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BDS4 OSCE > Ortho > Flashcards

Ortho Flashcards

(72 cards)

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1
Q

What plane should be parallel to the ground in an EOE?

A

Frankfurt plane

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2
Q

What does the frankfurt plane consist of?

A

Orbitali (inferior border of the orbit) and the tragus of the ear

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3
Q

What does the A-P skeletal assessment consist of?

A

Looking
Palpating - 2 finger method, to figure out is skeletal is Class I II or III
Lateral ceph

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4
Q

What methods are there to do a vertical assessment?

A

Visual inspection
Measurements from vertical face heights
Lateral ceph
Measure the FMPA

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5
Q

Explain where the different frankfurt and mandibular planes meet to produce different FMPA’s, and what these mean for face height.

A

Average FMPA meet at the occiput (back of head)
Increased FMPA - lines meet in front of the occiput = high angle = long face
Reduced FMPA - lines meet behind the occiput = low angle = short face

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6
Q

What points does the mandibular plane run from?

A

Menton = lowest point on mandibular symphysis
Goneal angle/goean

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7
Q

How does FMPA correlate to face height?

A

LOW ANGLE = SHORT FACE
HIGH ANGLE = LONG FACE

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8
Q

How do you measure face heights? eg what are the points etc

A

Split face into 3 equal parts - menton to subnasali, subnasali to glabella, glabella to hairline (tricheon).
All thirds should be equal - often ignore upper third, so Total Face Height is from glabella to menton
Total face height should be double lower face height = upper face height

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9
Q

What are the different face height measurements you can have?

A

Average face height - LAFH = UAFH
Increased face height (long) - LAFH > UAFH
Decreased face height (short) - LAFH<UAFH

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10
Q

How do you measure the transverse assessment - vertically?

A

Asymmetry vertically
Create a midfacial plane - glabella, nasion, pronasali, subnasali, philtrum, middle of chin (pogonion - most anterior part of chin)
Get floss, run it through the points, and see symmetry
Will mainly show mandibular asymmetry
Can check with the clavicular notch/adams apple below the mandible too

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11
Q

How do you measure the transverse assessment - horizontally?

A

Assessing canting
Interpupillary line should be horizontal and parallel to upper maxillary occlusal plane
Usually would use Win spatulas
(works well if there are no problems with orbit positioning, eg in orbital dystopia)

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12
Q

What is a class I incisor relationship?

A

The incisal edge of the lower incisor occludes with or is directly below the cingulum plateau of the upper incisors.

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13
Q

What is a class II div I incisor relationship?

A

The incisal edge of the lower incisor lies posterior to the cingulum plateau of the upper incisors. There is an increased overjet.

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14
Q

What is a class II div II incisor relationship?

A

The incisal edge of the lower incisor lies posterior to the cingulum plateau of the upper incisors. The upper incisors are retroclined and overjet is reduced.

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15
Q

What is a class III incisor relationship?

A

The incisal edge of the lower incisors lies in front of the cingulum plateau of the upper incisors. Overjet may be reduced or reversed.

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16
Q

What is normal overjet?

A

2-4mm

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17
Q

What is overjet?

A

The horizontal distance from the labial surface of the lower incisors to the upper incisal edge.

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18
Q

What is overbite?

A

The vertical distance between the lower incisal edge and the upper incisal edge

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19
Q

What is normal overbite?

A

Usually upper incisors cover 1/3 of the lower incisors

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20
Q

What are the types of overbite?

A

Complete (lower incisors occluding with upper incisors or palatal mucosa)
Incomplete (no contact between lower incisors and upper incisors or palatal mucosa)

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21
Q

What is a buccal crossbite?

A

Buccal cusps of lower teeth are buccal to the buccal cusp of the upper

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22
Q

What is a lingual crossbite?

A

Buccal cusps of the lower teeth occlude lingual to the palatal cusps

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23
Q

What should you always check if there is a crossbite?

A

Whether there is a mandibular displacement or not

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24
Q

What is a mandibular displacement?

A

On closure from the rest position, there is a premature occlusal contact which cause the mandible to be displaced to the left or right and/or anteriorly into maximum intercuspation.

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25
What is a class I molar relationship?
The mesial cusp of the upper first molar occludes/lies opposite the buccal groover of the lower first molar
26
What is a class II molar relationship?
Mesial cusp more forwards 1/2 unit or full unit class 2
27
How much is a unit of space?
A mesio-distal width of a premolar - 7mm
28
What is class III molar relationship?
1/2 or full Molar more backwards
29
Where should the canine sit in a normal canine relationship?
The cusp tip of the upper canine lies opposite the embrasure space between the lower 3 and 4.
30
How do you measure crowding?
Measure the overlap space
31
What is mild moderate and severe crowing?
Mild - 0-4mm Moderate - >4-8mm Severe - >8mm
32
What should you check about each arch?
Shape eg U, V, square, omega Caries/restorations Proclination/retroclination Crowding
33
What are the benefits of ortho treatment?
To improve facial appearance To improve function - speech and/or mastication To prevent damage to teeth and/or soft tissues
34
What is IOTN?
Index of orthodontic treatment need Consists of the aesthetic component and the dental health component
35
What is the dental health component of IOTN?
MOCDO Missing/impacted teeth Overjet Crossbite Displacement of contact points Overbite
36
Why is it important to check for missing teeth?
Cystic changes, root resorption, can damage other teeth
37
Why is it important to check for overjet?
Trauma issues
38
Why is it important to check for crossbite?
Trauma to teeth through occlusal trauma TMJ problems - causes stress (little evidence)
39
Why is it important to check for displacement of contact points (crowding)?
Harder to keep crooked teeth clean
40
Why is it important to check for overbite?
AOB - problems with function Deep OB - mucosal trauma
41
What is reverse overjet also called?
Negative overjet = reverse overjet = anterior crossbite
42
What is the difference between anterior X bite and reverse OJ?
If only 1-3 incisors are involved then it is anterior cross-bite, if 4 then reverse overjet
43
What can you do as a GDP to tackle overjet?
Offer a guard to the child to prevent trauma, since cannot start tx when child is young
44
What is relationship between OJ, trauma and lips?
As overjet increases, incidence of trauma increases More incidence of trauma with incompetent lips than competent lips
45
What is important in crossbite in IOTN?
The mandibular displacement/slide not the size of the X bite
46
How is IOTN different to clinical crowding?
Because crowding you measure all of the crowding IOTN you measure the biggest displacement of contact points
47
How do you measure the displacement of a contact point?
In a straight line (crow flies) from the point of the displaced tooth to where it should lie in the arch
48
What about IOTN do you need to know as a GDP?
Does the pt meet the eligibility criteria Will it be beneficial to the pt
49
Why do we treat children with braces?
Teeth move best during adolescence Payment reasons - free for kids
50
What are the 3 main intra-oral risks of braces?
Enamel demineralisation/caries Root resorption Relapse
51
What are all of the intra-oral risks of braces?
Enamel demineralisation/caries Enamel trauma Enamel wear Pulpal reactions Root resorption Periodontal tissues Allergy Trauma Relapse
52
What are the extra-oral risks of braces?
Allergy (to nickel brackets or latex bands) Trauma Burns TMD
53
What are the systemic risks of braces?
Cross-infection Infective endocarditis
54
How much root resorption usually occurs after brace treatment?
1 to 2mm with blunted roots Some suffer a lot more!
55
Why do we take OPG's before braces?
To assess root length
56
How do dentists stop teeth going back to normal after brace treatment?
Wearing retainers for life
57
What is the aesthetic component of IOTN?
Ranks dental attractiveness - 1 is most attractive, 10 is least attractive
58
What are the issues with the aesthetic component?
Not objective Does not relate A-P direction (eg doesnt account for class III's) Only permanent dentition Stained or chipped teeth ignored
59
When do you refer to hospital?
If part of a multidisciplinary team. Not for routine extractions - GDP can do these! Orthodontists only do ortho.
60
What are the grades and groups for IOTN?
Grade 1 - no need for tx Grade 2 - little need for tx Grade 3 - borderline need for tx Grade 4 - moderate need for tx Grade 5 - severe need for tx Grade 1,2 no/little need 3 - borderline 4,5 - need
61
Where can you refer?
Hospital - consultant orthodontist Specialist practice - specialist orthodontist
62
How do you decide whether to refer a 3?
The aesthetic component - if 6 or above then refer
63
What are the letter suffixes after the numbers for each part of MOCDOO (other)?
M (h,i) O (a,b) C (c) D (d) O (e,f) O (g)
64
What are all of the conventions for IOTN DHC?
- If any teeth in the buccal segment deviate from a full interdigitation the grade is 2g - Crossbites: anterior should involve 1-3 incisors and posterior cusp-to-cusp or full crossbite - Crowding: <4mm space for a tooth to erupt is recorded as an impaction --> 5i - Contact point displacement is noted when teeth deviate from line of arch - Impeded eruption is 5i, however partially erupted but tipped tooth is recorded as 4t - OJ measures with a ruler parallel to occlusal plane and radial to line of arch - The most prominent incisor is recorded - ROJ - all incisors are involved - Rotations not recorded if in the line of the arch - Discrepancies between ICP-RCP are recorded as a crossbite - Spacing not recorded unless the tooth deviates from line of arch and contact point displacement is measured - Residual extraction space not recorded - Infraoccluded teeth are recorded if only 2 cusps visible and/or adjacent teeth are tipped (5s) - Open bites are measured at the greatest height - With borderline grades, the lower DHC is recorded - The patient should be asked what aesthetic grade they think they are
65
What are the letters in a grade 1 IOTN score?
Minor tooth irregularities, no real need for tx
66
What are the letters in a grade 2 IOTN score?
2a - overjet 3.5-6mm with competent lips 2b - reverse overjet 0-1mm 2c - crossbite with 0-1mm displacement 2d - contact displacement 1-2mm 2e - openbite 1-2mm 2f - increased openbite upto 3.5mm with no gingival contact 2g - pre or post-normal occlusions
67
What are the letters in a grade 3 IOTN score?
3a - overjet 3.5-6mm with incompetent lips 3b - reverse overjet 1-3.5mm 3c - crossbite with displacement 1-2mm 3d - contact point displacement 2-4mm 3e - anterior or lateral openbite 2-4mm 3f - deep overbite with no trauma but gingival contact
68
What are the letters in a grade 4 IOTN score?
4h - less extensive hypodontia requiring pre-restorative ortho +/- ortho space closure to obviate need for prosthesis 4a - overjet 6-9mm 4b - reverse OJ >3.5mm but no masticatory or speech problems 4m - reverse OJ 1-3.5mm with masticatory/speech problems 4c - crossbites with >2mm displacement 4l - posterior lingual crossbite 4d - contact point displacements >4mm 4e - anterior/lateral open bites >4mm 4f - increased overbite with gingival trauma 4t - partially erupted teeth tipped or impeded by adjacent teeth 4x - supernumerary teeth present
69
What are the letters in a grade 5 IOTN score?
5i - impeded eruption 5h - severe hypodontia (more than 1 tooth missing in any quadrant) 5a - overjet >9mm 5m - reverse overjet >3.5mm with functional difficulties 5p - cleft lip and palate 5s - submerged deciduous teeth
70
Limitations of the dental health component
- 2 components might contradict each other - Spacing is not accounted for - Worst scenario is assumed for study models - The complexity of treatment is not indicated - Stained/chipped teeth and poor gingivae are ignored - may be of great concern to patient
71
What is malocclusion?
Not a disease - an appreciable deviation from the ideal that may be considered aesthetically or functionally unsatisfactory.
72
What are the aetiologies of malocclusion?
Skeletal - AP, vertically, transversely Soft tissue/habits - lips, tongue, facial muscles, habits, adenoids Dental - tooth number, size/form, position, soft tissues pathology

BDS4 OSCE (3 decks)

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