PERIODONTOLOGY AND ORTHODONTICS – AN INTERFACE

Question 1

perio and ortho in children

Answer 1

If gingivitus develops in repsonce to Otho appliances almost never extends into periodontitis

Question 2

perio and ortho tx prior to commencement

Answer 2

before otho treatment OH course is ideal

hygiene aids are often needed , take more care to clean teeth

Question 3

where are the difficult areas to clean during ortho tx

Answer 3

M and D area of each tooth between brackets

gingival margin below the bracket

Question 4

special aids for cleaning during ortho tx

Answer 4

interproximal brish
standard interspace brish
powered rotary brish
superfl0ss

Question 5

ortho tx for pts undergoing perio tx

Answer 5

no contraindication for those who have perio disease as long as disease brought under control before and during ortho tx

Question 6

most common ortho problems found in perio compromised pts include

Answer 6

proclination of mx anterior teeth 
irregular interdental spacing
rotation of teeth
overeruption
migration/loss of teeth 
traumatic occlusion

Question 7

need to control inflammation

Answer 7

if disease not under control a combo of inflammation ortho forces and trauma produce a more rapid destruction that would occur with inflammation alone

Question 8

how to identify active perio disease

Answer 8

persistent bleeding on probing

Question 9

groups at risk of PD/ortho infklammation

Answer 9

those with min disease and no progression despite gingival inflmamtion
those with moderate progression
those with rapid progression

Question 10

reducing microorganism during perio tx

Answer 10

molar bonding over molar bands for cleaning

elastomeric rings may have higher levels of microorgansism

Question 11

summary of Orto and pd tx

Answer 11

patient with perio and driving can be treted
disease must be undercontrl and maintained through tx
beware areas of unexpected bone loss

Question 12

how to minimise recession for these ots

Answer 12

teeth should stay in the arch

Question 13

recession

Answer 13

arch expansion can lead to recession
root needs to be tipped into line of arch
labial movement of incisors puts supporting tissues at risk