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BDS3 Orthodontics > Interceptive Orthodontics > Flashcards

Interceptive Orthodontics Flashcards

1
Q

What is meant by interceptive orthodontics?

A

any procedure that will reduce or eliminate the severity of a developing malocclusion

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2
Q

Ectopic eruption. - impaction of the first permanent molar - management (first molar stuck behind ‘e’ and fails to fully erupt)

A

if patient >7 years old wait 6 month s
- 90% self correct
orthodontic separator
attempt to distalise first molar
- extract E
- distal disking of e

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3
Q

causes of unerupted central incisors

A

supernumeraries
trauma to primary tooth
- dilaceration to permanent tooth
other pathology or developmental anomaly
congenital absence - rare

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4
Q

what is meant by the term ‘dilaceration?

A

An abnormal bend in the root or crown of a tooth, caused by trauma or developmental disturbances

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5
Q

unerupted central incisors - management

A

remove any retained primary teeth and supernumeraries
create/maintain space
monitor for 12 months if pt <9 years (immature root apex)
- still fails to erupt or patient >9 years then surgically expose/bond gold chain and apply orthodontic traction

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6
Q

Closed exposure technique for maxillary incisor

A
  • mucoperiosteal flap raised
  • orthodontic traction hook bonded to palatal surface
  • flap replaced leaving gold chain entering oral cavity through attached mucosa
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7
Q

open exposure technique for maxillary incisors

A

rarely done for upper incisors
- simple epithelial flap cut over crown of tooth
- reserved for impactions which are soft tissues only, and tooth crown is superficial

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8
Q

when is interception indicated for early mixed dentition?

A
  • early loss of deciduous teeth
  • potential crowding
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9
Q

Early loss of deciduous teeth - consequence

A

localised crowding

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10
Q

Balancing extraction - meaning

A

removal of a tooth from opposite side of the same arch
- in order to preserve symmetry and reduce midline shift

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11
Q

Compensating extraction - meaning

A

removal of a tooth from the opposing quadrant
- to maintain the buccal occlusion

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12
Q

Early loss of primary teeth - management

A

As and Bs
- little impact
- don’t balance or compensate
Cs
- balance
Ds
- small centreline shift
- balance under GA?
- more likely if patient is corwded
Es
- tend not to balance
- major space loss
- upper>lower space loss
- consider space maintainer

Cs, Ds and Es - compensating extractions not required

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13
Q

removable space maintainer - features

A

passive URA
typical components:
retention
- e.g. clasp 6s 0.7mm HSSW
- labial bow U3-3 0.7mm HSSW with southed clasp
baseplate
- extend acrylic around teeth to prevent unwanted mesial drift
mesial stop 0.6mm HSSW on individual teeth if required

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14
Q

fixed space maintainer - features

A

palatal and lingual arches
band and loop

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15
Q

First molars of poor prognosis - considerations before extraction

A
  • age of patient/stage of dental development
  • degree of crowding
  • malocclusion type
  • condition of teeth
  • capacity of patient to receive complex dental care
  • availability of services
  • willingness of child and parent to engage log term with ongoing dental care
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16
Q

6s extractions - considerations

A

Lower 6
- consider compensating if upper will remain unopposed for a prolonged period of time and there is clear occlusal requirement
- seek orthodontic advice

upper 6
- unerupted 7 can be expected to drift medially into contact with second premolar as it erupts

don’t balance with sound tooth
don’t balance if well aligned or speed

17
Q

first molar extraction - most ideal time to extract

A
  • 7s bifurcation calcifying
  • 8s present
  • mesial angulation of lower permanent molar
  • class 1/reduced overbite
  • moderate lower crowding
  • mild/moderate upper crowding
18
Q

anterior cross bite - things to assess clinically

A

displacement
mobility of lower incisor
tooth wear
gingival recession

19
Q

digit habit management

A

positive reinforcement
bitter tasting nail varnish
glove on hand, Elastoplast
habit breaker appliance
- fixed or removable

20
Q

Give examples of habit breaker appliances

A

URA with palatal goal posts
Fixed appliance with tongue rake

21
Q

Early mixed dentition age

A

6-8

22
Q

late mixed dentition age

A

10-13

23
Q

interceptive orthodontic indications in late mixed dentition

A

retained deciduous teeth
infra occluded deciduous teeth
canines
overjets
hypodontia

24
Q

indications for extracting retained deciduous tooth

A
  • permanent successor present and partially erupted
  • primary is causing deflection in its path of eruption
25
Q

infra occluded deciduous teeth - assessment

A

assess radiograph for
- presence or absence of success
- ankylosis of primary tooth (no PDL space/no clear lamina dura
- root resorption of primary

26
Q

Infra occluding teeth aetiology

A

ankylosis of primary tooth
surrounding alveolar bone continues to grow
primary tooth gets left behind

27
Q

Infra occluding teeth - diagnosis

A
  • percussion
  • check for mobility
  • radiographs - OPT or PA
28
Q

Infra occluding teeth - management when permanent successor is present

A
  • monitor 6-12 months
  • extract if primary tooth is below inter proximal contact point
  • consider extraction if root formation near completion
  • if extract - maintain space
29
Q

Infra occluding teeth - management when permanent successor is absent

A

depends on
- degree on crowding
- degree of infra occlusion
- any other features of malocclusion
retain if in goof condition - consider onlay
extract if below inter proximal contact point
- maintain space for prosthetic tooth
- or reduce space to one premolar unit
- or close space

30
Q

risks of rdoing nothing when treating infra occluded teeth

A

permanent successor can become more ectopic
infra occlusion worsens with tipping of adjacent teeth
- primary tooth becomes inaccessible for extraction
caries and periodontal disease

31
Q

Ectopic maxillary canines - how to intercept?

A

consider extracting the c
leave ectopic canine and observe
surgical exposure and orthodontic appliance
autotransplantation

32
Q

Extraction of Cs are more likely to be successful when….

A

patient between 10-13
canine distal to midline of upper lateral incisor
sufficient space available

33
Q

ectopic maxillary canines - risks of doing nothing

A
  • permanent successor becomes more ectopic
  • canine fails to erupt
  • risk of root resorption of adjacent teeth
  • risk of internal resorption of canine crown (low risk)
  • risk of cyst formation around canine (rare)
  • over eruption of lower canine
  • reduced or more complex option to resolve issue when cs eventually lost
    permanent canine can become ankylosed (incidence increases with age)

BDS3 Orthodontics (10 decks)

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