BDS4 Risk and benefits to ortho

Question 1

what are needs to iotn dhc?

Answer 1

1 & 2 No Need/Low Need
(min benefit)
3 Borderline Need
(some benefit)
4 & 5 Need/High Need
(significant benefit)

Question 2

what does MOCDO mean?

Answer 2

• MISSING TEETH
• OVERJET
• CROSSBITES
• DISPLACEMENT of contact points
• OVERBITES

Question 3

effects of impacted teeth?

Answer 3

• cause resorption
• supernumerary prevent normal eruption
• can be associated with cyst formation

Question 4

what size is big risk with overjet and why and when is it worse?

Answer 4

• Overjet >6mm
• risk of trauma to upper incisors
• worse with incompetent lips

Question 5

what is associated with anterior crossbites?

Answer 5

• loss of perio support
• tooth wear

Question 6

what may posterior crossbites lead to?

Answer 6

• significant - lead to
  *asymmetry
  *requiring early correction

Question 7

what does deep traumatic overbites lead to?

Answer 7

• gingival stripping
• loss of perio support

Question 8

what are 5 big risks to ortho? and couple others

Answer 8

• decalcification
• root resorption
• relapse
• soft tissue trauma
• recession

others
*loss perio support
*FTA

Question 9

what is decalcification

Answer 9

• loss of calcium and weakens enamel to caries

Question 10

how to prevent decal?

Answer 10

1. Case selection
2. Oral Hygiene
3. Diet advice
4. Fluoride

Question 11

what is a good case selection?

Answer 11

• motivated pt
• good OH pre tx
• low caries risk
• if low or borderline need - best avoid tx

Question 12

what is fluoride of mw?

Answer 12

225ppm - 0.05% f mw

Question 13

what is percentage of sevre root resorption

Answer 13

1-5%

Question 14

how much do teeth get resorbed in ortho?

Answer 14

average approx 1mm over 2 years fixed applianced

inevitable consequence

Question 15

what teeth are most affected to root resorption?

Answer 15

any teeth but
UI > LI >6s

Question 16

what are risk factors to root resorption?

Answer 16

– Type of tooth movement
*Prolonged, high force
*Intrusion
*Large movements
*Torque (root movement)
– Root form - blunt, pipette, resorbed already – Previous trauma
– Nail biting ?

Question 17

what are features most prone to relapse?

Answer 17

– Lower incisor crowding
– Rotations
– Instanding 2’s
– Spaces & diastemas
– Class II div 2
– Anterior open bites
– Reduced perio support/short roots

Question 18

how to manage relapse?

Answer 18

1. case selection
2. informed consent
3. retainers - fixed and removable

Question 19

how to prevent relapse after tx?

Answer 19

• Removable retainers
  –Clear Occlusal retainer (COR)
  –Pressure or vacuum formed (PFRs/VFRs)
  – Essix
  – Hawley type - good for occlusion
• Remove for OH
• Can wear part time
• Patient control
• Easy to spot problem

Question 20

what is important to know about fixed retainers?

Answer 20

• prone to plaque and calculus buildup
• Need excellent OH
• Tend to leave in situ for life
• Require more care/ long-term maintenance

Question 21

what do you tend to for fixed retainers

Answer 21

• place vacuum formed retainer on top

Question 22

what are types of soft tissue trauma for ortho?

Answer 22

• pain/discomfort
• ulceration

Question 23

what is management of recession?

Answer 23

• Correct tx planning - teeth within bone avoid over expansion
• Thin biotype
• Warn Pt
• Gingival graft

Question 24

what must you do with active perio disease and ortho tx?

Answer 24

– Must be treated, stabilised, maintained before ortho tx starts
– During ortho Tx – accelerates alveolar bone loss and perio
destruction
– Treated as priority over continuing Tx

Question 25

what is prevention of headgear trauma?

Answer 25

Safety mechanisms - 2 minimum
* Snap away traction spring
* Nitom facebow
* Masel strap

Question 26

what are allergies related to ortho tx

Answer 26

• Latex
• Nickel
• Adhesive - colophony

Question 27

what is sucess of tx dependent on?

Answer 27

– severity of malocclusion
– motivation of patient
– operator expertise

Question 28

why is fta/poor tx a risk?

Answer 28

clinician
*poor diagnosis
*poor tx planning
*operative technique error

patient
*unfavourable growth
*poor co-op