1ST QUIZZ Flashcards

(176 cards)

1
Q

physiological process associated
with growth in which the tooth moves from its original
position either in the maxilla or mandible to its final
position in the oral cavity but this process can be
affected by multiple congenital or environmental
causes

A

DENTAL ERUPTION

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2
Q

What phenoms does the eruption considers:

A
  • root development
  • alveolar bone growth
  • eruption secuence
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3
Q

Phases of tooth eruption

A

1) pre eruptive
2) pre functional
3) functional

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4
Q

It takes place inside the bone
and there is only a lateral
displacement from the point of origin of the dental lamina
towards the covering gum

A

Pre eruptive phase

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5
Q

1)Differentiated area in bone
tissue.
2)Calcification of the crown.
3)Fully outlined crown.

Tooth eruption phase

A

pre eruptive phase

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6
Q
  • This cord has connective tissue and remains of
    the dental lamina that cross the bone during
    the eruption of the tooth
  • Many osteoclasts appear in the _________ ________that will enlarge this canal for the passage
    of the tooth.
     The reduced epithelia will join to the oral
    epithelium and then the fused epithelia are
    formed, an when the apoptosis occurs (due to
    avascularization) it allows the tooth to emerge.
A

gubernacular cord

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7
Q

It begins when 50%/75% of the tooth root is
formed.
There is an intense vertical displacement
which allows the tooth to move towards the mucosa

A

pre functional phase

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8
Q

It begins at the moment the
tooth makes contact with the
antagonist and begins to
perform the chewing function
This lasts the entire life of the tooth

A

Functional phase

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9
Q

What factor can affect the tooth eruption process?

A
  1. craniofacial growth & development
  2. heredity
  3. Genetic control of the growth peak and sequence of dental development
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10
Q

Nolla’s table

A

(aprender o guardar foto)

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11
Q

Aprenderse cronología de la erupción temporal y permanente

A
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12
Q

constitute one of the local factors associated with the etiology of malocclusions can cause alterations in dental alignment and create more complex malocclusion problems.

A

anomalies of number (such as supernumerary or hyperdontia or hypodontia)

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13
Q

what are some of the consequences of dental anomalies when developing of occlusion:

A
  • delat in the normal eruption of the teeth
    -ectopic eruption
    -Changes in the midline
    -Transpositions
    -rotation
    -abnormal spacing
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14
Q

Mention all the dental anomalies seen in class

A
  • supernumerary
  • agenesia
  • microdontia
  • macrodontia
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15
Q

It is the absence of one or more dental organs and is a common developmental anomaly in both dentitions (deciduous and permanent) it is the result of a disorder of the dental lamina
which prevents the formation of the tooth germ. The absence isoften bilateral

A

AGENESIA

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16
Q

what are the most frequently absent dental

A
  • third molar
  • upper lateral incisors
  • Ldl
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17
Q

is an alteration in the eruptive trajectory of the dental organ leading to its impaction against the adjacent tooth. Ectopic teeth are found in unusual positions or displaced from their normal anatomical location. The presence of an ectopic tooth can lead to malocclusion.

A

Ectopic eruption

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18
Q

is the change in the position of two adjacent teeth in relation to
their roots in the same quadrant of the dental arch which can lead
and inverted eruption position and alter the normal sequence of
eruption. They are generally unilateral, more frequent in the upper
arch.

A

transposition

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19
Q

despite of having been fully formed they have not emerged in the mouth during the usual period, and they can remain partially or completely inside the jaw bone

A

impacted teeth

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20
Q

Klinefelter syndrome and Down syndrome what can occur in these syndromes

A

taurodontism

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21
Q

Mention the factors that can cause the dental anomalies

A
  1. Systemic factors
  2. Genetic factors
  3. Environmental factors
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22
Q

Any alteration in the bone growth of the maxilla or mandible and
in the dental positions that impede the correct function of the
chewing system with the subsequent consequences that this
dysfunction has on the teeth themselves the gums and the bones
that support them the temporomandibular joint and facial
aesthetics

A

Malocclusion

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23
Q

What are the general factors of the malocclusion?

A
  1. hereditary
  2. congenital defects
  3. oral habits
  4. trauma and accidents
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24
Q

local factors of the malocclusion

A
  1. anomalies in the number of teeth
  2. ’ tooth size
    3 ‘ dental shape
  3. premature loss of decidious teeth
  4. late eruption of permanent teeth
  5. prolonged retention of decidious teeth
  6. Cavities
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25
It is the anteroposterior relationship between the upper and lower permanent canines.
Canine classification
26
A normal molar relationship but there's other alignment irregularities
Angle's Class I
27
Mesibucal cuspid of the 1st permanent upper molar occludes in front of the buccal grove
Angle's Class II
28
Mesiobuccal cuspid of the 1st upper molar ocludes behind of the buccal groove
Angle's Class III
29
The cusp of the upper canine occludes between the canine embrasure and the lower first premolar
Class I (Canine classification)
30
The cusp of the upper canine occludes IN FRONT the embrasure of the canine and the lower first premolar
Class II (Canine classification)
31
The cusp of the upper canine occludes BEHIND the embrasure of the canine and lower first premolar
Class III (Canine classification)
32
Area occupied by the dental papilla.
Embrasure
33
which are the anomalies in the number of teeth?
agenesis supernumerary
34
Characteristic of the agenesis
- absence can be seen in both arches - absence usually bilateral - more common in permanent teeth
35
Mention the 2 types of agenesis
Hypodontia Anodontia
36
Is the absence of formation of three or more dental organs The most common one:  Third molars.  Upper lateral incisors
Hypodontia
37
Disorder in which there are no temporary or permanent teeth because of the congenital absence of tooth germs. This alteration is classified according to the number of missing teeth and can be partial or total
Anodontia
38
characterized by having more teeth than the regular number of teeth
hyperdontia
39
a is due to the hyperactivity of the dental lamina with the consequent formation of additional tooth germs
hyperdontia
40
They appear more frequently in the maxilla. * When the affected region is located in the midline of the palate between the two upper central incisors it is called mesiodens. *Heredity seems to play a more significant role in cases of missing teeth and also in supernumerary teeth.
Supernumerary teeth
41
which are the three types of supernumerary teeth?
- Supplementary teeth - Conical teeth - Mesiodens
42
It has a normal morphology and size. They appear in permanent dentition as extra upper lateral incisor or as lower incisor.
Supplementary teeth
43
They present a conical crown and smaller root than a normal tooth
Conical teeth
44
Type of conical teeth that is located in the premaxilla near the midline between the upper central incisors is known as
MESIODENS.
45
Which are the 2 types of Anomalies in the tooth size
- microdontia - macrodontia
46
The term microdontia is applied to teeth that are smaller than the limits of variation considered normal.
Microdontia
47
which are the 3 types of microdontia?
1. True generalized microdontia 2. Relative generalized microdontia 3. Localized microdontia
48
It is the most common type of microdontia and it usually affects the upper lateral incisors and third molars.
Localized microdontia
49
The term _______ is applied to teeth that are bigger than the limits of variation considered normal.
Macrodontia
50
which are the 3 types of macrodontia
1. true generalized macrodontia 2. Relative generalized macrodontia 3. Localized macrodontia
51
It is a very rare condition and has been observed in some cases of pituitary gigantism and hemifacial hypertrophy
True generalized macrodontia
52
It is the result of a bonedental discrepancy where the size of the teeth is bigger related to the jaws.
Relative generalized macrodontia
53
It is not common and its etiology is unknown; it mainly affects the upper central incisors. The macrodontic tooth is a normal tooth in all respects except its size.
Localized macrodontia
54
Characteritics of the anomalies in the dental shape
Dental morphology is determined by genetics. Alterations in the shape of the teeth can be present in any dental group.
55
Classification in the dental form
1. fusion 2. gemination 3. dilaceration 4. dens in dente
56
Is the union of two developing teeth into a single structure.These teeth may have two independent pulp canals
Fusion
57
From a single enamel organ two teeth form or attempt to form and normally there is only one pulp canal.
Germination
58
Its an excessive root angulation and may be the result of a trauma in the deciduous dentition
Dilaceration
59
Also called an invaginated tooth. This developmental anomaly is a lingual invagination of the enamel and can occur in primary and permanent teeth
Dens in Dente
60
Refers to the early loss of primary teeth that can compromise the natural maintenance of the perimeter or arch length and therefore the eruption of the substitute tooth.
Premature loss
61
The deciduous teeth not only serve as dental organs for chewing they also serve as “____ ______” for the permanent teeth.
space maintainers
62
what are some of the problems premature loss can lead to:
1. loss of dental balance 2. shortening of the arch lenght 3. extrusion of the opposing tooth 4. Problems in the ATM (TMJ) 5. Early prosthetic tx
63
what are some of the possible causes for premature loss on primary teeth?
- diseases (dental such as caries, periodontitis, etc) - involuntary causes (trauma) - bad oral habits (causing mobility and tooth loss before than expected)
64
also constitutes a disorder in the development of the dentition. Mechanical interference can cause the permanent teeth and cause a bad position and leading a malocclusion.
Prolonged retention of deciduous teeth
65
if a delay of more than six months of the eruption of a permanent teeth we may be facing a case of ________________
Prolonged retention of deciduous teeth
66
This may be due to physical barriers such as: dense tissues, bone crypts at the line of eruption of the permanent tooth, supernumerary teeth that prevent the eruption.
Delayed eruption of permanente teeth
67
what are the barriers (3) that doesn't allow the permanent teeth to erupt and so the delay the whole process
Supernumerary teeth. Deciduous roots. Bone barriers.
68
Is the union/fusion between a tooth and the alveolar bone. This is due to some type of injury, which causes perforation of the periodontal ligament and the formation of a “bone bridge” joining the cement and the hard sheet.
Ankylosis
69
Relationshionship between cavities and maloclusions (Interproximal cavities)
represent one of the most common causes of space loss
70
Which are the three types of Anomalies in the dental structure
- Imperfect amelogenesis - Imperfect dentogesisis - Dentin dysplasia
71
Its a hereditary disorder of enamel formation affecting primary and permanent dentition.
Imperfect amelogenesis
72
There are 3 types of imperfect amelogenesis
1. Hypoplasic 2. Hypocalcified 3. Hypomaduration
73
is the type of imperfect amelogenesis in which he enamel does not have normal thickness in certain areas or in its entirety.
Hypoplasic
74
is the type of imperfect amelogenesis in which he enamel has a normal thickness but is fragile and can be easily removed.
Hypocalcified:
75
is the type of imperfecte amelogenesis in which the thickness of the enamel is normal but it doesn’t have a normal hardness and transparency and opaque spots appear on the incisal edges of the teeth.
Hypomaturation
76
It consists on opalescent teeth made up of irregularly formed and hypomineralized dentin that obliterates the coronal root and pulp chambers. The teeth range in color from bluish gray to yellowish. The dentin is abnormally soft, despite to the exposure of dentin the teeth are not especially prone to dental caries
Imperfect dentogenes
77
It is an inherited disorder characterized by abnormal dentin formation and abnormal pulp morphology
Dentin dysplasia
78
Which are the two types of dentin dysplasia?
Type I: root dentin dysplasia Type II: Coronal dentin dysplasia
79
Type of dysplasia in which Teeth are affected in both dentitions. The teeth have a normal color and in some cases may present a bluish or brown transparency in the cervical region. The roots of the teeth are short, blunt, bulging, conical, or absent.
Type I Root dentin
80
Type of dysplasia in which Both the primary and permanent dentition are affected in this type of dysplasia, however the appearance of the temporary teeth is different from the permanent teeth. Primary teeth clinically show a bluish gray, brown or yellowish color and have a translucent or opalescent appearance, the permanent teeth appear clinically normal and the roots in both dentitions are normal.
Type II
81
'Straight' 'dentition'
Orthos Odontos= orthodontia
82
He was a major contributor in the early development of orthodontic treatments
Normal W. Kingsley
83
Father of the modern orthodontics
E. Angle
84
specific area of dental practice that has as its responsability the study and supervision of the growth and thedevelopment of the dentition and its related anatomical structures from birth to dental maturity, including all preventive and corrective procedures of dental irregularities requiring the repositioning of teeth by functional or mechanical forces
Orthodontics
85
Study Field of orthodontics
- prevention & correction of malocclusions -tx and dento-facial abnormalities - growth of the cranio-facial complex - development of malocclusion
86
The objective is to act before the appearance of malocclusions when the diagnosis indicates that they are going to occur and will alter the normal development of the dental and maxillary/mandible organs. It is usually applied at young ages to avoid possible malocclusion.
Preventive orthodontics
87
Types of space mantainers
1. nance bottom 2. lingual arch 3. band and loop
88
The aimed is to correct bad dental positions or habits that are occurring but they can still be treated to change their evolution.
Interceptive orthodontics
89
Interceptive orthodontics methods
- serial extractions - correction of developing crossbite - control of oral habits - removal of supernumerary and akylosed teeth
90
Mention all the bad oral habits
- thumb sucking - Onychophagy -Tongue thrusting -Mouth breather - Lip biting
91
It is applied when the malocclusion has already been established and has altered the normal course of the dentofacial complex.
Corrective orthodontics
92
Mention the orthodontic's goals
- facial aesthetics - dental aesthetics - functional oclussion - periodontal health & stability
93
Teeth have a strong tendency to move mesially even before they erupt into the mouth; this phenomenon has been called the
mesial thrust tendency
94
Appliances used to maintain space or regain the mayor amount of space so that they can guide the eruption of the permanent teeth into a proper position.
Space Maintainers
95
The most important function of space maintenance is to maintain the ________ relationship
mesiodental
96
what's important to mantain in the primary and early permanent dentition is important for the normal development of the occlusion.
the arch length
97
Functions of space mantainers
- Maintain arch length and perimeter. - Prevent space loss. - Prevent the development of a malocclusion or reduce it’s severity
98
Requirements that a space maintainer must have
- Maintain the desired proximal space.  It should not interfere with the eruption of the permanent successor tooth.  It should not interfere with the opposite tooth.  It must provide enough mesiodistal space for permanent teeth.  It should not interfere with phonation, chewing or functional jaw movement.  They should be simple in design.  They should be easy to clean and maintain.
99
IDEAL CHARACTERS OF THE SPACE MAINTAINERS
- Simple - Strong and stable - Passive (not cause teeth movement) - Do not increase the risk of caries development
100
General considerations for the placement of space mantainer
a) time elapsed after loss b) px's dental age c) amount of space loss d) tooth eruption sequence e) late eruption of permanent teeth
101
Consequences of premature loss
- Decrease in the perimeter and length of the arch with the consequent deviation from the midline.  Causing malocclusions such as crowding, ectopic eruption or impaction of permanent teeth.  Alteration of the molar and canine relationship.  Changes in the vertical plane such as deep bites, and in the transverse plane such as crossbites
102
Planning for the space maintainance: we need
- Clinic exam - X-rays - Dental Casts
103
Type of space mantainer
a) unilateral (band & loop) b) bilateral (lower lingual arch, transpalatal arch, nance appliance, removable acrylic appliance)
104
The indication for placement of a band and loop space maintainer is for loss of the
first primary molar
105
The band & loop is indicated to maintain the space for a missing second primary molar, only if we have
the presence of the first permanent molar
106
Advantages of band & loop
 Allows the eruption of permanent teeth.  Easy to construct and adjust.  Not expensive.  Non-invasive or painful
107
The indications for a lingual arch space maintainer are:
Bilateral loss of the mandibular primary molars after eruption of the permanent incisors. * Unilateral loss of more than one tooth in the mandibular arch
108
Its design is of bilateral bands on molars that are connected by a heavy wire that rests on the cingulum of the anterior incisors
LOWER LINGUAL ARCH
109
Its design is made of bilateral bands on the first molars that are connected by a heavy wire, and the arch wire is directed toward the palatal surface and is embedded in an acrylic button resting on the soft tissue.
nance appliance
110
The indications for a Nance appliance are:
Bilateral loss of the maxillary primary molars.  Unilateral loss of more than one tooth in the maxillary arch
111
Its design is made of bilateral bands on the first molars that are connected by a heavy wire that transverse the hard palate without touching soft tissue. Although it is easier to clean than the Nance appliance but it is not as stable, especially when bilateral second primary molars are missing
TRANSPALATAL ARCH
112
indications for a Transpalatal Arch appliance:
Bilateral loss of the maxillary primary molars.  Unilateral loss of more than one tooth in the maxillary arch.
113
In the mandibular primary dentition, a loss of the second primary molars along with the both first primary molars, will indicate the placement _______ ________.
of an acrylic appliance
114
Removable acrylic appliance is indicated:
 There has been a loss of more than one tooth in a quadrant, and the permanent molars have’nt erupted yet
115
It is a procedure within the field of Interceptive Orthodontics that can be applied in cases of bone-dental discrepancy where the supporting bone is less than the sum of the size of the dental materia
SERIAL EXTRACTION
116
was the first to propose in one of his dental treatises, the extraction of deciduous teeth to achieve greater alignment of the permanent dentition.
Pierre Fauchard
117
It’s a timed planned sequential extraction of certain deciduous teeth followed by the removal of specific permanent teeth in order to guide the eruption permanent teeth into a favorable position.
SERIAL EXTRACTION
118
SERIAL EXTRACTION is based on 2 principles
a) Arch Length /tooth size discrepancy. B) Physiologic tooth movement
119
Indication for serial extractions
a) Premature loss of primary teeth. b) Arch length deficiency and tooth size discrepancy . c) Crowded maxillary and mandibular incisors. d) Class I malocclusion.
120
CONTRAINDICATIONS of serial extractions
- Severe Class II or Class III malocclusion. - Cleft palate cases. - Extensive caries of first permanent molar
121
Methods of serial extractions
a) DEWEL METHOD b) TWEED METHOD c) METHOD NANCE
122
Extraction of deciduous canines, followed by deciduous first molars an finally first premolars
Dewel Method
123
Extraction of deciduos first molar, followed by first premolars and then deciduos canines.
Nance Method
124
* Extraction of deciduos first molar, followed by the first premolars then the decidiuos canines and laterals
Tweed method
125
Mention 3 clinical findings in the Thumb sucking habit:
Proclined upper incisors. b) Retroclined lower incisors. c) Finger involved( dry chapped skin) and calloused digits
126
Mention 3 clinical findings in the Lip biting habit
a) Proclined upper incisors. b) Retroclined lower incisors. c) Enlarged, red lower lip.
127
Mention 3 clinical findings in the Tongue thrusting habit
a) Proclined upper incisors. b) Proclined lower incisors. c) Anterior spacing
128
Mention clinical findings in the Nail biting habit
a) Anterior spacing and misalignment. b) Exposed nail beds.
129
Mention 4 clinical findings in the Mouth breather habit:
a) Narrow upper arch. b)Posterior crossbite and anterior open bite. c) Incompetent dry pale lips. d)Swollen dry gingiva.
130
Mention 3 clinical findings in the Bruxism habit
a) Tooth fractures. b)Prominent masseter muscles. c)Jaw’s pai
131
t is a routine behavior that is repeated regularly and tends to occur unconsciously.
a habit
132
are the most frequent causes of these badformations mostly seen in the early childhood and mixed dentition stages.
habits
133
a oral habit depends on:
a) intensity b) duration c) frequency
134
Which bad oral habit plays the most critical role in the tooth movement
duration
135
Clinical and experimental evidence suggests that ___to ___ hours of force per day are enough to cause tooth movement
4 to 6
136
Is the placement of the thumb or more fingers in the oral cavity with repeated and forceful sucking movements associated with strong buccal and lip contraction
Thumb sucking (active and passive)
137
Treatment approaches of sucking habit include:
Direct Interview. II. Reward System. III. Reminder therapy appliance and non-appliance reminders. IV. Appliance Reminder Therapy.
138
Mention the 2 types of appliance reminder therapy
1) removable palatal crib 2) fixed palatal crib
139
Abnormal tongue function and posture that cause many malocclusions. The effects and management at early stages may be helpful to prevent future severe skeletal malocclusions.
Tongue thrusting
140
Types of tongue thrust
A) Anterior tongue thrusting. B) Posterior tongue thrusting. C) Both: anterior/posterior tongue thrusting. D) Lateral tongue thrusting. E) Unilateral tongue trusting.
141
treatment of tongue trusting
Myofunctional therapy. II. Simple habit control. III. Habit-breaking appliance.
142
types of appliance therapy for tongue trusting
a) Removable appliance it has an active component bow as a remainder and the tongue crib has retentive components and acrylic base plate. b) Nance palatal arch appliances which has an acrylic button that can be used to place the tongue in the correct position. c) Using fixed appliances with fixed tongue cribs.
143
Is the habitual breathing through the mouth instead of nose and it can be abnormal when the patient breathes through the mouth even during rest. In about 85% of cases mouth breathing represents an involuntary subconscious adaptation to reduced patency of the nasal airway and mouth breathing is a simply requirement in order to get enough air.
Mouth breathing
144
Etiology of the motuh breathing
1) obstructuve ( a complete obstruction through the nassal passages) 2) habitual (continuous breathing) 3) anatomic ( a short upper lip)
145
Almost all mouth-breathing patients should be referred to the specialist so
to the Otorhinolaryngology
146
One of the most effective ways to reestablish the nasal breathing is preventing the access of air through the oral cavity by this we use a ____ ______. which consist on a thin sheet of acrylic extending deep into the vestibular sulcus and the labial & buccal breathing holes can be punch out so that they can allow the entrance of some amount of air into the mouth
Oral screen
147
Involves manipulation of the lips and perioral structures there will be a big overjet with the protrusion of the upper anterior teeth and a lingual inclination of the lower anterior teeth followed by a skeletal discrepancy.
Lip biting
148
The treatment of lip biting should be direct towards the etiology of the habit.
Appliance fixed therapy: lip bumper
149
is made of stainless steel wire . It is placed on the jaw from the right molar to the left molar. The curve of this lip bumper is located more to the gingival margin direction, 3 mm from the labial teeth surface. The anterior area can be covered by plastic or acrylic which functions are to help the adaptation of lip and cheeks muscles, so the pressure of lip muscle on teeth will decrease
lip bumper
150
Is a common oral habit noticed in children and adults. The etiology includes: anxiety, stress, loneliness, imitation of other family member, inactivity, transference from a thumb-sucking habit.
Onicofagia
151
tx for onicofagia
- application of chemical with hot flavor on the nail area
152
Adenioid long face, incompetent lip posture and narrow external nares are
Extraoral features.
153
Their mechanical properties result in simple tipping movements of teeth, therefore multiple simultaneous tooth movements with apical control are not possible. It is for these and other reasons that removable appliances are usually only indicated for specific interventions in the mixed dentition, and the appliance choice in specific cases of permanent dentition.
Removable Appliance
154
Active removable appliances
 Mechanical appliances: Carry some active components which are activated to exert active forces.  Functional appliances: Work by modifying muscle forces and exerting intermaxillary action
155
Passive removable appliances
These appliances remain passive in the mouth and they don’t exert active pressure. Example:  Space maintainers.  Retainers.
156
these movements areproduced when a single force is applied against the crown of the tooth
Tipping movements
157
Indications of RA
Provide a useful means of extra oral force to a teeth segment or an entire arch to help achieve intrusion or distal movement. Also employed for arch expansion which is another example of their usefulness in moving blocks of teeth. They are use in a passive role as a space maintainers and also as retainers appliances.
158
Components of RA
a) Retentive components b) Active components c) Baseplate Anchorage
159
These components help to retain the appliance in place and resist displacement.  The effectiveness of the active components depend on retention of the appliance.  Good fixation will help patient compliance, anchorage and tooth movement.
retentive components
160
types of retentive components in RA
Labial arch Clasps
161
Used for two retention purposes:  As a component of the Hawley retainer.  Can also bring a minor overjet reduction.
Labial arch
162
Are placed between the maximum circumference of the neck of the tooth and they provide excellent retention should not apply active force and no interference with occlusion.
Clasps
163
In the active components, they Apply forces to the teeth, so that they can bring the desired tooth movement.
SPRINGS
164
types of active components (springs)
Simple Spring Compound Spring
165
consists of 2 helix of small diameter can be made for 1 or more incisors. The spring is placed perpendicular to the palatal surface of the tooth with a long retentive arm. Indication:  To move one or more teeth in the same direction, example: the pro-inclination of 2 or more upper incisors for the correction of anterior tooth crossbite.
Z spring (simple spring)
166
Finger spring.- the helix is placed opposite to the direction of the intended tooth movement. It should also be placed along the long axis of the tooth to be moved, perpendicular to the direction of tooth movement. Indication:  Mesio-distal movement of teeth. Example: closure of anterior diastemas.
Compound Spring
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It forms the major part of removable appliance. It acts as a major connector that connects the other individual components and it also distribute the reaction forces to the anchorage areas
baseplate Passive (used as a major connector) Active ( by modifyng as the anterior or posterior bitplane)
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several important points to be considered when using a removable appliance
Oral hygiene maintenance, is less complicated for patients.  It shortens the fixed orthodontic treatment when is used in the preliminary stage of the treatment plan.  As an interceptive method, the appliance may be recommended for those with an increased overjet (protruded upper anterior teeth) in the middle mixed dentition age.  It has a lower relapse rate during retention period compared to fixed appliances.  In other cases the outcome of the treatment should be maintained with subsequent fixed treatment.
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Functional Appliances Also called
Myofunctional appliances.
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They have no active components such as springs or elastics but instead they use harness forces generated by the masticatory and facial musculature. This is achieved by constructing the appliance such that it holds the mandible in a better postured position away from it’s rest position.
funcitonal appliances or myofunctional appliances
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Thus they are mostly used in the treatment of Class III and Class II malocclusions, particularly Class II division I where the overjet is increased.
Functional appliances
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Components of funcitonal appliances
Buccal shield. 2) Labial pad. 3) Lingual pad. 4) Palatal bow
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Mode of action of fuctional appliances
The appliance holds the mandible in a forward postured position and the facial musculatures are stretched, this would applied a posterior force to the upper arch and an anterior force to the lower arch. The lower incisors have acrylic capping to prevent excessive labial movement of the lower incisors.
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Indications for Functional Appliances
The patient must still be growing preferably approaching a phase of faster growth.  The pattern and direction of facial growth should be reasonably favorable.  The patient must be well motivated. These appliances must be worn for a substantial amount of time. This requires a considerable effort and commitment by the patient and the family particularly in the early stages of treatment.
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Types of functional appliances
1) BIONATOR. 2) FRANKEL. 3) TWIN BLOCK. 4) ANDRESEN ACTIVATOR. 5) HEADGEAR 6) HARVOLD ACTIVATOR
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