CDS Orthodontics Flashcards

Question

Unofficial 7th Andrews key

Answer 1

If you have a small lateral incisor, all of the teeth in that segment need to be slightly further forward

Answer 2

Minor deviations from the ideal that do not constitute an aesthetic or functional problem

Answer 3

Teeth may be RCTed, have root resorption, could be ankylosed

Answer 4

Thumb sucking Lower lip sucking Tongue thrust Chewing nails

Answer 5

British Standard Institute BSI

Answer 6

The lower incisor edges lie posterior to the cingulum plateau of the upper incisors, there is an increased overjet and the upper central incisors are proclined or of average inclination

Answer 7

Concerns about aesthetics Concerns about dental health - trauma

Answer 8

Usually associated with class 2 skeletal pattern Commonly due to retrognathic mandible (maxillary protrusion is less common) Do see with skeletal class 1, very rarely with class 3 but its possible

Answer 9

Skeletal pattern, tooth inclination or both

Answer 10

Prominence of incisors and/or underlying skeletal pattern

Answer 11

Lower lip trap

Answer 12

Increased OJ - proclined or average incisors Overbite varies Can be aligned/spaced/crowded Habitually parted lips may lead to drying of gingivae and exacerbation of any pre-existing gingivitis

Answer 13

Thumb/fingers Blanket Lip Combination NNSH no nutritive sucking habits Effect depends on duration

Answer 14

Proclination of upper anteriors Retroclination of lower anteriors Localised AOB or incomplete OB Narrow upper arch - may see unilateral crossbite

Answer 15

Stop habit Allow spontaneous movement Treat residual malocclusion if required

Answer 16

Positive reinforcement Removeable appliance habit breaker Fixed appliance habit breaker

Answer 17

Accept Attempt growth modification - first choice of tx if pt correct age, difficult beyond age 14 Simple tipping of teeth - more applicable to older patients Camouflage Orthognathic surgery - more severe, if pt has concerns about jaw position

Answer 18

Mildly increased overjet Significant overjet but not unhappy - might present later when they are more concerned

Answer 19

Pt must be made aware of risk of trauma Advice re mouthguard

Answer 20

Headgear Functional appliance

Answer 21

Tries to restrain growth of the maxilla, horizontally and/or vertically Has most effect by distalising the teeth

Answer 22

Utilise, eliminate or guide the forces of muscle function, tooth eruption and growth to correct a malocclusion

Answer 23

Used mostly for Class II div I Can use for div 2 Limited use for class III

Answer 24

Posture the mandible downwards and forwards Restrains maxillary growth

Answer 25

Functional appliance in which lower teeth are held forward, muscles retract upper teeth For class II

Answer 26

Fixed functional appliance used to correct skeletal class II

Answer 27

Mostly dento-alveolar changes - distal movement upper dentition, mesial movement of lower, proclination of upper incisors and retroclination of lower incisors Minor degree of skeletal change - suggested maxillary restraint and mandibular growth only has 1-2mm effect

Answer 28

During growth If possible coincide with pubertal growth spurt Options for early use about 10 years old for 2 phase tx or later use with permanent or late mixed dentition for 1 phase tx

Answer 29

Early skeletal effects not maintained in long term Overall tx time increased - 2 phase treatment with fixed in early permanent dentition Research shows little difference between those treated early and those who waited until permanent dentition

Answer 30

Improve appearance earlier - teasing and potential psychological benefit Reduce risk of trauma Often better compliance with appliance wear

Answer 31

Active component - Roberts retractor 0.5mm HSSW in tubing Retention - Adams clasps 16 and 26 0.7mm HSSW Anchorage - stops mesial to 13 and 230.7mm flattened HSSW Baseplate - Self cure PMMA and FABP OJ+3mm

Answer 32

Carried out when growth is complete Skeletal discrepancy is severe in A/P and/or vertical dimension Usually involves mandibular surgery, can also involve maxillary Fixed appliance required before/during/after surgery

Answer 33

Skeletal bases Soft tissue - lip competence, smile line TMJ

Answer 34

Consider growth potential Malocclusion - esp class III

Answer 35

Mandible is positioned further back Increased tendency for a large overjet

Answer 36

Anterior cranial base

Answer 37

Posterior cranial base

Answer 38

Antero-posterior Vertical Transverse

Answer 39

Frankfort plane parallel to the floor

Answer 40

Top of the external auditory meatus to the inferior border of the orbit

Answer 41

Inner most curvature of the lips

Answer 42

Maxilla 2-3mm in front of the mandible

Answer 43

Maxilla more than 3mm in front of the mandible

Answer 44

Mandible in front of or less than 2mm behind the maxilla

Answer 45

Frankfort mandibular planes angle Lines drawn continuous with these should join at the occiput

Answer 46

Assess symmetry, considering interpupillary line, mid-sagittal plane Cupids bow normally in midline Ignore tip of the nose Compare chin point to the line If asymmetry suspected, view pt from behind/above

Answer 47

Lines meet further forward than occiput Expect minimal overbite or AOB, because back teeth will meet first

Answer 48

Lines meet behind the occiput Expect deep bite, jaws too close together

Answer 49

Lips - competent or incompetent, lower lip level, lower lip activity Tongue - position, habits, swallowing Habits - thumb, digit sucking Speech - lisp, straightening teeth will not fix a lisp as it is learned

Answer 50

Meet at rest with relaxed mentalis

Answer 51

Not together with relaxed mentalis

Answer 52

Upper incisors sit ahead of lower lip Can procline them May lead to relapse of overjet if persists at the end of tx - ensure lips are competent at end of tx

Answer 53

Could retrocline lower incisors Indicates likely instability at end of tx

Answer 54

Can cause symmetrical or asymmetrical problems Proclined uppers and retroclined lowers Narrow upper arch +/- unilateral posterior crossbite Localised AOB or incomplete OB

Answer 55

Tongue is held lower, cheeks push in the upper posteriors, bringing teeth cusp to cusp and eventually causing a crossbite to get intercuspation

Answer 56

Path of closure Range of movement Pain Click Deviation on opening Muscle tenderness Mandibular displacement Discrepancy between ICP and RCP - over 4mm causes problems Ortho can not cause and can not treat TMJ problems (possible exception of crossbite)

Answer 57

Teeth present OH Perio health - BPE Teeth of poor prognosis Crowding/spacing/rotations Inclination/angulation Palpate for canines if unerupted (especially under 13s) Not teeth of abnormal shape Absent teeth Extra teeth

Answer 58

90 degrees

Answer 59

110 degrees

Answer 60

Degree of crowding - uncrowded, mild, moderate, severe Presence of rotations Inclination of canines - mesial, upright, distal Angulation of incisors - upright, proclined, retroclined

Answer 61

Uncrowded/mild/moderate/severe Presences of rotations Mesial/upright/distal inclination of canines Angulation of incisors to frankfort plane - upright/retroclined/proclined

Answer 62

Incisor relationship Overjet - biggest of all incisors Overbite/open bite Molar relationship Canine relationship Cross bites Centrelines

Answer 63

Less than 4mm space deficit

Answer 64

4-8mm space deficit

Answer 65

8+mm space deficit

Answer 66

Normal OJ and OB Lower incisor edges occlude with or lie immediately below the cingulum plateau of the upper incisors

Answer 67

Lower incisor edges occlude posterior to the cingulum plateau of the upper incisors, upper incisors are proclined or of average inclination and there is an increased OJ

Answer 68

Lower incisor edges occlude posterior to the cingulum plateau of the upper incisors and upper central incisors are retroclined OJ usually minimal or may be increased

Answer 69

Lower incisor edges lie anterior to the cingulum plateau of the upper incisors OJ is reduced or reversed

Answer 70

Measure the biggest OJ of the 4 incisors with pt in maximum intercuspation

Answer 71

Overlap of the teeth

Answer 72

Upper incisor covers 1/2 to 1/3 of the lower incisor crown

Answer 73

Upper incisor covers less than 1/3 of the lower incisor crown

Answer 74

Upper incisor covers more than half of the lower incisor crown

Answer 75

No overlap of the incisors at all - measure how big this is at maximum and which teeth are involved

Answer 76

Increased overbite covering entire lower incisor crown, can contact teeth or palate or can not contact anything

Answer 77

Reduced Average Increased - incomplete or complete, contacting tooth or palate

Answer 78

Used to be used to define malocclusion using buccal segment relationship

Answer 79

Mesiobuccal cusp of upper 6 occludes with buccal groove of lower 6

Answer 80

Mesiobuccal cusp of upper 6 occludes anterior to buccal groove of lower 6

Answer 81

Mesiobuccal cusp of upper 6 occludes posterior to buccal groove of lower 6

Answer 82

Class I - upper canine behind lower canine Class II - upper canine in front of lower canine Class III - Upper canine far behind lower canine

Answer 83

Teeth are aligned one cusp from the ideal occlusion

Answer 84

Teeth are aligned 1/2 cusp from the ideal occlusion and so will meet cusp to cusp

Answer 85

Holds archwire to each bracket Tiny elastic or a twisted wire

Answer 86

Tied to all of the brackets Creates force to move teeth into proper alignment

Answer 87

Connects to the bands or directly bonded to the teeth and hold the archwire in place

Answer 88

Band cemented ring of metal wrapped around a tooth

Answer 89

Elastic hooks used for the attachment of rubber bands, which help move teeth toward their final position

Answer 90

Anchorage Rotation Limited widening or contraction

Answer 91

0.9mm HSSW Most commonly attached to upper 6s with the use of ortho stainless steel bands to which the appliance is attached with the use of spot welding/soldering

Answer 92

0.9mm HSSW Constructed in a rigid fixed manner and requires minimal adjustment prior to fitting Most commonly attached to the upper 6s with the use of ortho stainless steel bands to which the appliance is attached with the use of spot welding/soldering

Answer 93

Bilateral expansion Asymmetrical expansion Fan style expansion Rotation of molars Expansion in cleft palate Modified to procline incisors Assist in habit breaking

Answer 94

Highly versatile can be adapted for a number of scenarios 0.9mm HSSW Constructed in a rigid fixed manner and requires minimal adjustment prior to fitting Most commonly attached to the first permanent molars with the use of orthodontic stainless steel bands to which the appliance is attached with the use of spot welding/soldering

Answer 95

Bodily tooth movement Rotations easily fixed Can be used as easily in lower arch as upper Individual force can be applied to every tooth Not easily removed by patient Works 24/7 Precise 3D movement of the teeth Less invasive of tongue space Minimal palatal coverage

Answer 96

Increased risk root resorption Decalcification Can be perceived as visually unattractive Can cause soft tissue trauma Cost High motivation required to oral hygiene Poor anchorage Highly trained specialist training required Etching teeth is a destructive process

Answer 97

Tipping of teeth Excellent anchorage Generally cheaper than fixed Shorter chairside time required Oral hygiene easier to maintain Non-destructive of tooth surface Less specialised training required Can be easily adapted for overbite reduction Can achieve block movements

Answer 98

Less precise control of tooth movement Can be easily removed by pt Generally only 1-2 teeth can be moved at one time Specialist technical staff required to construct appliances Rotations very difficult to correct

Answer 99

Adequate staff training Equipment - correct operation and maintenance Justification - only take radiographs when required and select the most appropriate view

Answer 100

There is a significant increased risk of fatal cancer from the larger extra-oral films and larger volume CBCT compared with an intra-oral periapical or bitewing

Answer 101

To reduce field of view and therefore radiology dose e.g. dentition only in an OPT = 50% dose reduction

Answer 102

State of development - presence or absence of permanent teeth Presence and position of ectopic or supernumerary teeth Stage of development of individual teeth The morphology of unerupted teeth State of the alveolar bone (periodontal disease) State of the teeth - size of restorations, gross caries, periapical infection, other pathology

Answer 103

What view is being taken and the justification as to why

Answer 104

The benefit to the pt from the diagnostic information should outweigh the detriment of the exposure

Answer 105

Once you have viewed the radiograph report on your radiographic findings in the patients clinical records

Answer 106

The patient must be examined clinically

Answer 107

Systematically Teeth present Roots of teeth - apical pathology/resorption State of crowns - caries/restorations/hypoplasia Alveolar bone loss Other pathology such as bone cysts Reason for the film request

Answer 108

Limitations in the width of the focal trough (particularly front of mouth) Patient positioning wrong Patient moving during exposure

Answer 109

18-20 seconds

Answer 110

Those who can not bite edge to edge within the groove on the bite block

Answer 111

Blurred or completely invisible

Answer 112

Teeth appear narrower This is because the teeth are further from the centre of rotation and the xray beam therefore passed more quickly through these teeth relative to the speed of the image receptor

Answer 113

The teeth will look wider on the film because the teeth are closer to the centre of rotation and the xray beam therefore passed more slowly through these teeth relative to the speed of the image receptor

Answer 114

Shadow created on the opposite side and slightly higher up the opt from the object which caused them Can be caused by metal objects, restorations, earrings or by normal anatomic features

Answer 115

Xray beam is angled 8 degrees upwards

Answer 116

To look for pathology in the upper anterior region of the maxilla To confirm the presence of unerupted teeth Root resorption (PA view better for this) To aid localisation of unerupted teeth in combination with another radiographic view (parallax)

Answer 117

To assess root resorption To look for evidence of periapical infection To assess if a tooth might be ankylosed To aid localisation of unerupted teeth in combination with another radiographic view (parallax)

Answer 118

To assess caries status To provide more information on tooth prognosis To get more information on alveolar bone levels

Answer 119

OPT and anterior occlusal maxillary OR Two periapical views

Answer 120

Anterior occlusal maxillary and OPT

Answer 121

There must be a change in position of the Xray tube between the two radiographs Objects further away from the beam will move in same direction Objects closer to the beam will move in the opposite direction

Answer 122

To aid diagnosis Treatment planning Progress monitoring

Answer 123

Frankfort plane horizontal Teeth in RCP Soft tissues contacted at nasion and bilaterally with ear rods in EAM

Answer 124

3 dimensional radiograph similar to CT scan A scanning image produced by the machine moving around patient's head and creating a cylindrical or spherical field of view Computer software produces images in axial, sagittal and coronal planes and can scroll through these images

Answer 125

Localisation of impacted teeth if we need more information of their proximity to adjacent teeth and the possibility of resorption To get a better view of structural anomalies Some orthognathic cases Some cleft palate cases

Answer 126

Radiation dose considerably higher Patient set up takes longer, patient may have to stay still for a longer exposure Reporting - additional training beyond BDS required to interpret and report Cost

Answer 127

You have examined the pt The information gained will influence your treatment plan You can not get the information any other way

Answer 128

A small maxilla, a large mandible, or some degree of both

Answer 129

Their class III appearance will worsen during this phase of treatment

Answer 130

Class III incisor relationship Proclined upper incisors Crowded upper arch Well aligned lower arch

Answer 131

rapid maxillary expansion device

Answer 132

Lower incisor edge occludes anterior to the cingulum plateau of the upper central incisor. The overjet is reduced or reversed

Answer 133

Strong genetic link (pattern controversial - autosomal dominant/recessive) Environmental factors - Cleft lip and palate, acromegaly Can be skeletal or dental

Answer 134

Usually have class 3, can present with class 1 or rarely class 2

Answer 135

Those with the greatest A-P discrepancy Increased FMPA and AOB also make treatment more complex

Answer 136

Can be average, increased or reduced

Answer 137

FMPA Facial height proportions (LAFH:TAFH) Lateral cephalometry

Answer 138

Retrusive maxilla sits on a wider part of the mandible, often leading to bilateral crossbites

Answer 139

Vary Class III incisors Class III molars (not always) Tendency to reverse overjet Reduced overbite, AOB may be present Crossbites - anterior or buccal Alignment - maxilla often crowded, mandible often aligned or spaced Dentoalveolar compensation - proclined upper incisors, retroclined lower incisors Tendency for displacement on closing

Answer 140

Not involved in aetiology Do encourage dentoalveolar compensation Tongue proclines upper incisors Lower lip retroclines lower incisors

Answer 141

Proclined upper incisors Retroclined lower incisors

Answer 142

Aesthetics - dental and profile concerns Dental health - attrition, gingival recession, mandibular displacement Function - speech and mastication

Answer 143

> number of teeth in anterior crossbite Skeletal element in aetiology > A-P discrepancy Presence of anterior open bite

Answer 144

Tends to be unfavourable Mandibular growth continues for longer Potential for class III to get worse Do not do anything irreversible until growth has stopped - could affect future treatment if surgery required

Answer 145

Mild class III Unsure how growth and development will progress No dental health indications

Answer 146

Early correction of incisor relationship

Answer 147

Accept underlying skeletal relationship and correct incisors to class I

Answer 148

it is a mild malocclusion

Answer 149

Further forward mandibular growth may be counter-balanced by some dento-alveolar compensation

Answer 150

If permanent canines are high above the lateral roots - delay if canines have dropped down into buccal position as risk of resorption to lateral incisor

Answer 151

Big OB at the start

Answer 152

Reduce/redirect mandibular growth and encourage maxillary growth

Answer 153

Pellotes (shields) labial to upper incisors to hold lip away Palatal arch to procline the upper incisors Lower labial bow to retrocline the lower incisors

Answer 154

Can the pt meet edge to edge incisors before tx

Answer 155

Reverse twin block Frankel III

Answer 156

14 hour/day

Answer 157

Disrupts circum-maxillary sutures, so ideally used before these fuse

Answer 158

Late mixed and permanent dentition

Answer 159

Infrazygomatic crest and lower canine region

Answer 160

Mucoperiosteal flaps must be raised for insertion and removal - two surgical procedures

Answer 161

Growth stopped Mild to moderate class III skeletal base and AND not <0 degrees Average or increased overbite Able to reach edge to edge incisor relationship Little or no dentoalveolar compensation

Answer 162

Extract further back in the upper arch Extract further forward in the lower arch Classic pattern - upper 5s and lower 4s Not always possible - dental health may dictate extraction pattern

Answer 163

Aim for class I incisors Procline upper incisors Retrocline lower incisors Correct overjet

Answer 164

Surgical manipulation of the mandible and/or maxilla to produce optimal dentofacial aesthetics and function Pt usually has aesthetic or functional concerns and a moderate/sever skeletal discrepancy Growth completed before

Answer 165

Orthodontist Maxillofacial surgeon Technician Psychologist

Answer 166

Approx 18 mo to level, align, decompensate and coordinate Uppers 109 degrees Lowers 90 degrees

Answer 167

Approx 6 months

Answer 168

Identify the class III Refer to hospital service or specialist practitioner Potentially URA tx to correct anterior cross bite

Answer 169

Often aligned or spaced

Answer 170

Proclined upper incisors Retroclined lower incisors

Answer 171

Transpalatal arch

Answer 172

Anchorage Rotation Limited widening or contraction

Answer 173

Transpalatal arch with nance button

Answer 174

Bilateral expansion Asymmetrical expansion Fan style expansion Rotation of molars Expansion in cleft palate Modified to procline incisors Assist in habit breaking

Answer 175

Tipping of teeth Excellent anchorage Generally cheaper than fixed Shorter chairside time required Oral hygiene easier to maintain Non-destructive to tooth surface Less specialised training required to manage Can be easily adapted for overbite reduction Can achieve block movements

Answer 176

Less precise control of tooth movement Can be easily removed by the patient Generally only 1-2 teeth can be moved at one time Specialist technical staff required to construct the appliances Rotations very difficult to correct

Answer 177

Bodily tooth movement Rotations easily fixed Can be used as easily in the lower arch as well as the upper Individual force can be applied to every tooth Not easily removed by the patient Works 24/7 Precise 3D movement of teeth Less invasive of tongue space Minimal palatal coverage

Answer 178

Increased risk of root resorption Decalcification Can be perceived as visually unattractive Can cause soft tissue trauma Cost High motivation required in regards to oral hygiene Poor anchorage Highly trained specialist training required Etching teeth is a destructive procedure

Answer 179

Conventional removeable retainers Thermoplastic retainers Bonded retainers

Answer 180

Intrusion requires a lot more force

Answer 181

These have a high incidence of relapse

Answer 182

The lower incisor occludes posterior to the cingulum plateau of the upper incisor and the upper incisors are retroclined Overjet is reduced but can be increased

Answer 183

Class I 60% Class II div 1 15-20% Class II div 2 5-18% Class III 3-8%

Answer 184

1. Choose gold standard tooth - most desirable angulation 2. Visualise long axis and horizontal plane 3. Place bracket where the two lines meet, with horizontal slots for archwire parallel to the occlusal plane 4. Visualise long axis and horizontal plane of the next tooth 5. If the goal is extrusion, place the bracket slightly further up 6. If this is a smaller tooth than the gold standard, move the bracket 1-2mm closer to the incisal edge, to avoid over extrusion 7. If you want to change the angulation of a tooth, place the bracket at the desired horizontal plane

Answer 185

Shape memory of the archwire

Answer 186

Along the desired horizontal plane

Answer 187

Skeletal Soft tissue Dental Pathology

Answer 188

Usually underlying mild or moderate skeletal class 2 Can also be class 1 or 3

Answer 189

Typically reduced - reduced FMPA Often associated with a forward rotational pattern of growth of the mandible Prominent chin

Answer 190

High resting lower lip line - secondary to decreased lower face height, retroclines lower incisors Marked labio-mental fold High masseteric forces Upper 2s have shorter clinical crown so escape the effect of the lower lip, trapping the lower lip

Answer 191

Class II division 2

Answer 192

Tend to have high masseteric forces and therefore space closure problems

Answer 193

Retroclined upper and lower incisors Deep OB OJ usually reduced Class II buccal segments Increased interincisal angle Upper laterals thin with poorly developed cingulum

Answer 194

50-55% of cases have a form of congenital dental anomaly 20-33% with impacted canine ~15% lateral incisor microdontia

Answer 195

Aesthetic concerns Dental health concerns - traumatic overbite, IOTN DHC 4f

Answer 196

Severity of malocclusion Age and motivation of patient Dental health Patient concerns

Answer 197

Acceptable aesthetics Patient not concerned or not suitable Overbite is not a significant problem

Answer 198

Growing patient (~12F 14M, adolescent growth spurt) Mild to moderate skeletal 2 pattern

Answer 199

Convert class II div 2 to class II div 1 by proclining the upper incisors with a URA - Modified twin block - Spring or screw - Upper sectional fixed appliance - ELSA Detail the occlusion with fixed appliances if crowding/rotations

Answer 200

Accepting the underlying skeletal base relationship and aiming for class I incisor relationship Suitable for mild to moderate class II skeletal pattern Careful extraction decision - space closure is difficult in low angle cases Usually fixed appliances

Answer 201

Needs OB reduction and correction of inter-incisal angle Overbite will relapse if not corrected Inter-incisal angle corrected by combination of palatal torque of upper incisors and proclination of lower incisors

Answer 202

Too severe a malocclusion for orthodontics alone - AP or vertical or combination Non growing patients Profile concerns Usually 18ish

Answer 203

Fixed appliances to decompensate in preparation for the surgery - conversion from class II div 2 to class II div 1 and decompensation Over jet allows for mandibular advancement Surgery Lateral open bites to increase lower anterior face height Post surgery fixed orthodontics, while posteriors continue to erupt to increase LAFH Entire process can take 3 years

Answer 204

Refer to orthognathic surgery if significant skeletal component - after growth completed

Answer 205

Deep OB best corrected when pt still growing, which can be growth modification with functional appliance if AP discrepancy - URA with FABP

Answer 206

Reduced FMPA Reduced lower anterior face height Prominent pogonion

Answer 207

Hyperactive mentalis muscle Forward mandibular growth rotation High lower lip line retroclining the upper incisors Lack of an effective occlusal stop on the cingulum plateau of the upper incisors

Answer 208

To maintain stability of the treatment result

Answer 209

Unerupted ectopic canine and peg laterals

Answer 210

Frenectomy - used to be believe fleshy frenum caused diastema, no evidence, this isn't really done any more Impacted canines can be exposed - usually buccal apically repositioned flap or palatal open exposure Impacted premolar exposures

Answer 211

Leave alone and monitor Extract the canine Surgical exposure and orthodontic alignment Transplant

Answer 212

Causes damage to the PDL

Answer 213

Minimal handling of the tooth - Radiograph both sites to estimate size of the hole required - CBCT of the area, cobalt chrome replica model of the tooth made to make sure it fits before extracting the tooth

Answer 214

Removal of the retained upper C Removal of overlying mucosa and follicle with scalpel Removal of overlying bone with Rongeurs Pack the socket with whiteheads varnish gauze to prevent gingivae from growing over it again Place a horizontal mattress suture The erupting upper 3 will then be bonded onto fixed ortho

Answer 215

We cannot reasonably get a result by exposure and traction There is potential for damage to other teeth Space is available or can be made available without premolar extraction The older patient who is seeking a quick fix

Answer 216

Raise a flap completely Remove the canine and store in sulcus or in saline Prepare the bone and place the canine into anatomical position Treat as avulsed tooth - splint 2 weeks Will require RCT - some are done before transplantation, some after Flap then closed with sutures

Answer 217

Buccally placed

Answer 218

Increased chance of ankylosis

Answer 219

For buccally placed canines Three sided flap is raised Flap is repositioned apically and sutured in this position As the canine comes down it will bring the attached mucosa with it

Answer 220

Poor gingival margin as there is no attached gingivae

Answer 221

Cut a hole to expose an impacted tooth and leave it open Never done on buccal side Not suitable if the tooth has a long way to move because by the time it moves the gap will have closed over

Answer 222

If tooth very deep or high up, raise flap, take away the bone to uncover the tooth then bond a chain to it and stitch the flap closed again

Answer 223

They are ankylosed

Answer 224

Surgical removal of fleshy labial frenum

Answer 225

V to Y Z plasty

Answer 226

1. Pt compliance unnecessary 2. Absolute anchorage as there is no periodontal ligament 3. Easily used under a variety of treatment modalites 4. Easily placed 5. Removeable, if necessary It is tempting to use implants but this is not suitable as they can integrate into the jaw and be difficult to remove Only titanium has osseointegration property to fuse to the bone Stainless steel mini implants are used instead

Answer 227

Removes the cortical bone that strongly resists orthodontic force in the jaw and keeps the marrow bone to maintain blood circulation and continuity of bone tissues to reduce risk of necrosis and facilitate tooth movement

Answer 228

100 births per year in Scotland 1000 in UK Cleft palate is more common in females Cleft lip and palate more common in males

Answer 229

LAHSHAL classification

Answer 230

L - lip cleft l - partial lip cleft

Answer 231

Lowercase letter

Answer 232

Hard palate cleft

Answer 233

Soft palate

Answer 234

In England and Wales 2:1 In Scotland 1:1

Answer 235

Syndromes associated Family history Sex ratio (CP F>M CLP M>F Ethnic predisposition - Asian, Hispanic, Native American Laterality - more common on left

Answer 236

Social deprivation Smoking Alcohol Anti-epileptics Multivitamins

Answer 237

Aesthetics Speech Hearing Airway Dental

Answer 238

They can not feed Children and mothers in UK are seen without 24 hours to teach mothers to feed with special bottles

Answer 239

Purely for aesthetic reasons There are no health implications

Answer 240

Soft palate

Answer 241

a condition in which one side of the face is smaller or underdeveloped or has parts that are missing

Answer 242

a genetic disorder that causes fusion of the skull, hands, and feet bones characterized by deformities of the skull, face, teeth, and limbs

Answer 243

Microdontia Hypodontia Teeth coming through severely rotated/out of place

Answer 244

3-6 months lip closure 6-12 months palate closure 8-10 years alveolar bone graft 12-15 years definitive orthodontics 18-20 years surgery

Answer 245

Lip surgery Palate closure Alveolar bone graft

Answer 246

Orbicularis oris repair

Answer 247

because babies are obligate nose breathers until 6 months. If done too early is could block their airway

Answer 248

1. Missing teeth 2. Impacted teeth 3. Crowding 4. Growth tendencies - 20% have class III tendencies, top jaw tends not to come forward from about 10 or 11 5. Caries

Answer 249

Constricted upper arch

Answer 250

Teeth come through in difficult places to clean, can be hypoplastic, and cleft is associated with lower socioeconomic background which also has increased caries risk Caries is a problem because strep bacteria present in the mouth at the time of bone graft could be very dangerous

Answer 251

GDP Paediatric dentist Dental therapist Orthodontist Orthodontic therapist Restorative dentist Oral surgeon

Answer 252

Branch of dentistry concerned with facial growth, development of the dentition and occlusion, and the diagnosis, interception and treatment of occlusal anomalies

Answer 253

Where the teeth are in the optimum anatomical position, both within the mandibular and maxillary arches and between the arches when the teeth are in occlusion

Answer 254

Term used to describe dental anomalies and occlusal traits that represent a deviation from the ideal occlusion It is rare to have a truly perfect occlusion and malocclusion is a spectrum reflecting variation around the norm

Answer 255

Depends on age, race, criteria for assessment, methods used (eg whether radiographs are considered) In UK 9% of 12 year olds and 18% of 15 year olds are undergoing ortho tx, with a further 37% of 12 year olds and 20% of 15 year olds requiring tx

Answer 256

The impact of the malocclusion and whether treatment is likely to provide a demonstrable benefit to the patient To judge tx need, potential benefits are balanced against the risk of possible complications and side effects in a risk benefit analysis

Answer 257

Increased awareness and acceptance of appliances Increasing availability of less visible appliances Increasing dental awareness and the desire for straight teeth

Answer 258

Caries Plaque induced periosontal disease TMD

Answer 259

Localised periodontal problems -Crowding causing tooth/teeth to be pushed out of the bony trough, resulting in recession -Periodontal damage related to traumatic OB -Anterior crossbites with evidence of compromised buccal periodontal support on affected lower incisors Increased overjet with increased risk of dental trauma Unerupted impacted teeth with risk of pathology Crossbites associated with mandibular displacement

Answer 260

Risk of injury is more than doubled in individuals with an overjet greater than 3mm Increases with overjet size and lip incompetence

Answer 261

When normal tooth eruption is impeded by another tooth, bone, soft tissues, or other pathology Supernumerary can cause impaction and if judged to be impeding normal dental development, orthodontic tx may be required

Answer 262

Teeth that have formed, or subsequently moved, into the wrong position. Often ectopic teeth become impacted

Answer 263

Unerupted impacted teeth may cause localised pathology, most commonly resorption of adjacent roots or cystic change. This is most frequently seen in relation to ectopic maxillary canine teeth which can resorb roots of the incisors and premolars

Answer 264

Hygiene Fluoride exposure Diet

Answer 265

In caries susceptible children for example with special needs, malalignment may reduce the capacity for natural tooth cleansing an potentially increase the risk of caries, orthodontic tx methods for reducing food stagnation such as extraction or simple alignment to reduce localised crowding would be considered

Answer 266

Very weak Increased dental awareness and positive OH and diet habits can follow orthodontic treatment BUT poor plaque control is a contraindication for ortho tx

Answer 267

Comprises a group of related disorders with multifactorial aetiology including psychological, hormonal, genetic, traumatic and occlusal factors Research suggests that depression, stress and sleep disorders are major factors in the aetiology of TMD and parafunctional activity

Answer 268

Lots of debate Ortho tx does not cause or cure TMD Where signs of TMD are found it is wise to refer the patient for a comprehensive assessment and specialist management before embarking on ortho tx

Answer 269

Oral health related quality of life Can be negatively affected by issues relating to dental appearance, masticatory function, speech and psychosocial well-being

Answer 270

AOB Markedly increased or reverse overjet Severe hypodontia

Answer 271

The formation of different sounds through variable contact of the tongue with surround structures, including palate, lips, alveolar ridge, dentition

Answer 272

It is unlikely that ortho tx will significantly change speech in most cases, as speech patterns are formed early in life before the permanent dentition is present Teeth are only one component in this complex neuromuscular process

Answer 273

Where patients cannot attain contact between the incisors anteriorly, this may contribute to the production of a lisp. In these cases, correcting the incisor relationship and reducing interdental spacing may reduce lisping and improve confidence to talk in public

Answer 274

Malocclusion has been linked to reduced self-confidence and self esteem, with more sever malocclusion and dentofacial deformities causing higher levels of oral impacts

Answer 275

Diastemas or rotations have been corrected

Answer 276

South end clasp for retention in the anterior region

Answer 277

Adams clasps 16 14 24 26 Palatal finger spring 12

Answer 278

0.7mm HSSW

Answer 279

Adhesion cohesion

Answer 280

0.9mm HSSW

Answer 281

Nickel titanium Can be different diameter depending on need Can be round or square rectangular

Answer 282

A - Hard palate B - Soft palate C - Dorsum of tongue D - Oropharynx E - Oropharynx

Answer 283

1- Middle cranial fossa 2- Inferior nasal concha 3-Infra orbital rim 4- Nasal septum 5- Orbit 6-Zygomatic arch 7-Articular eminence 8-Nasopharynx 9- Soft palate 10- Maxillary sinus 11- Hyoid bone 12- Mental foramen 13- Hard palate 14-Outline of dorsum of the tongue

Answer 284

Unerupted UR873 UL378 LL7 LR75 Missing Lower 8s The upper left second permanent molar may be partially erupted, further information from clinical examination would be required to confirm. On the right it appears as though there is a faint radiopaque shadow overlying UR7 indicating that mucosa is covering this tooth Roots - dilaceration UR4 and UL4 Tooth roots otherwise normal for age of patient Possible caries - LL6o, UR5d, UL5d, bitewings would be required to confirm Alveolar bone levels - normal Any other pathology - NAD in maxillary sinuses, surrounding bone, TMJ Unerupted canines may be palatal. Clinical findings +/- an anterior occlusal maxilla radiograph would be required to confirm the position of these teeth

Answer 285

Pt too far forward in the OPT machine - anterior teeth blurred and very narrow

Answer 286

The Xray beam is angled up at 8 degrees

Answer 287

The Frankfort plane has not been horizontal, the patient is looking downwards creating the smiley face

Answer 288

Sella Nasion A point B point Anterior Nasal Spine Posterior Nasal Spine Porion Orbitale Gonion Menton Pogonion

Answer 289

Superior border of the external acoustic meatus

Answer 290

Midline bony depression between the eyes where the frontal and the two nasal bones meet, just below the glabella

Answer 291

Midpoint of the pituitary fossa

Answer 292

The point at the deepest midline concavity on the maxilla

Answer 293

The point at the deepest midline concavity on the mandibular symphysis between infradentale and pogonion

Answer 294

Constructed point of intersection of the ramus plane and the mandibular plane

Answer 295

The most forward projecting point on the anterior surface of the chin

Answer 296

Inferior border of the orbit

Answer 297

Most inferior point on the mandibular symphisis

Answer 298

A - sella nasion B - Frankfort plane C - Maxillary plane D - Occlusal line E - Mandibular plane

Answer 299

2-4 degrees

Answer 300

Class II skeletal pattern

Answer 301

Class III skeletal pattern

Answer 302

To reduce overbite by propping the anterior teeth open so that eruption of the posteriors can continue and prop the anteriors more open

Answer 303

Root morphology on radiographs Colour of enamel Size Mobility Palpate for the missing permanent

Answer 304

Palpate palatally and buccally Check for mobility of the C Check radiographs

Answer 305

Ectopic tooth germ Trauma to primary Genetic Associated with other dental anomalies like missing other teeth such as laterals, peg laterals, supernumerary - long path of eruption believed to be guided by position of the lateral, explaining the link Crowding

Answer 306

Missing teeth Overjet Crossbites Displacement of contact point Overbite/open bite

Answer 307

Facilitate eruption of 23 Align upper and lower arches Correct class II skeletal relationship Produce class I incisors Produce class I molar relationship

Answer 308

How likely is the 3to come into place? - How horizontal is it angled in relation to the sagittal plane - How high is it - at or above apical third is not good - How far mesially has it moved - canine crown more than halfway across the lateral incisor is not good

Answer 309

Root resorption Cyst Ankylosis Eventual loss of primary canine and complex restorative solutions Crown resorption of the ectopic tooth - rare

Answer 310

- Pt does not want complicated treatment - Position of the canine is too ectopic to move into place - Ectopic tooth is causing root resorption

Answer 311

When the tooth is deeper

Answer 312

Bridgework etc carried out and maintained by GDPs

Answer 313

Congenital absence of one or more teeth (not including third molars)

Answer 314

Third molars

Answer 315

Complete absence of teeth

Answer 316

6 or more congenitally absent teeth

Answer 317

6% (6.3% F 4.6% M)

Answer 318

Females (6.3% : 4.6%)

Answer 319

1-2% population

Answer 320

0.9% (much less than in permanent)

Answer 321

L5 U2 U5 lower incisors

Answer 322

Ectopic canines

Answer 323

Last in the series more commonly missing

Answer 324

Non syndromic - this can be familial or sporadic Syndromic - >100 craniofacial syndromes associated such as CLP, anhydrotic ectodermal dysplasia Environmental - trauma or radiotherapy/chemotherapy

Answer 325

Delayed or asymmetric eruption Disorder in sequence Retained or infra-occluded deciduous teeth Absent deciduous tooth Tooth form

Answer 326

Microdontia Short roots Impaction Delayed formation/eruption Malformation of other teeth Crowding and/or malposition of other teeth Maxillary canine/first premolar transposition Taurodontism Enamel hypoplasia Altered craniofacial growth

Answer 327

developmental disturbance of a tooth in which body is enlarged at the expense of the roots. An enlarged pulp chamber, apical displacement of the pulpal floor and lack of constriction at the cementoenamel junction are the characteristic features Most common/most difficult in 7s

Answer 328

Study models Radiographs Photographs Conebeam CT

Answer 329

To investigate the volume of the alveolar bone for potential implants

Answer 330

History Extra oral exam Intra oral exam Investigations Problem list Definitive plan

Answer 331

Accept Ortho only Restorative only Ortho and restorative

Answer 332

The canines are important in lateral excursions (canine guidance)

Answer 333

Can't be done until age 21+ Need minimum 6.5-7mm space Root separation Often bone grafts needed Technically very demanding in aesthetic zone Significant cost

Answer 334

Spacing Drifting Over-eruption Aesthetic impairment Functional problems

Answer 335

GDP recognition Referral to specialist orthodontist Seen in GDH Initial assessment in orthodontics and allocate when appropriate to hypodontia clinic for orthodontic and restorative input

Answer 336

Restorative and ortho

Answer 337

Inter disciplinary team Joint assessment and treatment planning with precise aims Joint collaboration at transitional stages of treatment Follow up of treated cases

Answer 338

Satisfies expected aesthetic objectives Be least invasive Satisfies functional objectives (both immediately and long term)

Answer 339

Not the most popular choice but can have good aesthetics Good for multiple replacements in different areas and good for soft tissue replacement Easy to do, not destructive to tooth surface and can be used as an intermediate option

Answer 340

Relatively simple Can do when young Non destructive Can look good Can be placed on a semi permanent basis

Answer 341

Failure rate Appearance sometimes not good - try again, new material Orthodontic retention needs are high

Answer 342

The canines are important in lateral excursions e.g. canine guidance

Answer 343

Cant do until age 21 Must have 6.5mm space (the whole way up root length) Often need bone graft Root separation Significant chairside time Significant cost

Answer 344

No prosthesis, relatively low maintenance Good aesthetcs with appropriate orthodontic and restorative techniques Can be done at an early age

Answer 345

Hypodontia Closure of spaces left by absent teeth as well as adjustments to the teeth present such as extrusion/intrusion or occlusal adjustments, to make them appear more like a normal dentition

Answer 346

Appliances that are fixed to the teeth by the clinician and can not be removed by the patient

Answer 347

Precision tooth movement Full control over movement of tooth and root

Answer 348

Simple tooth movement - tipping

Answer 349

Less dependent on compliance 3D control Complex tooth movement Control of root

Answer 350

Require excellent OH Risk of iatrogenic damage Poor intrinsic anchorage

Answer 351

Less risk of iatrogenic damage Good intrinsic anchorage

Answer 352

Can be lost Only simple tooth movements - tipping No control over other movement Greater compliance required

Answer 353

Correction of mild to moderate skeletal discrepancies (camouflage) Alignment of teeth Correction of rotations Centreline correction OB and OJ reduction Closure or creation of spaces Vertical movements - intrusion/extrusion

Answer 354

Andrew's 6 Keys - Tight approximal contacts with no rotations - Class I incisors - Class I molars - Flat occlusal plane or slight curve of spee - Long axis of teeth have a slight mesial inclination except the lower incisors - The crowns of the canines back to the molars have a lingual inclination

Answer 355

Bracket/tube Band Archwire Modules Auxillaries Anchorage components Force generating components

Answer 356

Stainless steel bonded in place with GI Not always needed Molar tubes more common which are easier to keep clean and less traumatic to the soft tissues Pre- welded attachments such as tubes or cleats will be on the bands Require space before placement - usually needs separator visit

Answer 357

If using molar bands

Answer 358

Most commonly SS Sometimes CoCr, Ti, Au Ceramic and polycarbonate available - more aesthetic

Answer 359

Bracket slot Tie wings Bracket base

Answer 360

Mesial-distal angulation

Answer 361

Buccal-lingual inclination Thickness of bracket base and slot angle

Answer 362

Determines the tip, torque and in/out control

Answer 363

Composite via acid etch Photo initiation using light cure 440-480nm wavelength Micromechanical retention

Answer 364

Micromechanical retention

Answer 365

SS, NiTi, CoCr, beta-titanium, composite/glass

Answer 366

Light force NiTi is good for light continuous force, by shape memory

Answer 367

Stainless steel

Answer 368

It cannot be bent into a loop or a deflection, it will return to it's original shape NiTi - not formable Stainless steel - formable

Answer 369

No elastomeric modules required Little gate on bracket opened chairside to release the wire and replace Can be a plaque trap and become difficult to open and close

Answer 370

Making space

Answer 371

Used where extraction spaces are quite large, to give it rigidity and help wire stay in place on biting

Answer 372

Elastomeric power chain NiTi coils Intra-oral elastics Active ligatures

Answer 373

Teeth move by utilising the energy stored in the elastic or spring

Answer 374

Elastics degrade very quickly so they lose a lot of force in the power chain in the first 24-48 hours

Answer 375

Every force has an equal but opposite reactionary force

Answer 376

Root surface area

Answer 377

Linking groups of teeth together as a unit increasing the root SA to use for anchorage

Answer 378

Equal root SA, equal tooth movement E.g. closing a diastema

Answer 379

TADS temporary anchorage devices Non osseointegrating mini screw

Answer 380

Transpalatal arch Lingual arch The cortical plates provide increased resistance to tooth movement, maintaining intermolar width

Answer 381

Lower canine to upper first molar

Answer 382

Upper canine to lower first molar

Answer 383

Maintaining the final tooth position with a passive orthodontic appliance

Answer 384

Pre-existing spacing, rotations, instanding laterals, ectopic teeth, AOB, proclined lower incisors, diastemas Fixed retainers

Answer 385

2 weeks full time wear except during eating and drinking, then night early OR Straight to nights only

Answer 386

Pressure formed retainers Hawley removeable retainer

Answer 387

Usually when there has been a high relapse potential feature Must have enough occlusal clearance Must have good OH

Answer 388

Composite can debond and go unnoticed by the patient, leading to relapse or caries Multistranded twist wire - if this starts to unravel they can become active Requires careful monitoring and ID cleaning

Answer 389

Decalcification Root resorption Relapse

Answer 390

Tooth wear Ceramic brackets are harder than enamel so can cause wear, ensure no contacts

Answer 391

Assessment and diagnosis (including treatment aims) Treatment plan Commence treatment (average case 18-24months, orthognathic cases 24-30 months) Routine adjustments 4-8 weeks

Answer 392

Pain Mucosal irritation Ulceration Appliance breakage

Answer 393

Continue to see patient for routine care and check ups - reinforce OHI and diet advice Liaise with orthodontist if concerned Make appliance safe in case of an orthodontic emergency - snipping jaggy wire or removing lose components

Answer 394

Palatal arch Inter-maxillary elastics Baseplate of an upper removeable appliance Osseo-integrated mini screw

Answer 395

Behaviour management techniques, nail polish FIRST Habit breaker appliance if this has not worked and child still motivated

Answer 396

Class II div I case with increased OJ in the mixed dentition Mild skeletal class III with class III incisors in mixed dentition Deep OBs (utilise eruption potential)

Answer 397

More eruptive potential

Answer 398

Digit sucking habit Tongue thrust Trauma Underlying skeletal vertical excess

Answer 399

1 or 2 palatal goal posts

Answer 400

Molar bands with a palatal arch with a vertical wire tongue rake on it

Answer 401

No it is far enough from the midline than it is not necessary

Answer 402

This is because of the potential for overeruption of the upper 7 with removal of the lower 6, preventing the lower 7 from erupting into the ideal position. Overeruption much less common in the lower

Answer 403

Not routinely You would consider it, if you think the upper is going to remain unopposed for a long time Potential for overeruption of the upper preventing the lower 7 from erupting into ideal position

Answer 404

Any procedure which will reduce or eliminate the development of a feature of malocclusion

Answer 405

If the tooth is in normal position you wont be able to, as premolars develop between the roots of primary molars If it is ectopic it is more likely palatal

Answer 406

Trauma Missing permanent

Answer 407

If it is submerged below the contact point

Answer 408

If there is a permanent successor - extract and space maintain If there is no successor, consider 1. Retain and provide a crown/onlay 2. Extract and close the space This depends on prognosis of the infraoccluded tooth and on how this options would fit into treatment plan of any other malocclusal features

Answer 409

Z spring and posterior bite plane

Answer 410

It would decrease OB, which is bad for relapse of crossbite

Answer 411

Caries risk to partially erupted If you can disimpact, you maintain arch length and space for the rest of the dentition

Answer 412

XLA E Distal discing - however this can cause loss of space Try spacers for 1 week

Answer 413

- Low frenal attachment - Missing teeth eg lateral - Microdontia - Normal sized teeth but large arch - Unerupted supernumerary

Answer 414

- Pulp has invaginated on itself during development - Pulp looks as if it is coming right into the clinical crown - Poor prognosis because of potentially communication between oral cavity and pulp

Answer 415

Patient safety - ideally without compromising the orthodontics but sometimes there is no choice

Answer 416

Can this be accounted for? Did it break while in the patients mouth? Is it possible it has been swallowed?

Answer 417

Chest Xray immediately

Answer 418

If early in ortho tx - new appliance made as no orthodontic movement has happened yet If later, you don't want pt to go without for any length of time due to risk of relapse Turn the South End clasp into a C clasp If tx almost finished and this is adequately retentive, leave If they will have it for a while longer have a new one made

Answer 419

Trim sharp part flush with baseplate Cut southend clasp in the middle Fold over sharp edge with Adams 64 pliers

Answer 420

This will thin the wire and make it sharper

Answer 421

PMMA will melt or catch fire once melting point for soldering material is reached

Answer 422

Account for missing components - if can't chest xray Make the appliance safe by trimming sharp edges If still retentive - this is fine If not - the component must be replaced Send the URA imbedded in an impression of the URA in the mouth or with original working cast Lab can remove a segment of acrylic and fill with new acrylic and new component

Answer 423

The new impression will have a slightly different fitting surface, creating a space between the cast and the URA, new acrylic will flow underneath, contaminating the fitting surface and the appliance will no longer fit - ACRYLIC CREEP

Answer 424

Extra-oral - do not need to account for missing pieces Advise patient not to wear in its current state and do not try to repair themself Give the patient a thermoplastic retainer to prevent relapse

Answer 425

Remove ligature and bracket, send back to orthodontist Cannot rebond bracket because you do not know the ortho txp and exact location

Answer 426

Take it all off, check lingual surfaced for signs of caries Offer to leave it, or take impressions to get models, make a new bonded retainer Offer thermoplastic retainer If pt wants neither, inform them that teeth will go back to their original position, can make them sign something, must record in the patients notes

Answer 427

Can not bend this wire as it is 0.9mm HSSW and would exert huge force on the still attached 6, can not solder in the mouth, transpalatal arch is now useless Wrap floss around omega loop and use slow speed to cut in short bursts when the transpalatal arch meets the band Plenty of water and short bursts to avoid overheating The smooth both bands on 6s

Answer 428

Could be soldered, if this doesn't work, can cut at other arrowhead to make a single arrowhead clasp, bend wire to make safe If so badly distorted than can't be modified, cut the clasp off to make safe and see if appliance is still retentive If not, get clasp replaced - impression in mouth or URA on old cast to prevent acrylic creep

Answer 429

Can not push wire to rebond as this would apply force to the tooth Could cut the wire between 42 and 43 and smooth the wire Explain this to patient and give option to replace

Answer 430

Could cut the wire at 25 and bend it back to make it safe It is not possible to create a perfect seal without taking the band off fully and rebonding, we do not know the exact angulation of the band

Answer 431

Could make new appliance if start of treatment Could bend both into C clasps

Answer 432

Bracket will not rotate around square rectangular wire Ensure with figure of 8 ligature that the bracket is secured to the archwire, inform the patient that this is debonded, show them how to clean underneath and advise to go back to orthodontist ASAP

Answer 433

Can't solder Cut at the other side arrowhead and bend the arrowhead shut to modify into a single arrowhead clasp Still getting retention from single arrowhead clasp, other adams and southend and baseplate If not retentive have a new Adams clasp added

Answer 434

Trim over extended wire and bend Also cut the other end and bend into a retentive tag

Answer 435

Remove composite from this tooth Check for caries Check integrity of the wire Etch bond and reapply composite to this tooth

Answer 436

Most likely cause - trauma First account for components where possible - chest XRAY if necessary Carefully take off ligatures and take out archwires Leave remaining brackets Trauma stamp Splint mobile teeth - brackets may be useful

Answer 437

Retention Overbite reduction Habit breaker

Answer 438

Adams clasps 16 and 26 0.7mm HSSW Southend clasp UR1 UL 1 0.7mm HSSW PMMA self cure acrylic baseplate extending palatal of incisors

Answer 439

Band and loop Fixed palatal arch URA with extended PMMA baseplate

Answer 440

Buccal canine retractor Roberts retractor Palatal finger spring Z spring Midpalatal screw

Answer 441

Speaks normally Wearing it at appt No excess salivation Can insert and remove easily Worn appearance of acrylic Good fit Indentations on palatal mucosa Evidence of tooth movement Active components are passive/clasps loose

Answer 442

The angle between Sella, Nasion and soft tissue point A

Answer 443

class II skeletal pattern

Answer 444

Accept Functional/growth modification URA - Orthodontic camouflage Fixed - Orthodontic camouflage Functional + fixed appliances Complex surgical correction

Answer 445

Please construct a URA to correct an anterior crossbite on the 12

Answer 446

AC - 12 Z spring 0.5mm HSSW R 16+26 14+24 Adams clasps 0.7mmHSSW A moving only one tooth B Self-cure PMMA Posterior bite plane

Answer 447

Improve dental aesthetics Refused tx as a child Lack of earlier opportunity Unhappy with result of earlier tx due to relapse or poor initial tx Adjunctive to restorative tx After periodontal drift Part of surgical correction of jaw discrepancy

Answer 448

Lack of growth Potentially periodontal disease, missing teeth, heavily restored teeth Motivation

Answer 449

Non growing Growth modification is not possible so must accept skeletal pattern OR surgery OB correction more difficult - may need tooth intrusion Midpalatal suture is closed - can only expand the maxillary base with surgery

Answer 450

Yes if it is obturated correctly and symptom free

Answer 451

Decreased cell turnover, initial movement can be slower Use lighter forces

Answer 452

To upright abutments to aid restoration Intrusion of over-erupted teeth Extrusion to increase crown length

Answer 453

May see tooth migration Perio treatment must be stable first This will require long term retention

Answer 454

To align and coordinate dental arches and decompensate incisors

Answer 455

Tight approximal contacts with no rotations Class I incisors Class I molars Flat occlusal plane or slight curve of spee Long axis of the teeth have slight mesial inclination except lower incisors Crowns of the canines back to the molars a lingual inclination

Answer 456

Lingual appliances Clear brackets Ceramic brackets

Answer 457

Pros More aesthetic If patient gets decalcification it wont be seen Cons No wow factor at end of treatment Difficult to apply

Answer 458

Risk of tooth wear abrasion

Answer 459

Improvement in appearance, function, and dental health

Answer 460

Large AOB Severely increased OJ Marked reverse OJ

Answer 461

Can cause resorption Supernumeraries can prevent normal eruption Can be associated with cyst formation

Answer 462

Risk of upper incisors trauma increases with size of OJ, worse with incompetent lips

Answer 463

Loss of perio support Tooth wear

Answer 464

Significant displacement may lead to - Asymmetry - Requiring early correction

Answer 465

Potential increase in caries and perio risk, little evidence but these teeth are more difficult to clean

Answer 466

Gingival stripping Loss of perio support

Answer 467

Decal RR Relapse Soft tissue trauma Recession Loss of periodontal support Headgear injuries Enamel fracture and tooth wear Loss of vitality Allergy Poor/failed treatment

Answer 468

Staining Cavitation Caries

Answer 469

Case selection Oral hygiene Diet advice Fluoride

Answer 470

Motivated, good OH, low caries risk

Answer 471

Toothbrushing, interdental brushing, minimum 2x daily thoroughly, after every meal, diclosing tablets, target gingival margins and around each bracket

Answer 472

Low sugar, avoid snacking between meals, avoid fizzy juice, sports drinks, sweets

Answer 473

Toothpaste 2x+ daily, spit don't rinse 2800ppmF 2x daily in high risk Mouthwash 225ppmF in between brushing Fluoride varnish 22600ppmF 4 monthly

Answer 474

inevitable consequence, average approx 1mm over 2 years fixed teeth Affects any teeth but UI>LI>6s Mostly unnoticed

Answer 475

Types of movement (prolonged high force, intrusion, large movements, torque) Root form (blunt, pipette, resorbed already) Previous trauma

Answer 476

Have a retainer fit quickly after bridge cementation to prevent relapse

Answer 477

Lower incisor crowding Rotations Instanding 2a Spaces and diastemas Class II div 2 AOB Reduced perio support/short roots

Answer 478

Case selection Informed consent Retainers

Answer 479

Minimum 2 safety mechanisms - Snap away traction spring - Nitom facebow - Masel strap

Answer 480

Ceramic brackets

Answer 481

Clinician - poor diagnosis, poor treatment planning, poor operator technique Patient - unfavourable growth, poor compliance, repeated breaking, poor attendance

Answer 482

Increased overjet Posterior crossbite Narrow maxillary dental arch Retroclined lower incisors Proclined upper incisors Anterior open bite

Answer 483

Greater than 5 degrees

Answer 484

3-5 degrees

Answer 485

Reduction of the overjet and correction of the molar relationship through dentoalveolar change

Answer 486

Reduced FMPA High resting lower lip line Reduced lower anterior face height Prominent pogonion

Answer 487

High lower lip line retroclining the upper incisors Lack of an effective occlusal stop on the cingulum plateau of the upper incisors Hyperactive mentalis muscle Forward mandibular growth rotation

Answer 488

To maintain stability of the treatment result

Answer 489

Class II div 2

Answer 490

Their class III appearance will worsen during this phase of treatment

Answer 491

Class III incisors Proclined upper incisors Crowded upper arch Well aligned lower arch

Answer 492

Palatal arch Baseplate of a URA Osseo-integrated mini screw Intermaxillary elastics

Answer 493

Nickel titanium

Answer 494

Cobalt chromium Ceramic Stainless steel Gold

Answer 495

The angulation of the tooth in a bucco-lingual direction

Answer 496

- Where appropriate care should be delivered close to home - Care should be delivered within a multidisciplinary environment - All appropriate clinicians should be present within the multidisciplinary team - The patient should see GDP regularly for routine dental care

Answer 497

Cleft surgeon Speech and language therapist Psychologist Orthodontist

Answer 498

A - Sella (midpoint pituitary fossa) B - Nasion C - Porion D - Posterior nasal spine E - Orbitale F - Anterior nasal spine G - Soft tissue point A H - Gonion I - Soft tissue point B J - Pogonion K - Menton

Answer 499

A - 13 +23 palatal finger springs and guards 0.5mm HSSW R - 16 + 26 Adams clasps 0.7mm HSSW and 11+21 Southend clasp 0.7mm HSSW Anchorage - moving only 2 teeth B - self cure PMMA, FABP overjet +3mm

Answer 500

Active component - Roberts retractor 22 21 11 12 0.5mm HSSW with 0.5mm ID tubing Mesial stops 13 and 23 0.7mm flattened HSSW Anchorage - moving 4 teeth Baseplate - Self cure pmma and FABP OJ + 3mm

Answer 501

Midline palatal screw Adams clasps 16 26 14 24 0.7mm HSSW Reciprocal anchorage Self cure PMMA and posterior bite plane

Answer 502

13 +23 buccal canine retractors 0.5mm HSSW +0.5mm ID tubing 16 26 Adams clasps 0.7mm HSSW 11 +21 Southend clasp 0.7mm HSSW Moving only 2 teeth Self cure PMMA and FABP OJ+3mm FOLLOWED BY 22 21 11 12 Roberts retractor 0.5mm HSSW and 0.5mm ID tubing Mesial stops 13 and 23 0.7mm flattened HSSW 16 and 26 Adams clasps 0.7mm HSSW Moving 4 teeth Self cure PMMA FABP OJ +3mm

Answer 503

12 Z spring 0.5mm HSSW 16 26 14 24 Adams clasps 0/7mm HSSW Moving only 1 tooth Self cure PMMA with PBP

Answer 504

Tag Baseplate Leg Flyover Arrowhead Undercut Bridge

Answer 505

LHS Active arm Coil Tag RHS Active arm Guard wire Coil

Answer 506

URA with active components palatal finger sprins on 13 and 23 16 and 26 adams clasps FABP This would retract 13 and 23

Answer 507

Roberts retractor 12-22 Mesial stops 13 and 23 Adams clasps 16 and 26 FABP This would reduce the overject and over bite

Answer 508

Midline palatal screw Adams clasps 16 26 14 24 Posterior bite plane This would expand the upper arch

Answer 509

13 and 23 buccal canine retractors 16 and 26 adams clasps 11 21 south end clasp FABP This would retract the buccally placed canines and reduce the OB

Answer 510

22-12 Roberts retractor 13 and 23 mesial stops 16 26 adams clasps FABP This would reduce OJ of 12-22 and reduce OB

Answer 511

12 Z spring 16 26 14 24 Adams clasps Posterior bite plane This would correct the anterior crossbite on the 12

Answer 512

Any procedure which will reduce or eliminate the development of a malocclusion

Answer 513

- Ectopic tooth germ, just developed in the wrong place - Trauma to primary (rare) - Genetic tendency - Ass. with other dental anomalies like missing laterals or other teeth, canines have a long path of eruption, possibly guided by the 2s position which would explain this relationship - Crowding - canine often last to erupt

Answer 514

Down syndrome Turner syndrome Cleidocranial dysostosis Hereditary gingival fibromatosis Cleft lip and palate Rickets

Answer 515

Root morphology Shade of enamel Size Mobility Palpate for the permanent

Answer 516

OPT and anterior occlusal maxilla OR 2xPA

Answer 517

Do nothing Surgical exposure and orthodontic alignment Interceptive extraction of the C Surgically remove the ectopic tooth Autotransplantation - last resort

Answer 518

How likely the tooth is to come into place - How horizontally is it angled in relation to the sagittal plane? - How high - at or above apical third is not good - How far mesially has the canine come? Canine crown more than halfway across the lateral incisor is not good

Answer 519

Root resorption Cyst Ankylosis Eventual loss of the retained deciduous tooth and complex restorative solutions required in the future Crown resorption of the ectopic tooth

Answer 520

IF the patient does not want complicated treatment or to wear orthodontic appliances If the position is too ectopic for movement into place If root resorption of the lateral occurs If primary canine of good prognosis If there is no significant risk of damaging adjacent teeth during the surgical procedure

Answer 521

Surgical exposure - open or closed depending on the site of the canine If canine is deep - closed, gold chain bonded during surgery and left sticking out when flap closed If canine less deep - open - cut a window in the flap over the canine crown, attach traction hook and suture in a surgical pack to be left for around 10 days to prevent healing over

Answer 522

- Malposition of the tooth is too great for orthodontic alignment to be possible - No evidence of ankylosis of the canine - Canine root development is ideally 2/3-3/4 length root - Patient is looking for a quicker treatment option

Answer 523

Patient may need to undergo RCT of the transplanted tooth Patient needs to accept risk of ankylosis or external root resorption of the transplanted root

Answer 524

8 years clinically assess and 10-11 palpate for unerupted canines

Answer 525

Impact on the forming crown Deflection of the root away from an adjacent supernumerary or cyst

Answer 526

Orthodontic fixed appliance to move the upper lateral into central position, and restore this tooth with composite as a central incisor Orthodontic fixed appliance to open space for an implant, fixed prosthesis, RBB, removeable prosthesis Autotransplantation if premolars require extraction to address other aspects of the malocclusion Do nothing and allow further mesial drift, if pt <9years old you may get quite a bit of space closure

Answer 527

Minimum 3-4months

Answer 528

Minimum 6 months

Answer 529

12 months or more

Answer 530

Circumferential supracrestal fiberotomy Interproximal enamel reduction Frenectomy

Answer 531

Competent lips - good indicator of stability (If patient was still growing a functional appliance could be worn at night only as a "retainer")

Answer 532

225ppm 0.05% sodium fluoride mouthwash Calcium phosphopeptide-amorphous calcium phosphate tooth mousse Fluoride varnish Fluoride toothpaste Diet advice

Answer 533

Light forces for only a short treatment time - less risk

Answer 534

Hawley is better at allowing the posterior teeth to settle into occlusion after orthodontic fixed appliance treatment

Answer 535

ICON resin infiltrate

Answer 536

Exceeding 4mm or more than one third of the original root length 1-5%

Answer 537

Thin gingival biotype Pre-existing narrow width of attached gingivae Treatment which will tend to move the teeth towards the cortical plates of the alveolar bone Poor oral hygiene Plaque retention

Answer 538

Achieving a good amount of overbite such as 50%

Answer 539

Shortened roots with evidence of previous root resorption Pipette shaped or blunted roots Teeth which have suffered previous trauma Patient habits such as nail biting Iatrogenic - use of excessive force, intrusion and prolonged treatment time

Answer 540

around 1mm - not usually clinically significant

Answer 541

- Individuals susceptible to periodontal disease - movement of teeth outside the envelope of alveolar bone - Patients with narrow alveolus - Patients with thin gingival biotype - Patients with existing crowding that has pushed teeth outside the alveolar bone - Higher risk buccally than lingually

Answer 542

Early, reversible stage white lesions in the development of caries, occurring when a cariogenic plaque accumulates in association with a high sugar diet If not managed early they can become permanent damage and eventually caries

Answer 543

Teeth which have been previously traumatised

Answer 544

Excessive apical root movement can lead to a reduction in blood supply to the pulp and even pulpal death

Answer 545

development of enamel opacities on the labial surfaces of the teeth

Answer 546

Poor OH High sugar diet High caries risk

Answer 547

Microabrasion ICON resin infiltration Fluoride varnish

Answer 548

The partial or full return of the pre treatment features of a malocclusion following active treatment

Answer 549

Fixed retainers Removeable retainers Interproximal reduction Circumferential supracrestal fiberotomy Frenectomy

CDS Orthodontics Flashcards

(647 cards)