6 - Growth and Development Flashcards
(40 cards)
What do you need for diagnostic records for orthodontics?
- Dental study models
- 8 series photographic collage
- Complete intra-oral radiographs
- Cephalometric radiograph including tracing
- Anterior-posterior radiograph when indicated (for example, when there is a possible facial or occlusal asymmetry)
Some adjustments in this standard will more than likely be forthcoming, with the use of CBCT becoming more commonplace.
What are common orthodontic treatment risks to be covered when getting consent?
- Caries
- Root resorption
- Periodontal disease
- Necrotic pulp
- Discomfort
- Trauma
- TMD considerations
- Impacted teeth
- Length of treatment
- Prognosis
- Relapse
What are the three basic components of a comprehensive orthodontic assessment for a patient?
- Patient questionnaire
- Examination (oral health, function, and facial proportions)
- Diagnostic records
Do you have to have cephalometric evaluation for diagnostic records for orthodontic patients?
No. Depending on the severity of the patient’s problem, certain orthodontic records may not be necessary.
How would CBCT influence the way orthodontic assessments have been done in the past?
CBCT may eliminate the need to make separate dental study models, intra-oral radiographs and cephalometric radiographs bc all three of these can be captured in the 3D CBCT image.
What four broad areas of treatment need to be coveted during the process of informed consent?
- Type of treatment to be rendered
- Risks
- Benefits
- Alternatives to the treatment
What are the alternatives to extraction and distal shoe placement?
- Aggressive pulpectomy of the primary second molar
- Extraction and no space management and permit the permanent first molar to drift mesially and impact the second premolars
- Extraction and use of a removable acrylic pressure appliance that would guide the first permanent molars via pressure and without penetrating the alveolar mucosa
What angulation is usually built into the distal shoe blades from an occlusal to gingival direction and why?
Angles mesially to help prevent the permanent first molar from getting impacted under the distal shoe blade.
When should bilateral space maintainer be placed on the permanent first molar?
Once the first permanent molars are erupted far enough for banding.
What space maintainers are used for space maintenance of the mixed dentition?
For unilateral loss: band and loop spacer
For bilateral loss prior to eruption of the permanent incisors: bilateral band and loop spacers (concerns about the anterior portion of the lower lingual arch wire precludes consideration of this appliance until the incisors erupt)
For bilateral loss after eruption of the permanent incisors: lower lingual arch or acrylic partial denture
What is the leeway space?
The extra space between the permanent premolars and canines compared to the primary molars and canines.
What is the Tanaka Johnston Analysis?
- Divide the width of the lower permanent incisors in half.
- To this number, add 10.5mm for the lower buccal segment; add 11mm for the upper buccal segment.
- Subtract the number calculated above from the combined widths of the primary molars and canine for the buccal segment in question to get the leeway space for that area.
If there is lower anterior crowding, what are the options for management in the mixed dentition?
- Space redundancy - Wait until the permanent dentition has erupted to close the space, do bonding, or consider tooth replacement.
- No crowding - Even with no crowding, long-term alignment cannot be guaranteed in some patients. Development of alignment problems later on in life may benefit from retention.
- Mild crowding (1 to 4 mm) - Use of a lower lingual arch to hold the leeway space (lingual arches typically hold only 3 to 5mm of space), disking of select primary teeth.
- Moderate crowding (5 to 9mm) - Flaring of anterior teeth, distalization of permanent first molars, or arch expansion with appliances such as a lip bumper or limited orthodontic with bands on the molars, brackets on the incisors (“2x4”) and open coil springs.
- Severe crowding (10mm or more): Serial extraction, or wait until the permanent dentition and consider extraction, followed by full orthodontics.
Why should lower lingual arches not be placed prior to eruption of the permanent lower incisors?
The anterior portion of the lingual wire can interfere with normal eruption of the incisors.
What can oral habits cause?
- Decreased arch width
- Crossbite
- Increased overjet
- Decreased overbite or open bite
What two important concepts are necessary to correct an oral habit?
- Often, parental anxiety and scolding about the habit increases its intensity, instead of ameliorating it.
- The child must be old enough to understand the need to stop the habit and must want to stop the habit for interventions to be helpful.
What do you do if a patient is determined to continue an oral habit despite an intra-oral appliance?
In these cases, the patient may not truly want to stop the habit and a child therapist should be consulted to determine if there are other psycho-social issues involved.
What are the three main areas of treatment for a patient with an oral habit?
- Behavior modification: This technique uses positive reinforcement to encourage the child’s compliance. E.g., a rewards calender (a star is placed for each successful day of no oral habit and at the end of each week a small reward is given, usually works within a month’s time)
- Extra-oral means: Various options are available including wrapping an Ace bandage around the elbow at night to keep the child from bending her arm to place their digit in her mouth (must be careful not to cut off blood circulation), placement of bitter-tasting liquids on the digit, and use of a glove-like appliance that covers the thumb and straps around the wrist.
- Intra-oral appliances: Palatal appliances with cribs, loops, irritating spurs, or beads can all be helpful.
What is the main difference between non-nutritive sucking habits that are benign and those that have deleterious oral effects?
Patients with habits of minimal frequency, duration or intensity have no or milder deleterious effects.
What two important concepts are necessary to correct an oral habit?
- Often, parental anxiety and scolding about the habit increases its intensity, instead of ameliorating it.
- The child must be old enough to understand the need to stop the habit and must want to stop the habit for interventions to be helpful.
What are the three main areas of treatment for a patient with an oral habit?
- Behavior modification: This technique uses positive reinforcement to encourage the child’s compliance. E.g., a rewards calender (a star is placed for each successful day of no oral habit and at the end of each week a small reward is given, usually works within a month’s time)
- Extra-oral means: Various options are available including wrapping an Ace bandage around the elbow at night to keep the child from bending her arm to place their digit in her mouth (must be careful not to cut off blood circulation), placement of bitter-tasting liquids on the digit, and use of a glove-like appliance (or sock) that covers the thumb and straps around the wrist.
- Intra-oral appliances: Palatal appliances with cribs, loops, irritating spurs, or beads can all be helpful.
What is the main difference between non-nutritive sucking habits that are benign and those that have deleterious oral effects?
Patients with habits of minimal frequency, duration or intensity have no or milder deleterious effects.
In managing a patient’s sucking habit, what is the most critical component to consider for success?
The child must be old enough to understand the need to stop the habit and must want to stop the habit for interventions to be helpful.
Deleterious effects on the teeth and supporting structures are minimized if children will stop their digit sucking habits by approximately what age?
Before age 6; that is, before eruption of the permanent teeth.
