Microbial Risk Factors in Orthodontics
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Questions and Answers

What is the definition of dental plaque?

Dental plaque is a complex microbial population that comprises salivary polymers, water, bacteria, present in teeth surface.

What is the main component of plaque mass?

Water

What is the main reason why orthodontists need to manage oral hygiene in their patients?

Patients with orthodontic appliances have an increased amount of plaque due to the presence of appliances, leading to a higher risk of periodontal disease.

Which of these are types of plaque?

<p>All of the above (E)</p> Signup and view all the answers

What are the two main types of bacteria found in supragingival plaque?

<p>Streptococcus sanguinis and Streptococcus mutans</p> Signup and view all the answers

What are the three main stages of plaque formation?

<p>Formation, Initial Adhesion, Colonization/Plaque maturation</p> Signup and view all the answers

What is the main agent responsible for occlusal caries?

<p>Streptococcus mutans</p> Signup and view all the answers

The DMFT index measures the number of decayed, missing, or filled teeth in a person's mouth.

<p>True (A)</p> Signup and view all the answers

CAMBRA is a tool used to help dentists evaluate a patient's risk of developing caries.

<p>True (A)</p> Signup and view all the answers

What are three factors that increase the incidence of caries?

<p>Dry mouth, poor oral hygiene, smoking</p> Signup and view all the answers

Chlorhexidine mouthwash can be used long-term to prevent bacteria from adhering to the enamel surface.

<p>False (B)</p> Signup and view all the answers

Fluoride products minimize the risk of caries.

<p>True (A)</p> Signup and view all the answers

What are the two main components of MI paste?

<p>Calcium and Phosphate</p> Signup and view all the answers

What are the three main types of caries?

<p>Occlusal, Interproximal, and root caries</p> Signup and view all the answers

What are the three key components of the caries triade?

<p>Bacteria, diet, and harmful food behaviours</p> Signup and view all the answers

The aim of the study in the text is to confirm the relationship between orthodontic treatment and an increase in caries.

<p>True (A)</p> Signup and view all the answers

Younger patients demonstrate less oral hygiene care than adults.

<p>True (A)</p> Signup and view all the answers

Orthodontic treatment is associated with a decrease in the development of dental caries.

<p>True (A)</p> Signup and view all the answers

The study's findings about the relationship between orthodontic treatment and caries development are accurate for all age groups.

<p>False (B)</p> Signup and view all the answers

Which of the following is NOT a type of medical disorder that may be found among orthodontic patients?

<p>Ankylosing spondylitis (C)</p> Signup and view all the answers

Which of the following procedures is considered HIGH RISK for infective endocarditis?

<p>All of the above (D)</p> Signup and view all the answers

Pre-medication is only recommended for patients at high risk for developing infective endocarditis.

<p>False (B)</p> Signup and view all the answers

What are two examples of antibiotics commonly used as pre-medication for infective endocarditis?

<p>Amoxicillin and Clindamycin</p> Signup and view all the answers

Steel ties are preferred over O-ties for orthodontic treatment.

<p>False (B)</p> Signup and view all the answers

What are two examples of fixed appliances that should be avoided in patients with a history of bleeding disorders?

<p>Nance and Expanders.</p> Signup and view all the answers

What is the main characteristic of thalassemia?

<p>It is a reduction in the synthesis of hemoglobin.</p> Signup and view all the answers

What is a common facial characteristic associated with thalassemia?

<p>All of the above (D)</p> Signup and view all the answers

Leukemia is a more prevalent disease in children than adults.

<p>True (A)</p> Signup and view all the answers

Orthodontic treatment is generally contraindicated for patients with leukemia.

<p>False (B)</p> Signup and view all the answers

Patients with juvenile rheumatoid arthritis typically have limited mandibular movement.

<p>True (A)</p> Signup and view all the answers

Orthodontic treatment is contraindicated for patients with cystic fibrosis.

<p>False (B)</p> Signup and view all the answers

Patients with renal failure generally have delayed tooth eruption.

<p>True (A)</p> Signup and view all the answers

Orthodontic treatment is contraindicated for patients with hypothyroidism.

<p>False (B)</p> Signup and view all the answers

Patients with asthma should avoid taking NSAIDs.

<p>True (A)</p> Signup and view all the answers

Patients with HIV are more susceptible to infections.

<p>True (A)</p> Signup and view all the answers

Long-term use of antiretroviral medication can lead to bone loss.

<p>True (A)</p> Signup and view all the answers

Orthodontic treatment is contraindicated for patients who have received organ transplants.

<p>False (B)</p> Signup and view all the answers

Orthodontic treatment is contraindicated for patients with seizure disorders.

<p>False (B)</p> Signup and view all the answers

Orthodontic treatment is contraindicated for patients with autism.

<p>False (B)</p> Signup and view all the answers

Patients with schizophrenia are more likely to have a class II malocclusion.

<p>False (B)</p> Signup and view all the answers

Orthodontic treatment is generally contraindicated for patients with ADHD.

<p>False (B)</p> Signup and view all the answers

Patients with diabetes mellitus have an increased risk of developing periodontal disease.

<p>True (A)</p> Signup and view all the answers

Orthodontic treatment is contraindicated for patients with hypophosphatasia.

<p>False (B)</p> Signup and view all the answers

Orthodontic treatment can exacerbate periodontal disease.

<p>True (A)</p> Signup and view all the answers

It is generally safe to extract teeth for patients who are taking bisphosphonate medications.

<p>False (B)</p> Signup and view all the answers

Orthodontic treatment can cause a decrease in tooth movement for patients who are taking bisphosphonates.

<p>True (A)</p> Signup and view all the answers

Orthodontic treatment can cause an increase in root resorption for patients who are taking bisphosphonates.

<p>False (B)</p> Signup and view all the answers

Orthodontic treatment can cause an increase in root resorption for patients with asthma.

<p>True (A)</p> Signup and view all the answers

Orthodontic treatment can cause tooth eruption to occur at a faster rate for patients with diabetes mellitus.

<p>True (A)</p> Signup and view all the answers

Orthodontic treatment can cause enamel erosion and periodontal issues for patients with eating disorders.

<p>True (A)</p> Signup and view all the answers

Orthodontic treatment can worsen preexisting conditions for patients with eating disorders.

<p>True (A)</p> Signup and view all the answers

It is generally safe to extract teeth for patients with hypophosphatasia.

<p>False (B)</p> Signup and view all the answers

Orthodontics can play an important role in preparing patients for future restorative work.

<p>True (A)</p> Signup and view all the answers

What is the average amount of intrusion achieved for mandibular incisors?

<p>2.6 mm</p> Signup and view all the answers

Intrusion of anterior teeth is always the preferred approach when treating a gummy smile.

<p>False (B)</p> Signup and view all the answers

Intrusion of anterior teeth can be achieved using a Ricketts Utility Arch or a Burstone Intrusion Arch.

<p>True (A)</p> Signup and view all the answers

Intrusion of anterior teeth typically results in less root resorption than extrusion

<p>False (B)</p> Signup and view all the answers

The orthodontic-restorative interdisciplinary relationship is enhanced by virtual smile design tools.

<p>True (A)</p> Signup and view all the answers

Perioplastic surgeries are only used to correct esthetic issues.

<p>False (B)</p> Signup and view all the answers

What are some of the objectives of perioplastic surgeries?

<p>Periodontal-prosthetic corrections, crown lengthening, ridge augmentation, esthetic surgical corrections coverage of the denuded root surface, esthetic surgical correction around implants, and surgical exposure of unerupted teeth for orthodontics</p> Signup and view all the answers

A free gingival autograft is harvested from the palate.

<p>True (A)</p> Signup and view all the answers

A connective tissue graft is harvested from the palate.

<p>False (B)</p> Signup and view all the answers

A free gingival autograft is a full-thickness graft.

<p>False (B)</p> Signup and view all the answers

A free gingival autograft will shrink over time.

<p>True (A)</p> Signup and view all the answers

Spring aligners are often used in combination with power arms.

<p>True (A)</p> Signup and view all the answers

Black triangles are more common in the maxillary arch of females.

<p>True (A)</p> Signup and view all the answers

Black triangles are more common in patients with a thin periodontium.

<p>True (A)</p> Signup and view all the answers

Black triangles can be caused by excessive crowding

<p>True (A)</p> Signup and view all the answers

The incidence of black triangles is more common in patients who are older.

<p>True (A)</p> Signup and view all the answers

A high incidence of black triangles has been reported in patients who have undergone orthodontic treatment with fixed appliances.

<p>True (A)</p> Signup and view all the answers

Low-level laser therapy (LLLT) is used for pain relief and bone regeneration acceleration.

<p>True (A)</p> Signup and view all the answers

High-intensity laser therapy (HILT) is used for pain relief and bone regeneration acceleration.

<p>False (B)</p> Signup and view all the answers

The most prevalent tooth that is congenitally missing is the upper lateral incisor.

<p>True (A)</p> Signup and view all the answers

Microdontia is the opposite of macrodontia, with the tooth being larger than normal.

<p>False (B)</p> Signup and view all the answers

When considering placing a canine substitute, the ideal incisor shape is narrow at the cementoenamel junction (CEJ) buccal-lingually and mesiodistally.

<p>True (A)</p> Signup and view all the answers

The ideal profile for a canine substitute is a balanced profile, with a straight line.

<p>True (A)</p> Signup and view all the answers

Canine guidance is the most common type of occlusion seen in the population.

<p>False (B)</p> Signup and view all the answers

Canine guidance is inherently more stable than other types of occlusion.

<p>False (B)</p> Signup and view all the answers

Narrow-diameter implants (NDIs) are a more invasive approach that requires more bone volume than traditional implants.

<p>False (B)</p> Signup and view all the answers

Orthodontic treatment is generally contraindicated for patients with congenital agenesis of maxillary lateral incisors.

<p>False (B)</p> Signup and view all the answers

A composite pontic is held in place using a TAD with a bracket-like head.

<p>True (A)</p> Signup and view all the answers

The Bolton analysis can be used to assess tooth size discrepancies in both the primary and permanent dentition.

<p>False (B)</p> Signup and view all the answers

If the Bolton anterior ratio is less than 77.2%, it indicates maxillary anterior excess.

<p>True (A)</p> Signup and view all the answers

In a gummy smile, the incisor display is generally more than 2mm.

<p>True (A)</p> Signup and view all the answers

The ideal width of upper central incisors is 62% of their height.

<p>False (B)</p> Signup and view all the answers

Flashcards

What is dental plaque?

Dental plaque is a sticky film that forms on your teeth. It's made up of bacteria, saliva, and food particles.

Why is plaque buildup important for orthodontists?

Orthodontic treatment makes it harder to clean your teeth, leading to more plaque buildup and an increased risk of gum disease.

What is the plaque index?

This index measures the amount of plaque on your teeth, helping to assess your oral hygiene.

What is the significance of a high plaque index?

The plaque index is a common way to measure how much plaque is on a person's teeth. It helps to assess oral hygiene and identify areas where more cleaning is needed.

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What happens to plaque during the initial months of orthodontic treatment?

During the first six months of orthodontic treatment, there's a significant increase in plaque buildup due to the presence of braces.

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What is periodontal disease?

Periodontal disease is an infection of the gums that can lead to bone loss and tooth loss. It's important to manage periodontal disease during orthodontic treatment.

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What is probing depth in the context of periodontal disease?

A high probing depth indicates an unhealthy gum pocket. The deeper the pocket, the more severe the gum disease.

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What is CAL (Clinical Attachment Loss)?

The loss of bone supporting the teeth due to periodontal disease.

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How is periodontal disease categorized into stages?

Stage I and II periodontal disease are considered less severe, while Stage III and IV are more progressed and can lead to tooth loss.

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How does smoking affect periodontal disease?

Smoking increases the risk of developing periodontal disease and losing teeth.

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What are the key factors in periodontal disease staging?

The combination of severity, complexity, and extent/distribution determines the overall impact of periodontal disease.

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What factors determine the grading of periodontal disease?

The progression of periodontal disease is assessed based on factors like bone loss, type of defect, and risk factors like smoking and diabetes.

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What is SRP (Scaling and Root Planing)?

SRP (Scaling and Root Planing) is a deep cleaning procedure performed by a dental hygienist to remove plaque and tartar from below the gum line.

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What are dental caries?

Dental caries, commonly known as cavities, are holes in the teeth caused by tooth decay.

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How do dental caries form?

The process of enamel erosion and dentin decay is caused by acids produced by bacteria feeding on sugars, particularly sucrose.

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What bacteria cause dental caries?

The main bacteria responsible for dental caries is Streptococcus mutans, and other bacteria like Lactobacilli are involved in the progression of decay.

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What is the DMFT index?

The DMFT index is a way to track the number of decayed, missing, and filled teeth in a person's mouth.

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What is CAMBRA (Caries Risk Assessment)?

CAMBRA (Caries Risk Assessment) helps dentists identify factors that increase a patient's risk of developing cavities. It's a way to tailor treatment plans.

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What is fluoride?

Fluoride is a mineral that strengthens enamel and makes it more resistant to decay.

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What is MI paste?

MI paste contains calcium and phosphate, which help to remineralize weakened enamel and prevent cavities.

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What is chlorhexidine mouthwash?

Chlorhexidine mouthwash is a strong antiseptic that kills bacteria and prevents plaque formation.

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How does orthodontic treatment affect diet?

Orthodontic treatment can make it difficult to eat certain foods. This can lead to nutritional deficiencies if not addressed.

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What are the different fluoride products and preventive measures recommended based on caries risk?

Depending on the individual's caries risk, different fluoride products and preventive measures are recommended to minimize the risk of decay.

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What is fluoride varnish?

Fluoride varnish is a highly concentrated form of fluoride that is applied to the teeth for effective protection against cavities.

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What is glass ionomer (GI) around brackets?

Glass ionomer (GI) is a type of dental material that releases fluoride and helps to strengthen the tooth structure.

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What is the ADA (American Dental Association) recommendation for dental hygiene?

Dental hygiene practices, like brushing twice a day and flossing once a day, are crucial for maintaining healthy teeth and gums, especially during orthodontic treatment.

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What is Prevident 5000 toothpaste?

Prevident 5000 is a high-fluoride toothpaste that provides extra protection against cavities, especially for patients at high risk.

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What is infective endocarditis?

Infective endocarditis is an infection of the inner lining of the heart, and it can be a serious complication during procedures that could cause bleeding in the mouth.

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What is premedication in the context of infective endocarditis?

Premedication with antibiotics is recommended for patients with certain medical conditions to reduce the risk of infective endocarditis during dental procedures.

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What are bleeding disorders?

Bleeding disorders are conditions that make it difficult for the blood to clot. This can make dental procedures more risky.

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What is thalassemia?

Thalassemia is a blood disorder that affects the production of hemoglobin, which carries oxygen in the blood.

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What is leukemia?

Leukemia is a type of cancer that affects the blood and bone marrow.

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What is cystic fibrosis?

Cystic fibrosis is a genetic disorder that affects the lungs, digestive system, and other organs.

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What is juvenile rheumatoid arthritis?

Juvenile rheumatoid arthritis is a type of arthritis that affects children.

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What is renal failure?

Renal failure is a condition where the kidneys are not able to properly filter waste from the blood.

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What is hypothyroidism?

Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormone.

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What is hyperthyroidism?

Hyperthyroidism is a condition where the thyroid gland produces too much thyroid hormone.

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What is asthma?

Asthma is a chronic respiratory disease that causes inflammation and narrowing of the airways.

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What is HIV?

HIV (Human Immunodeficiency Virus) weakens the immune system, making individuals more susceptible to infections.

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What is organ transplantation?

Organ transplantation involves replacing a diseased or failing organ with a healthy organ from a donor.

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What are seizure disorders?

Seizure disorders are conditions characterized by sudden, abnormal electrical activity in the brain, leading to changes in behavior, sensation, or consciousness.

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What is autism?

Autism is a neurodevelopmental condition characterized by difficulties with social interaction, communication, and repetitive behaviors.

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What is schizophrenia?

Schizophrenia is a severe mental disorder characterized by delusions, hallucinations, and disordered thinking.

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What is ADHD?

ADHD (Attention-Deficit/Hyperactivity Disorder) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity.

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What is diabetes?

Diabetes is a chronic condition characterized by high blood sugar levels due to problems with insulin production or function.

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What is hypophosphatasia?

Hypophosphatasia is a rare genetic disorder that affects bone mineralization. It is caused by a deficiency in the enzyme alkaline phosphatase.

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What are eating disorders?

Eating disorders are characterized by unhealthy eating habits and distorted body image.

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What is anorexia nervosa?

Anorexia nervosa is an eating disorder characterized by an intense fear of gaining weight and a distorted body image.

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What is bulimia nervosa?

Bulimia nervosa is an eating disorder characterized by recurrent episodes of binge eating followed by compensatory behaviors such as purging.

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What is rumination syndrome?

Rumination syndrome is a functional gastrointestinal disorder characterized by repeated regurgitation of food.

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What is pica?

Pica is a persistent craving and consumption of non-nutritive substances.

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What is GERD?

GERD (Gastroesophageal Reflux Disease) is a digestive disease where stomach acid or bile flows back up into the esophagus, causing irritation and symptoms.

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What are bisphosphonates?

Bisphosphonates are drugs that are used to treat osteoporosis and other bone diseases.

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What is hypertension?

Hypertension is a condition characterized by high blood pressure.

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What is extrusion in orthodontics?

Extrusion is the movement of a tooth upward, bringing it closer to the biting surface.

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What is intrusion in orthodontics?

Intrusion is the movement of a tooth downward, bringing it further away from the biting surface.

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What is VDO (vertical dimension of occlusion)?

The vertical dimension of occlusion (VDO) is the distance between the upper and lower teeth when the jaws are closed.

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What is crown lengthening?

Crown lengthening is a surgical procedure that exposes more of the tooth's crown by removing gum tissue.

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What is ridge augmentation?

Ridge augmentation is a procedure that increases the height or width of the jawbone.

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What is a free gingival autograft?

Free gingival autograft is a type of tissue graft where a piece of gum tissue is taken from another part of the mouth and transplanted to the area where the gum recession is.

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What is a diastema?

A diastema is a gap between two teeth.

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What are spring aligners?

Spring aligners are orthodontic appliances that use gentle pressure to slowly move teeth into the correct position.

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What are black triangles in dentistry?

Black triangles are open spaces between teeth that are visible at the gum line.

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What is laser in dentistry?

Laser is a type of light energy that is used in dentistry for a variety of procedures, such as soft tissue surgery and tooth whitening.

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What is gingivectomy?

Gingivectomy is a surgical procedure that removes excess gum tissue.

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What is gingivoplasty?

Gingivoplasty is a surgical procedure that reshapes the gum tissue.

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What is fiberotomy?

Fiberotomy is a procedure that cuts the fibers that surround the tooth, which can help to reduce the chances of the tooth moving back to its original position after orthodontic treatment.

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What are congenitally missing teeth?

Congenitally missing teeth are teeth that are absent from birth.

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What is microdontia?

Microdontia is a condition where teeth are smaller than normal.

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What is canine substitution?

Canine substitution is a procedure where the canine tooth is used to replace a missing lateral incisor.

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What are dental implants?

Implants are artificial tooth roots that are surgically placed into the jawbone.

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What is the Bolton analysis?

The Bolton analysis is a way of comparing the sizes of the upper and lower teeth to determine if there are any discrepancies in the tooth sizes.

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What is a gummy smile?

A gummy smile is a smile that shows too much gum tissue.

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What is the dental esthetic screening index (DESI)?

The dental esthetic screening index (DESI) is a tool that is used to assess the esthetics of a smile.

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What is EARR (External Apical Root Resorption)?

External apical root resorption (EARR) is a condition where the root of a tooth is resorbed, or dissolved, from the outside.

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What is APE (Altered Passive Eruption)?

Altered passive eruption (APE) is a condition where the gum tissue does not erupt properly, which can lead to a gummy smile or periodontal pocketing.

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Study Notes

Microbial Risk Factors During Orthodontic Treatment

  • Microbial populations in the oral cavity are complex, including bacteria, salivary polymers, water, and polysaccharides.
  • 80-90% of plaque volume is water, 70% of dry weight is bacteria.
  • Plaque builds up and hardens into calcified deposits over time.
  • Orthodontic appliances can increase plaque buildup, therefore oral hygiene management is vital during treatment.
  • Types of plaque (supragingival, subgingival, occlusal, enamel plaque) vary depending on oxygen levels, with subgingival plaque being more anaerobic and supragingival being richer in aerobic bacteria.

Dental Plaque Formation

  • Plaque formation involves colonization/plaque maturation.
  • The initial stages consist of initial adhesion followed by transport to the surface and establishment of strong attachments.
  • The evolution of the plaque, if not removed, may lead to calcification.
  • Various types of bacteria are related to different plaque types, such as occlusal, interproximal, and root caries.

Clinical Evaluation of Periodontal Status

  • Measurements of gingival and plaque indices were taken at various time points during orthodontic treatment to evaluate periodontal health.
  • The goal is to avoid harmful effects of orthodontic treatment on oral health.
  • Relationship between periodontal disease and orthodontic treatment.

The Impact of Patients With Pre-existing Conditions

  • Patients with various pre-existing conditions, such as gender, age, previous orthodontic history etc., are assessed for risks associated with orthodontic treatment.
  • Patients with pre-existing conditions need careful assessment and management.
  • Specific guidelines and recommendations are needed to maintain appropriate oral health in such conditions.

Periodontal and Peri-Implant Diseases and Conditions

  • Classification of periodontal and peri-implant diseases are explained.
  • Severity, complexity, and extent/distribution are important criteria for classifying the disease.
  • Parameters such as CAL and RBL are used for assessing severity.
  • Different stages of the disease show different complexity, therefore management will vary accordingly.
  • The stage and complexity of the disease impacts the extent and distribution of the disease in the oral cavity.
  • Specific description of each stage is included for clarity.
  • The grading of the disease is associated with progression rate, response to therapy, and systemic health.

Periodontal Treatments

  • Periodontal therapies such as SRP, gingival therapy, and other regular cleanings are needed to maintain good oral health during orthodontic treatment.
  • Patients are monitored and reevaluated to assess the progression of the disease.
  • Important to refer patients to appropriate specialists for care.
  • Specific strategies for caries treatment and maintenance are recommended.

Caries

  • Caries formation involves the dissolution of hydroxyapatite by acids produced from bacterial metabolism, particularly of carbohydrates like sucrose.
  • The formation of caries is impacted by the initial presence of enamel defects, and lack of topical fluoride, but also with poor oral hygiene.
  • Specific food and drink types are identified for their potential risk of caries development during or after orthodontic treatment

Relationship Between Orthodontics and Caries

  • Orthodontic treatments may be associated with an increase in caries.
  • Immature enamel and less oral hygiene in younger patients may increase risks.
  • Relationship between caries and orthodontic treatment should be considered for patients with high caries risk.
  • Use CAMBRA risk assessment tools to help evaluate patient risks.

Other Factors Affecting Oral Health During Orthodontic Treatment

  • Patients with certain medical conditions may have increased or decreased risk of developing periodontal disease.
  • Various factors such as poor oral hygiene, smoking, and diet may influence dental caries development and management.
  • Proper oral hygiene and diet are important for overall oral health maintenance during orthodontic treatment.
  • Monitoring and adherence to professional recommendations is essential.
  • Management strategies are included for various conditions like diabetes, asthma, HIV, bleeding disorders, and more.
  • Maintaining adequate oral hygiene is important for preventing diseases.

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Description

This quiz explores the complex microbial populations present in the oral cavity during orthodontic treatment. It covers the types of dental plaque, its formation, and the implications of orthodontic appliances on oral hygiene management. Learn about the importance of maintaining oral hygiene to prevent plaque buildup and calcification.

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