5B

Question 1

Adjunctive therapy:

● Goal to

Answer 1

reposition teeth to facilitate other dental procedures (restore fxn & control disease)

Question 2

Adjunctive therapy:

○ Main goal is

Answer 2

NOT ideal occlusion/alignment

Question 3

Adjunctive therapy:

● Generally limited in

Answer 3

scope (ie. doesn’t fix overjet, but creates space for implant placement)

Question 4

Adjunctive therapy:

● Always inter-disciplinary →

Answer 4

Prosthodontist, Perio, OMFS, &/or Endo

Question 5

Adjunctive therapy:

● Patient characteristics:

Answer 5

○ Adults with underlying dental disease

○ Sequencing care is critical

Question 6

Adjunctive therapy:

■ Orthodontics to realign teeth for

Answer 6

better restorative treatment

○ Control/eliminate disease process - primary goal

Question 7

Adjunctive therapy

■ No orthodontics or restorative until

Answer 7

underlying perio or caries stopped

○ These pts have very specific biomechanical treatments

Question 8

Effect of reduced periodontal support

● Many pts requiring adjunctive therapy have

Answer 8

reduced periodontal support

Question 9

● Reduced periodontium (changes C-res) ⇒

Answer 9

alters amount of orthodontic force

○ Apical migration of C-res

Question 10

Common Adjunctive Procedures

1. Uprighting molars ⇒ common scenario where

Answer 10

molar/PM extracted & adjacent teeth or abutments drift into unrestrained extraction spac

Question 11

Common Adjunctive Procedures
Uprighting molars
○ Need to consider

Answer 11

of teeth being uprighted & anchorage

Question 12

Common Adjunctive Procedures
Uprighting molars
■ Uprighting molars can be

Answer 12

difficult & requires a lot of anchorage

Question 13

Common Adjunctive Procedures
Uprighting molars
○ 2 methods of uprighting molars:

Answer 13

■ Distal crown tip
■ Mesial root tip
■ Combination of distal crown tip & mesial root tip

Question 14

■ Distal crown tip ⇒ Maintains

Answer 14

space for pontic

Question 15

Distal crown tip

● If NO antagonist →

Answer 15

distal tipping will extrude tooth

Question 16

Distal crown tip

○ Coil

Answer 16

spring mechanism

Question 17

Distal crown tip

○ ↑ crown ht &

Answer 17

↓ mesial pocket

Question 18

DISTAL CROWN TIP

○ May require

Answer 18

crowd reduction to improve crown:root ratio

Question 19

■ Mesial root tip

● Reduces

Answer 19

pontic space (eliminates need for pontic, but more difficult)

Question 20

Mesial root tip

○ Requires

Answer 20

T-loop, spring, or helical mechanics (more complicated)

Question 21

Mesial root tip

Answer 21

● Intrudes tooth

Question 22

■ Combination of distal crown tip & mesial root tip

● Goal is

Answer 22

distal crown tip, but want to prevent extrusion

Question 23

Combination of distal crown tip and mesail root tip

○ To prevent extrusion →

Answer 23

use T-loops or helical mechanics to intrude tooth &/or move roots mesially

Question 24

1. Forced eruption:

○ Indications:

Answer 24

■ Subgingival tooth fx

Question 25

1. Forced eruption: ○ Indications: ● Can’t restore

Answer 25

subgingival fx; will either need to extract or extrude tooth to provide tooth structure for restoration

Question 26

1. Forced eruption: ○ Indications: ■ Periodontal disease & vertical bony defect ○ Treatment options:

Answer 26

■ Perio crown lengthening - limitation is crown-root ratio | ■ Orthodontic rapid extrusion

Question 27

1. Forced eruption: ○ Indications: ■ Orthodontic rapid extrusion

Answer 27

● Spring helical mechanism (straight wire would tip adjacent teeth)

Question 28

1. Forced eruption: ○ Orthodontic extrusion ⇒

Answer 28

orthodontic forces used for extrusion

Question 29

Ortho extrusion | ■ PDL/alveolar bone follows

Answer 29

extruding tooth

Question 30

1. Forced eruption: | ○ Rapid extrusion ⇒

Answer 30

heavier forces & more frequent activations

Question 31

1. Forced eruption: | ■ Tooth extruded without

Answer 31

periodontium following (partial extraction)

Question 32

1. Forced eruption: | ■ Lengthens

Answer 32

clinical crown - to expose sound tooth & root structure

Question 33

1. Forced eruption: | ○ Retention period important -

Answer 33

long retention period to prevent re-intrusion

Question 34

1. Intrusion for supra-erupted teeth | ○ Anterior tooth intrusion ⇒

Answer 34

possible with conventional orthodontics

Question 35

Intrusion for supra-erupted teeth | ○ Posterior tooth intrusion ⇒

Answer 35

possibly ONLY with reinforced anchorage - TADs or implants

Question 36

Intrusion for supra-erupted teeth | Intrusion ⇒ one of the most

Answer 36

difficult orthodontic movements to accomplish

Question 37

Intrusion for supra-erupted teeth | ● Often with extrusion, patients have

Answer 37

vertical periodontal defects (bc bone following extruded tooth)

Question 38

Skeletal anchorage ⇒ utilizes

Answer 38

osseointegration (implants) or TADs (temporary anchorage devices)

Question 39

● TADs ⇒ allow

Answer 39

previously difficult tooth movements possible (ie. posterior tooth intrusion)

Question 40

TADs | ○ Simplifies

Answer 40

ortho biomechanics & speeds up treatment

Question 41

TADs | ■ Allows for

Answer 41

symmetric force. (ie. placing TAD’s buccally & lingually to extruded tooth allows intrusion w/o tipping)

Question 42

Tooth Proportions: | ● Maxillary incisors: ideally ~

Answer 42

10mm tall & 8.5 mm wide

Question 43

Tooth proportions | ○ Ideal width to height ratio

Answer 43

80-84% ● Golden proportion ● Recurring Esthetic Dental Dimension ○ 70% proportion recommended for average teeth length (lateral width 70% of central)

Question 44

Maxillary & mandibular anterior attrition & supra-eruption ● As teeth undergo attrition →

Answer 44

tend to supra-erupt & gingival margins change

Question 45

○ Laterals should have the most

Answer 45

cervical gingival margin

Question 46

● Intruding anteriors will create

Answer 46

open bite for general dentist to restor

Question 47

Congenitally missing maxillary lateral incisors | ● Canines can erupt in place of

Answer 47

missing laterals (good bc brings alveolar bone with it; allows for future implant if decide to distalize canines)

Question 48

Congenitally missing maxillary lateral incisors ● Treatment plan depend on pt: ○ Class II with overjet →

Answer 48

treat canine as lateral & close space to reduce overjet

Question 49

Congenitally missing maxillary lateral incisors ● Treatment plan depend on pt: ○ Class I →

Answer 49

distalize canines to class I position & restore w/ implants

Question 50

Congenitally missing maxillary lateral incisors | ■ Adj. roots must be

Answer 50

upright to allow for implant placement