Space Analysis And Extraction Need Flashcards

1
Q

How can you work space out?

A
  • Visualisation
  • Brass wire technique
  • Relfex microscope
  • Scanning program
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2
Q

Visualisation

A
  • Count up overlap of each tooth (minus any area of spacing e.g. between lower 1s.
  • Very unreliable and most common method used.
  • It’s overestimate crowding
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3
Q

Brass wire technique

A
  • Cut piece of brass wire to best fit arch form from distal of 6’s.
  • Add up mediocre- distal widths of each tooth from 6-6 with caliper.
  • Take the sum widths away from length of a brass wire to give you how many mm crowding there is.
  • Best to carried out on study model
  • Time consuming
  • Underestimate crowding
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4
Q

Relfex microscop

A
  • A computer program linked to microscope accurately estimates crowding
  • Very accurate
  • Expensive equipment
  • Time consuming
  • Not practical in real world
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5
Q

Scanning programmes

A
  • Rapidly growing area of dentistry
  • Improving in accuracy speed and cost.
  • Linked with computer programmes which can estimate amount of crowding
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6
Q

Which one is best technique to measure crowding?

A
  • Brass wire
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7
Q

Scale of crowding

A
  • Mild - 0-4
  • Mod 4-8
  • Sever more than 8
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8
Q

Royal London space planning ?
Space requirements implication

A
  • Crowding / spacing
  • Levelling curve of spee
  • Arch expansion
  • Incisor A-P position
  • Angulation of teeth
  • Inclination of teeth

Once you add up space requirement and space creation the total should be zero

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9
Q

Royal London space analysis conclusion

A
  • Very rigid and formal way
  • time consuming
  • most orthodontist learn to this in their head with experiences
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10
Q

When do we extract 4s not 5s ?

A
  • More crowding 4s
  • Less crowding 5s
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11
Q

When do we extract 5s ?

A
  • Lower in Proclined after tb phase because they don’t want to Retroclined incisor again
  • less crowding case
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12
Q

Methods of orthodontic space creation

A
  • Tooth extraction
  • Expansion
  • Distal movement e.g using HD or TAD’s
  • IPR (interproximal enamel reduction)
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13
Q

Angles 1910,

A
  • Believed 32 teeth would provide functional and best aesthetic that’s why believed in expansion
  • Strongly criticised angles’s non xtn because Aesthetic effect - excess facial protrusion following extreme expansion
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14
Q

1940’s Tweed and begg

A

Tweed - Disappointed with relapse - Hence retreated 100 pt with Xtn upper 4s
- Observed occlusion was more settle
Begg- also abandoned a non Xtn policy due to of relapse

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15
Q

Why we need extraction teeth?

A
  • Relief crowding
  • OJ and OB Reduction
  • Anchorage considerations
  • buccal segment relationship correction
  • To correct incisor relationship in CLASS III - lower incisor retroclination to correct CL III relationship
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16
Q

Proposed disadvantages of Extraction

A
  • Less attractive facial appearance
  • Potential longer treatments
  • Pain , anxiety, other possible adverse effects of actual Xtn procedure
17
Q

Factors in Xtn decision

A
  • Before planing Xtn of any permanent teeth it is essential to ensure that all remaining teeth are present , healthy, and developed in satisfactory position
  • Medical history
  • Tooth quality
  • Pathology
  • Amount of crowding
  • Impacted teeth
  • Occlusal feature
  • Skeletal feature
  • Ease of Xtn
  • Profile and soft tissue
18
Q

Factor in Xtn decision - Occlusal feature

A
  • OJ, OB - flattening of curve of spee require space
  • buccal segment relationship
  • Central line discrepancies
19
Q

Factor in Xtn decision
Skeletal condition

A
  • Saggital jaw relationship - More severe crowding less space is available for camouflage
  • Vertical relationship- Low angle less likely Xtn space closure more difficult
  • Transverse relationship- Elimination of crossbite
20
Q

Assessing space requirements in orthodontic planing -

A
  • Assesment of crowding / spacing
  • Anchorage planning
  • Xtn planning
  • Levelling curve of spee
  • Tooth angulation
  • Tooth size