on the tooth.
