#3 Diagnosis and Treatment Planning

Question 1

What are the 3 limitations of Angle’s Classification?

Answer 1

1 - Only considers the A-P plane.
2 - Does not include intra-arch problems (crowding/spacing)
3 - Does not discriminate between skeletal and dental malocclusions.

Question 2

Define diagnosis

Answer 2

systematic approach to establishing the dental/orthodontic problems

Question 3

Define treatment planning

Answer 3

Determining potential solutions for the identified problems and integrating them into a cohesive plan

Question 4

What are the 5 components of Ackerman and Profit’s Classification of Malocclusion?

Answer 4

1 - Facial proportion and esthetics
2 - Alignment and symmetry within the dental arches
3 - Skeletal and dental relations in the transverse plane
4 - Skeletal and dental relations in the antero-posterior plane
5 - Skeletal and dental relations in the vertical plane

Question 5

How do you prioritize the “problem list”?

Answer 5

Sequence the 5 components of the Ackerman-Profit scheme based on severity.

Question 6

What is the sequence of 4 steps in treatment planning ?

Answer 6

1 - Control all disease states first
2 - Setting priorities for orthodontic treatment
3 - Balance between patient’s wishes and the severity of the problem
4 - Above all do no harm

Question 7

What factors influence the choice of a specific treatment plan?

Answer 7

• Interaction among the various possible solutions (ex: relation between horizontal and vertical dimensions)
• Compromise (between esthetics, occlusion and stability)
• Cost-Risk/Benefit Analysis

Question 8

What are the 4 indications need for treatment?

Answer 8

1 - Psychosocial indications (bucktoothed and crosseyed people are treated differently)
2 - Developmental indications
3 - Functional indications (Respiratory; TMD; Matiscation & Speech) you’re bucktoothed AND can’t chew leather
4 - Trauma/Disease control

Question 9

What are the stages in serial extractions?

Answer 9

1 - Ext of primary canines as primary permanent laterals erupt
2 - Ext of primary first molars 6 to 12 months before normal exfoliation
3 - Ext of first premolars as they are just emerging before the canines erupt
4 - Spontaneous space closure as canines erupt distally and molar/premolars drift medially.

Question 10

What is the goal of serial extractions?

Answer 10

The goal is to transfer the incisor crowding posteriorly to the premolar extraction site, and the key to success is the extraction of the first premolars before the canines erupt.