Maintainers

Question 1

What is the importance of maintaining the integrity of the dental arch from the most premature period in the development of the human being allows a normal occlusion

Answer 1

Guide to eruption for the permanent teeth
Adequate establish of occlusion in permanent dentition
phonetic function
chewing function
aesthetic function
prevention of oral habits

Question 2

When does the most common loss occurs __ months after the loss of a primary tooth

Answer 2

Within 6 consecutive month after the loss of a primary tooth

Question 3

Children may experience premature tooth loss

Answer 3

local: caries , trauma
systemic: premature birth, cerebral palsy, syndrome/ disorders

Question 4

teeth have a strong tendency to move ____ even before they erupt into the mouth

This phenomenon is called

Answer 4

mesially

mesial thrust tendency

Question 5

Premises for the use of maintainers: 6
DA TES TIE CAS ANAB TP

Answer 5

dental age of the patient
tooth eruption sequence
time elapsed since extraction
degree of crowding and available space
anomalies or absence of permanent teeth
tooth type and position

Question 6

the provision of an appliance which is concerned only with the control of loss, considering measures to supervise the dentition development

Answer 6

Maintenance

Question 7

appliances used to maintain or regain the mayor amount of so that they can guides the eruption of the permanent teeth into a proper position.

Answer 7

Maintainers

Question 8

Most important function of maintenance is to

Answer 8

maintain the mesiodistal relationship

Question 9

The maintenance of the arch length in the primary and early permanent dentition is important fo the

Answer 9

Normal development of the occlusion

Question 10

premature loss of primary teeth can result in the

Answer 10

In the loss of the arch length leading a malocclusion

Question 11

the pattern of loss depends on many factors including:

Answer 11

age, stage of development in which teeth has bee lost, he presence of crowding or space.

Question 12

maintainers function

Answer 12

1. maintain arch length and perimeter
2. prevent loss
3. prevent the development of a malocclusion or reduce its severity

Question 13

requirements that a maintainers must have

Answer 13

• maintain the desire proximal space
• it should not interfere with the eruption of the permanent successor teeth
• it should not interfere with the opposite tooth
• it must provide enough mesiodistal for permanent teeth
• it should not interfere with phonation, chewing ot functional jaw movement
• they should be simple in design
• easy to clean and maintain

Question 14

Ideal characteristics of the maintainers

Answer 14

simple
strong and stable
passive not cause the movement
do not increase the risk of caries development

Question 15

general consideration to place a maintainers

Answer 15

• time elapsed after loss
• px dental age
• amount of space lost
• tooth eruption sequence
• late eruption of permanent teeth

Question 16

general consideration to place a maintainers
Where closure usually occurs in the fits six months, therefore the maintainer should be placed as soon as possible

Answer 16

Time elapsed after loss

Question 17

general consideration to place a maintainers
Where the stage of root development of the successor tooth should be evaluated, regardless of the child’s age

Answer 17

Px dental age

Question 18

general consideration to place a maintainers
Where if a situations in which ⅔ of the existing fo the correct positioning of the permanent tooth has been lost there will be a need for orthodontic treatment to correct these deviations

Answer 18

Amount of space lost

Question 19

general consideration to place a maintainers
Where the relationship of the developing teeth and adjacent eruptions must be observed in the created by the premature loss of any dental organ

Answer 19

Tooth eruption sequence

Question 20

general consideration to place a maintainers
Where it occurs due to partial impaction or deviation in the eruption path of the permanent successor teeth. In this case, extraction of the temporary tooth and placement of the space maintainer are almost indicated.

Answer 20

Late eruption of permanent teeth

Question 21

Consequences of premature loss

Answer 21

• decrease in the perimeter and length of the arch with the consequent deviation from the midline
• causing malocclusions such as **crowding, ectopic eruption or impaction of permanent tooth*
• alteration of the molar and canine relationship
  changes in the vertical plane such as deep bites, and in the transverse plane such as crossbites.
• structural changes may occur in the bone tissue according to the age at which tooth loss occurs and defects may occur in the height of the alveolar bone
• at the soft tissue level, anomalies caused in the gingival mucosa may be favored and oral habits such as atypical swallowing in edentulous spaces may be generated compromising aesthetics and may produce alterations in phonetic development

Question 22

however not every premature loss of a temporary tooth will be treated systematically by placing a maintainer and they not always have the same characteristics

Answer 22

!

Question 23

This planning should have a general vision of the px seeking to preserve the total perimeter of the dental arch and maintain the of the tooth lost prematurely
For an adequate planning, the dx must be analyzed with the aim of individualizing each case the most appropriate way

with:
clinic exam
x-ray
dental casts

Answer 23

Planning for the maintenance

Question 24

Types of maintainers

Answer 24

• unilateral
  - band and loop
• bilateral
  - lower lingual arch
  - transpalatal arch
  - nance appliance
  - removable acrylic appliance

Question 25

Types of unilateral maintainers

Answer 25

Band and loop

Question 26

Types of bilateral maintainers

Answer 26

lower lingual arch transpalatal arch nance appliance removable acrylic appliance

Question 27

**Indicated for the loss of the first primary molar** It is indicated to maintain the for a missing second primary molar, only if we have the presence of the first permanent molar

Answer 27

Band and loop

Question 28

Advantages of Band and loop

Answer 28

allows the eruption of permanent teeth easy to construct and adjust not expensive non invasive or painful

Question 29

bilateral loss of the **mandibular primary molars** after eruption of the permanent incisors unilateral loss of more than one tooth in the mandibular arch

Answer 29

Lower lingual arch

Question 30

it is design of a bilateral band on molars that are connected by a heavy wire that rests on the cingulum of the anterior incisors

Answer 30

Lower lingual arch

Question 31

bilateral loss of the **maxillary primary molars** unilateral loss of more than one tooth in the maxillary arch

Answer 31

Nance appliance

Question 32

its design is bilateral bands on the first molars that are connected by a heavy wire, and the arch wire is directed toward the palatal surface and is embedded in an **acrylic button** resting on the soft tissue

Answer 32

Nance appliance

Question 33

Bilateral loss of the **maxillary primary molars** unilateral loss of more than one tooth in the maxillary arch * solo cuando se pierde otro diente además del posterior, uno anterior o premolar, si solo se cae posteriores siempre es mejor poner un nance

Answer 33

Transpalatal arch

Question 34

its design of a bilateral bands on the first molars that are connected by a heavy wire that transverse the hard palate **without touching soft tissue.** Easier to clean, not very stable as the nance bottom

Answer 34

Transpalatal arch

Question 35

there has been a loss of more than one tooth in a quadrant, and the permanent molars haven’t erupted yet in the mandibular primary dentition, a loss of the second primary molars along with the both first primary molars

Answer 35

Removable acrylic appliance

Question 36

Procedure within the field of interceptive orthodontics that can be applied in cases of bone-dental discrepancy where the supporting bone is less that the sum of the size of the dental material

Answer 36

Serial extraction

Question 37

was the first to propose in one of his dental treatises, the extraction of deciduous teeth to achieve greater alignment of the permanent teeth

Answer 37

Pierre Fauchard

Question 38

Its and interceptive orthodontic procedure it's a timed planned sequential extraction of certain deciduous teeth followed by the removal specific permanent teeth in order to guide the eruption of permanent teeth into a favorable position

Answer 38

Serial extraction

Question 39

2 basic principales of serial extraction

Answer 39

1. Arch length / tooth size discrepancy 2. Physiologic tooth movement

Question 40

First basic principal for serial extraction Arch length / tooth size discrepancy

Answer 40

when there is an excess of tooth material, compared to the arch length, specific extraction of some teeth has to be done so that the rest of the teeth can be guided to a normal occlusion

Question 41

Second basic principal for serial extraction physiologic tooth movement

Answer 41

Human dentition shows a physiologic tendency to move towards an extraction space. But if we choose to remove some specific teeth, the rest of them which are in the eruption process, will be guided by the natural forces into extraction spaces

Question 42

Indication for serial extraction

Answer 42

- premature loss of primary teeth - arch length deficiency and tooth size discrepancy - crowded maxillary and mandibular incisors - class I malocclusion

Question 43

Contraindications for serial extraction

Answer 43

- severe class II or CLass III - cleft palate cases - extensive caries of first permanent molar

Question 44

Serial extraction methods

Answer 44

- Dewey method - Tweed method - Nance method

Question 45

extraction of deciduous canines followed by deciduous first molars an finally first premolars

Answer 45

Dewey method

Question 46

extraction of deciduous first molar followed by the first premolar then the deciduous canines and laterals

Answer 46

Tweed method

Question 47

extraction of deciduous first molar, followed by the first premolars then the deciduous canines

Answer 47

Nance method