Emergencies Flashcards
How do you manage a fractured southend clasp near the baseplate?
Trim and smooth so it is flush with the baseplate
Cut southend in half and create a C clasp
Curl wire back on itself so not sharp
Give OHI and refer back to orthodontist
What can’t you do with a fractured southend clasp that is near the baseplate?
Can’t solder with lead as it is toxic
Can’t solder with silver as high mp
Can’t resin with composite as it is rigid and will break
What is the management of composite debond?
Remove composite
Check for caries, check for integrity of the wire, check the wire is passive
Rebond composite
Give OHI
How do you manage a bracket debond on 43?
Check integrity of tooth and archwire
If bracket moves- take bracket and ligature off
Give bracket to pt
Give OHI and refer back to orthodontist
How do you manage a broken Adam’s clasp?
Account for the missing part
Trim wire back to level of the baseplate
If unretentive send to lab with original working cast for repair
Check retention without clasp, with new impression the URA will not get a seal to the cast causing acrylic creep and will contaminate fitting surface
Take impression with appliance in situ and send to lab with URA in
How do you manage a broken transpalatal arch?
Tie floss around arch to ensure the airway is safe
Cut out- no longer fit for use
Give OHI and refer back to orthodontist
Can’t bend as force would be through the 6’s
Can’t cut with wires due to force
How do you manage a broken URA outside of the mouth?
Advise not to try wear or repair current appliance
Don’t remake as not your patient
Offer to make thermoplastic retainer to prevent relapse until pt can get back to orthodontist
How do you manage a debonded lower fixed retainer if the debond is at the end?
Assess integrity of the wire- if curled do not rebond
Trim to level of adjacent teeth
Check for caries
Give OHI and say to pt about relapse and if they wish to have it fixed then contact orthodontist
How do you manage an adams clasp that is broken at the arrowhead?
can resolder as it is away from the baseplate
If can’t be soldered
–cut side that is broken and make flush cut at join between the arrowhead and the bridge, turn the wire back on itself to make safe
–check retention without clasp
What is the management of an orthodontic band that has been debonded?
Cut archwire between 6 + 5
Bend the wire back on itself to make it safe
Give band to pt
OHI and refer back to orthodontist
What is the management of a broken adams clasp where it eminates from the baseplate?
Can’t solder as too close to PMMA
Cut at opposite end to form single arrowhead
If can’t modify, find working cast
If cant find working case, take impressions in situ
What is the management of an Adam’s clasp that is broken in the middle?
Create C clasps from both sides
Can’t solder as it affects the soft tissue
What is the management for a bracket debond on a central incisor?
Can’t rotate as rectangular crosswire
inform pt of issue
Ensure ligature attached
OHI to patient- move bracket to clean underneath
Refer back to orthodontist
What is the management of a wire slip?
Don’t try to put it back
Cut wire and make safe on both ends
Refer back to orthodontist
What is the management of a lingual retained where the majority has debonded?
Take retainer + composite off
Check for caries
Can offer to refer back to orthodontist or make thermoplastic retained
Explain risks of no retainer
If patient refuses treatment- get them to sign notes
