Week 5 Adjunctive therapy

Question 1

What is the primary goal of adjuntive therapy?

Answer 1

Not to correct malocclusion

to reposition teeth facilitate other dental procedures: restore function, control/eliminate disease process

Question 2

True or False?

Goal is not always ideal occlusion and alignment

Answer 2

True

Question 3

What is the fastest growing area in ortho?

Answer 3

Adult treatment

Question 4

Age of patients for adjunctive therapy?

Answer 4

typically in 40-50s

Question 5

Duration of adjunctive therapy

Answer 5

a few months

rarely more than a year

Question 6

Long term retention is supplied by _____ in adjunctive therapy?

Answer 6

Restorations

Question 7

True or False?

TMD is considered as adjunctive therapy?

Answer 7

False

TMD is not considered as adjunctive therapy?

Question 8

True or False?

Adjunctive orthodontic treatment is almost always inter-disciplinary in nature

Answer 8

True

Question 9

Best determinant of timing for placement of a dental implant is when?

Answer 9

on completion of vertical alveolar growth

in younger patients

Question 10

How do you upright the tooth?

Answer 10

1. Distal crown tip

2. Mesial root tip

Question 11

What is distal crown tip?

Answer 11

By merely tipping, comparatively easier tooth movement, space is opened (pseudopocket due to an extraction or a missing tooth)

The space is maintained for restoration of tooth (Implant or bridge)

Question 12

True or False?

Uprighting multiple molars is easier than uprighting a single molar.

Answer 12

False

Uprighting a single molar is much easier!

Question 13

What is mesial root tip?

Answer 13

Need to move root by mesial movement.

it is significantly more difficult than distal crown tip because it requires root movement through alveolar bone of significant distance space is closed mesially.

To do this, you need to use the skeletal anchorage. It needs to be done very slowly (takes upto 3 years)

It requires a long time since it is a cortical bone remodeling.

Question 14

What is one thing you need to consider when tipping a tooth?

Answer 14

Extrusion!

When tipping a tooth to distal, it is common for a tooth to be extruded. if there is an antagonist, it is easy to control the extrusion. If there is no antagonist, the case becomes more complex and you need to apply the force to fix it.

Question 15

What do you use to prevent extrusion to tip the tooth?

Answer 15

T-loop spring mechanic or Helical mechanic

These springs tip the crown and also move roots mesially little bit to prevent extrusion of molar.

so it produces some intrusive movement

so crown tip with intrusion to prevent extrusion

Question 16

Intrusion rate?

Answer 16

0.5mm per month

Question 17

0.5 mm intrusion of Max posterior translates into about _____ closure of anterior open bite.

Answer 17

1 mm

Question 18

Intrusion upto ____ can be obtained.

Answer 18

4 mm

Question 19

True or False?

Relapse can occur with intrusion. Reasonably good short/medium term stability.

Answer 19

True

Question 20

True or False?

Controlled space closure is enhanced by using Temporary Anchorage Device (TAD) and auxiliary helical spring.

Answer 20

True

Question 21

Indications of Forced eruption?

Answer 21

Tooth fracture (subgingival): This gives no room to restore, if the patient wants restoration instead of implant… you would have to extrude that tooth

Periodontal disease and vertical bony defect

Question 22

Treatment options for forced eruption?

Answer 22

Perio crown lengthening - limitation is Crown-root ratio

Orthodontic rapid extursion

Question 23

What is the orthodontic extrusion (Extrusion)?

Answer 23

uses orthodontic forces.

the PDL including alveolar bone follows the extruding tooth.

Question 24

What is the Rapid Extrusion?

Answer 24

uses heavier forces, more frequent activation and results in extruding the tooth beyond the PDL (lengthen clinical crown without PDL and Bone involvement).

Long retention period!: important because the tooth can reintrude back for a significant time period.

Question 25

When do you intrude the teeth?

Answer 25

Supra-erupted teeth eg. missing occlusal conterpart (antagonist)

Question 26

Anterior tooth intrusion can be done… how?

Answer 26

it is difficult but possible with

conventional orthodontic technique

Question 27

Posterior teeth intrusion can be done.. how?

Answer 27

Only possible with reinforced anchorage systems (eg. TADs or Implants)

Question 28

What is the most difficult orthodontic tooth movement to accomplish?

Answer 28

INTRUSION!!!

Question 29

TADs is placed how to apply the force to intrude the tooth without tipping?

Answer 29

Placed both facially and lingually

Question 30

What is the orthodontic anchorage?

Answer 30

Resistance to undesirable tooth movement

Question 31

What is the skeletal anchorage?

Answer 31

utilizes either osseo-integration (implants) or metal to bone mechanical resistance Temporary Anchorage Devices (TADs)

Question 32

Applications of TADs?

Answer 32

Makes previously difficult tooth movements possible (intrusion of posterior teeth)

Simplifies orthodontic bio-mechanics

Speeds up ortho treatment

Question 33

Most commonly missing teeth?

Answer 33

1. 3rd molars

2. Max lateral incisors