Etiology of Malocclusion: Local & General Factors
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Questions and Answers

What condition is associated with decreased cranial base measurements?

  • Anterior crossbite
  • Cleft lip and palate
  • Hypopituitarism (correct)
  • Cleidocranial dysostosis
  • Which of the following nutritional deficiencies can impact the growing dentition?

  • Vitamin C deficiency
  • Vitamin E deficiency
  • Calcium deficiency
  • Vitamin B12 deficiency (correct)
  • What is a common feature of cleidocranial dysostosis/dysplasia?

  • Narrow nasal bridge
  • Prominent brow area (correct)
  • Delayed dental eruption
  • Absence of the zygomatic prominence
  • Which infectious disease is linked with dental hypoplasia?

    <p>Mumps</p> Signup and view all the answers

    What postnatal trauma can lead to the early loss of deciduous teeth?

    <p>Malnutrition</p> Signup and view all the answers

    Which vitamin deficiency is associated with retarded eruption of teeth?

    <p>Vitamin A and D</p> Signup and view all the answers

    What genetic condition is associated with a wide nasal bridge and abnormal shoulder development?

    <p>Cleidocranial dysostosis</p> Signup and view all the answers

    What prenatal factor is known to cause intrauterine molding?

    <p>Alcohol consumption</p> Signup and view all the answers

    What is the effect of prolonged force, regardless of its magnitude, on alveolar bone?

    <p>Alveolar bone bends</p> Signup and view all the answers

    What is the primary result of the remodeling process induced by orthodontic treatment?

    <p>Tooth movement</p> Signup and view all the answers

    According to the bioelectric theory, what initiates changes in bone metabolism?

    <p>Electric signals produced by bone flexing</p> Signup and view all the answers

    What cellular activity occurs on the concave side of the periosteum during bone remodeling?

    <p>Increased osteoblastic activity</p> Signup and view all the answers

    What triggers tooth movement according to the described theories?

    <p>Stretching of the periodontal ligament</p> Signup and view all the answers

    What phenomenon describes the generation of electric signals in crystalline materials under pressure?

    <p>Piezoelectricity</p> Signup and view all the answers

    Why is the force applied during orthodontic treatment considered effective despite its brief duration?

    <p>Short bursts are sufficient to initiate remodeling processes</p> Signup and view all the answers

    What biological reaction does compressing the periodontal ligament (PDL) primarily lead to?

    <p>Bone resorption</p> Signup and view all the answers

    What is a common effect of prolonged thumb sucking?

    <p>Narrow arch and high palatal vault</p> Signup and view all the answers

    What condition can result from the presence of macrodontia?

    <p>Increased crowding</p> Signup and view all the answers

    Which of the following teeth anomalies is characterized by a peg-shaped structure?

    <p>Peg-laterals</p> Signup and view all the answers

    Which factor is most likely to cause posterior crossbite?

    <p>Mouth breathing</p> Signup and view all the answers

    What is one of the consequences of premature loss of deciduous teeth?

    <p>Challenged space for developing permanent teeth</p> Signup and view all the answers

    What impact does a low labial frenum have in dental development?

    <p>Causes diastema</p> Signup and view all the answers

    What is the primary cause of delayed eruption of permanent teeth?

    <p>Supernumerary teeth</p> Signup and view all the answers

    Which condition refers to the abnormality of tooth shape resembling a cow's molar?

    <p>Taurodontism</p> Signup and view all the answers

    What happens when there are extra teeth present in the dental arch?

    <p>Crowding and rotation of teeth</p> Signup and view all the answers

    What oral habit shares similar consequences with thumb sucking regarding dental alignment?

    <p>Nail biting</p> Signup and view all the answers

    What complication can occur as a result of retained deciduous teeth?

    <p>Constrictive dental arch</p> Signup and view all the answers

    Which of the following is a primary outcome of lip biting?

    <p>Labial proclination of incisors</p> Signup and view all the answers

    What is the impact of mouth breathing on dental health?

    <p>May lead to oral dryness and malocclusion</p> Signup and view all the answers

    What characterizes lingual inclination of mandibular incisors?

    <p>Increased anterior open bite</p> Signup and view all the answers

    What is a potential cause of abnormal eruptive path in teeth?

    <p>Arch length deficiency</p> Signup and view all the answers

    Which condition is considered a local factor in the etiology of malocclusion?

    <p>Congenitally lost permanent tooth</p> Signup and view all the answers

    What sequence of events can improper dental restoration lead to?

    <p>Functional shift of the jaw</p> Signup and view all the answers

    In orthodontic tooth movement, where does bone resorption occur?

    <p>In the positive charge area</p> Signup and view all the answers

    What is defined as a physiologic tooth movement?

    <p>Tooth eruption into the oral cavity</p> Signup and view all the answers

    What is a characteristic of orthodontic forces?

    <p>Does not change the tooth but alters its position</p> Signup and view all the answers

    What can the presence of impacted molars indicate?

    <p>Spacing issue in the dental arch</p> Signup and view all the answers

    Which of these is a potential result of a supernumerary tooth?

    <p>Arc length deficiency</p> Signup and view all the answers

    What happens to blood flow when pressure is applied to a tooth during orthodontic treatment?

    <p>Blood flow decreases</p> Signup and view all the answers

    Which type of cell is primarily associated with the tension side during orthodontic tooth movement?

    <p>Osteoblasts</p> Signup and view all the answers

    What is the main consequence of maintaining a force on a tooth in terms of osteoclast activity?

    <p>Increased osteoclast activity</p> Signup and view all the answers

    Which factor is NOT influenced by the application of orthodontic force?

    <p>Osteoblast proliferation</p> Signup and view all the answers

    What does the RANKL, RANK, and OPG signaling pathway primarily regulate?

    <p>Bone formation and resorption</p> Signup and view all the answers

    Which mediator is known to stabilize RANKL expression in the periodontal ligament (PDL) under hypoxic conditions?

    <p>HIF-1</p> Signup and view all the answers

    What is the role of prostaglandin E2 (PGE2) in orthodontic tooth movement?

    <p>Stimulates osteoclast differentiation</p> Signup and view all the answers

    During orthodontic treatment, what happens to oxygen levels on the tension side?

    <p>They increase</p> Signup and view all the answers

    Which of the following is a result of hypoxia in the periodontal ligament during orthodontic force application?

    <p>Promotion of vascular growth</p> Signup and view all the answers

    What is the immediate outcome of pressure applied to a tooth in terms of osteoclast and osteoblast activity?

    <p>Increase in osteoclasts and decrease in osteoblasts</p> Signup and view all the answers

    Which hypothesis was proposed by Schwarz in 1932 regarding orthodontic tooth movement?

    <p>Deformation of crystal structure generates current</p> Signup and view all the answers

    What is a critical event that occurs after orthodontic forces are applied?

    <p>Release of chemical mediators</p> Signup and view all the answers

    What occurs to the levels of carbon dioxide when tensile force is applied?

    <p>They significantly decrease</p> Signup and view all the answers

    What is the result of tissue compression on the tooth?

    <p>Inhibition of cell replication</p> Signup and view all the answers

    Study Notes

    Etiology of Malocclusion: Local & General Factors

    • Hypopituitarism: Associated with absent zygomatic prominence, Class III malocclusion, high palatal vault, crowding, and anterior & posterior crossbite. Decreased cranial base measurements and delayed tooth eruption are also observed.
    • Cleidocranial Dysostosis/Dysplasia: Birth defect affecting bones and teeth. Characterized by prominent brow and lower jaw, wide nasal bridge, and missing or abnormally developed shoulder and collarbones. Deciduous teeth exfoliate irregularly.
    • Infectious Diseases: Mumps can cause dental hypoplasia, while Rubella may lead to delayed tooth eruption.
    • Nutritional Deficiencies: Impact growing dentition. Vitamin A and D deficiencies, vitamin B12 deficiency, folic acid deficiency, and protein deficiency can all affect tooth development and eruption. Hypervitaminosis A can cause cleft lip and palate.
    • Prenatal Trauma: Intrauterine molding and birth trauma to the mandible are common causes.
    • Postnatal Trauma: Includes thumb/finger sucking, lip biting, and nail biting.
    • Thumb/Finger Sucking: Normal subclinical up to 3 years old; clinically significant between 3-7 years old; intractable habit beyond 7 years old. Causes include inadequate nursing, insecurity, hunger, or learned habit. Prolonged sucking leads to increased overjet, anterior open bite, maxillary incisor flaring, mandibular incisor lingual inclination, narrow arch, high palatal vault, incompetent lips, posterior crossbite, mandibular retrognathism, maxillary prognathism, and speech defects.
    • Lip Biting and Sucking: Causes lower lip lingual inclination, maxillary incisor proclination, and open bite.
    • Nail Biting: Similar effects to thumb sucking, including narrow maxillary arches, crowding, incisal edge attrition, and speech defects.
    • Mouth Breathing: May be treated with appliances or lip taping.
    • Abnormal Tooth Number: Supernumerary teeth cause crowding, rotation, delayed eruption, diastema, and torsiversion. Missing teeth create diastema.
    • Anomalies in Tooth Size: Macrodontia causes crowding, while microdontia causes spacing or diastema.
    • Anomalies in Tooth Shape: Peg laterals, taurodontism, Hutchinson's teeth, and talon's cusps are examples. Talon's cusp results from enamel and dentin invagination, often in maxillary incisors, and can be unilateral or bilateral. Fusion and gemination can also occur. Dens en dente (dens invaginatus) is an invagination prone to caries and infection.
    • Abnormal Labial Frenum: A low frenum can cause diastema and may be treated with frenectomy.
    • Premature Loss of Deciduous Teeth: Leads to impacted or misaligned permanent teeth, midline shift, and potential speech defects.
    • Prolonged Retention of Deciduous Teeth: Similar issues to premature loss including impacted and misaligned permanent teeth, labial/buccal or palatal/lingual eruption of succedaneous teeth.
    • Delayed Eruption of Permanent Teeth: Caused by early loss of adjacent primary teeth, mucosal thickening, heredity, or presence of supernumerary teeth, cysts, or ankylosed deciduous teeth.
    • Abnormal Eruptive Path: Secondary to arch length deficiency, supernumerary teeth, retained deciduous teeth, root fragments, traumatic displacement of tooth buds, impacted molars, or coronary cysts.
    • Improper Dental Restoration: Teeth drift, leading to occlusal collapse and decreased arch length. Overcontoured restorations decrease space, and undercontoured restorations cause supraeruption.

    Biologic & Mechanical Basis of Orthodontic Tooth Movement

    • Physiologic Tooth Movement: Naturally occurring, such as eruption, migration, supraeruption, or mesial drifting. Driven by mastication and internal forces.
    • Orthodontic Tooth Movement (OTM): Movement due to externally applied force. A PDL phenomenon; the tooth itself doesn't change, only its position.
    • Orthodontic Force: Force applied to effect tooth movement, generally lower than orthopedic forces.
    • Theories of Tooth Movement: Prolonged force (even low magnitude) triggers a physiologic response leading to bone remodeling and OTM.
    • Bone Remodeling: Bone resorption occurs under pressure; bone formation occurs under tension.
    • Bioelectric Theory: Changes in bone metabolism are controlled by electric signals produced when alveolar bone flexes under light pressure. Piezoelectric signals initiate remodeling.
    • Piezoelectricity: Deformation of crystal structures produces electrical current, altering bone metabolism.
    • Pressure-Tension Theory: Stretching or tension on one side and pressure on the opposite side of the tooth when force is applied, causes differing responses in bone remodeling.
    • Changes in Oxygen Tension and Release of Chemical Mediators: Oxygen reduction after force application stabilizes RANKL expression, and stimulates cell proliferation & angiogenesis via HIF-1 and VEGF. Hypoxia is critical for remodeling.
    • Cell Mediators: Prostaglandin and interleukin-1 beta increase in the PDL after force application, mediating cellular response.
    • RANK/RANKL/OPG Signaling Pathway: RANKL (receptor activator of nuclear factor kappa beta ligand) expressed by osteoblasts, binds to RANK on osteoclasts, stimulating osteoclast formation and resorption. OPG (osteoprotegerin) is decoy receptor and inhibitor of RANKL, expressed by osteoblasts.
    • Changes in Blood Flow: Related to the magnitude of applied force; sufficient blood flow is necessary for successful OTM. Forces which compromise blood supply hinder OTM.

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    Description

    This quiz explores the various local and general factors influencing malocclusion, including hypopituitarism, cleidocranial dysostosis, infectious diseases, and nutritional deficiencies. Understand how these factors contribute to dental developmental issues such as irregular exfoliation and delayed eruption. Test your knowledge on the complex interactions between genetics, nutrition, and dental health.

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