Clinical Examination Flashcards
What are the features of a leptoprosopic face?
Vertical Maxillary excess (VME)
Open bite type skeletal with or without a dental overbite
Divergent
What are the different types of facial paterns observable from a frontal view?
1) Mesoprosopic - “average”
2) Leptoprosopic - “long face”, Vertical maxillary excess (VME)
3) Euryprosopic
also check for assymetry and cant of occlusal plane
What are the features of a euryprosopic face?
“short face”
Deep bite
Convergent
What are the facial patterns observable from the profile view?
1) Stright - orthognathic, “class I”
2) Convex - retrognathic, “class II”, posterior divergent
3) Concave - prognathic, “class III”, anterior divergent
How can lip variation be analysed?
1) Length - about 18-22mm is normal
2) POsitive relative to teeth
- > Rest and smile
- > Incisor and gingival display
- > Lip trap
3) Competence - competent, potentially competent, incompetent
4) Tone - relaxed and in function
How can lip related problems be managed?
1) Correction of overjet - appliences + elimination of habits
2) Correction of facial height - Orthopaedics, orthognathic surgery
3) Promotion of nasal respiration
- lip exercises
- ENT surgery
4) lip lengthening - cheiloplasty, freeing the mentallis attachment
What aspects of the tongue should be observed during a clinical exmantion?
Visceral (infantile) swallow or a somatic (mature) swallow
Foward tongue posture and function? If so, suspect mouth breathing
How can tongue related problems be managed?
1) Patient education and awareness of tongue posture
2) Myofunctional modification - speech therapy, desensitisation techniques
3) Barriers - various fixed or removable appliances
4) Change the form
- change arch shape and occlusion by orhodontic, orthopaedic or surgical means
- partial glossectomy
What dental malocclusions are related to cheek related problems?
1) Crossbites (related to narrow maxilllary arch form)
2) Anterior open bite (as cheek related prpblems are associated with low tongue position)
Cheek related problems are normally adaptive to mouth breathing
How can cheek related problems be managed?
1) investigate mouth breathing
2) Apply expansion as needed
- Removable or fixed appliances
- SME or RME
- Surgically assissted (if adult)
How can the treatment timing of orthodontic treatment be classified?
1) early - deciduous and mixed dentition
2) adolescent - early secondary dentition, around puberty
3) adult - essentially non-growing
What are the main goals of early orthodontic treament (deciduous and mixed dentition)?
1) Prevention
- Maintaining normal development
- Preventing problems which could occur
2) Interception
- If development not taking place as it should be
- Treatment if applied to elminate or reduce the problem
What are the goals of adolescenet orthodontic treatment (early secondary dentition)?
1) Prevention
2) Interception
3) Correction
- Some orthopaedic but mainly orthodontic
- Management of skeletal imbalance may require camouflage or surgical approaches
