Orthodontics - TEST #1

orthodontics is

speciality of dentistry with supervision, guidance, and correction of the growing + mature dentofacial structure

facial aesthetics to improve are

appearance

facial profile

occlusion

WHO health definition

state of complete physical, social, and mental well being

treating perio disease is considered

social + mental well being

orthodontics indications

severe malocclusions

large overjet

midline

perio health due to crowed teeth

severe class II

orthodontics contraindications

bone + blood disorders

lack of motivation

successful orthodontic treatment requires

co operation

compliance

who has had high orthodontics discontinuation rates

children + adolescents

orthodontics poor health can result in

decalcification

decay

gingival overgrowth

severe root resorption is

more than 1/3rd of root is lost

severe root resorption occurs between ?? orthodontically treated teeth

1-5%

severe root resorption is seen in the

anterior max

factors for orthodontics potential for relapse

rotated teeth

lower incisor crowding

age related changes

malocclusion is

abnormal / malpositioned relationship of max + mand teeth

etiologic sites of malocclusion

neuromuscular

bones

teeth

neuromuscular system affects occlusion by….?

major muscle groups that affect bone / teeth

strong mentalis

strap like lower lip results in

retroclination of lower incisors

bone etiology is the most

serious malocclusions in skeletal organ

2 stages of treatment of skeletal disharmonies

1. during growth phase (removable/fixed appliances)

2. after growth phase (surgical intervention)

most common site of fracture is

mandible condyle during childhood

= can cause asymmetry

PHOTO = curve of Wilson

juvenile rheumatoid arthritis is

before age 16

results in development of severe class II

teeth etiology developmental causes

eruption sequence

is age or eruption sequence more important

eruption sequence is more important because it will determine occl

congenitally missing teeth is called

anodontia

hypodontia

which teeth are congenitally missing teeth

max laterals

mand 1st pre molars????

8s

small teeth is called

mesoden

what are the two categories of supernumeraries

hyperdontia

mesoden

gemination is

developmental disturbance with single tooth germ trying to divide forming large single-rooted tooth

factors related to malocclusion

genetics

environmental

sucking/tongue thrusting/mouth breathing

mouth breathing can lead to

adenoidal face

adenoidal face characteristics

nostrils underdeveloped

upper lip is short

longer faces

minor malocclusion is

slight variations in displaced teeth

major malocclusion is

involves entire dental arches + skeletal bones

class I

medial buccal cusp of max 1st molars occludes with medial buccal groove of mand 1st molar

class I malocclusion

deviation from class I

crowding, rotations

class II malocclusion

body of mand is in distal relationship with max

class II malocclusion gives appearance of

max anterior teeth protruding over mand anterior teeth

class II division I malocclusion is

the maxillary incisors are protruded and the mandible is in a retruded position

class II division II malocclusion is

one or more max incisors are retruded and the mandible is in a retruded position to the max

class III malocclusion

body of mand is in abnormal median relationship with max

class III malocclusion gives appearance of

mand teeth protruding in front of max anterior teeth

planes of occlusion is for

primary teeth

terminal plane is

ideal molar relationship in the primary dentition, when in centric occlusion

mesial step is

primary mandibular second molar is mesial to the maxillary second molar

distal step is

primary mandibular second molar is distal to the maxillary second molar

not an ideal molar relationship in the primary dentition

what is the most common contributor to malocclusion

crowding

lower anteriors

overjet is

protrusion of max incisors

expressed in mm

open bite is

lack of vertical overlap of max incisors

causes opening of anterior teeth when posteriors are closed

cross bite is

tooth is not properly aligned with opposing tooth

cross bite types

posterior

unilateral

bilateral

anterior

posterior cross bite is

Lingual cusps of maxillary teeth do not occlude in the center of occlusal surface of mandibular tooth

Cusps are located either facial or lingual to their normal position.

unilateral cross bite is

posterior crossbite that affects only one side of the mouth

bilateral cross bite is

posterior crossbite that affects both sides of the mouth.

anterior cross bite is

maxillary incisors are located lingual to the mandibular incisors

overbite is

Increased vertical overlap of the maxillary incisors

expressed in %

slight overbite is

incisal edge of the maxillary central incisors rest in the incisal 1/3 of the mandibular central incisors.

moderate overbite is

incisal edge of the maxillary central incisors rest in the middle 1/3 of the mandibular central incisors.

severe overbite is

incisal edge of the maxillary central incisors rest in the cervical 1/3 of the mandibular central incisors.

orthodontics extra oral exam

soft tissue

facial / profile type

TMJ

lip posture

method of breathing

swallow pattern

musculature - mentalis

soft tissue profile involves

convex

concave

normal

convex soft tissue profile is

upper & lower lips are ahead of a line connecting a point halfway along the lower border of the nose and the most forward point on the chin

concave soft tissue profile is

upper & lower lips are behind a line connecting a point halfway along the lower border of the nose and the most forward point on the chin

face is divided into

3 horizontal sections

upper face extends from

hairline to base of forehead (trichion) between the eyebrows (glabellar)

midface extends from

base of forehead to base of nose (subnasale)

lower face extends from

base of nose to the bottom of chin (menton)

lower face can be sub divided into

thirds

upper lip is

upper 1/3 rd

lower lip is

lower 2/3rd

transverse face divided into

5 vertical sections

what are the 3 facial types

brachycephalic

dolichocephalic

mesocephalic

brachycephalic is

short wide head

dolichocephalic is

long narrow head

mesocephalic is

average

what are the 3 profile types

retrognathic

prognathic

mesognathic

retrognathic is

prominent maxilla and a mandible posterior to its normal relationship

chin is back

convex

retrognathic leads to what occlusion

class II malocclusion

both divisions

prognathic is

prominent, protruded mandible and normal max

concave

prognathic leads to what occlusion

class III

mesognathic

protruded jaws that gives a flat profile

normal

mesognathic leads to what occlusion

class I

class I malocclusion

nasolabial angle is

formed between upper lip and base of nose

nasolabial angle

90-110

high nasolabial angle implies

retrusive upper lip

low nasolabial angle implies

lip protrusion

lip relationships types

competent

potientally competent

incompetent lips

competent lips

together at rest

potentially competent lips

apart at rest

due to physical obstruction

incompetent lips

apart at rest

require excessive muscular activity to obtain lip seal

normal tongue position

at rest dorsum touches the palate and tip is lingual to lower incisors

protracted tongue position

tip of tongue rests above lower incisors

protracted tongue position results in

open bite

protracted tongue caused by

pharyngitis

tonsitilits

retracted tongue position

tip of tongue doesn't touch incisors at all

retracted posteriorly

seen in less than 10%

frequent in edentulous adults

what % of max incisors should show while smiling

75-100%

3 levels of orthodontic treatment are

simple preventive

interceptive

corrective

simple preventive is

easiest type

usually in primary / mixed

involves removable / fixed appliances that will stop a habit

interceptive is

mixed dentition

changes the growth pattern

involves bionators expanders

corrective is

most involved treatment

permanent dentitions (14 or older)

involves full brackets

role of DH in orthodontics

collaboration

recognizing facial profiles / hereditary factors

understanding financial situations

observing cross bites + occlusions

noticing personalities