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BDS4 CDS Ortho > fixed appliances > Flashcards

fixed appliances Flashcards

1
Q

definition of fixed appliances

A

An appliance which is fixed to the teeth and cannot be removed by the patient

Consists of brackets, bands, archwires and auxillaries

Precision tooth movers

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2
Q

fixed vs removable appliances
tooth movements

A

fixed - 3D
removable - simple

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3
Q

fixed vs removable appliances
root movement

A

fixed - control over, able to do complex tooth movement
removable - no control over root

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4
Q

fixed vs removable appliances
pt compliance

A

fixed - no dependent
removable - dependent on

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5
Q

fixed vs removable appliances
OH level

A

fixed - needs excellent
removable - can be taken out to aid OH

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6
Q

fixed vs removable appliances
risk of iatrogenic damage

A

fixed - greater
removable - less

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7
Q

fixed vs removable appliances
intrinsic anchorage

A

fixed - poor
removable - good (baseplate)

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8
Q

when to use fixed appliance

7

A

Correction of mild to moderate skeletal discrepancies
* Camouflage (accepting underlying mild skeletal discrepancy and trying to get class I incisor relationship)

Alignment of teeth

Correction of rotations

Centreline correction

Overbite and overjet reduction

Closure of spaces/ creating spaces

Vertical movements of teeth (extrusion/intrusion)

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9
Q

tx goal

A

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 the teeth have a slight mesial inclination except the lower incisors.
The crowns of the canines back to the molars have a lingual inclination.

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10
Q

andrew’s 6 keys

A

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 a slight mesial inclination except the lower incisors.
The crowns of the canines back to the molars have a lingual inclination.

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11
Q

7 components of a fixed appliance

A

Bracket/tube

Band –* good if heavily restored/MIH for bonding, good robust end point of appliance
*
Archwire – changed at most visits, depending on prescription

Modules / doughnuts –* bands that are changed every visit*

Auxiliaries – chains etc

Anchorage components

Force generating components – coils, springs etc

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12
Q

molar bands and molar tubes

used for

A

good if heavily restored/MIH for bonding, good robust end point of appliance

molar tube – more discreet and less harsh than molar bands, for particular tooth – not universal

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13
Q

most commonly used type of archwire

A

straight wire
in/out/tip/torque already built in, no need for wirebending

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14
Q

3 components of brackets

A

Bracket slot
Tie wings
Bracket base

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15
Q

materials brackets can be made of

3

A

Metal
SS, CoCr, Ti, Au

Polymers

Ceramics

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16
Q

molar bands
made of and how to place

A

Stainless steel with prewelded attachments
* Tubes or cleats

Require space before placement
* Separator visit

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17
Q

bonding ortho appliances to teeth

2 types

A

Composite via acid etch technique
* Used for brackets and tubes NOT bands
* Photo-initiation reaction using light cure 440-480nm wavelength of light
* Micromechanical retention

Glass Ionomer
* For molar bands

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18
Q

composite via acid etch bonds

A

ortho brakets and tubes to teeth

Photo-initiation reaction using light cure 440-480nm wavelength of light
Micromechanical retention

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19
Q

glass ionomer bonds

A

molar bands only

20
Q

composite applied to brackets how

A

can get pre-coated brackets - less flash, more efficient but £££

or apply one by one from composite tube

21
Q

etch system options for ortho

A

one system etch and bond - less concern over isolaation (no need ti wash/dry in between) so more efficient

so seperate etch and bond system not preferred

22
Q

materials for archwires

A

various materials, shapes and sizes

Stainless Steel (SS)
Nickel Titanium (NiTi)
Cobalt Chromium (CoCr)
Beta-Titanium (TMA)
Composite/glass

23
Q

nickel titanium properties as an archwire

4

A

Flexible

Light continuous force

Shape memory
* Return to original shape
* Cannot bend

Higher friction than SS

24
Q

stainless steel properties as an archwire

2 main

A

**Working archwires to slide teeth (low friction) **

Formable
* Archwire bends
* Loops

25
force generating components of fixed appliances can be | 4
Teeth move by utilising the energy stored in the elastic or spring Sliding mechanics * elastic power chain * NiTi coils * Intra-oral elastics * Active ligature
26
anchorage is
resistance to unwanted tooth movement | newton's 3rd law:Every force has equal but opposite reactionary force
27
newton's 3rd law
Every force has an equal but opposite reactionary force
28
first aspect of ortho tx planning is
anchorage plan carefully to avoid unnecessary complications
29
simple anchorage
1 larger tooth and 1 smaller tooth so smaller tooth moves
30
compound anchorage
Inc SA size against tooth going to move – inc movement of smaller tooth area less unwanted tooth movement, more favourable
31
reciprocal anchorage
equal weighting so move at same rate e.g. for Diastema
32
absolute anchorage
High anchorage demanding case but v imp that no unwanted tooth movement - Hard options: * Temporary anchorage devices (TADS) * Non osseointegrating mini screw * Major development in orthodontics * Anchorage control * Tooth movement mechanics
33
5 options for absolute anchorage
* Temporary anchorage devices (TADS) * Non osseointegrating mini screw * Major development in orthodontics * Anchorage control * Tooth movement mechanics
34
cortical anchorage
Cortical plates provide ↑ resistance to tooth movement Maintains Intermolar width e.g. Using transpalatal arch, palatal nance button
35
anchorage options | 6
simple compound reciprocal absolute cortical intermaxillary
36
headgear in fixed appliances
use is in decline Must ensure appropriate safety mechanisms * Written and verbal instructions
37
retainers
Appliances designed to prevent relapse * Fixed * Removable Must be stressed at consent stage of treatment lifelong retention required
38
retention is
maintaining the final tooth position with a passive orthodontic appliance lifelong retainers - fixed or removable
39
malocclusion features with high relapse potential | 6
* Diastema/ space closure * Rotations * Palatally ectopic canines * Proclination of lower incisors * Anterior open bite * Instanding upper lateral incisors
40
removable retainers
Pressure formed retainers Clear overlay retainers) * Variety of materials and thickness * Can include prosthetic tooth for aesthetics Well tolerated ! Retainer wear pattern for removable pressure formed retainer * Varies between clinicians *2 weeks full time wear except for eating and drinking, night only thereafter or Straight to nights only * | Hawley is old metal removable retainer
41
fixed orthodontic retainers | used for what situs esp
higher relapse situ, need enough space and clearnace * Spaced closure * Diastema * Proclination of lower labial segment * Periodontal cases * Ectopic canines * Instanding upper 2’s For some Orthodontists all cases
42
fixed ortho retainers made of require
Bonded wire retainer - can be lab made (better) or chairside Requires careful monitoring and interdental cleaning * Ensure composite attachments intact and sound * Refer back to orthodontist if problems
43
main risks of fixed appliances | 3
Decalcification Root Resorption Relapse
44
enamel in fixed appliances due to
From opposing brackets Higher risk with ceramic brackets
45
5 stages in the pt journey of fixed appliance tx
Assessment & diagnosis * Treatment aims Treatment plan Commence treatment * Average case 18-24months * Hypodontia case 24-30 months * Orthognathic case 24-30 months Routine adjustments * Every 4-8 weeks retention
46
intial problems encountered in fixed appliance tx | 4
* Pain * Mucosal irritation * Ulceration * Appliance breakage
47
role of GDP in fixed appliance pt management | 6
* Continue to see patient for routine care and check ups * Reinforce OHI and Diet advice * Liaise with orthodontist if concerns * Make appliance safe in case of an “orthodontic emergency” * Snipping of jaggy wire * Removal of loose component

BDS4 CDS Ortho (9 decks)

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