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4 - ortho > interceptive orthodontics > Flashcards

interceptive orthodontics Flashcards

1
Q

What is interceptive orthodontics?

A

Any procedure that will reduce or eliminate the severity of a developing malocculsion

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2
Q

What problems can be caused by an anterior crossbite?

A

Toothwear
Gingival recession
Displacement on closure

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3
Q

How are anterior crossbites managed?

A

URA
Posterior bite plane
Z-spring to tip incisor forwards

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4
Q

Why should posterior crossbites be fixed early?

A

So permanent dentition will erupt into a normal position

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5
Q

How are posterior crossbites managed?

A

Maxillary expansion with a URA using a quad helix

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6
Q

Why are increased OJs often treated in the mixed dentition?

A

Trauma risk
Poor aesthetics - psychosocial problems

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7
Q

What is the aetiology of an increased OJ?

A

Skeletal - usually class 2, mandibular deficiency most common
Soft tissue - lower lip trap, hyperactive lower lip
Dental - upper incisor proclination, lingual displacement of lower incisors, digit sucking habit

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8
Q

What are the therapeutic effects of functional appliances?

A

Retrocline maxillary incisors and distalise molars
Procline mandibular incisors and mesialise molars
Remodel glenoid fossa
May enhance mandibular growth and restrain maxillary growth - limited evidence

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9
Q

What are the problems with a reverse OJ?

A

Displacement on closure
Incisal edge wear
Difficulty eating
Speech problems

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10
Q

Describe the aetiology of a reverse OJ

A

Skeletal - class 3, hypoplastic maxilla, prognathic mandible
Dental - mandibular displacement, retained upper deciduous incisors

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11
Q

How are reverse OJs managed?

A

Growing pt - procline upper incisors (URA) or attempt growth modification
Be careful of expected future growth

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12
Q

How can growth modification treat a reverse OJ?

A

Chin strap/cup
Functional appliance
Protraction headgear

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13
Q

What are the consequences of a deep overbite?

A

Palatal ulceration
Gingival stripping

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14
Q

How can a deep OB be treated?

A

URA with FABP
Will allow lower molars to erupt
Pt must be growing to accommodate the increase in OVD
May convert div II to div II then twin block

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15
Q

What are the problems of digit sucking habits?

A

AOB or reduced OB
Proclined upper incisors and retroclined lower incisors
Increased OJ
Posterior crossbites

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16
Q

What is the aetiology of a digit sucking habit?

A

≥6 hours duration
Prevention of eruption of incisors
Labio-lingual pressure on incisors
Lowering of tongue position

17
Q

How are digit sucking habits managed?

A

Encourage cessation at home initially
Conservative - positive reinforcement, bitter nail varnish, plaster on thumb
Removable or fixed habit deterrent appliance
Appliance to deal with effect - OJ reduction, closure of AOB, cross-bite reduction

18
Q

What can be used in appliances for habit deterrent?

A

Palatal goal post
Or
Fixed tongue rake

19
Q

What are the problems with supernumerary teeth?

A

Impeded eruption of associated teeth
Displaced eruption of adjacent teeth
Poor aesthetics
Damage to adjacent teeth - not common

20
Q

Describe conical supernumeraries and their management

A

Usually close to midline (mesiodens)
Usually 1 or 2
Tend not to prevent eruption but may displace centrals
Extract only if erupt or impeding tooth movement

21
Q

Describe tuberculate supernumeraries and their management

A

Main cause of failure of eruption of central incisors
Usually develop palatal to centrals
Remove and possible exposure of centrals

22
Q

Describe supplemental supernumeraries and their management

A

Normal morphology
Tend to extract
Decision based on tooth form and position

23
Q

What conditions increase the incidence of supernumeraries?

A

Cleft lip and palate
Cleidocranial dysostosis

24
Q

What is the aetiology of midline diastemas?

A

Developmental
Generalised spacing
Hypodontia (absent 2s)
Proclination of upper incisors
Low fraenal attachment
Pathology

25
Q

How are midline diastemas managed?

A

None if developmental
Surgical removal of supernumeraries - not always necessary
Early closure if severe and child is concerned
Fraenectomy (probs not)
Bonded retainer

26
Q

What are the consequences of early loss of deciduous teeth?

A

Es - impacted 5s, will often erupt to inside of the arch
As + Bs - minimal effect on centreline don’t balance or compensate
Cs - consider balance to maintain centreline if crowded, do not compensate
Ds + Es - space loss, consider space maintenance, little effect on centreline, no need to balance

27
Q

When is space maintenance required?

A

Early loss of deciduous teeth
Early loss of first permanent molar
Traumatic loss or delayed eruption of maxillary incisors
Preserve Leeway space

28
Q

When is the XLA of a mandibular first permanent molar ideal?

A

Calcification of bifurcation of 7
Mesial angulation of 7
Presence of 8
Age 8-9

29
Q

What are the consequences of early and late loss of mandibular first permanent molars?

A

Early - distal migration of second premolar
Late - poor spontaneous space closure and mesial tipping and lingual rolling of 7s

30
Q

What is the aetiology of impacted first permanent molars?

A

Poor eruption angle
Ectopic crypt
Morphology of second deciduous molar crown
Small maxilla

31
Q

What are the consequences of impacted first permanent molars?

A

Pulpitis of E
Premature exfoliation of E

32
Q

How are impacted first permanent molars treated?

A

Observe - 6 months
XLA E - space maintain or treat crowding later
Dis-impact - separators, band E and bracket 6 with open coil, discing of E, URA with finger spring and attachment on 6

33
Q

What is the aetiology of primary molar infra-occlusion?

A

Temporary ankylosis
Lower D most common
Mandible > maxilla
M:F equal
Percussion sound
Blurring or absence of PDL on X-ray

4 - ortho (14 decks)

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