Ortho/Surgical Treatment & Implants 18% 12Q

Question 1

do you have to level the COS before a mandibular advancement?

Answer 1

no, could help brachyfacial patients to level after b/c it will inc LAFH

Question 2

what is the most stable surgical movement?

Answer 2

maxillary impaction

Question 3

what surgical movements are highly stable?

Answer 3

1. maxilla up
2. mandible forward
3. chin in any direction
4. maxilla forward (just stable)

Question 4

what surgical movements are stable when modifications are made?

Answer 4

5. maxillary asymmetry
6. maxilla up + mandible forward
7. maxilla forward + mandible back
8. mandibular asymmetry

Question 5

what surgical movements are problematic?

Answer 5

9. mandible back only
10. maxilla down
11. maxillary expansion

Question 6

hard tissue:soft tissue changes for genioplasty is ___ : ___

Answer 6

1:1

Question 7

hard tissue:soft tissue changes for maxillary advancement is ___ : ___

Answer 7

3:1

Question 8

what are the 2 most common complications with a BSSO

Answer 8

condylar sagging

post-surgical trismus

Question 9

which surgical movement is most likely to produce popping of crepitus?

Answer 9

mandibular advancement

Question 10

what complication can lead to a change in occlusion with a mandibular setback?

Answer 10

condyles located posteriorly creating an anterior open bite

Question 11

for patients with mandibular prognathism who undergo mandibular setback, the position of the hyoid bone includes (small / large / no ) AP changes in relation to the pharyngeal wall

Answer 11

no significant

Question 12

for patients with mandibular prognathism who undergo mandibular setback, the position of the hyoid bone includes

• downward movement
• backward movement

1. both
2. downward only
3. backward only

Answer 12

downward movement

Question 13

for patients with mandibular prognathism who undergo mandibular setback, physiologic adaptations ( did / did not ) occur to ensure maintenance the airway

Answer 13

did

Question 14

Early intervention surgery is done only if functional condyle is needed in the case of partial ____________ + ____________________ of one condyle

Answer 14

ankylosis

osteochondroma

Question 15

what is one ST side effect after Mx impaction

Answer 15

alar base widens

Question 16

distraction osteogenesis is used in patients with ____________ deficiency, like syndromic patients who have CLP or Crouzons, and in some instances in patients with mandibular __________

Answer 16

maxillary

crowding

Question 17

with distraction osteogenesis, the latency period (from time of surgery to beginning traction) is:

Answer 17

5-7 days

Question 18

one advantage to distraction osteogenesis is that it can increase bone in ___ planes of space with concomitant ___________ adaptation

Answer 18

all 3 planes

soft tissue

Question 19

Cascade of events after surgical fracture

1. ______________ forms due to vascular disruption
2. Reorganization of clot as a result of invading ____________
3. Initiation of healing and soft ____________ formation
4. 5th – 7th day: inflammatory granulation tissue of the initial soft callus converted into an organized ______________ zone similar to RPE
5. _____________ can be initiated

Answer 19

1. Hematoma
2. capillaries
3. callus
4. fibrous CT
5. Traction

Question 20

the surgical option of a true mandibular deficiency is:

Answer 20

distraction osteogenesis at the mandibular symphysis

Question 21

with distraction osteogenesis, slow incremental traction has allowed for up to ___mm mandibular lengthening with NO associated pain

Answer 21

20mm

Question 22

is there an increase in TMD with distraction osteogenesis patients?

Answer 22

no

Question 23

distraction osteogenesis is the treatment of choice for what circumstances?

Answer 23

limb length discrepancies, skeletal deformities, severe bony defects

Question 24

what is one main contraindication for rigid fixation?

Answer 24

condylar displacement

Question 25

when considering soft tissue changes, the upper lip ratio is ___ : \_\_\_

Answer 25

3 : 1

Question 26

when considering soft tissue changes, the chin ratio is ___ : \_\_\_

Answer 26

1 : 1

Question 27

post-op paresthesia after L8 extraction ( is / is not ) common

Answer 27

is

Question 28

the surgeon can minimize relapse by _____________ repositioning of the segments during surgery

Answer 28

passive

Question 29

LeFort I osteotomy affects the ( middle / lower ) ⅓ of the face

Answer 29

lower

Question 30

Maxillary advancement has what effect on upper incisor show

Answer 30

increases U1 display

Question 31

the main blood supply to the maxilla is the:

Answer 31

ascending pharyngeal artery

Question 32

which surgical movement can make a patient look older?

Answer 32

maxillary impaction

Question 33

what is an indication for a LeFort II?

Answer 33

retursive maxilla and nose

Question 34

the proximal segment of the mandible ( does / does not ) include the condyle

Answer 34

does

Question 35

the distal segment of the mandible includes:

Answer 35

teeth

Question 36

\_\_\_\_\_\_\_\_\_\_\_ fixation promotes stability

Answer 36

rigid

Question 37

Name as many factors as you can that can cause or lead to an increased predilection for condylar resorption

Answer 37

1. Rheumatoid arthritis 2. Trauma 3. Neoplasia 4. Ortho Tx 5. Orthognathic Sx 6. Pre-Existing TMJ 7. Age 15-35 female 8. High mandibular plane angle

Question 38

\_\_\_% of non-impacted asymptomatic L8s eruption normally

Answer 38

33% or ⅓

Question 39

with autotransplantation, _______________ is the most likely cause of tooth loss

Answer 39

external root resorption

Question 40

just as in RPE, the limiting factor to overall expansion in SARPE Tx is the:

Answer 40

zygomatic ridge

Question 41

the best mandibular surgical technique for patients with TMD is:

Answer 41

IVRO - intraoral vertical ramus osteotomy

Question 42

When considering growth which continues after surgery: maxillary ___________ dimension stops but _________ dimension continues, and mandibular growth is \_\_\_\_\_\_\_\_\_\_\_

Answer 42

maxillary AP dimension stops but vertical dimension continues normal

Question 43

Head of implant fixture should be \_\_\_mm apical to desired gingival margin

Answer 43

4mm

Question 44

maxillary implant healing time is ___ - ___ months while mandibular implant healing time is ___ - ___ months

Answer 44

Max 6-8 Mand 4-6

Question 45

the implant study on experimental animals showed a \_\_\_% success rate

Answer 45

94%

Question 46

Implant may be placed if there is no change in ___________ facial development taken from serial cephs 12 months apart

Answer 46

vertical

Question 47

In general implants may be placed in females age \_\_\_, but is is better to wait until age \_\_\_. in males, you can place at age ___ but it is better to wait until age \_\_\_.

Answer 47

F 14, 17 M 19, 21

Question 48

Bone on the (tension / compression ) side of the implant is thicker

Answer 48

compression (opposite to ortho)

Question 49

When replacing an over-retained primary tooth, the implant placement timing is:

Answer 49

2 months after extraction

Question 50

Type of movement most likely to cause disosseointegration of an implant

Answer 50

**Tipping**

Question 51

how much force is necessary to disosseointegrate an implant?

Answer 51

none (N/A)

Question 52

Worst type of bone to use for bone graft for later implant

Answer 52

Hydroxyapatite

Question 53

what type of bone is present at the interface of an implant?

Answer 53

composite bone

Question 54

the minimum osseointegration for TADs is \_\_\_%

Answer 54

5%

Question 55

TADs that are osseointegrated show __________ movement

Answer 55

no movement

Question 56

if cortical plate is difficult to penetrate, a ________________ may be needed to prevent high insertion torque and potential for screw failure (proffit)

Answer 56

Pilot hole