adult orthodontics Flashcards
What are the differences from ortho in children, in adults?
Lack of growth
Periodontal disease
Missing and heavily restored teeth
Physiological factors
Adult motivation
How does lack of growth affect ortho in adults?
Growth modification not possible - must accept skeletal discrepancy or have surgery
OB correction more difficult - may need tooth intrusion
Mid palatal suture is closed - can only expand maxillary base with surgery
How can periodontal issues affect ortho?
Loss of support leads to tooth centre of rotation moving apically and anchorage value reducing
Can a patient still get ortho if they have periodontal disease?
Previous support loss - they can still have tx
Active perio disease - they cannot have tx
How can missing and restored teeth affect ortho?
Tooth loss leads to drifting and tilting of teeth
Restored teeth can complicate bonding
RCT teeth okay if obturated correctly and symptomless
How motivated are adults for ortho?
Often very well motivated
May request aesthetic appliances
How may ortho be used as an adjunctive to restorative treatment?
Upright abutments to aid bridges, dentures and implants by creating a path of insertion
Intrusion of over-erupted teeth
Extrusion to increase crown length
How may ortho be used as an adjunctive to perio treatment?
May see tooth migration in perio
May see proclined incisors, spacing and an increased OB in perio
How is ortho used as an adjunctive to orthognathic surgery?
Assessment and planning - orthodontist, maxillofacial surgeon, technologist and clinical psychologist
Pre-surgical orthodontics - align and coordinate dental arches and decompensate incisors
Surgery
Post-surgical orthodontics
What type of brackets may be used for a more aesthetic appearance?
Ceramic
Describe lingual appliances?
Technically challenging to adjust
Custom brackets made after scanning the teeth
Indirect bonding - brackets loaded into pressure formed retainer and put on all in one go
Expensive
What is aligner technology?
Removable aligners eg - Invisalign
Attach composite to tooth through slot in trays, this then applies a slight force to the teeth
What is an Inman aligner?
Removable appliance to align teeth - not really used nowadays
What should the majority of adult patients receive after ortho treatment?
A fixed retainer and a thermoplastic retainer
What is Cfast?
Brackets and archwire used by GDP to align anterior teeth
However - all pts need to be adequately assessed and given all tx options - specialist opinion good idea
