Interceptive Ortho 2

Question 1

How might one manage digit habits?

Answer 1

Positive reinforcement

Bitter nail varnish

Glove on the hand

Habit breaker appliance e.g. goal posts or tongue rake

Question 2

How do you know if patient is wearing their appliance?

Answer 2

Ask

Did they walk in with it

Can they easily take it out and put it in

Do they have a lisp or excess salivation, then not wearing

Wear on the appliance

Gingival erythema from appliance being in

Question 3

What is an infra occluding tooth?

How diagnose?

Answer 3

Ankylosed primary tooth

Alveolar bone grows up and over the tooth

Diagnose with percussion, mobility testing and radiographic examination

Question 4

What would you look for on radiograph when managing an infra-occluding tooth?

Answer 4

Presence of successor?

Ankylosis of tooth and loss of PDL

Root resorption

Question 5

What to do to infra occluding tooth when permanent successor is present?

Answer 5

Monitor 6-12mo

Extract if primary is below interproximal contact

Consider extract if root formation nearly complete of successor

Maintain space if extracting

Question 6

What to do to infra occluding tooth when permanent successor is not present

Answer 6

Extractif below interproximal contact

Retain and consider an onlay

Space management essential

Question 7

When should maxillary canines be palpable?

Answer 7

9-11yo

Question 8

When will extraction of Cs usually be successful with ectopic canines?

Answer 8

Patient 10-13

Canine distal to midline of upper lateral

Sufficient space

Question 9

What is a growth modifying appliance?

Give example

Answer 9

An appliance used to guide the growth of skeletal bases and jaws in a patient, so that they end up in a harmonious relationship

Headgear, functional appliances, palatal expanders

Question 10

Risk of doing nothing to an infra occluding tooth???

Answer 10

Permanent successor more ectopic

Infra-occlusion worsens with tipping of adjacent teeth
- more inaccessible for extraction

Caries and periodontal disease

Question 11

When should i radiograph for canines if not palpable?

Answer 11

11 years

Question 12

How monitor for delayed eruption / ectopic 3s?

Answer 12

Palpate for them

Angulation of the 2s

Mobility of C

Symmetry

Question 13

When is extraction of C favourable?

Answer 13

Pt 10-13

Canine distal to midline - 90% success, 60% if not

Sufficient space

Less than 55 degrees to mid saggital plane

Await 12 months after extraction

Question 14

Risks of doing nothing with ectopic maxillary canines?

Answer 14

More ectopic successor
- becomes impacted

Root resorption of adjacent teeth

Cystic changes

Ankylosis of permanent canine

Question 15

Interceptive tx for class 3?

Answer 15

Growth mod
- enhance max growth
- reduce mandibular growth

Protraction headgear +/- RME

Functional appliances - reverse twin block, frankel III

Question 16

When is class III growth modification most successful?

Answer 16

Skeletal 1 or mild class III

Maxillary retrusion

Anterior displacement on closing

Avg or reduced lower face height

8-10 years old