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Orthodontics > Risks and Benefits of Orthodontics > Flashcards

Risks and Benefits of Orthodontics Flashcards

1
Q

Psychological benefits

A
  • severe malocclusion affects facial attractiveness
  • unattractive people are perceived unfavourably
  • correction may improve self- esteem
  • impact on minor malocclusions is more variable and debatable
  • QoL improvement
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2
Q

Benefits of orthodontics

A

Improvement in
1. Appearance (dental and facial)
2. Function
3. Dental health

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3
Q

Benefits in Function

A
  • mastication
  • speech
  • improvement when associated with severe malocclusion, such as large anterior open bites, severe increased OJ, reverse OJ
  • rarely improves speech defects
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4
Q

IOTN Dental Health Component

A

1&2 - no need/ low need with min benefit
3 - borderline need with some benefit
4 & 5 - need/ high need with significant benefit

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5
Q

MOCDO

A

M - missing teeth
O - overjet
C - crossbite
D - displacement of contact points
O - overbite

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6
Q

Impacted teeth

A
  • can cause resorption
  • associated with cyst formation
  • supernumerary teeth can prevent normal eruption
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7
Q

OJ of more than 6mm

A
  • risk of trauma to upper incisors
  • worse with incompetent lips
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8
Q

Anterior crossbites

A
  • loss of perio support
  • toothwear
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9
Q

Posterior crossbites

A
  • significant displacement may lead to asymmetry and early correction
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10
Q

Displacement (ie: crowding)

A
  • caries has more to do with diet and fluoride
  • crowded teeth are more difficult to clean and takes longer
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11
Q

Deep traumatic Overbite

A
  • cause gingival stripping
  • loss of perio support
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12
Q

TMD and some malocclusions

A
  • crossbite with displacement (functional shift)
  • class 2 with retrusive mandible
  • class 3
  • AOB
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13
Q

Potential problems of dental anomalies

A
  1. Missing/ ectopic teeth - RR, cyst formation
  2. OJ >6mm - upper incisor trauma
  3. Crossbite - toothwear, gingival recession, asymmetric growth
  4. Displacement - limited threat of caries/ perio disease
  5. Overbite - trauma and gingival damage
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14
Q

Summary in short

A
  • ortho tx are mostly elective
  • benefits more apparent at end of tx
  • risks throughout course of tx
  • benefits must outweigh risks
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15
Q

Risks of ortho

A
  • Decalcification
  • RR
  • Relapse
  • ST trauma
  • recession
  • loss of periodontal support
  • headgear injuries
  • enamel fracture & toothwear
  • loss of vitality
  • allergy
  • poor/failed tx
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16
Q

Decalcification

A
  • weakens tooth enamel to caries
17
Q

Preventing calcification

A
  • case selection
  • oral hygiene
  • diet advice
  • fluoride
18
Q

Good case selection

A
  • motivated pt
  • good OH pre- tx
  • low caries risk
19
Q

Maintaining good OH

A
  • toothbrushing and interdental brushing
  • twice a day
  • after every meal
  • disclosing tablets
  • target gingival margins and around each bracket
  • GDPs help
20
Q

Dietary advice

A
  • non- cariogenic diet
  • avoid snacking between meals
  • avoid fizzy, diluting drinks
  • avoid sport drinks
  • sugar free gums to stimulate salivary buffers
21
Q

How to prevent decal with fluoride?

A
  • toothpaste
  • MW
  • duraphat varinish
  • F releasing GIC
22
Q

For high risk pt?

A
  • Duraphat toothpaste 2800/ 5000 ppm; use twice daily
  • MW 0.05% (225ppm); use in between brushing not after
  • Duraphat varnish 22600ppm
23
Q

Toothpaste concentration

A

F MW 0.05% - 225ppm
Infant TP - 500-1000 ppm
Normal TP - 1450 ppm
Duraphat TP - 2800 ppm

24
Q

Root Resorption

A
  • inevitable consequences of tooth movement
  • average approx 1mm over 2 yrs fixed appliances
  • any teeth but UI > LI > 6s
  • severe in 1-5%
25
Q

Risk factors of RR

A
  • prolonged, high force of movement
  • intrusion
  • large movements
  • torque root movement
  • blunt, pipette, resorbed already
  • previous trauma
26
Q

Relapse

A
  • lower incisors are more prone to relapse
  • crowding
  • rotations
  • instanding laterals
  • spaces and diastemas
  • class 2 div 2
  • anterior open bites
  • reduced perio support/ short roots
27
Q

Relapse prevention

A
  • removable retainers; clear occlusal retainer; pressure/ vacuum formed/ essix/ hawley type
28
Q

Fixed retainers

A
  • prone to plaque and calculus build up
  • can break and not notice
  • need excellent OH
  • tend to leave insitu for life
  • require more care/ long term maintenance
29
Q

Soft tissue trauma

A
  • pain. discomfort
  • ulceration - ortho wax
30
Q

Recession

A
  • increasing problem
  • avoid overexpansion
  • thin biotype
  • warn patient
  • gingival graft
31
Q

Safety mechanisms of headgear

A
  • snap away traction spring
  • nitom facebow
32
Q

Allergies?

A
  • latex
  • nickel
  • adhesive - colophony

Orthodontics (6 decks)

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