55 ARTICLES P2

Question 1

Describe the relationship between tooth and speech.

Answer 1

There is a relationship between position and speech, certain malocclusions being associated with speech difficulties.

Question 2

What are some malocclusions linked to speech difficulties?

Answer 2

Open bite, Class III, upper anterior teeth spacing, and increased overjet are malocclusions associated with speech difficulties.

Question 3

Do open-bite or edge-to-edge occlusion affect specific speech sounds?

Answer 3

Open-bite or edge-to-edge occlusion can affect speech sounds like /s/, /z/, /th/, and /l/.

Question 4

Is there definitive proof that altering tooth position can improve articulation disorders?

Answer 4

No, there is no definitive proof that altering tooth position can improve articulation disorders.

Question 5

Is the severity of malocclusion directly related to the severity of mis-articulation?

Answer 5

No, there is no clear evidence that the severity of malocclusion is directly related to the severity of mis-articulation.

Question 6

Describe infantile swallowing.

Answer 6

The jaws apart with the tongue filling the space between the gum pads or teeth; the lips are active in sucking movements; the tongue is placed between the dental ridges in contact with the lower lip and beneath the nipple that is being sucked.

Question 7

When does the typical adult swallowing appear?

Answer 7

Between the ages of 2 and 12.

Question 8

When do tongue-thrusters tend to evolve a normal adult swallowing without therapy?

Answer 8

Between 8 and 12 years of age.

Question 9

What growth curve does the tongue follow in Scammon’s growth curves?

Answer 9

The neural tissues.

Question 10

At what age does the tongue approach maximum size?

Answer 10

At or near age 8 years.

Question 11

What growth curve does the mandible follow in Scammon’s growth curves?

Answer 11

The general body curve.

Question 12

What is the clinical implication of the growth difference between the tongue and mandible?

Answer 12

The natural tendency for the large tongue to be positioned relatively high and forward in the oral cavity in the early years of growth.

Question 13

What are the 3 reasons for tongue-thrusting during speech or swallowing in children in the mixed dentition stage?

Answer 13

1. Adaptive behavior to morphologic variations in the mouth or pharynx (airway) 2. Neurologic abnormality contributing to the tongue thrust.

Question 14

Describe myofunctional therapy for tongue-thrusting.

Answer 14

Myofunctional therapy involves exercises and techniques to correct improper tongue posture and swallowing patterns.

Question 15

Do children with tongue thrust and speech problems only require myofunctional therapy?

Answer 15

No, they may benefit more from speech articulation therapy techniques.

Question 16

Define malocclusion in the context of tongue thrusting treatment.

Answer 16

Malocclusion refers to misalignment of the teeth or incorrect relation between the teeth of the two dental arches.

Question 17

How can delaying tongue therapy until malocclusion treatment begin be advantageous?

Answer 17

It allows for the correction of malocclusion to potentially resolve the tongue thrust without specific therapy, gives the child time to transition swallow pattern naturally, and enhances the effectiveness of tongue therapy when carried out with tooth movement.

Question 18

What are the airway problems associated with tongue thrusting?

Answer 18

Airway problems related to tongue thrusting include a reduced size of the oropharyngeal (faucial) isthmus and hypertrophied tonsils and adenoids.

Question 19

Should swallowing exercises be recommended for children with a reduced faucial isthmus size?

Answer 19

Swallowing exercises may not be recommended for children with a reduced faucial isthmus size due to potential complications.

Question 20

Describe the importance of correcting resting tongue position in treating malocclusion.

Answer 20

The resting tongue position is more important for malocclusion than correcting tongue-thrusting swallowing.

Question 21

Do swallowing exercises play a role in myofunctional therapy for tongue-thrusting?

Answer 21

No, swallowing exercises should be avoided in myofunctional therapy for tongue-thrusting.

Question 22

Define the recommended treatments for children with tongue thrust, malocclusion, and speech problems.

Answer 22

The recommended treatments include orthodontic treatment for open bite, speech therapy, and tongue positioning exercises.

Question 23

How does tongue thrusting relate to malocclusion in most cases?

Answer 23

Tongue thrusting does not cause malocclusion but may be an adaptation to it, with the resting posture of the tongue affecting tooth eruption.

Question 24

What percentage of children with tongue thrust and anterior open bite at age 8 may show improvement without therapy by age 12?

Answer 24

Up to 80% of children may show improvement without therapy by age 12.

Question 25

Describe the three-dimensional airway changes in children after adenotonsillectomy for obstructive apnea.

Answer 25

The airway changes post-surgery involve improvements in air passage dimensions and reduced obstruction.

Question 26

Define the apnea hypopnea index (AHI).

Answer 26

AHI is the measure of apneas (complete breathing stoppages) and hypopneas (shallow breaths) per hour of sleep.

Question 27

How many manifestations of obstructive sleep apnea (OSA) are typically seen in growing children? Name at least three.

Answer 27

Seven manifestations are common, including growth failure, behavioral problems, and mouth breathing.

Question 28

Do expectations typically align with reality regarding airway changes after adenotonsillectomy in children with obstructive apnea?

Answer 28

The study aims to determine if the expected improvements in airway dimensions post-surgery match the actual outcomes.

Question 29

Describe the main cause of obstructive sleep apnea in growing individuals.

Answer 29

Enlarged tonsils and adenoids are often the primary culprits behind obstructive sleep apnea in children.

Question 30

Describe the recommended treatment for obstructive sleep apnea (OSA) in growing children.

Answer 30

Surgical removal of the tonsils and adenoids.

Question 31

Define Adenotonsillectomy.

Answer 31

Surgical procedure involving the removal of both the adenoids and tonsils.

Question 32

How was the research conducted in the study on three-dimensional airway changes after adenotonsillectomy in children with obstructive apnea?

Answer 32

30 patients with OSA were evaluated using polysomnography to measure various parameters before and after adenotonsillectomy.

Question 33

Do parents and PSG parameters confirm a significant improvement in breathing patterns after adenotonsillectomy in children with obstructive apnea?

Answer 33

Yes, both parents’ reports and PSG parameters indicated a significant improvement.

Question 34

Describe the contribution to volumetric gain in the OSA group after adenotonsillectomy.

Answer 34

The extension of the walls of the respiratory tract due to increased airflow permeability.

Question 35

Who authored the study on three-dimensional airway changes after adenotonsillectomy in children with obstructive apnea?

Answer 35

Bertoz et al.

Question 36

Describe the study’s findings regarding the between airway volumetric changes and PSG after adenotonslectomy in children with obstructive apnea.

Answer 36

The study found a low correlation between the increase in air volume and PSG parameters, indicating that AHI may not be a reliable indicator of clinical changes.

Question 37

Define AHI in the context of obstructive sleep apnea diagnosis.

Answer 37

AHI stands for Apnea-Hypopnea Index, which is the criterion standard for diagnosing OSA and is measured through a full-night in-laboratory PSG.

Question 38

How were the airway measurements collected in the study, and what were the limitations of this method?

Answer 38

The airway measurements were collected from orthodontic records using conventional dental CBCT equipment while patients were awake, limiting the accuracy of dimensions likely to occur during sleep.

Question 39

Do the study’s conclusions recommend using airway volumetric changes after adenotonsillectomy as a reliable measure of breathing improvement in children?

Answer 39

No, the study concludes that volumetric changes in the airways post-surgery should not be used as a valid and reliable aspect to quantify breathing improvement in children.

Question 40

Describe the impact of inter-patient volumetric variation on the correlation between AHI and airway volumetric changes post-adenotonsillectomy.

Answer 40

The significant inter-patient volumetric variation contributes to the low correlation between AHI and airway volumetric changes, affecting the reliability of using AHI as an indicator of clinical improvement.

Question 41

Describe the immediate impact of rapid maxillary expansion on upper airway dimensions.

Answer 41

Rapid maxillary expansion leads to a significant increase in the width of anterior and posterior nasal floor, resulting in a significant increase in nasopharynx and nasal cavities airway volumes.

Question 42

Do chronic mouth-breathers commonly exhibit transverse maxillary arch deficiency?

Answer 42

Yes, chronic mouth-breathers often exhibit transverse maxillary arch deficiency, which can lead to posterior cross-bite if pronounced.

Question 43

Define the objective of the research conducted by Izuka et al.

Answer 43

The objective was to assess short-term tomographic changes in upper airway dimensions and quality of life of mouth breathers after rapid maxillary expansion (RME).

Question 44

How was the rapid maxillary expansion (RME) protocol carried out in the study?

Answer 44

The RME protocol involved 4 activations at the time of delivery (1⁄4 turn for each activation, 0.25 mm), followed by two daily activations until overcorrection was achieved.

Question 45

Describe the methods used in the study by Izuka et al. to assess mouth-breathers with maxillary atresia.

Answer 45

The study assessed 25 mouth-breathers with maxillary atresia using CBCT scans and a standardized quality of life questionnaire answered by the patients’ legal guardians before and immediately after the RME procedure.

Question 46

Describe the immediate impact of rapid maxillary expansion (RME) on upper airway dimensions.

Answer 46

Short-term RME leads to a significant increase in airway volume of the nasopharynx and nasal cavities, as well as in the anterior and posterior widths of the nasal floor.

Question 47

What is the effect of rapid maxillary expansion (RME) on the quality of life of mouth-breathing patients with maxillary atresia?

Answer 47

RME significantly improves the quality of life of mouth-breathing patients with maxillary atresia by decreasing respiratory symptoms and enhancing overall well-being.

Question 48

Define rapid maxillary expansion (RME).

Answer 48

Rapid maxillary expansion is a orthodontic treatment that widens the upper jaw to create more space in the mouth and improve breathing.

Question 49

How does rapid maxillary expansion (RME) impact respiratory symptoms in patients?

Answer 49

RME leads to a significant decrease in respiratory symptoms in patients with maxillary atresia, improving their breathing and overall respiratory conditions.

Question 50

Do mouth-breathers experience immediate benefits from rapid maxillary expansion (RME)?

Answer 50

Yes, mouth-breathers experience immediate benefits from RME, including increased airway volume and improved quality of life shortly after the procedure.

Question 51

Describe the craniofacial characteristics of chronic mouth breathers.

Answer 51

1. Maxillary constriction
2. Posterior cross-bite
3. Retrusion and clockwise rotation of the mandible
4. Class II skeletal pattern
5. Excessive vertical growth

Question 52

Define the objective of the study conducted by Feres et al.

Answer 52

To compare the cephalometric pattern of children with and without adenoid obstruction.

Question 53

How was the sample divided in the study based on adenoid obstruction?

Answer 53

The sample was divided into ‘Positive’ group with pathological adenoid hypertrophy and ‘Negative’ group without adenoid hypertrophy.

Question 54

Do you know the gold standard method for adenoid evaluation in the study?

Answer 54

Naso-fiber-endoscopic examination.

Question 55

Describe the results of the study regarding cephalometric variables in obstructive and non-obstructive patients.

Answer 55

Individuals showed tendencies towards vertical craniofacial growth, convex profile, and mandibular retrusion, with no differences between obstructive and non-obstructive patients in cephalometric variables.

Question 56

Describe the correlation between craniofac skeletal pattern and the degree of adenoid in the study.

Answer 56

Correlations between skeletal parameters and the percentage of adenoid obstruction were either low or not significant.

Question 57

Do the results of the study suggest a strong association between specific craniofacial patterns like Class II and hyperdivergency with adenoid hypertrophy?

Answer 57

Results suggest that specific craniofacial patterns, such as Class II and hyperdivergency, might not be associated with adenoid hypertrophy.

Question 58

Define the relationship between a reduction in the nasopharyngeal airway and actual clinical obstruction according to the study.

Answer 58

No, a reduction in the nasopharyngeal airway is not directly related to an actual clinical obstruction.

Question 59

What is a limitation of the study regarding the evaluation of adenoid hypertrophy?

Answer 59

It is a cross-sectional evaluation of adenoid hypertrophy.

Question 60

How might sudden dimensional changes in adenoid lymphoid tissue occur according to the study?

Answer 60

As previously reported, the adenoid lymphoid tissue might be susceptible to sudden dimensional changes as a consequence of allergic sensitization.

Question 61

Describe the 3 degrees of severity of Orthically Induced In Root Resorption (OIIRR).

Answer 61

1. Cemental or surface resorption with remodeling. . Dentinal resorption with repair. 3. Circumferential apical root resorption.

Question 62

How does the repair process of the resorbed lacunae start in OIIRR?

Answer 62

It starts 2 weeks after force removal, with the placement of acellular cementum followed by cellular cementum.

Question 63

Define the effects of L-thyroxine on OIIRR.

Answer 63

L-thyroxine decreases root resorption while increasing tooth movement.

Question 64

How do Bisphosphonates affect OIIRR?

Answer 64

Bisphosphonates are potent inhibitors of bone resorption, decreasing tooth movement. There is also a dose-dependent inhibition of root resorption.

Question 65

What are the effects of Corticosteroids on OIIRR?

Answer 65

Low doses of 1 mg/kg decrease root resorption, while doses of 15 mg/kg increase root resorption.

Question 66

How does Alcohol impact OIIRR?

Answer 66

Alcohol increases root resorption through vitamin D hydroxylation in the liver.

Question 67

Describe the clinical steps that should be considered by the orthodontist in relation to Orthodontically Induced Inflammatory Root Resorption (OIIRR).

Answer 67

Informing patients/parents about the risk, familial considerations, age and gender factors, general health considerations, evaluation of dentition parameters, and assessing malocclusion.

Question 68

What familial consideration should orthodontists keep in mind when treating a new patient with a close sibling who was previously treated for OIIRR?

Answer 68

Orthodontists should try to obtain the final radiographs of the sibling.

Question 69

How does general health, specifically chronic asthma, relate to the incidence of OIIRR during orthodontic treatment?

Answer 69

Patients with chronic asthma, medicated or non-medicated, have an increased incidence of OIIRR, often affecting the maxillary molars.

Question 70

Define the impact of incomplete root formation on teeth undergoing orthodontic treatment.

Answer 70

Teeth with incomplete root formation continue to develop roots during treatment but may not reach their expected length potential.

Question 71

What parameters should be evaluated from radiographs in relation to OIIRR risk during orthodontic treatment?

Answer 71

Root morphology, endodontic treatment, bone morphology, agenesis, aplasia, ectopy, and transplanted teeth.

Question 72

How do invagination and taurodontism contribute to the risk of OIIRR during orthodontic force induction?

Answer 72

They have been found to be risk factors for OIIRR.

Question 73

Describe the impact of hypodontia on the risk of OIIRR during orthodontic treatment.

Answer 73

Hypodontia puts existing teeth at risk for OIIRR.

Question 74

What is the recommended waiting period for exerting force on transplanted teeth during orthodontic treatment?

Answer 74

Orthodontists are advised to wait at least 3 months after transplantation before exerting force on the teeth.

Question 75

How does malocclusion relate to the risk of OIIRR during orthodontic treatment?

Answer 75

No malocclusion is immune to OIIRR.

Question 76

Describe two kinds of movement likely to increase the risk of Orthodontically Induced Inflammatory Root Resorption (OIIRR).

Answer 76

Jiggling and movement caused by application of intermaxillary elastics.

Question 77

What are the 4 clinical steps during treatment to reduce the risk of OIIRR?

Answer 77

1. Avoid light-force rectangular wires. 2. Longer intervals between activations. 3. Avoid prolonged active treatment duration. 4. Take periapical radiographs after 6 months.

Question 78

What should be done after treatment if OIIRR is present?

Answer 78

1. Take final radiographs and inform the patient. 2. Follow-up radiographic examinations for severe resorption. 3. Consider endodontic treatment for extreme cases.

Question 79

Define the diagnostic tools for OIIRR.

Answer 79

Radiographs, including periapical views. CBCT for more accurate diagnosis.

Question 80

How can severe OIIRR impact treatment goals?

Answer 80

Severe resorption may lead to reassessment of treatment goals, considering alternative options like prosthetic solutions, releasing teeth from active arches, stripping instead of extracting, or early fixation of resorbed teeth.

Question 81

Describe the natural process of cemental repair or termination of active processes of OIIRR.

Answer 81

It occurs naturally after the removal of bands and brackets.

Question 82

Describe the author of the study on periodontal tissue response to orthodontic movement of teeth with infrabony pockets.

Answer 82

Wennstrom et al.

Question 83

Do orthodontic forces alone convert gingivitis into destructive periodontitis? Why or why not?

Answer 83

No, they do not. The inflammatory lesion in gingivitis is different from the tissue reactions caused by orthodontic movement.

Question 84

Define the findings of the study regarding orthodontic therapy on teeth with inflamed, infrabony pockets.

Answer 84

The study showed that such therapy may accelerate the loss of connective tissue attachment.

Question 85

How are infrabony pockets affected by orthodontic tooth movement compared to other areas?

Answer 85

Infrabony pockets are more susceptible to increased destruction due to the impact of orthodontic forces on the periodontium.

Question 86

What is the main conclusion drawn from the study on orthodontic movement into infrabony pockets?

Answer 86

1. Orthodontic movement into such pockets may harm periodontal attachment. 2. Periodontal treatment should precede orthodontic therapy.

Question 87

Who is the author of the content?

Answer 87

Samir E. Bishara, BDS, DOrtho, DDS, MS

Question 88

What are the two most widely quoted studies that relate third molars to crowding of incisors?

Answer 88

Bergstrom and Jensen’s study, Vego’s study

Question 89

Describe the morphologic factors that can influence the space available for third molars.

Answer 89

1. Vertical direction of condylar growth 2. Reduced mandibular length 3. Backward-directed eruption of the mandibular dentition

Question 90

Should third molars be enucleated at an early age if they are expected to be impacted?

Answer 90

There is a dichotomy regarding the need and consequences of enucleation, with concerns about surgical complications and economic factors.

Question 91

Why should third molars not be solely blamed for late mandibular incisor crowding?

Answer 91

Long-term studies show increased crowding during adolescence and adulthood in both untreated and orthodontically treated individuals after retention is discontinued.

Question 92

Describe the risks involved with the procedure the use of general analgesia or for third molar.

Answer 92

Risks may include nerve damage, bleeding, infection, and adverse reactions to anesthesia.

Question 93

Do of enucleation believe that third molars can cause problems in young adults and lead to pathologic later in life?

Answer 93

Yes, proponents believe that third molars can cause issues in young adults and pathologic changes in later years.

Question 94

Define the predictability of the ultimate position of third molars based on earlier observations of their inclination.

Answer 94

The ultimate position of third molars is not predictable based on earlier observations of their inclination.

Question 95

How did Kahl et al’s study on orthodontically treated patients with impacted third molars contribute to the understanding of third molar positions over time?

Answer 95

The study found that third molars can rotate or change inclination over time, with various factors having no predictive value on their final position.

Question 96

What are the reasons for extracting third molars according to the content?

Answer 96

Reasons include prophylactic measures, pericoronitis, orthodontic concerns, caries and pulpitis, and issues like cysts, tumors, and root resorption.

Question 97

Describe the consensus on the removal of asymptomatic impacted third molars with no evidence of pathosis.

Answer 97

There is still no consensus on the removal of asymptomatic impacted third molars without pathosis, but many agree that impaction or malposition may justify removal.

Question 98

Describe the conclusions drawn from the content regarding third molars.

Answer 98

The conclusions include the lack of evidence linking third molars to posttreatment changes in incisor alignment, the need for justifiable reasons for extraction, consideration of impact on future treatment plans, and the recommendation to remove third molars in young adulthood.

Question 99

Define the relationship between third molars and alignment of anterior dentition according to the content.

Answer 99

The content suggests that the relationship between third molars and alignment of anterior dentition is not a cause and effect one, but rather that they both occur around the same stage of development.

Question 100

How should a clinician approach the recommendation for extraction of any tooth based on the content?

Answer 100

The clinician should have a justifiable reason for recommending extraction and consider the impact on future treatment plans from various dental aspects.

Question 101

Do the conclusions support the routine removal of asymptomatic third molars?

Answer 101

No, the conclusions do not support routine removal of asymptomatic third molars, emphasizing the need for a valid reason for extraction.

Question 102

Describe the recommended timing for the removal of third molars according to the content.

Answer 102

The content recommends removing third molars in young adulthood rather than at an older age if extraction is indicated.

Question 103

Describe the study conducted by Thomas Lewis DDS in 1959 regarding fractured anterior teeth their protrusion.

Answer 103

The study examined 343 white school children aged 8 to 13, noting the degree of protrusion of their anterior teeth and the presence of fractures. Fractures were categorized as mild or severe, and statistical analysis indicated a significant relationship between protrusion and fractured anterior teeth.

Question 104

Define the Chi Square test used in the study by Thomas Lewis, DDS in 1959.

Answer 104

The Chi Square test is a statistical method used to determine if there is a significant association between two categorical variables. In this study, it was employed to analyze the relationship between the incidence of fractured anterior teeth and the protrusion of those teeth.

Question 105

How were fractures classified in the study by Thomas Lewis, DDS in 1959?

Answer 105

Fractures in the study were classified as mild if only the enamel was involved, while all other fractures were recorded as severe. This classification helped differentiate the severity of the fractures observed in the anterior teeth of the children.

Question 106

Do the findings of the study by Thomas Lewis, DDS in 1959 suggest a random relationship between protrusion and fractured anterior teeth?

Answer 106

No, the statistical analysis of the data using the Chi Square test indicated a significant relationship between the incidence of fractured anterior teeth and the protrusion of those teeth, suggesting a non-random association.

Question 107

Describe the age group of the participants in the study by Thomas Lewis, DDS in 1959.

Answer 107

The study included 343 white school children aged between 8 and 13 years. This specific age group was examined to assess the relationship between the protrusion of anterior teeth and the incidence of fractures in those teeth.

Question 108

Describe the purpose of the MD/FL index.

Answer 108

The MD/FL index is designed to detect and evaluate tooth shape deviations that impact mandibular incisor crowding.

Question 109

Who are the authors of the index for assessing tooth shape deviations as applied to the mandibular incisors?

Answer 109

Harvey and Sheldon Peck are the authors.

Question 110

What does the MD/FL index aim to assess?

Answer 110

The MD/FL index aims to assess tooth shape deviations that contribute to mandibular incisor crowding.

Question 111

Define the MD/FL index.

Answer 111

The MD/FL index is an index used to evaluate and identify tooth shape deviations affecting mandibular incisor crowding.

Question 112

How does the MD/FL index help in dental assessments?

Answer 112

The MD/FL index helps in detecting and evaluating tooth shape deviations that play a role in mandibular incisor crowding.

Question 113

What is the MD/FL index used for in odontometry?

Answer 113

Assessing tooth shape deviations in mandibular incisors.

Question 114

Describe the crown shape of well-aligned mandibular incisors.

Answer 114

Resemble a ‘kite-shaped’ crown.

Question 115

How does a high MD/FL index indicate tooth irregularity?

Answer 115

Represents a severe shape deviation in lower incisors.

Question 116

Define the term ‘contact slippage’ in relation to tooth shape.

Answer 116

Mechanical susceptibility due to acute mesial and distal surfaces.

Question 117

Do well-aligned mandibular incisors contribute less tooth substance to arch length?

Answer 117

Yes, due to a relatively narrowed MD diameter.

Question 118

Describe the purpose of the index used the odontometric study on mandibular incisors.

Answer 118

The index is used to assess tooth shape deviations in the mandibular incisors.

Question 119

What is the demographic of the samples used in the odontometric study?

Answer 119

The study used samples of young white American women.

Question 120

Define MD/FL index the context of the study.

Answer 120

MD/ index is a ratio calculated by dividing the mesistal (MD) crown diameter by the faciolingual (FL) crown diameter of the mandibular incisors.

Question 121

Describe the two groups mentioned in the content.

Answer 121

The 1st group consisted of 45 women with ‘perfect’ lower incisor alignment, while the 2nd group was a control sample of 70 women.

Question 122

What was the purpose of recording MD and FL crown diameters of the mandibular incisors for each subject?

Answer 122

To calculate the MD/FL index for each tooth in order to assess tooth shape deviations.

Question 123

How were the MD and FL crown diameters of the mandibular incisors recorded?

Answer 123

They were recorded for each subject in both groups by direct intraoral measurement.

Question 124

What was done with the data after calculating the MD/FL index for each tooth?

Answer 124

The data were processed statistically.

Question 125

Describe the purpose of selective reproximation (IPR) of the maxillary incisors.

Answer 125

To maintain a harmonious anterior intermaxillary relationship in case of severe shape deviation of mandibular incisors.

Question 126

Define the term ‘index’ as used in the context of assessing tooth shape deviations.

Answer 126

An index is a tool or system used for evaluating and quantifying deviations in tooth shape.

Question 127

How may selective reproximation (IPR) of the maxillary incisors be beneficial in cases of severe shape deviation of mandibular incisors?

Answer 127

It may be necessary to maintain a harmonious anterior intermaxillary relationship.

Question 128

Describe the MD/FL index in orthodontics.

Answer 128

The MD/FL index is used to assess tooth shape deviations, particularly in mandibular incisors.

Question 129

Do male-female differences in the MD/FL index have clinical significance?

Answer 129

No, they are not clinically significant.

Question 130

Define the main factor contributing to lower incisor crowding according to the content.

Answer 130

Lower incisors crown shape is not the only factor; other factors include occlusion, habits, deciduous tooth loss, and aging.

Question 131

How are well-aligned mandibular incisors described in terms of crown shape?

Answer 131

Well-aligned mandibular incisors have a distinctive ‘kite-shaped’ crown shape.

Question 132

Describe the importance of crown dimensions, tooth shape, and the MD/FL index in clinical orthodontics.

Answer 132

Achieving mandibular incisor alignment or stability in orthodontics requires consideration of crown dimensions, tooth shape, and the MD/FL index.

Question 133

Describe the long-term profile changes observed in extraction and nonextraction patients.

Answer 133

Long-term profile changes were similar in extraction and nonextraction patients treated to the same incisor position and lip line, with significant changes in profiles between 15 and 30 years of age.

Question 134

What were the main factors contributing to the long-term profile changes in the study?

Answer 134

Increased growth in the nose and chin were identified as the main factors contributing to the long-term profile changes observed.

Question 135

How did males and females differ in terms of long-term profile changes according to the study?

Answer 135

Males showed greater long-term changes than females due to normal sexual dimorphism in aging of the soft tissue profile, especially in the nose and chin.

Question 136

Define the perception of profile changes during the long-term follow-up period.

Answer 136

Small-to-moderate changes in profile were perceived, with no significant difference in perception between orthodontists and laypeople.

Question 137

Describe the findings regarding profile preferences among orthodontists and laypeople in the study.

Answer 137

There was no pattern of profile preferences identified among orthodontists or laypeople, despite clear preferences expressed for 87% of the profiles.

Question 138

How did the study conclude regarding the predictability of aging based on appearance changes over time?

Answer 138

The study concluded that orthodontists cannot determine whether a patient will age for the better or worse based on appearance changes over time.

Question 139

Describe the authors of the content.

Answer 139

The authors are Vincent G. Kokich and Peter A. Shapiro.

Question 140

What are the rationales for lower incisor extraction in orthodontic treatment?

Answer 140

Rationales include minimizing arch expansion, protecting supporting structures, decreasing tooth movement, minimizing facial change, and reducing treatment time.

Question 141

What should be done before attempting a lower incisor extraction in orthodontic treatment?

Answer 141

Before extraction, tooth-size analysis and a careful diagnostic setup (wax-up) should be performed.

Question 142

How much enamel can be safely removed from the inter-proximal surfaces of the maxillary teeth during orthodontic treatment?

Answer 142

The amount depends on the thickness of enamel, which can be determined from radiographs.

Question 143

Where is the inter-proximal enamel usually the thickest in upper anterior teeth?

Answer 143

The inter-proximal enamel is usually thickest on the mesial surfaces of the canines.

Question 144

Describe the 5 goals that form the basis for providing orthodontic treatment.

Answer 144

1. Creating a harmonious balance among tooth alignment. 2. Maximizing occlusal contacts. 3. Enhancing dentofacial esthetics. 4. Creating a functional occlusion. 5. Achieving a relatively stable final result.

Question 145

Define the 9 generally accepted reasons for extracting permanent teeth in orthodontics.

Answer 145

1. Resolution of crowding. 2. Resolution of inter-arch tooth size discrepancies. 3. Reduction of excessive proclination of the anterior teeth. 4. Reduction in lip procumbency (profile reduction). 5. Correction of the midline. 6. Camouflage skeletal mal-relationships. 7. Adjunctive decompensation of the dentition prior to orthognathic surgery. 8. Interdisciplinary considerations (perio-endo-restorative/prosthetic). 9. Establish a more ideal intercuspation or inter-incisal relationship of teeth.

Question 146

How does the extraction of teeth impact the patient’s hard tissue support?

Answer 146

The supporting alveolar bone may be compromised in situations like extracting a partially erupted tooth, a buccally displaced ectopically erupted tooth, an ankylosed tooth, or excessive expansion of dental units.

Question 147

How does the extraction of teeth affect the patient’s soft tissue support?

Answer 147

The soft tissue support may be affected when extracting teeth that could compromise the supporting alveolar bone, such as partially erupted, buccally displaced, ectopically erupted, or ankylosed teeth.

Question 148

Do interdisciplinary considerations play a role in the decision to extract permanent teeth in orthodontics?

Answer 148

Yes, interdisciplinary considerations such as perio-endo-restorative/prosthetic factors can influence the decision to extract permanent teeth in orthodontic treatment.

Question 149

Describe the considerations that must be evaluated before extracting.

Answer 149

Esthetics, long-term stability, occlusal functionality, and potential periodontal compromise.

Question 150

Do patients need to cooperate with the chosen treatment plan before extracting teeth?

Answer 150

Yes, cooperation is crucial, especially regarding mechanotherapeutic cooperation or home care.

Question 151

Define the concept of arch development in clinical orthodontics.

Answer 151

Arch development is a controversial concept that involves expanding the intercanine width or maxillary expansion.

Question 152

How does expanding the mandibular intercanine width without long-term fixed retention typically fare in terms of prognosis?

Answer 152

It carries a guarded prognosis for stability and may lead to periodontal compromise.

Question 153

Describe the importance of considering implant site development when dealing with dental units of poor prognosis.

Answer 153

It is essential to keep the site viable for future implants, which may require altering the extraction plan.

Question 154

Define the potential negative sequalae that must be weighed against the value of maintaining a full set of teeth during extraction therapy.

Answer 154

Esthetic considerations, long-term stability, occlusal functionality, and periodontal compromise.

Question 155

How should the position of teeth in relation to interdental relationships be evaluated before extraction?

Answer 155

It should be assessed whether the final positions will affect the functionality of the occlusal scheme.

Question 156

Describe the potential risks associated with exodontia.

Answer 156

Risks include temporal and financial considerations, as well as discomforts associated with extraction therapy.

Question 157

How should the potential for periodontal compromise be assessed before deciding on tooth extraction?

Answer 157

It should be evaluated whether the positions of the teeth will contribute to periodontal compromise in any way.

Question 158

Describe the considerations for lower molar uprighting in tooth extraction.

Answer 158

Freeway space, mandibular rotation impact on lower facial third, risk of open bite, and maxillary arch width for lateral uprighting.

Question 159

What is interproximal reduction (IPR) used for in dental procedures?

Answer 159

Resolving minor to moderate crowding by changing the size or shape of dental units.

Question 160

How does reproximation impact occlusion when there is no initial inter arch tooth size discrepancy?

Answer 160

It may create occlusal issues by removing tooth structure in just one arch.

Question 161

Define inter arch mechanics in dental treatments.

Answer 161

Methods used to address inter-arch occlusal discrepancies.

Question 162

How do Class II elastics affect the dentoalveolar structures in dental treatments?

Answer 162

They have horizontal and vertical components impacting maxillary and mandibular teeth positioning.

Question 163

What are the potential consequences of reproximation to resolve crowding if extraction may be needed later?

Answer 163

It may create tooth size arch length discrepancies that complicate future treatments.

Question 164

Describe the potential periodontal effects of mandibular dental proclination resulting from inter-arch elastic traction.

Answer 164

Excessive proclination can lead to issues like gingival recession and bone dehiscence.

Question 165

How can molar distalization help resolve inter-arch discrepancies in orthodontic treatment?

Answer 165

Molar distalization can be achieved using extraoral or intraoral appliances to address issues like Class II malocclusions.

Question 166

Define the contraindications for molar distalization in orthodontic treatment.

Answer 166

Contraindications include open bite patients and those with a protrusive profile.

Question 167

When is molar distalization recommended in orthodontic treatment?

Answer 167

It is recommended for correcting Class II malocclusions in deep-bite patients with a concave or normal facial profile.

Question 168

What is the potential risk associated with excessively flared teeth in orthodontic patients?

Answer 168

Patients with overjet greater than 5-6 mm are at higher risk of injury due to teeth being outside the protection of perioral musculature.

Question 169

How can molar distalization or tooth extraction help create space for anterior teeth in orthodontic treatment?

Answer 169

Molar distalization can provide space for anterior teeth retraction, while extraction of dental units is another option for creating space.

Question 170

Describe the manifestations of bimaxillary dentoalveolar protrusion.

Answer 170

Manifestations include lip incompetency, gummy smile, and potential for inflammatory hyperplasia.

Question 171

How can lip procumbency be addressed effectively?

Answer 171

One approach is through 1st premolar extractions.

Question 172

Define the term ‘facial midline’ in the context of dental treatment.

Answer 172

It refers to the symmetry of the face, particularly in relation to the alignment of soft tissue features.

Question 173

What role do occlusal interferences play in causing functional shifts of the mandible?

Answer 173

Occlusal interferences, especially in the upper lateral incisors, can lead to functional shifts of the mandible.

Question 174

How can asymmetry in the facial midline be corrected?

Answer 174

By addressing the etiology of the asymmetry to determine if it is skeletal or functional.

Question 175

Describe the diagnostic considerations for determining the need for extraction therapy in dental treatment.

Answer 175

Assess the degree of deviation and special needs in each quadrant of the arch to decide if extraction therapy is necessary.

Question 176

What is the significance of aligning the mandibular dental midline with the facial and maxillary midlines in treatment?

Answer 176

It aims to achieve symmetry and proper alignment of the lower teeth with the rest of the face for optimal esthetic and functional outcomes.

Question 177

Describe the three absolute caveats that must be addressed before embarking on camouflage therapy in orthodontics.

Answer 177

1. Patient’s capability to participate in necessary cooperation requirements. 2. Potential preclusion of receiving more ideal treatment in the future. 3. Patient’s awareness of compromised treatment.

Question 178

What does pre-surgical orthodontics consist of in the context of orthognathic surgery?

Answer 178

1. Arch alignment. 2. Arch coordination. 3. Dental decompensation.

Question 179

How is decompensation typically managed in orthodontics when dental compensatory discrepancies are mild?

Answer 179

Decompensation can usually occur on a non-extraction basis.

Question 180

Define interdisciplinary considerations in orthodontics, specifically perio-endo-prostho-etc.

Answer 180

It involves collaboration between different dental specialties like periodontics, endodontics, prosthodontics, etc.

Question 181

Describe a common difficult problem in orthodontics involving posterior spacing, anterior crowding, and excessive anterior proclination.

Answer 181

Posterior spacing due to tooth loss, anterior crowding, and excessive anterior proclination with associated lip incompetency.

Question 182

How can the issue of posterior spacing and anterior crowding with excessive proclination be addressed in orthodontics?

Answer 182

Options include retracting anterior teeth, extracting teeth closer to the needed space, or relying on restorative/prosthetic solutions.

Question 183

Describe the generally accepted guidelines for extraction therapy considerations.

Answer 183

Extract teeth nearest to the site of deformity, crowding, or desired change.

Question 184

How might extraction therapy impact occlusion and function?

Answer 184

It could deepen the bite, affect contacts, and result in group function during lateral excursions.

Question 185

Define anchorage considerations in the context of choosing extraction units.

Answer 185

Consider how the choice of teeth to extract might affect the stability and support for orthodontic treatment.

Question 186

How can the choice of which teeth to extract affect the skeletal pattern?

Answer 186

It could impact the vertical dimension, anteroposterior relationship, and relative maxillo-mandibular discrepancy.

Question 187

Describe the evolutionary perspective on the number of premolars per quadrant in early hominids.

Answer 187

Early hominids had 4 premolars per quadrant, losing the first 2 from anterior to posterior.

Question 188

What are common considerations for extracting maxillary or mandibular 1st premolars?

Answer 188

They are usually closest to crowding, proclination, and allow for more posterior anchorage for anterior retraction.

Question 189

How can lower premolars serve as alternatives to orthognathic surgery in certain circumstances?

Answer 189

Lower premolars may be extracted to camouflage discrepancies in cases of skeletal prognathism if surgical correction is not an option.

Question 190

Describe the considerations for extracting second premolars in orthodontic treatment.

Answer 190

Considerations include their distance from crowding sites, impact on profile, effect on smile aesthetics, potential for protraction of posterior teeth, esthetic enhancement, vertical dimension control, preservation of width/length ratio, rapid space closure, and facilitation of Class I molar relationship.

Question 191

What are the challenges associated with removing lower premolars in orthodontic treatment?

Answer 191

Challenges include avoiding excessive retroclination of mandibular incisors, settling posterior occlusion, and preventing supraeruption of maxillary second molars.

Question 192

Define the reasons for extracting first molars in orthodontic treatment.

Answer 192

Reasons include significant posterior crowding and extensive caries.

Question 193

How do second premolars impact the control of first molar tipping and contact points in orthodontic treatment?

Answer 193

Their extraction may result in decreased control over first molar tipping and contact point alignment.

Question 194

Describe the potential effects of extracting second premolars on smile aesthetics in orthodontic treatment.

Answer 194

Extracting second premolars may enhance smile aesthetics by reducing the visual perception of the buccal corridor.

Question 195

What are the considerations for extracting second premolars to help achieve a Class I molar relationship in orthodontic treatment?

Answer 195

Extracting second premolars can facilitate obtaining a Class I molar relationship by aiding in space closure and maintaining proper tooth alignment.

Question 196

Describe the key reason to consider molar extraction treating skeletal open bites.

Answer 196

The wedge effect.

Question 197

When should the extraction of the maxillary 2nd molar be considered?

Answer 197

When severely damaged, ectopically erupted, severely rotated, crowding in the tuberosity area, or minimal first molar distalization is required with not enough space for 3 molars.

Question 198

What are the advantages associated with maxillary second molar extraction therapy?

Answer 198

Reduced treatment time, lesser potential for extraction site reopening, easier distalization of the first molar.

Question 199

What are the most common reasons for the extraction of maxillary lateral incisors?

Answer 199

Significant abnormalities in tooth shape and size, balancing the arch in cases of aplasia, significant distance movement due to ectopic position, root resorption from ectopically erupting canines.

Question 200

What are the potential negative sequelae to be addressed in case of upper laterals extraction?

Answer 200

Need for restorative treatment on adjacent teeth, effect on the midline, resulting overjet.

Question 201

When should extraction of maxillary canines be considered?

Answer 201

In ectopic eruption/impaction situations or when there is a poor risk/benefit ratio relative to attempting to save the canines.

Question 202

Why is the decision to extract mandibular canines usually less of an issue compared to upper canines?

Answer 202

Lower first premolars can easily replace a canine from an anatomical and functional perspective.

Question 203

What should be the primary goals when considering tooth extraction in orthodontic treatment?

Answer 203

To create a functional occlusion, achieve a relatively stable position, and confer an aesthetic benefit to the patient.

Question 204

Describe the approach to tooth extraction in orthodontic treatment.

Answer 204

Under appropriate clinical circumstances and specific patient needs, virtually any tooth can be a viable candidate for extraction.

Question 205

In what situations should extraction of maxillary canines be considered?

Answer 205

In ectopic eruption/impaction scenarios or when the risk/benefit ratio of saving the canines is poor.

Question 206

Describe the authors of the study on orthodont treatment with removal of one mandibular incisor.

Answer 206

The authors are Gısli Vilhjalmsson, John P. Zermeno, and William R. Proffit.

Question 207

Do lower incisor extractions simplify orthodontic treatment in what circumstances?

Answer 207

In severe crowding of the mandibular but not the maxillary incisors, mild anterior crossbite with good alignment in both arches, and when there is a discrepancy in the anterior arch form.

Question 208

Define the major objections (disadvantages) of lower incisor extraction in orthodontic treatment.

Answer 208

The objections include unsightly black triangles due to loss of interdental papilla height, possible tooth size discrepancy affecting occlusal relationships, and patient concerns about visible extraction sites.

Question 209

How were the extraction sites prepared in the study?

Answer 209

The extraction sites were prepared by tipping the tooth to be extracted lingually while simultaneously closing the space in front of it.

Question 210

Describe the duration required to prepare the site of extraction in the study.

Answer 210

It takes 2-6 months to prepare the site of extraction in the study.

Question 211

Describe the importance of extraction site preparation before attempting to extract a lower incisor in orthodontic treatment.

Answer 211

It involves setting up a model to rearrange the mandibular anterior teeth, observing the resulting occlusal relationships, and selecting the incisor to be extracted based on factors like bone height and crowding.

Question 212

Do you extract a lower incisor with enamel decalcification or a lingually inclined incisor in orthodontic treatment?

Answer 212

Yes, a lower incisor with enamel decalcification or a lingually inclined incisor may be selected for extraction based on factors like bone quality and crowding.

Question 213

Define the rationale behind selecting a central incisor for extraction over a lateral incisor in orthodontic treatment.

Answer 213

It is easier to remove a central incisor because it is more challenging to upright the canine relative to a central incisor, which can help prevent issues like black triangles.

Question 214

Describe the impact of orthodontic with removal of one mandibular inc on black triangles based on patient age groups.

Answer 214

In patients below age 20, this approach eliminated post-treatment black triangles and almost eliminated partial loss of the interdental papilla. In patients aged 20-40, it reduced the prevalence of black triangles. In patients over 40, it did not show significant benefits.

Question 215

What compensates for tooth size discrepancy in orthodontic treatment involving removal of one mandibular incisor?

Answer 215

Tooth size discrepancy is largely compensated by the different labio-lingual orientation of maxillary and mandibular anterior teeth.

Question 216

How does the extraction space change during extraction site preparation in orthodontic treatment with removal of one mandibular incisor?

Answer 216

The extraction space quickly disappears during extraction site preparation.

Question 217

Do extraction of a mandibular incisor and premolar extractions significantly differ in terms of speed and ease?

Answer 217

There are no direct data comparisons, but extraction site preparation adds 2-6 months to treatment length and some management complexity.

Question 218

Define the major indication for the extraction of one mandibular incisor in orthodontic treatment.

Answer 218

Camouflage of a mild skeletal Class III problem is the major indication for this extraction pattern.

Question 219

How does the new extraction site preparation procedure impact the loss of interdental papilla height in orthodontic patients?

Answer 219

The new procedure prevents the loss of interdental papilla height in almost all patients under age 20 and decreases its probability in those aged 20-40.

Question 220

Describe a pseudo Class III malocclusion.

Answer 220

It is a functional forward displacement of the mandible caused by retroclined maxillary incisors.

Question 221

What is the main objective of treating pseudo Class III malocclusion?

Answer 221

To change the inclination of the upper retroclined incisors.

Question 222

How is early treatment of pseudo Class III beneficial?

Answer 222

It corrects the anterior mandibular displacement before canine and premolar eruption, creates space for buccal segment eruption, and provides a normal maxillary growth environment.

Question 223

What method was used in the study for treating pseudo Class III malocclusion?

Answer 223

Simple fixed appliance (2x4 appliance) was used on 27 patients.

Question 224

What were the results of the treatment for pseudo Class III malocclusion in the study?

Answer 224

All patients achieved a positive overjet during active treatment, which was maintained for 5 years post-treatment.

Question 225

Describe the treatment approach for pseudo Class III malocclusion in the mixed dentition.

Answer 225

The treatment approach involves using a simple fixed (2x4) appliance as a first-phase treatment to normalize overjet and overbite, allowing for the proclination of upper incisors before the eruption of the buccal segment.

Question 226

What is the significance of proclination of upper incisors in the treatment of pseudo Class III malocclusion?

Answer 226

Proclination of upper incisors before the eruption of the buccal segment allows the canines and premolars to erupt into a Class I in centric relations, contributing to the stability of the occlusion.

Question 227

How did the follow-up study on early treatment of pseudo Class III malocclusion conclude regarding overjet maintenance?

Answer 227

The study showed that treatment with a simple fixed appliance in the mixed dentition resulted in a positive overjet that was maintained in the long-term, with only a minority of patients needing a second-phase treatment.

Question 228

Define the term ‘self-correction of anterior crossbite’ in the context of dental treatment.

Answer 228

Self-correction of anterior crossbite refers to the natural correction of misalignment in the front teeth during the transition from primary to early mixed dentition without the need for intervention.

Question 229

What caution should be exercised regarding very early treatment of anterior crossbite based on the provided content?

Answer 229

Very early treatment of anterior crossbite should be implemented with caution to avoid unnecessary clinical procedures, as self-correction during the transition from primary to early mixed dentition is potentially high.

Question 230

Describe the study mentioned in the content.

Answer 230

The study compared the long-term outcomes of premolar extraction and nonextraction in Class II patients, focusing on changes in hard-and-soft-tissue protrusion and dental changes over a 15-year period.

Question 231

What method was used to assess the extraction/nonextraction decision in the study?

Answer 231

Discriminant analysis was used to evaluate the anatomical basis of the extraction/nonextraction decision in the Class II patients.

Question 232

Define the term ‘profile convexity’ as mentioned in the content.

Answer 232

Profile convexity refers to the degree of prominence or protrusion of the facial profile.

Question 233

How did premolar extraction impact the hard-and-soft-tissue protrusion in the study?

Answer 233

Premolar extraction resulted in a significant reduction (about 2-3 mm) in the hard-and-soft-tissue protrusion.

Question 234

Describe the difference in mandibular displacement between the extraction and nonextraction groups.

Answer 234

Both groups experienced mesial mandibular displacement, with extraction patients showing significantly more displacement compared to nonextraction patients.

Question 235

What were the findings regarding signs and symptoms of dysfunction (TMD) between the extraction and nonextraction groups at recall?

Answer 235

At recall, the two groups did not differ significantly in terms of signs and symptoms of dysfunction (TMD).

Question 236

How did the study’s findings challenge common beliefs about premolar extraction outcomes?

Answer 236

The study’s findings contradicted the common belief that premolar extraction often leads to ‘dished in’ profiles, ‘distalized’ mandibles, and craniomandibular dysfunction (TMD).

Question 237

Describe the effects of premolar-extraction on soft- and hard-tissue convexity in Class II patients.

Answer 237

Premolar extraction reduces soft- and hard-tissue convexity by 2-3 mm, while nonextraction therapy has little effect.

Question 238

What are the posttreatment changes observed in both clear-cut premolar-extraction and nonextraction Class II patients?

Answer 238

Posttreatment changes, including an additional convexity reduction, are generally similar in both groups.

Question 239

Define the difference in profiles between clear-cut nonextraction and premolar-extraction patients after growth is completed.

Answer 239

Clear-cut nonextraction patients tend to have ‘flatter’ profiles compared to premolar-extraction patients with crowding and spacing.

Question 240

How are pre- and posttreatment tooth movements related to jaw growth patterns in Class II patients?

Answer 240

Tooth movements are related to the pattern of jaw growth, with some relapse possibly being a dentoalveolar compensation for residual posttreatment growth.

Question 241

Describe the common movement of upper buccal segments in nonextraction treatment versus premolar-extraction treatment.

Answer 241

In nonextraction treatment, upper buccal segments are commonly ‘distalized,’ while they tend to come forward if premolars have been extracted.

Question 242

What is the tendency for mandibular displacement during treatment in relation to extraction and nonextraction approaches?

Answer 242

There is a tendency for the mandible to be displaced mesially during treatment, more so in extraction than nonextraction.

Question 243

Describe the long-term difference, if any, in signs and symptoms of TMD between extraction and nonextraction therapy.

Answer 243

There is apparently no significant long-term difference in signs and symptoms commonly associated with TMD between extraction and nonextraction therapy.

Question 244

Describe the authors of the study.

Answer 244

J.F. Camilla Tulloch, BDS, FDS, DOrth, Ceib Phillips, PhD, MPH, and William R. Proffit, DDS, PhD.

Question 245

What was the focus of the first phase of the clinical trial?

Answer 245

To determine if the growth pattern of Class II patients can be modified.

Question 246

What was the focus of the second phase of the clinical trial?

Answer 246

To investigate if inducing differential growth effects during early treatment makes a difference in the end.

Question 247

How were the participants in the first phase of the trial assigned to different groups?

Answer 247

166 preadolescent children with increased overjet were randomly assigned to undergo early growth modification with headgear, a functional appliance, or no treatment.

Question 248

Define the treatment provided in the first phase of the trial.

Answer 248

Early growth modification with headgear (combination=straight) or a functional appliance (modified bionator), or no treatment.

Question 249

Describe the evaluation process for all patients in the first phase of the trial.

Answer 249

All patients, both treated and controls, were evaluated at 15 months by one clinician following a strict treatment protocol.

Question 250

Describe the second phase of the clinical trial mentioned in the content.

Answer 250

The second phase involved 107 patients who had completed comprehensive treatment, with each doctor determining the treatment for the patients.

Question 251

What benefits were considered in the progress report of the clinical trial during the second phase?

Answer 251

The benefits considered were the amount of skeletal change, the change in Peer Assessment Rating (PAR) score, the duration of comprehensive treatment, and the complexity of treatment.

Question 252

Define Peer Assessment Rating (PAR) score.

Answer 252

The Peer Assessment Rating (PAR) score is an occlusal index used on study models to assess the initial degree of malocclusion, treatment results, and improvement.

Question 253

How was the impact of early growth modification on subsequent treatment reviewed in the clinical trial?

Answer 253

The impact was reviewed by assessing the amount of skeletal change, changes in PAR score, duration of treatment, and complexity of treatment.

Question 254

Describe the treatment protocol during phase 2 of the clinical trial.

Answer 254

During phase 2, the treatment protocol was not specified, and each doctor was allowed to determine the treatment for the patients based on differences in patients and clinicians’ proficiency.