1.Clasificarea Angle a anomaliilor dento-maxilare p.

90
Angle's classification: relationship of mandible and upper jaw
represented by mesio-diatal relationship between the fixed max. 1st
molar and the mand. 1st molar.
Class I: neutral relation of the first molars, changes only present in
frontal region (e.g. unilateral/frontal group abnormalities, cross bite,
open bite, deep bite)
Class II: lower teeth oclude distal to normal post. positioning of
mandible, with two subdivisions
1st subdivision: oral breathing type, narrow elongated jaw, frontal
teeth in protrusion
2nd subdivision: nasal breathing type, retrusion of upper frontals
Class III: mesial position and reverse frontal occlusion
Deep bite can be included in class I (if its accompanied by neutral
relations) and class II (distal position of lower teeth)
Transversal and vertical relations not taken into consideration only
sagital

2.Amprenta in ortodontie p. 56
Upper dental impression has to show:
Dento-alveolar arcades
Bone palate
Median palatal raphe
Maxillary tuberosity
Upper frenulum (without deviation)
Lower dental impression:
Dento-alveolar arcades
Lingual face of mandible up to floor of the mouth
Lingual frenulum
Lower lip frenulum
Steps:
1. Preparing the patient
Appropiate language for kids
Explaining purpose and content
Cleaning and rinsing of mouth
Always start with lower arcade (easier, no gag reflex)
2. Choosing the spoon
Creating additional retention (spoons with holes, bonding
on the edges, strips of adhesive tape)
3. Preparation of impression material
Alginate is used the most
Silicone can also be used (special situations)
Material should be placed in higher quantity on anterior
part of spoon
4. Impression itself
Lower arcade: inserting loaded spoon into the mouth, from
right to left, centering the spoon, pressing it slowly and
simultaneously from posterior to anterior. Patient lifts the
tongue upward and forward. Dentist holds spoon with both
hands on the arcade
Upper arcade: same as before, but dentist raises upper lip
and pushes the material into the upper vestibule, keep
spoon pressed on arcade (from behind the patient). Patient
is asked to perform the Valsalva maneuver (holding nose
and lips closed, trying to blow air out)
Kidney tray placed close to patients mouth draining
saliva
Wash impressions, control at teeth level, alveolar
processes, edges (length, thickness)
Wrap in damp towels, pour as soon as possible

3.Caracteristicile arcadelor si ocluziei in dentatia temporara la varsta

de 3 ani p. 23
crescent-shaped dental arches
adjoining teeth relationship, without clusters or gaps
clearly noticeable occlusion configuration
straight occlusion plane
 crown base slightly higher than apical base for maxilla, equal for
mandible
distal facet of 2nd upper molar at tuberosity level, lower 2nd molar
at ascending ramus level of mandible
mandibular arch overlaps maxillary arch
each temporary tooth has two opposite teeth, except lower
central incisors and 2nd upper molars
reduced incisors overlapping, or even head to head
upper median line and lower median on the same plane
upper canine in contact with lower canine and 1st lower molar
distal facets of 2nd molars situated on a vertical plane post-
lactation plane

4.Examenul facial- descrieti etapa clinica de inspectie p. 35

Inspection:
Frontal norm
face frame: oval, round, triangular, square
symmetry or asymmetry of the face, estimation of area and cause:
chin deviation, septum deviation, scars
facial wrinkles: dull or noticeable
skin aspect: smooth, rough, dry, color alteration, integrity
lip line: closed open, ajar
lip color and dermal portion: high, medium, short
stomion lower lip outer position with respect to free margin of
upper incisors: high, low
lip relationship: positive stage or reversed
middle-level nasal, Nasion Subnazal (N Sn) and sub-nasal with
respect to lower-level, Subnazal Gnation (Sn Gn): reduced,
increased
Lateral norm
profile field, between two lines perpendicular to Frankfurt plane:
o Dreyfuss plane or frontal plane nasal plane
o Simon plane or orbito-frontal plane
profile types: straight, convex, concave
Palpation
Bone outlines (alterations, mobility)
 Points of trigeminal branch emergences
Muscle points
Muscle groups
TMJ examination
Mouth opening: within standard limits (3-4cm), limited or blocked
Opening can be normal, arch-like or jerky
Lower median line movement during opening and closing:
straight, deviated, bayonet
Correlation between upper and lower median lines
Movement symmetry and amplitude
Presence of cracklings, crepitation, joint swings, pain, deformity
5.Criteriile ocluziei functionale si stabile p. 31
1. Stable and simultaneous occlusion on most teeth when condyles
are centered
2. Previous guidance in accordance with functional movements and
TMJ possibilities
3. Reverse occlusion/opening of all cuspidate teeth during
propulsion
4. Reverse occlusion/opening of all cuspidate teeth during lateral
movement on passive side
5. Absence of interferences during lateral movements of cuspidate
teeth on active side

6.Deglutitia atipica p. 103

Infant deglutition: labial incompetence, remote alveolar ridges
Persistence of infant deglutition after eruption of primary teeth and in
adulthood upper and lower protrusions, open frontal and lateral
occlusions
patient pushes tongue against incisors while swallowing

7.Mentinatoarele de spatiu mobilizabile p. 132

Activator: united palatal and lingual plate, acts as space maintainer
(premature extractions) prevents oral breathing, atypical deglutition,
maintains results
Recommended for:
Mixed dentition
Distal occlusion
Narrow maxillary with protrusion
Open functional occlusion
Jaw latero-deviation
8.Mentinatoarele de spatiu fixe p. 133

9. Descrieti obiceiurile vicioase de supt p. 104

Harmful forces with abnormal directions. Lead to imbalances of the
dental arches, direct pressure on teeth. Depends on childs age, period
of practice, intensity, applied position and technique
Frequent changes: upper protrusion, lower retrusion, open bite
Finger sucking can either be innate or learned, considered normal up to
2-3 years.

10.Principiile de tratament ortodontic- enumerare p. 116

1. Artificial forces: springs and screws operating within biological
limits
2. Natural forces: contractions of orofacial muscles functional
therapy (controlling muscle forces)

Need of:
Area of application: isolated teeth/dental groups, dental arches,
jaws, TMJ
Support area: anchorage
 Force
all 3 called: orthodontic trinomial

11. Aparatele biomecanice-caracteristici, indicatii, avantaje,

dezavantaje p. 121
Characteristics:
Onset of orthodontic forces
Modification of elastic components
Through action of mechanical elements
Application and removal done by patient
Recommended:
Interceptive therapy
Active therapy
Retainer results
Advantages:
Complex actions and widely used
Made in laboratory
Number of prefabricated components available
Low price
Easy to modify and repair
Monitoring at shorter intervals
If force is too strong, braces stability lowers, no adverse effects
Disadvantages:
Easily removed by patient, success of treatment needs his
collaboration
Can create phonetic problems
Inferiority complexes
No esthetic redress
Active only in retentions and proper anchorage
12.Caracteristicile arcadelor dentare si ocluziei la varsta de 4-6 ani p.
24
 Physiological abrasion of temporary teeth
o Hard food
o Active chewing
o Free movements of mandible
Maintain straight occlusal plane
Determines reduction of frontal overbite
Diastema and physiological gaps
o Considered an expression of growing jaws
o Important gaps:
At maxilla between II and III
At mandible between III and IV (primates gaps)
Back molar field
o Distal to 2nd molars
o Dental arches elongate necessary space for eruption of
1st permanent molars
Second physiological mesialisation of the mandible
o Favored by physiological abrasion
o Slanting of post-lactation plane to mesial stage
o Conditions created for neutral relationship of 6 year molars
simultaneous eruption
o If post-lactation plane slants to distal or remains straight
instable cusp-cusp relationship at level of 6 year molars
13.Diastema-forme clinice p. 194
Diastema: space between central incisors (transitory, true, false)
Transitory diastema: appears once the permanent central incisors erupt,
closes spontaneously once the permanent lateral incisors erupt (latest
by eruption of permanent canines)
True diastema:
2-3mm spacing or more between the central incisors
Parallel incisor axes
Small or normal sized teeth
Wide thick low inserted frenulum
Whitening of interdental papilla, mild ascension of lip
Symptoms: physiognomic disfunctions during smiling and speech,
saliva projection during phonation, stigmatism
Etiopathology: heredity, thick fibrous inter-incisal septum, median
hypertrophic low inserted frenulum, abundant fiber-mucous
membrane
 frenectomy, closing of diastema with finger hooks or fixed
braces (adults: prosthetic treatment)

False diastema:
Secondary to other anomalies
o Lateral incisors aplasia
o Small lateral incisors
o Included or erupted mesiodens
o Horizontally included canines
o Macroglossia
o Abnormal postures/disfunctions of tongue
o Teeth migration in periodontitis
o Traumas with median fractures
Variable inter-incisal space
Diverging incisor axes (absence of lateral incisors)
Horizontal incisors in case of supernumerary teeth
Fan like incisors with diverging axes in case of canine inclusion or
in presence of small apical bases
Symptoms: physiognomic disfunctions in smile and speech,
stigmatism, saliva projection during phonation
Radiograph is indispensable for diagnosis!
removal of cause, closing the diastema (fingers/wires, fixed
braces)
14.Precizati tipurile de tratament ortodontic p.120
1. Type of action
Passive braces
Active braces
2. Aggregation method
Fixed braces
Removable appliances
Mobile appliances
3. Application area
Intra-oral
Extra-oral
Intra-extra-oral
Bimaxillary
With mutual action
 15. Consecintele pierderii molarului de 6 ani in diverse etape de
varsta p. 216
7-9 years of age:
Ample distal migration f second premolar, gap transferred
between the two premolars
Distal movement of both premolars with spaces between canine
and 1st premolar
Extrusion of opposing tooth
10-11 years of age:
Tipping of 2nd molar and closure of the space from posterior
(biologic closure)
After 12 years of age:
2nd molar and premolars will tip towards the space, closing it
Opposing tooth can extrude and maintain the gap
Occlusal disfunction appears
16. Descrieti metoda de analiza teleradiografica a lui Tweed p. 79
Teleradiografie = lateral cephalogram
Based on Tweeds triangle, formed by the intersection of Frankfurt plane
with the mandible base plane and the axis of the inferior incisor
FMA (Frankfurt-mandibular plane angle):
Formed by intersection of Frankfurt plane with mandibular plane
allows to see facial vertical typology
Normal values: 25 +/-3 (normodivergent face)
Under 22: hypodivergent face
Over 28: hyperdivergent face
IMPA (Incisial-mandibular plane angle):
Intersection of mandibular plane with the axis of the inferior
incisor allows to see location of anterior part of mandible from
the bone base
Normal values: 88 +/-3
FMIA (Frankfurt-mandibular incisor angle):
Allows assessment of inferior incisor position in the facial scheme
Normal values: 67 +/-3
 17.Care sunt consecintele pierderii dintilor din zona de sprijin? p. 213
Causes: complications of caries; around age 6, 50% of molars cant be
saved
Consequences: vertical migration (extrusion), occlusal blockage, sagittal
migration

18. Descrieti pozitia de repaus a mandibulei si implicatiile ei in

diagnosticul anomaliilor dento-faciale

19. Descrieti consecintele cariei dintilor temporari si al extractiilor

premature p. 211
Premature extraction:
Extraction of a temporary tooth at least 1.5 years ahead of normal
replacement age
The longer the interval, the greater the consequences
Consequences depend on:
Which tooth is extracted
Number of extractions
Symmetry of interventions
Occlusal relations
Developmental status of the arches
20. Obiectivele profilaxiei prenatale p. 218
Genetic inheritance of hereditary conditions that exist in the family
During pregnancy:
Maintain health of mother
Balanced work regime
Adequate diet
No drugs, alcohol, medication
Avoiding stress and trauma
Respecting general and oral hygiene measures
At birth:
Avoiding long labor
Avoiding strong pulling or pressure
The following can be diagnosed:
o Congenital anomalies (cleft lip/palate)
o Hereditary anomalies (e.g. deep bite)

21. Precizati tipurile de deplasare dentare

*Tipping (Versiune) - the most frequently obtained movement by the
application of a force on a punctiform area of the crown. For a certain
tilt of the crown, the apex generates a movement in the opposite
directions.
*Bodily Movement (translatie) - is a corporal movement by the
application of a force on a linear area of the corwn which is equally
transmitted along the tooth apex.
*Rotation (Derotarea) - is a pivotal movement around the root axis and
requires joint forces.
*Torque (miscarea de torque) - is a more radicular movement in the
vestibulo-oral direction, the crown being less moved or kept in place.
* Intrusion(Intruzia) - is a vertical corporal movement towards the
muscle base, under the action of certain forces applied at the level of
the incisal edge or the occlusal forces.
*Extrusion(Extruzia) - is a vertical corporal movement towards the
occlusal plane, obtained through the application of certain forces in the
vertical direction or through the elimination of the occlusal contact.
22. Clasificarea antropologica
It considers the relations between the size of various segments of the
head and face, thus getting data on the direction and growth rate of
each individual if the measurements ar repeated periodically.
*Cephalic index
The ration between the maximum length and width of the skull.
Distance between:
Eu-Eu (Eurion the most external point of cranial vault located at the
level of parietal temporal base)
G-Op (Glabela the most prominent midpoint of the line between
eyebrows.
(Opitoskull the most prominent posterior point on the midline of the
skull)
Eu-Eu / G-Op = cephalic index

According to this index there are three facial types:

*dolichocepahlic: cephalic index value is below 75
*mesocephalic type: 75-80
*brachyephalic: 80

23.Obiectivele profilaxiei postnatale

Pre eruptive prophylaxis
*assure to give baby breastfeeding
*well balanced development of the child
*development of the peri-oral and intra-oral muscles
*physiologic mesialisation of the mandible
*optimum components of mothers milk
Feeding should last at least 15-20 minutes for baby to develop
orbicularis muscles

Oral hygiene measures:

*of the little baby is carried out by parents
*later supervised by parents
*educate child and family on how to brush correctly.
Dietary prophylaxis:
*balanced diet
*high consistency foods(fresh foods and vegetables)
*bilateral chewing
Functional prophylaxis:
*making sure that functions are normal and correcting dysfunction
*resolving parafunction and oral habits
*addressing postural attitude and habits

Terms:
*Function = activity done with the purpose of adapting to the
environment of a living element, organism or system.
*Dysfunction = deviant function
*parafunction = acitvity or habit that is not a necessity for a living
*Oral habit = involuntary movement that is repeated with no apparent
motivation
Most frequent oral habits :
*finger(thumb) sucking
*infantile deglutition
*nail biting
*biting and sucking of the lip
*tongue thrust forwards

24.Descrieti examenul grupelor musculare

the assessment: -of the relaxed position
-the tonus
-the facial muscle behaviour
1. Lip Orbicularis
Observation:
*Aspect of the lips
*the relationship between lips
*the relationship between the lips and dental arches
*the relationship between lips and teeth
*the stomion position
*contraction forces Netter procedure
*presence of extra functions (suction, sucking)

Netter procedure:
The orbicular internal beam the lip corners are removed
*hyper-tonus - the young patient manages to close the lips when
opposition is highest.
*normal tonus -the young patient manages to close the lips when
opposition is reduced.
*hypo-tonus -the young patient fails to close the lips
The external orbicular beam the young patient inflates the cheeks
while the examiner is :
*pressing them slowly and progressively with his/her hands
*hyper- tonus the young patient manages to keep air
*normal-tonus - the young patient is letting out air at a lighter pressure
*hypo-tonus -the young patient fails to inflate his/her cheeks

2.The tongue
Assesment of the following:
*the tongue volume
*the tongue in relaxed position
*the tip of the tongue and free margin position
*the lingual frenulum
*the tongue muscle dynamism/tonus

Raising - the young patient is asked to raise the tip of the tongue
towards the nose while the examiner counterbalances by pressing a
finger on the back of the tongue
Propulsion the young patient iis aksed to push backwards with his
tongue the examiners finger counterbalancing on the tip of the tongue
Right and left sideway motion: the young patient pushes the examiners
fingers set on a side Wrapping
3.The cheeks
to assess the contraction force of the buccinators muscles, the cheek is
clipped between the thumb and the index and the patient is asked to
suck it in
*hyper-tonus the young patient manages to suck in the cheeks
*normal-tonus -the young patient manages to suck in the cheeks in the
absence of opposition.
*hypo-tonus -the young patient fails to suck in the cheeks
Jaw raising muscles:
-the masseter muscle, the internal pterygoid muscle, the middle
temporal beam are examined by asking the young patient to close the
mouth while the examiner is counterbalancing pressing the lower arch.
The Propulsion muscles:
-the external pterygoid, the temporal anterior beam
The young patient sitting no the back is asked to make propulsion
movements then sideway movements, while the examiners hand
counterbalances the movement.
The constrictor muscles:
- The posterior beam of the temporalis and the superior hyoid

25.Descrieti examenul odontal

Starting from upper arch from the midline to the right, then to the left,
while in the lower arch it is done from the midline to the left, then to the
right.
Teeth are recorded on a dental chart:
-temporary teeth with roman numerals
-permanent teeth with arabic numberals
In the FDI system, the following digits:
-1,2,3,4 for permanent teeth
-5,6,7,8 for temporary teeth
Assessments of dental diseases are recorded as follows:
*C- for cavity
*A for root
*G for gangrene
*R for radicular root
In the case of tooth decay/caries, topography, depth and type of cavity
lesion are marked out. In the case of fillings, their topography and
quality are marked out. On the dental chart, the assessment of breaches
is recorded as follows:
*O if a temporary tooth is lacking around the age of its physiologic
replacement.
*X if it is a premature extraction of a temporary or premanent tooth.

26. Descrieti examenul parodontal

*the aspect of papilla, of marginal and attached gums, the level of the
epithelial insertion.
*the presence of superior and inferior gum tartar plaques, congestions,
bleedings, gingival retracement, fake or true bags (pungi parodontale)

27. Clasificarea aparatelor ortodontice

1. According to the type of action:
*Passive bracers
*Active bracers

2. According to the aggregation method:

*fixed bracers,
*removable appliances,
*mobile appliances

3.According to the applying area:

*intra-oral
*bimaxillary
*with mutual action
*extra-oral
*intra-extra oral

28.Obiectivele terapiei interceptive

*stopping parafunction and rebalancing functions
*supervising the teeth placement process
*providing conditions for normal occlusal and functional relations to be
established
*balancing force corridors
*diagnosing and early treatment of anomalies
*intercepting through surgical procedures

29.Avantajele terapiei interceptive

*lowering the rate of anomalies
*obtaining results on short term
*improving esthetics
*having the possibility to balance supporting bone growth with dental
size
*growth guidance
30.Elementele componente ale aparatelor biomecanice
Active (move the teeth)
o Biomechanic
Arcuri
Vestibular
Siguranca
Diapazon
Vestibulare
Screws
o Functional
Plateau retoincisive
Scut lingual (lingual shield)
Retention
o Adams
o Schwarz
o Stahl
o Mouth gaurd acrylic (gutiera)
Anchorage
Placa baza

31.Clasificarea scolii germane- p.91

Groups different abnormalities in syndromes that have common
symptoms
Maxilla compression syndrome
Crossbite syndrome
Progenic syndrome
Distal occlusion syndrome
Deep bite syndrome
Open bite syndrome
Consequences of premature extractions
Dental anomalies
32.Clasificarea scolii franceze- p.91
Topographic and etiological takes into account the growth process of
the dento maxillary apparatus
3 main groups
 o Maxillary abnormalities
Anatomical
Form and size disorders of the bone
base
Cause by general factors
Functional
Abnormalities of position
Deviation of the jaw
o Alveolar process abnormalities
Caused by loco regional functional factors
o Dental anomalies
Number
Shape
Volume
Structure
Position
Caused genetically
33.Descrieti examenul static al ocluziei- p. 44
Incisive
o Sagital
Overjet 1-2cm
o Transversal
Lower midline corresponds with the upper
midline
o Veritcal
Lower incisors are overlapped by the upper
incisors by one third
Canin
o Sagital
Upper canine cusp gets into contact with the
lower canine and the first temporary molar or
the pre molar
o Transversal
Upper canine palatel face gets into contact
with the vestibular face of the lower
temporary first canine and the premolar or
temporary molar
o Vertical
One third overbite
 Molar
o Sagital
Key of angle
o Transversal
Vestibular cusps of the upper molars overlap the
vestibular cusps of the lower molars
o Vertical
Cuspid-fossa
Cuspid-marginal creast

34. Tulburarea ordinii de eruptie p.107

Frontal area
o Lateral incisor before central incisor
Obstructions and trauma
Causes
Mesial migration and space reduction
Late eruptions and malplacement of the
cental incisors
Lateral areas
o Earlier eruption of the Premolars following the process
osteitice of the temporary molars
35.Descrieti aspirarea sau interpunerea buzei inferioare-consecinte
clinice- p.103
It occurs as a separate function or associated with other
functions
o Labiomental crease accentuated
o Aged facial appearance
o Retrusion of the lower frontal group
o Protrusion of the upper frontal group
36.Precizati factorii generali implicati in etiopatogenia anomaliilor
dento-maxilare- p.94
Heredity
o Shape and volume of the teeth and jaw
o Chronological order of the tooth eruption
o Numerical abnormalities
o Diastemas
 o Deep bite
o Open occlusion
o Anatomic mandibular prognation
Nero-endocine factors
o Hypophysis in hypofunction
Mandibular retrognathia
Dentoalveolar incongruence
Tooth eruption disorder
Dental crowns are small
Incompletely formed roots
Presistence of the primary tooth
Retentioned teeth, hypodontia
o Hypophysis in hyperfunction
Mandibular prognathism
Upper jaw is excessively developed in sense
transversal
Distema and trema
Macroglossia
Hypercementos, bulky teeth
Eruption accelerated
o Thyroid hipofunction
Delays in general growth
Base of the skull remains short
Disproportionate skull, wide face, infantile look
Clogged nose
Underdevelopment of the middle floor and the
facial sinuses
o Thyroid hyperfunction
Acceleration tooth eruption
Uncommon at children
Dental cavities and marginal periodontitis
o Parathyroid gland
Role in the mineralisation process
Disorder occur on the nascent teeth
Orofacial muscular contractions which apprear in
tetanus could cause some muscular changes
o Adrenal (suprarenala)
Cleft palate
o Gonads
 Influences development of testosterone, facial,
mandibular and muscles
Estrogen, oral mucosa and the gums
o Pancreas
Parodontal changes in juvenile diabetes
o Thymus hypofunction
Delay in the teeth evolution
Dental hypoplazia

Metabolic factors
o The phosphor calcium balance in the bones and teeth
are mentained constant by PTH, calcitonin and vitamin D
o Rickets
Open bite
Dystrophies dental
Ogival palate
Syndrome of jaw compression
Delays in tooth eruption

37. Descrieti tulburarile fonetice asociate anomaliilor dento-maxilare

p.104
It can interrupt the normal development of the dento maxillary
apparatus
Disorders in the pronunciation of certain sounds lead to
abnormal tongue pressure on certain dental groups
38. Contactele dentare premature si rolul lor in etiopatogenia
anomaliilor dento-maxilare p.109
Deviation of the jaw closing
o Causes
Lack of abrasion on the canine and temporary
molars
Dental malpositions
Sagital or vertical migrations
Excessive obturations
Incorrect prosthetics
o Tendency of elimination
Pathologic abrasion
Modification of tooth position
 Occlusion in two steps
o It may install
Mesial occlusion
Distal occlusion
Laterodeviation, crossbite
39.Descrieti miscarea de lateralitate-p. 51
Canine tooth guiding
o The inferior canine slides on the palatal surface of the
upper canine
o With the disocclusion of the non operating side
Group guidance
o Canine plus the lateral teeth on the active side with total
disocclusion of the passive side teeth
Interferences
o Active
Another tooth that is not the canine supports part
or the whole movement
o Passive
Teeth on the non active side still make contact
40.Aparatele functionale-indicatii, avantaje si dezavantajele utilizarii
lor p.130
Indications
o Prophyilaxis by eliminating the tongue parafunctions, lip
aspiration and oral breathing
o Treatments of functional etiologies malocclusion
Advantages
o Prevents oral breathing, atypical degluttion and thumb
sucking
o Applied during the period when the temporary molars
are replaced when the removable braces cannot anchor
adequately
o Braces increase saliva which leads to self-cleaning and
caries prevention
o Stimulates the harmonious development of all the
dento-maxillary apparatus components
o Controls the muscular forces
Disadvantages
o Hard to wear due to their large dimension
 o Long term treatment as only worn during the night
o Deprives the dento-maxillary abnormality of the major
functional stimulus (mastication)

41. Profilaxia posteruptiva:

-igiena orala: efectuat/controlat de parinti, medicul ajuta/evalueaza
-prof. alimentara: alimentatia echilibrata, masticatie bilaterala, alimente
ferme
-prof. fct: corectare disfunctiilor, cambatarea parafunctiilor/obiceiurilor,
eliminarea ticurilor
-mentinerea starii de sanatate odontala si refacerea morfo-fct a
aparatului dento max

42. Consecintele resp. orala:

43. caracteristicile arcadelor si ale ocluziei in dentitia permanenta

-arc max eliptica / arc md parabola

-baza apicala este mai mica decat baza coronara cu 15 max / baza ap
este mai mare cu 5 md
-dintii stabilesc puncte de contact interdentar
-planul de ocluzie drept / usoara curba transv si sag
-dintii max depasesc frontal si lateral cei ai md
-diecare dinte are 2 antag. (principal si secundar) cu exceptia IC md si M3
max

relatii normal la I, C, M:
I: sag:
transv:
vert:
C:
M:
44. Aparate mobilizabile: indicatii, avantaje, dezavantaje
indicatii: terapia interceptiva
terapia activa
in contentia rezultatelor

avantaje: -larg folosite

-confectioneaza in labor - tehnica simpla
-se gasesc prefabricate
-pretul scazut
-se pot modifica/repara usor
-controlul in intervale mai mari
-daca forta este prea mare -> stabilitatea aparatului scade ->
evita efecte negative

dezavantaje: -pot fi indepartate de pacient

-probleme fonetice
-nu permit redresari de finete
-nu sunt active daca nu sunt ancorat correct

45.examenul dinamic al ocluziei

1. pozitia de repaus (free way space 2-4mm inocluzie) -> pacientul
inghita, numere pana 10, pronunta cuvinte cu V,F,S
2. dupa aia drumul de inchidere pana la intercuspidare maxima
-> se observa: -pozitia mentonului
-punctul interincisiv inf
-contactele fct (varf cuspid - foseta)
-varf cuspid - creasta marginala
-contacte premature

3. miscare propulsie: ghidaj anterior (efectuat de IC uneori si IL -

dezocluzie lateral)
interferenta activa: efectuat prin numai un I
pasiva: contacte lateral

4. miscare lateralitate: -ghidaj C

-ghidaj grup (C + PM + M pe acelasi parte) -> dezocl
in partea pasiva
 interferenta activa: alt dinte efectueaza miscarea
(IL, PM)
pasiva: prezenta contactelor pe partea pasiva

46. examenul monomaxilar

47. diagnosticul in ortodontie

-se stabileste pe baza de: examenul clinic, model, antropometric,
fotostatic, radiologic, specialitate (pediatrie, ORL, Endocrinologie)

1. diagnosticul morfologic: anomaliile in ordinea gravitatii

2. functional: tulburarile functiilor fizionomice, fonetice, masticatorii,
autointretinere
3. etiologic: factorilor etiologic
4. prognosticul: se estimeaza: gravitatii, evolutia, sansele de ameliorare
se ia in considerare varsta, procesele de crestere, eruptia
dentara, predispozitia la carie

48. Aparatele fixe: indicatii, avantaje, dezavantaje

indicatii: dentatia permanenta/mixta
malpozitii severe
inchiderea spatii/diastema
anomalii md
anomalii clasa 2, 2/1, 2/2, 3
ochluzii deschisa
anomalii bazale in asociere cu trat chirurgical
parodontopati (-> stabilizarea a dintiilor)
 scop protetic la adulti (corectarea axelor dentare)

avantaje: modificari specifice (torque, uprighting, gresiune)

controleaza deplasarea apicala
deplasari in 3 planuri spatiale
usor asimilate de pacient, las loc pentru palatul si limba
nu pot fi indepartate de pacient

dezavantaje: -igiena riguroasa

-favorizeaza leziuni carioase, recesiuni gingivale
-pot apara deplasari nedorite
-pot determina rizaliza patologica
-pretind tehnica laborioasa/timp prelungit

49.caracteristicile fortelor ortodontice

1. intensitatea: dupa schwarz se disting 4 categorii de forte:
1. forte subliminare (15-20g/cm2)
2. forte ortodontice usoare (20-25 g/cm2)
3. forte orto mari (30-40 g/cm2)
4. forte supraliminarii (> 40 g/cm2)
-> impartirea fortelor usoare si puternice depinde de:
lungimea & forma radacinii
caracteristicile parodontiului
natura deplasarii
-> 1mm/luna depinzand de: varsta, tipul deplasarii, calitatea
structuriilor, reactivitatea ind

2. directia/sensul de actiune
-o forta aplicata intrun punct pe suprafata are 2 componente: forta
perpendiculara + forta tangent.
-2 forte in acelasi directie si in acelasi sens -> actiunea se insumeaza
-directia aceeasi - sensul contrariu (la acelasi forta) -> se anuleaza
-directia a 2 forte sunt paralele - sensurile contrarii - actiunea
tangentiala -> rotatie

3. ritmul de actiune
-fortele pot fi continue si intermitente
continue: forte usoare, actiune indelungata, rata mai mare de deplasare,
intensitate constanta, activari frecvente, eliberate de aparatele fixe

intermitente: alternanta perioadelor de actiune si repaus

50. examenul facial - palpare

-contururile osoase
-punctele de emergenta ale ramurilor trigeminale
-punctele sinusale
-grupe musculare
-examenul ATM: -amplitudinea deschiderii gurii (3-4cm normal)
-miscarea deschiderea (arc de cerc)
-excursia mentonului
-corelatia linia interincisive sup+inf
-simetria amplitudinea miscarilor
-prezenta cracmente, salturi, dureri

51.cheile ocluziei andrews (6 puncte)

1. relatia la nivel M, PM, C:

M: 1. DV cuspid M1 vine in contact cu MV cuspid M2

2. MV cuspid M1 max -> patrunde in primul sant V M1 md (cheia
lui angle)
3. MP cuspid M1 max -> foseta centrala M1 md

PM: V cuspizi PM max -> in contact cu ambrazura cuspizilor V md

P cuspizi au relatie cuspid - fosa cu md

C: varful C max -> contact usor mezial fata de ambrazura C md si PM1

2. angulatia coronara - inclinarea M-D

-treimea cervicala (of the crowns long axis) este situate distal fata de
treimea ocluzala
-coroanele sunt inclinate distal

3. inclinatia coronara - V-O

-treimea cervicala a suprafetei coronare V a I max este inclinata P, fata
de marginea incisiva
-IC max au inclinatia negativa
-toti alti au inclinatia poz. sau zero

4. lipsa rotatiilor dentare

5. contacte stranse
6. curba spee plata sau usoara

52. teleradiografie - repere mediane (10)

N: nasion (@nivel suturii naso-frontale)

SpNa: spina nazala anterioara (punctul cel mai anterior)
A: punctul subspinale a lui downs (punctul cel mai decliv de la nivelul
concavitatii anterioare a max)
Pr: prostion (punctul cel mai proeminent de pe arcada alv sup)
I: incizale sup (punctul cel mai anterior de pe marginea incizala a IC sup)
i: incizale inf (punctul inf)
Id: infradentale (punctul cel mai proeminent ant al arcadei alv inf)
B: punctul submental a lui downs (punctul cel mai decliv al concavitatii
ant a simfizei mentoniere)
Pg: pogonion (punctul cel mai proeminent al mentonului
Gn: gnation (punctul cel mai inf pe marginea bazala md)

53. teleradiografie - repere paramediane (11)

Ro: punctul cel mai inalt in regiunea bazei craniului

Cla: punctul cel mai inalt al apofizelor clinoidiene ant
S: sellae, centrul seii turcesti
Si: sellae inf (punctul cel mai inf)
Sp: sellae post
Or: orbitale (p cel mai decliv pe marginea inf a orbitei
SpNp: spina nazala post (punctul situat la limita dintre palatul dur si
moale)
Po: porion (p ant-sup pe conductul auditiv ext)
Ar: articulare (p situat la intersectia conturului ext al bazei craniului,
partea inf a piramidei occipitale cu marginea post a condilului md)
Ptm: pterigoidian (p sup + post al fosei pterigo-max)
Go: gonion (@ unghiului md)
54. examenul fotostatic - repere (9)
Tr: trichion - punct median la insertia frontala a parului (haaransatz)
Oph: ophrion - punct median tangent la linia sprancenelor
N: nasion - radacina nasului
Sn: subnasal - spina nazala ant
Pg: pogonion - cel mai proeminent de pe barbie
Sor: suborbitar - inf de pe marginea orbitei
Au: auricular - tragus
Gn: gnation - cel mai decliv pe marginea inf a mentonului
Go: gonion - unghiului md

55. meziodensul

56. ocluzia adanca acoperita

-caracteristic: supraacoperire accentuata
I md sunt in contact cu coletul celor max sau cu mucoasa
palatinala
trapta sag mare (determinata de: protruzie frontalilor max,
retruzie frontalilor md,
retrognatia md clasa 2/1 angle,
asocierea acestora)
-mijloace terapeutice:

-tratament: -modificarile sag + transv

57. anomalii plan trans - forme clinice

1. sindromul compresie de maxilar = maxilar ingust cu protruzie sau
maxilar ingust cu ighesuire fara protruzie
2. sindromul ocluziei incrutisata, laterognatia md fct (laterodevierea),
laterognatia md anatomica

58. anomalii plan vert - forme clinice

1.ocluzia acoperita (clasa 2/2 angle): forme clinice: ocluzia acoperita
adevarata
ocluzia acoperita falsa
2. ocluzia adanca in acoperis
3. ocluzia coborata (prabusita)

4. sindromul ocluziei deschise: fct, anatomica, lateral

59. anomalii plan sag - forme clinice

1. sindromul ocluziei distalizata (clasa 2 angle): retrognatia md fct,
retrognatia md anatomica
2. sindromul progenic (clasa 3 angle): angrenare inversa, prognatismul
md fct, progenia falsa (=retrognatia max), prognatism md anatomic
(=progenia adevarata)

60. Ectopia dentara

=anomalii in care dintele (erupt sau partial erupt) este situat in afara
arcadei -> V = ectopie
inauntru arcadei ->
L/P = entopie
-mult afectuat: C sau PM2 md

ectopia C: -etiologia: -persistenta C temp (nerezorbtia radacina)

-extractia prematura C temp
-lipsa spatiului: macrodontie, migrari, tulburari de
ordine de eruptie

-tratament: C ectopic in eruptie, spatiu prezent -> presiuni

digitale
C ectopic cu spatiu micsorat (1-3mm) -> utilizarea lee
way space
slefuire fetei m
M2 temp + dist PM1
dilatarea arcadei
 dist dintiilor
laterali
protruzia I
C ectopic cu spatiu micsorat >3mm -> extractii PM1
(PM2 sau M1)
incadrarea prin
aparat fix

61. Ocluzie deschisa anatomica obiective si mijloace terapeutice

(page 184)
Treatment Objectives
vertical growth inhibition
stimulating teeth eruption in the frontal area
vertical relations in 1/3 in the frontal area
stable relations in the lateral area

Treatment Options
control of bad habits (ex: oral breathing)
inhibition of vertical growth: vertex-menton traction
palatal plate with lingual shield
functional appliances:
activator extension of the lateral occlusal acrylate
setting free f the oral areas of the incisors
fixed appliance with intermaxillary tractions
orthodontic-surgical treatment

62. Prognatismul mandibular anatomic posibilitati de tratament.

(page 171)
Treatment Options
in temporary teeth chin cap traction
in permanent teeth:
orthodontic treatment
 surgical treatment

63. Ocluzie deschisa frunctionala etiologie si simptomatologie

(page 179)
Etiology
interposition of tongue in rest, deglutition, phonetics
interposition of lower lip
bad sucking habits (pacifier, finger)
interposition or biting of objects

Symptoms
facial exam no modification or slightly enlarged lower facial third
oral exam:
modification of the upper Spee curve or of both arches due
to the infraposition of the frontal group
transverse or sagittal associated modifications

64. DDM etiologie.

(page 186)
Embryological
different origin of the teeth and maxilla
teeth have a ectomesodermal origin
maxillaries have a mesenchymal origin
Phylogenetic
a more rapid and emphasized dimensional reduction of the
alveolar arch compared to the teeth
Genetic
crossed inheritance, large teeth from one parent, a small maxilla
from the other parent or visa versa
Neuro-endocrine and metabolic factors
pituitary dwarfism (small bones, normal sized teeth)
 acromegaly (excessive growth of the maxilla)
gonad dysfunctions (precocious dental eruptions in an
insufficiently developed maxilla)
Neuromuscular factors
lack of balance between the intraoral and extraoral muscles due
to oral dysfunctions (atypical deglutition, oral respiration, bad
sucking habits)
Dental factors
large teeth
small teeth
supranumerary teeth
Substitution of the support area
the order of substitution of the support area: it is favorable for the
canine to erupt before the second premolar
the integrity of the support area: if the support area is
compromised there are migrations of the permanent molars and
shortening of the arches
Iatrogenic factors
in case of the distalization of the 1st permanent molarfor the
framing of the canine or of the premolars there is a reduction on
the space of the second or third premolars
the DDM is manifested through the relapse of the treated
anomaly

65. Ocluzie adanca acoperita obiective terapeutice.

(page 176)
Treatment Objectives
leveling of the occluzal plane: ingression of the frontal teeth or
egression of the lateral teeth
reducing the overbite
protrusion of the incisors
teeth alignment
correcting the occlusion
in true deep bite egression of the lateral teeth due to a higher
free way space
 in false deep bite ingression of the frontal teeth due to the
lower free way space

66. Prognatismul mandibular functional obiective si mijloace

terapeutice
(page 167)
Treatment Objectives
removal of causative factors
disorientation of the occlusal relations
mandibular retropulsion
achieving articular jump
contention of the result

Treatment Options
polishing abraded cusps
palatal plate with mouth guard and protrusion arches
lingual plate with vestibular bow and inclined plane
occipital-to-menton traction chin cap
fixed appliance with class III interarch elastics

67. Prognastismul mandibular functional etiologie si simptomatologie.

(Page 165)
Etiology
presence of unabraded temporary teeth cusps
excessive occlusal blockage
extrusion of the lateral teeth due to premature extractions
tics of pouting with pushing the mandible forward
vicious habits of sucking, atypical swallowing
low and anterior position of the tongue
macroglossia
tonsillar hypertrophy mandibular propulsion for pharyngeal
isthmus enlargement
Symptoms
facial examination:
prominent lower lip and chin
reverse labial step
mentonier ditch deleted
slightly concave profile
mouth exam:
normal arch, possible upper retrusion
inferior protrusion and interdental spaces
variable reverse overjet
in the lateral area: class I or class III reports
uni, sometimes bilateral crossbite
functional exam:
mandibular position at rest
possibility of retropulsion until end-to-end anterior contacts
are obtained
mouth in 2 steps
- following the road closure trajectory premature
contacts occur, with open bite in the rest step 1
- mandible is driven forward in order to achieve
intercuspation step 2

68. Angrenajul Invers etiologie si mijloace terapeutice

(page 163)
Etiology
changes in the tooth axis
persistence of temporary teeth and posterior eruption of the
upper permanent teeth
large interval between anterior upper and lower teeth and
eruption, the lower teeth extrude and determine palatal eruption
of the upper
intramaxillary palatal position of the incisor teeth buds

69. Progenia Falsa obiective si mijloac terapeutice

(page 168)
Treatment Objectives
stimulating the development of the maxilla
inhibition of mandibular development
Treatment Options
palatal plate with transverse or tridimensional screws
extraoral forces Delaire facemask
stimulates maxillary growth
inhibits mandibular growth
fixed device palatal expander, quad-helix

70. Retrognatia mandibulara functionala etiologie si simptomatologie

(page 156)
Etiology
lack of physiological stimulation of the mandible
artificial diet of a newborn
diets that do not stimulate an active chewing and
physiological abrasion
Korbitz phenomenon:
mouth breathing narrow maxilla that keeps the mandible
in a distalized position
low, withdrawn position of the tongue
lip incompetence, parafunction of the lower lip, biting,
suction
vicious habits, thumb sucking
vicious posts
premature dental contacts
retrusion of the incisors teeth, large overbite

Symptoms
face exam:
reduced lower floor
accentuated menton
sucked lower lip
high stomion
 convex profile through retruded chin
endobuccal exam/
upper arch normal aspect, or modified with other
anomalies (DDM, protrusion - class II/I, retrusion Class
II/2)
mandibular arch frontal group is in supraposition, frontal
arch is crushed and crowded
occlusion:
reports of canine and molar distalization
variable overjet
functional exam:
ample propulsion opportunity of the mandible during
speech, with increased vertical dimension of the lower floor
the appearance of a large space of lateral inocclusion
improvement of the physiognomic appearance through the
mandible propulsion
disorders esthetic, masticatory, self-healing, possible
phonetic, oral breathing and atypical swallowing

71. Laterognatia mandibulara anatomica posibilitati terapeutice

(page 155)
Treatment Options
if patient comes early treatment follows the growth stimulation
of deficient segments
serious cases need surgical treatments

72. Ocluzie deschisa functionala posibilitati terapeutice

(page 181)
Treatment Options
muscular gymnastics
speech exercises
palatal plate with a lingual shield
functional appliances activator, Balters type II
fixed applainces
73. Incluzia dentara simptomatologie
(page 208)
Symptoms
temporary tooth persistence
lack of both the temporary tooth and the permanent tooth on the
arch
disorders in the eruption order
inclination of the adjacent teeth axis
eruption space kept, reduced, closed
presence of false diastema
bone swell in the vestibular or palatal area
associated local or regional disorders
after a long period of no activity, disorders may occur:
mechanical adj. teeth modify their position
pathological risalize
nervous disorders
cystic degeneration
infectious complications

74. Retrognatia mandibulara functionala posibilitati de tratament

(page 159)
Treatment Options
miogynastics
standard vestibular plate
palatal plate with screw and inclined plate
functional devices activator, Twin Block, Balters type I, Frankel
type I
fixed appliances Quad-helix, palatal expander
fixed appliance with class II interarch elastics
75. Ocluzie incruncisata simptomatologie si etiologie
(page 148)
Symptoms
Face examination
no change
changes characteristic to a narrow maxilla with protrusion
mouth examination
upper arch
- narrow uni or bilateral at the molar-premolar level
- dental crowding
- protrusion
mandibular arch normal
occlusion
uni or bilateral cross reports
interincisive line remains
small deviations are possible due to frontal crowding
functional
physiognomy function if anomaly is found in the teeth
visible in the smile
masticatory function by occluso-articular blockage
auto maintenance function affected

76. Ectopia de canin

(page 203)
the upper canine has to move on its long way during eruption
factors that can modify the position of the canine:
persistence of the temporary canine with a root without
risalise
premature extraction of the temporary canine
reduced or lack of space (due to: macrodontia, migrations
after extraction, disorders in eruption order)
Symptoms
swelling of the labial canine area
erupting canine or completely erupted canine, unilaterally or
bilaterally, usually situated in the vestibule, mesially inclined, with
reduced space
palatal erupted canine under the lateral incisor or far from it

Treatment
depends on dental age and presence or absence of space
ectopic erupting canine with space maintained:
digital pressure
ectopic canine with space maintained:
obtaining the articular jump palatal trays with protrusion
wires
stripping of the mesial side of the 2nd temporary molar and
the distalization of the 1st premolar
dilating the arch
distalizing the lateral teeth
protrusion of the incisors
ectopic canine with space shortening of more than 3mm
o extractions preferably 1st premolar , 2nd premolar if
necessary space is too small, 1st molar if compromised
spontaneous framing of the canine
framing of the canine with the help of mobile or fixed
appliances

77. DDM mijloace terapeutice

(page 191)
Treatment Options
1. Enlarging the arch
dilatation plate with median screw
 asymmetrical enlargement plate with asymmetrically
sectioned screw
expansion plate sectioned in Y, with V screw, with 3D
screw
disjunction
2. Distalization of the lateral teeth
distalization of the 1st permanent molar indicated in
secondary DDM after extractions
plate with section in the 1st permanent molar area screw
distalizor
3. Protrusion of the frontals
plates with palatal and lingual protrusion wires
4. Stripping of the mesial and distal areas of temporary teeth
mesial stripping of temporary canines
- in light crowdings
- when there is a lack of space for lateral incisors
Mesial stripping of temporary molars
- for the framing of canines
5. Extractions
in a larger than 5mm deficit
IMPORTANT: the choosing of teeth and the optimum
moment for extraction
- in primary DDM controlled extraction the
controlling of the replacing process by extracting the
temporary teeth at a proper time and ending with the
extraction of the 1st premolars
- in the belated DDM diagnosis (11 14 years)
extractions in an orthodontic purpose, as close as
possible to the crowding, the premolars

78. Ocluzie acoperita posibilitati de tratament

(page 177)
Treatment Options
palatal plate with Swartz hooks the allow egression, protrusion
wires, plane plate that determines the ingression of the frontal
teeth
activator for the lighter forms
type II Frankel appliance
 fixed appliance

79. Laterodevierea etiologie si simptomatologie

Etiology
growth disturbances consecutive to general factors
growth disturbances consecutive to ATM arthritis, osteomyelitis
ascending branch, trauma, surgeryunilateral tempero-mandibular
ankylosis
untreated functional forms

Symptoms
face exam
severe facial asymmetry
menton deviated to affected side
mouth examination
dento-alveolar lateral process of affected side is inclined
facially and healthy side inclined lingually (compensatory
phenomena)
occlusion
unilateral cross-occlusion
interincisive inferior line deviated from affected side
functional
deviation of interincisive line persists, even at rest
mandibular trajectory to habitual occlusion position (way of
closing) is unchanged

80. Ocluzie adanca in acoperis

(page 177)
high overbite
lower incisors come into contact with the gingival tissue of the
upper arch (palate)
increased overjet
the overjet is due to:
 retrusion of the lower frontal teeth
Angles class II/1 (distalization of the mandibular bone)
association of all of these
treatment in association with the sagittal and transversal
modifications
81. Maxilarul ingust cu protruzie: posibilitati de tratament

= Endoalveolie with proalveolie and upper prodentia ,affects the

temporary teeth and may excerbate on permanent tooth

Posibilitate de treat:

Prophylactic treatment : *preventing & combating Rachitism

*general body toning * elimination of oral breathing *Combate

sucking habits

Therapeutic target : #leveling the occlusal plane , # maxillary

expansion, # creating space.

Depending on physiognomic aspects ,size of space deficit ,severity of

narrowing protrusion size,level distalization ,the anomaly is
categorized by two groups : With extraction or without extraction

Therapeutic means . Miogymnastics & orthodontic appliances

1; standard vestibular plate or mad in lab

2:Palatine plate with screw median Vshaped screw,inclined plane

Anchored with hooks adams ,schwarz, sthal depending on the need

3:Functional Devices :Activator ,Twin block ,type 1 Balters ,type 1

Frankel

4:fixed appliance: Quad-helix ,circuit breaker

82. Prognatismul mandibular anatomic: etiologie si simptomatologie

 Etiologie: Heredity ,activty in excess of pituitary gland,

Macroglossi ,untreated mandibular functional Prognathia

Symptoms:

Facial exam : increased inferior floor , open goniac angle, prominent

menton

Endo-bucal exam: upper arch has a normal aspect or compensatory

Protrusion

,mandibular arch developed excessively with spacing

Occlusion : in front we have reverse occlusion , Negative overjet ,

increased overbite or Open bite .in lateral we have Mesialisation Angle
class II .

Treat: Temporary teeth we can use the Chin cap traction

Permanent: orthodontic or Surgical treat.

83. Ocluzia deschisa functionala: etiologie si simptomatologie

Etiologie : Dominated by functional factors:

-Interpostion of the tongue in rest ,deglutition, phonetics

-Interposition of the lower lip

-bad sucking habits - biting habits

Symtoms:

Facial-exam: -no modifications - maybe a slightly enlarged lower

face third.
Oral-exam: -Modification of upper spee curve or of both arches due
to the underposition of the frontal group .

Transversal or sagittal associated modifications

84. Angrenarea inversa: etiologie si simptomatologie

Etiology:-changes the tooth axix

-persistence of temporary teeth and posterior eruption of upper

permanent teeth .

-large interval between anterior upper and lower teeth and eruption
,lower teeth extrude and determine palatal eruption of the upper

-intramaxillary palatal position of incisor teeth bud.

Symptoms:

Face-exam:Normal relations

Oral-exam:changes to incisors position , change shape of arch ,

limited occ changes, in frontal area reverse bite occurs

Period-exam: gingivites + gingival retraction

Funct-exam: esthetic disorders , masticatory disorders (wood type)

85. Ocluzia deschisa anatomica: etiologie si simptomatologie

Etiologie :-

-heredity

-rachitis (maxillary bone malleability allows the much easier

deformation under the action of muscular forces)

-flanges, lip-bone or cervical scars .

 -egression or extrusion of lateral teeth

Symptom :

facial exam:long face , straight profile , enlarged lower third of face ,

fade facial soft tissue .

Oral-exam

-the lower arch may be flattened

Occlusion: symmetrical or asymmetrical vertical inoclussion over5-6mm,

Possible contacts on the level of last molars .

Func-exam: Phsiognomy , atypical deglutition ,oral breathing

Later-radio-exam: High value open bite, posterior rotation of mandible

88. Ocluzia deschisa functionala: posibilitati terapeutice

Terapeuticalobjectives :

-elimination of the casual factors (persuasion,constraint)

-favoring the teeth eruption

Orthodontical means: -muscular gymnastics for tounge & lips.

-Paltal plate with a lingual shield

-functional appliances (activator, Balters typ II)

-fixed appliance

89. Agenezia incisivului lateral superior

Lack of the upper lateral incisor can be unilateral or bilateral

If its unilateral the homonymous tooth may be normal ,frequently
smaller Issuspected because of:

The presistence of temporary teeth .

-disorders in the eruption order (eruption of 1pm before Li )

-eurption of a small lateral incisors and persistence of temporary one

in the opposite halfarch

90. Agenezia premolarilor

Frequently the lack of the second lower premolar .

Agenesis of (1.5,2.5) (3.5,4.5) some times Diagonal (1.5,3.5)

Important: Radiographyc exam !! to show the replacment teeth buds

91.Agenezia incisivilor centrali inferiori

If precocious diagnosis =space closure

Belated diagnosis=keeping the temporary lower central incisors as

long as possible .

92. Ocluzia incrucisata: posibilitati de tratament

in bilateral crossbite :-palatine plate median screw and smooth

lateral mouth guard

-fixed appliances:quad-helix, expander

In Unilateral crossbite:
 -dialtion of one half-arch on the uninetrested side the mouth guard
will have an occlusal relief in order for this region to be solidary with
the lower arch .

93. Angrenarea inversa: posibilitati terapeutice

Treat.

Unidentar reverse bite : Dental Emergency !

1:if the tooth erupting with a small overbite and maintained space
execises with spatula 3 times/day for 15-20 min

2:if the degree of over-coverage is high inclined plane device

3: if the degree of overbite is small palatine plate with mouth guard

and protusion arches

4:in frontal crossbites in which the lower incisors are proclined

Reichenbach-brukl device (lingual plate anchor with
hooks,inclinedplane,vestibular arch)

94. DDM : forme clinice

(Primary-transitory-secondary)

Primary DMD:-

quantitative growth deficit of the maxillaries

-large teeth SI=35mm

-association of the 2 factors

-precocious signs =pathological risalise and premature elimination of
temporary teeth.

TransitoryDMD:

-light form

-due to: disorders between late bone age and the precocious tooth
age.

- Dimensional diff between the temporary and permanent incisors .

-Light crowding may selfsolve by using the lee-way space if the

support area is kept and eruption order in favorable

Secondary DMD: -

directional growth dysfunctions

- Alveolatedysfynctions (endoalveolis, alveolar bone retrusion)

- Presence of suernumerary teeth
- Premature extractions

95.Progenia falsa: etiologie si simptomatologie

The sagital maxillary underdevelopment(maxillary Retrusion)

Etiology:

Congential anomalies (cleft palate)

Postoperative or posttraumatic scars.

 Lateral incisors aplasia

Reduce number of teeth in maxila

Premature extraction of temp-incisors

Trauma with loss of upper incisors

Symptoms:

Facial-exam:

obstructed upper lip

posible presence of scars

concave profile through obstructed upper lip

oral-exam;

-crowded teeth ,

-normal develpoment of mand-arch , insufficiently development max-

arc.

Cephalograms : SNA = 82 SNB=N ANB: Negative

Maxillary = Bispinal distance is less than 2/3 of mandibular length

=distance Go-Gn and smaller than the skull.NORMALY the maxillary is
3MM larger than the NS distance

96. Laterognatia mandibulara anatomica: etiologie si

simptomatologi.

Etiology

-growth disturbances consecutive to general factors

-growth disorders consecutive TMJ arthritis ,osteomyelitis ascending
branch, trauma,surgery,unilateral temporo-mandibular ankylosis

-functional forms untreated

Symptoms:

Face-exam:- severe facial asymmetry

- menton deviation on sick side

Occlusion- unilateral cross occlusion

- Interincisive inferior line deviated from affected side

Functional-exam:- deviation of the interincisive line persists even at rest

.

-mandibular trajectory to habitual occlusion position (the

way of closing)is unchanged .

97.DDM cu inghesuire : precizati criterile de apreciere a gravitatii

1:Crowding degree slight(2-3mm) medium (3-5) sever (>5 mm)

2:dental status of the teeth in support area. (no lesion, compromised)

3:value of lee-way space

4:eruption order ( radiographycally)

5:occlusal relations :

-incisors erupt aligned , but as a permanent tooth erupts ,two

temporary teeth are being mobilized and eliminated

- the first permanent molars determine pathological risalysis and the

early elimination of second temporary molar
-Msked DMD = the lateral incisors has a contact with mesial part of 1
pm or the temporary molar

98.Ocluzia coborata: prabusita

(deep bite with destruction of the posterior areas )

The frontal Overbite due to

The lack of lateral support of the vertical dimesion of the occlusion

Terminaledntaion

Symptoms:

Facial-exam: normal or decreased lower face third

Oral-exam: support are compromised by :

-extended cavities, gangrened roots,

-spacing

-egression of the nearby teeth

-frontal overbite

Func-exam:chwing and selfmaintanance disorders , leading to tmj

suffering

100. Ocluzia acoperita: etiologie si simptomatologie

it is a class II/2 malocclusio, characterized by accentuated overbite and
retrusion of upper incisors. Occurs in temp dentition but can be
trnsmittes to mixed and then to permanent dentition

ethiopathogenie

A hereditary characteristics confirmed by:

o Presence of box cap relation on the toothless arches
o More than one family member has it
o Arch form is not influenced by sucking habits
o Difficulty of treatments
o Often relapses
Symptoms
Facial exam
o in lower 3rd of the face
o Accentuated chin tissue
o Prominent chin
o Splay lips with strong contact on all the surfaces
o Highstomyon
o Well developed middle face 3rd in sagital plane (big nose
profile)
Oral exam
o Maxillary: it is shortened in S plane, of the arch from
retrusion of the incisors, M-B rotation of LI
o Mandibular: May present retrusion or crowding of the
frontal groups, accentuated Spee curve.
o In occlusion: frontally =ovepositioning of 2/3 + Medium
overjet
Laterally= Class II, Class I + lingualised occlusion
 Functional exam
o Phonetics- low voices
o Gummy smile
o Limited propulsion of lateralitate movement
o Direct trauma on the marginal gingival
o Causing periodontitis
Complementary exam
o Study model - shoretening of S arrow
o Picture exam smaller lower face + upper lip over the
orbital frontal plane + anterior positioning of the chin in
profile
o Lateral Radio exam skeletic class I or II + developed chin
bone + shortened lower face 3rd

101. ocluzia deschisa laterala

Rare
V inocclusion in the PM and M area
Can be unilateral or bilateral
Can be localized or extended
Transitory in the eruption perion

Etiology:

Localized growth disorder

Tongue or cheek interposition
Objects (pen) interposition

Treatment

Removal of causing factor

 Facilitating the eruption process may may lead to solving the
anomaly

102. Retrognatia mandibulara functionala: etiologie si

simptomatologie
it is a S discrepancy b/w the 2 maxillaries due to anterior Mand
positioning and extended anterior crossbite.

Ethiology:
Presence of unabraded temporary teeth cusps
Excessive occlusal blockage
Extrusion of the laterals due to premature extractions
Tics with pushing the Mand forward
Vicious habits of sucking
Low and anterior positioning of the tongue.
Macroglossia

Symptoms:

Facial exam
o Prominent lower lip +chin
o Reversed labial step
o Mentonier ditch detected
o Slightly concave profile
Oral exam
o Normal arch, possible upper retrusion
o Inferior protrusion + interdental space
o Variable overjet
o In lateral areas can be class I or III
 o Can be unilateral or bilateral crossbite
Functional exam
o Mand at normal position in rest
o Possibility to perform retropulsion until cap la cap contact is
obtained
o When closing the mouth it is done in two steps, 1st= when
closing remature contacts occure with open bite in the rest,
2nd= mandible is moved forward to achieve Intercuspation
Cephalogram
o Class III skeletal

103. Retrognatia mandibulara functionala: obiective si mijloace

terapeutice
it is a S discrepancy b/w the 2 maxillaries due to anterior Mand
positioning and extended anterior crossbite.

Ethiology:
Presence of unabraded temporary teeth cusps
Excessive occlusal blockage
Extrusion of the laterals due to premature extractions
Tics with pushing the Mand forward
Vicious habits of sucking
Low and anterior positioning of the tongue.
Macroglossia

Symptoms:

Facial exam
o Prominent lower lip +chin
 o Reversed labial step
o Mentonier ditch detected
o Slightly concave profile
Oral exam
o Normal arch, possible upper retrusion
o Inferior protrusion + interdental space
o Variable overjet
o In lateral areas can be class I or III
o Can be unilateral or bilateral crossbite
Functional exam
o Mand at normal position in rest
o Possibility to perform retropulsion until cap la cap contact is
obtained
o When closing the mouth it is done in two steps, 1st= when
closing remature contacts occure with open bite in the rest,
2nd= mandible is moved forward to achieve Intercuspation
Cephalogram
o Class III skeletal

104. Maxilarul ingust cu protruzie: obiective si mijloace terapeutice

similar to question 81 without the prophylactic treatment part < thank
you come again

105.Reincluzia dentara
Reinclusion = secondary retention

Characterized by total or partial return of a tooth that has been

present on the arch back into the depth of the bone
 Frequent in the 2nd temp M and rare in permanent Ms.
Tooth is absent from the arch or only the occlusal surface is
visible.
The space may be kept or reduced by the inclination of the
neighboring tooth

Cause is assumed to be:

Dental + bone ankyloses

Pressure forces of the adjacent erupting teeth
Tissue induction

Treatment:

Extraction of the reincluded tooth

Sometimes difficult to obtain a treatment.

106. Diagnosticul diferential intre ocluzia acoperita adevarata si falsa

Shortened lower face 3rd
Deep bite skeletical
High free way space
Overbite is reduced during phonetics
Excessive V growth of frontal zone + insufficient growth of lateral
zone

False deep bite:

Slightly shortened lower face 3rd

Lower values of deep bite
Low free way space
Overbite is maintained while resting
 It is basically due to excessive V growth of the frontal Max resgion

Differential diagnosis: states the affected funcstions

Ethiological diagnosis: hereditary abnormality

In TRUE: egression of the laterals due to the higher free way space

In FALSE: ingression of the frontals due to the lower free way space

107. Maxilarul ingust cu protruzie: etiologie si examen facial

it is the compression syndrome of maxilla = Endoalveolei with
proalveolie and prodentia. It affects Temp. teeth and may exacerbate
on permanent teeth.

Etiology:

Genetic factors
Rahitism
Oral breathing
Atypical deglutition
Interposition or aspiration of lower lip
Vicious habits of sucking

Facial exam:

Elongated and narrow face

Pale skin
 Lip slot open
Short upper lip
Lower lip interposed
Dry cracked lips
Caries of upper I groups
Gingivitis
Convex profile

108. Retrognatia mandibulara anatomica: etiologie si

simptomatologie
anatomical mandibular retrognathia = lack of Mand development with
or without affecting its shape.

Etiology:

Genetic factors e.g. trisomy 15-17, turner syndrome, pituitary

dwarfism
ATM diseases e.g. arthritis, ankylosis, trauma, malformations
Surgery near the condyle cartilage
Untreated functional forms

Symptoms:

Face exam

o lower floor
o Forced contact b/w lips
o Very retired chin
o Mand body
o Typical bird profile
 Oral exam

o Normal aspect of upper arch or presence of DMD with or

without protrusion
o Mand arch = proalveolodentia compensatory arch flaring,
DMD with crowding
o Occlusion = accentuated distalised report + S level

Functional exam

o Oral breathing + mastication disorder

o Limited or impossible Mand propulsion movement
o Will affect all the dento maxillary functions
o Atypical deglutition

109. Progenia falsa : posibilitati de tratament

false progeny = S Max underdevelopment = meaning Max retrusion

It is caused of underdevelopment of Max that gives the false impression

of growth in excess of mandible.

Treatments targets are to: stimulate Max development + inhibit Mand

development

Treatments:

Palatinal plate with transverse or tridimensional screw

Extra oral forces = Delaire facemask (it stimulates Max
development + inhibits Mand development)
Fixed device: palatal expander, quad helix

110.Laterodevierea: posibilitati de tratament

laterodevierea = functional mandibular laterognathia (transversal plane
anomaly)

It is a functional disturbance of mandible with lateral deviation while

closing.

Treatment targets = correction of Mand position inn occlusion + removal

of premature contacts

Treatment would be:

Cusp crinding + non abrased tooth extractions

Functional devices = activator
Monomaxillary plates with functional molded mouth guard.

111. Prognatismul mandibular functional: posibilitati de tratament

Therapeutic Target:

Removal of the causing factor

Disorientation of the occlusal relationship
Mand retropulsion
Achieving articular jump
Contention of the result

Therapeutic means:

Polishing unabraded susps

Palatine plate with mouth guard and protrusion arches
Lingual plate with Vestibular bow and inclined plane
Chin cap occipital to mention traction
Fixed appliances with class III interarch elastics
 112. Maxilarul ingust cu inghesuire, fara protruzie: posibilitati de
tratament
anomaly is visible during the mixed dentition together with eruption of
incisors, rotated and crowded.

Treatment objectives: create space + alignment of incisors + solving the

reverse gear

Treatments:

Palatine plate with screw

Activator
Fixed appliances
For crossbites a disorientation of bite through mouth guard is
needed
Proclination of incisors can be done 8 spring, S spring, mushroom
spring
If IP distance is reduced > 5mm, tooth extraction is needed

113. Precizati metodele de obtinere de spatiu in DDM cu inghesuire

Enlarging the arch with, plate with median screw + plate sectioned
in Y with V screw with tridimensional screw
Distalisation of lateral teeth, distalisation of M6 + distaliser + plate
with screw sectioned in M6 area
Protrusion of frontal teeth by, plates with palatal and lingual
protrusion wires
Stripping of the mesial and distal area of temporary teeth. >
mesial sripping of temp canine when lack space for incisors >
mesial stripping of temp Ms for framing of canines
 Extractions in cases of larger than 5mm deficit
o In primary DMD; controlled extraction, so controle the
replacing by extracting the temp teeth at proper time and
ending with extraction of PM1
o Belated DMD; 11-14 years, there is a need in extraction as
close as possible to crowding (PMs)

114. Prognatismul mandibular anatomic: etiologie si simptomatologie

anatomical prognathia is the real progeny. S discrepancy with reversing
due to excessive Mand development.

Etiology:

Hereditary
pituitary glands activity
Macroglossia
Untreated Mand functional prognathia

Symptoms:

Face exam

o lower floor
o Open goniac angle
o Prominent menton
o Lower lip protrusion
o Concave profile: lower lip and menton are located anterior
to the naso-frontal plane

Oral exam

o Max: normal aspect or compensatory protrusion

 o Mand: development + spacing + sometimes
compensatory retrusion
o Occlusion
in front: reversed occlusion + -ve overjet + overbite
or open bite
in lateral: mesialisation = angle class III

115. Ocluzia incrucisata: obiective si mijloace terapeutice

. treatment targets are: maxillary dilation + alignment of teeth + correct
occlusion relationships

Treatments:

in bilateral crossbite: palatine plate with median screw and

smooth lateral mouth guard + fixed appliances (quad helix,
expander)
in unilateral crossbite: dilation of one half arch + on the other side
(not interested side) a mouth guard will have an occlusal relief in
order for the region to be in solidary with lower arch.

116. DDM: etiopatogenie

DMD is the disorderance between the volume of the maxillaries and the
dental volume casuing spacing crowding etc. Can be due to 7 factors:

1) embryological: different origins of the teeth and the maxillaries,

because teeth are from aectomesodermical origin and the
maxillaries from mesenchymal origin
2) phylogenetic: more rapid and emphasized dimensional reduction
of the alveolate arch compared to the teeth
 3) genetic: crossed inheritance (larg teeth from one and small
maxillaries from another)
4) neuro-endocrine and metabolic:
pituitary dwarfism = small bones, normal sized teeth
acromegaly = growth of maxillaries
gonad dysfunction = early eruptions in under-developed
maxillaries
5) neuro-muscular: lack of balance b/w extraorally and intraorally
muscles due to oral dysfunctions such as: oral breathing, atypical
deglutition, sucking
6) dental: large teeth, small teeth, supernumerary
7) substitution of the support areas, it is favorable for the canine to
erupt before the PM2. If support area is compromised there will
be migrations.
8) Iatrogentic: in case of distalisation of M1 for the framing of canine
or the PMs, therefore will be space for the M2 and M3

117.Ocluzia deschisa functionala: obiective si mijloace terapeutice

targets of the treatment: eliminate the causing factor + favoring the
teeth eruption

Treatment:

Muscular gymnastic for the tongue and lips

Speech exercise
Palatal plate with lingual shield
Functional appliance: activator, balters type II
Fixed appliances
 118. Ocluzia incrucisata: etiologie si simptomatologie
anomaly occurred due to narrow Maxilla, can be bilateral or unilateral,
symmetrical or asymmetrical and can regard one or more teeth laterally
or entirely.

Etiology (similar to narrow Max plus):

Eruption disorder + changes in lateral axis

Oral versiune (tilting) of Max PMs + Ms
Vestibular versiune (tilting) of Mand PMs + Ms

Symptoms:

Face exam

o No changes
o Changes characteristics to narrow Max with protrusion

Oral exam

o Max: narrow uni/bilateral on the M-PM level + crowding +

protrusion
o Mand: normal appearance
o Occlusion: uni/bilateral crossbite + keeping interincisive line
but small deviations are possible due to crowding

119. Ocluzia adanca acoperita: precizati formele clinice

True deep bite:

Shortened lower face 3rd

Deep bite skeletical
High free way space
 Overbite is reduced during phonetics
Excessive V growth of frontal zone + insufficient growth of lateral
zone

False deep bite:

Slightly shortened lower face 3rd

Lower values of deep bite
Low free way space
Overbite is maintained while resting
It is basically due to excessive V growth of the frontal Max reagion

In TRUE: egression of the laterals due to the higher free way space

In FALSE: ingression of the frontals due to the lower free way space

120. Maxilarul ingust cu protruzie: examenul facial

similar to question 107 but only the facial exam part needed for this
question not etiology so please suck good on the facial part .