Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
37 Cards in this Set
- Front
- Back
|
How many apts are usually required in private practice for appliance removal?
|
2 apts
1. remove appliance 2. retainer delivery in 0-3 days |
|
|
What is doe in first appliance removal apt
|
- prophy
- impression for records and retainers - photos, final pan |
|
|
How many apts are usually required at UBC for appliance removal?
|
3 sessions at 1 week intervals
|
|
|
What do we do in the first appliance removal apt at ubc?
|
- remove bands
- sectional archire (just distal to 5s) - impressions for retainers |
|
|
What do we do in the second appliance removal apt at ubc?
|
- debond brackets
- prophy - impressoins for final models - insert retainers |
|
|
What do we do in the third appliance removal apt at ubc?
|
- check retainer
- make adjustments if needed |
|
|
How to deband?
|
- used debanding pliers, controlled movement
- triple check for sub-gingival band-lok |
|
|
How to debond?
|
- if possible leave archwire tied in
- debond brackets, then remove arch as a unit - brace the teeth, or get ptn to bite on a cotton roll |
|
|
Composite removal - instruments to use
|
- deband/debonding pliers
- scaler (band cement) - slow speed handpieve and 12 fluted carbide finished bur - no air/water spray needed - use scaler to detect remaining composite |
|
|
5 stages of orthodontic treatment
|
1. Leveling and aligning
2. Vertical correction 3. A-P correction 4. Finishing 5. Retention |
|
|
What is relapse?
|
- tendancy for the teeth to return to their original positions after active ortho tooth movement
- any deterioration of the occlusion after active treatment |
|
|
types of relapse?
|
1. Intra-arch alignment
2. Inter-arch occlusion |
|
|
3 major causes of relapse
|
1. Periodontal and gingival tissues
2. Teeth are in an inherently unstable position 3. Latent growth |
|
|
Describe how periodontal tissues can cause replase
|
with ortho tooth movement in healthy tissues:
- PDL remodelling normal (and necessary) during tooth movement - widening PDL space with slight tooth mobility |
|
|
Describe how gingival tissues can cause relapse
|
- elastic fibers stretched during tx
- main cause of short term relapse - remodelling takes 4-12 months - elastic supracrestal fibers remodel very slowly (12 months) |
|
|
Describe how unstable arch form can cause relapse
|
- Why put teeth there in the first place? somtimes teeth are moved to these positiosn to best serve esthetics or concerns of parents
- arch expansion and proclination of ant teeth more than 2mm or any expansion across canines |
|
|
T/F: lower intercanine distance is easy to change permanently
|
FALSE.
lower intercanine distance is VERY DIFFICULT to change permanently Why? pressure from corners of the mouth resist/match forces of braces in opposite direction |
|
|
When should craniofacial active growth stop?
|
18-19 YO
|
|
|
Describe how continued growth can cause relapse
|
- most ptn are young adolscents (13-14yo)
- growth continues into late teens - very slow growth continues throughout adulthood - differential growth bw maxialla and mandible will result in interarch changes - patient generally follow the same growth pattern throughout life - long-term changes in jaw position due to growth can indirectly cause crowding (intra-arch changes) - teeth are moved into position of soft tissue imbalance |
|
|
What is meant by cephalocaudal growth gradient?
|
things further away from brain tend to grow later (ex mx and md)
|
|
|
Do 3rd molars cause crowding?
|
Nope!
think about it... 3rd molars erupt at 18-19YO, but at this time jaw is STILL growing |
|
|
T/F: later mandible growth is a major cause of lower incisor crowding
|
True
|
|
|
General retention principles
|
- teeth tend to return to where they came from
- gingival/periodontal tissues and soft tissue forces contribute to short term and intra-arch relapse - continued growth is the major cause of long term and inter-arch relapse |
|
|
Retention - how long?
|
12 months full time wear + at least 12 months of night time wear UNLESS:
- patient still actively growing - sig arch expansion during tx |
|
|
What is a retainer?
|
appliance that provides resistance to the forces that cause relapse of the dentition
- can be passive in design |
|
|
T/F: Forces that cause relapse are intermittent and strong.
|
FALSE. Forces that cause relapse of the dentition are very LIGHT and CONTINUOUS
|
|
|
Types of retainers
|
1. Bonded
2. Removable - hawley - vacuform - posterior |
|
|
In which cases is it preferable to bond the retainer?
|
- poor patient compliance
- convinience - diastema (incr effectiveness for bonded>removable) |
|
|
In which cases is it preferable to give removable retainer?
|
- poor oral hygeine
- patient compliant |
|
|
Describe hawley retainer
|
- durable
- great for holding deepbite and transverse correction - verstile |
|
|
How is the hawley retainer versitile?
|
several variations possible:
- wrap around design - additional spring/clasps - acrylic on labial bow |
|
|
Features of vacuform retainers
|
- clear, relatively esthetic
- quick, easy fabrication - less durable - holds individual teeth - good for interm soln while retainer is being made |
|
|
Features of bonded retainers
|
- great for long term application
- best for holding spaces closed - no coorperatoin required - OH is more difficult |
|
|
What is the best option for retainer?
|
depends on the ptn!
- hawley better for deepbite and posterior crossbites - bonded better for diastemas or noncompliant patietns |
|
|
What is circumferential supracrestal fiberotomy?
|
- best for rotations
- preformed around time of deband - cut the supracrestal fibers |
|
|
Tx options for relapse
|
1. do nothing
2. adjust/squeeze the retainer on and increase frequency of wear 3. activate retainer 4. limited or full fixed tx (again) (choice depends on severity and ptn desire) |
|
|
What are active retainers?
|
- spring aligners
- series of aligners |
