Diagnosis and Treatment Planning Flashcards
What should be included in your orthodontic diagnosis?
- description of the malocclusion
- ## determine the causes of the malocclusion (dentoalveolar or skeletal)
Why is correct orthodontic diagnosis important?
- orthodontic appliances can move teeth very well but can modify skeletal relationship minimally
- a severe skeletal discrepancy may require surgical intervention
How could you treat an anterior crossbite that is dental related?
orthodontics
How could you treat an anterior crossbite that is skeletal related?
orthognathic surgery
What are the objectives of orthodontic treatment?
To produce an occlusion which is:
- stable
- functional
- aesthetic
What are the stages of treatment planning for orthodontic treatment?
- Plan around the lower arch
- Decide on treatment in lower
- Build upper arch around lower (aim for class I incisor and canine relationship
- Decide on molar relationship (class I or full unit class II molar relationship)
When doing an orthodontic examination of the lower arch, what are you looking for?
- crowding
- angulation of incisors in the mandibular plane
- angulation of the canines
- centrelines
- Curve of Spee
When doing an orthodontic examination of the upper arch, what are you looking for?
- crowding
- angulation of incisors
- angulation of canines
- centrelines
What would be considered ‘mild’ in terms of space being required in the lower arch?
0-4mm required
What would be considered ‘moderate’ in terms of space being required in the lower arch?
5-8mm
What would be considered ‘severe’ in terms of space being required in the lower arch?
8mm+
How is crowding assessed?
- measure space available and space required
OR - overlap technique
If a patient requires 0-4mm of space in lower arch, what can be done to achieve this?
- stripping (non-extraction)
- extract 5s
If a patient requires 4-8mm of space in lower arch, what can be done to achieve this?
- extract 5s
- extract 4s
If a patient requires 8mm+ of space in lower arch, what can be done to achieve this?
extract 4s (extraction of 4s gives more space despite 5s being bigger due to mesial drift of 6s)
If you extract teeth to make space in the lower arch you must…
extract in upper arch also (balancing)
What is the ideal canine relationship that you try to achieve in orthodontics?
Class I canine relationship
What is the function of a temporary anchorage device?
helps to prevent mesial drift of posterior teeth
How long does orthodontic treatment typically take?
24 months
What are the different treatment options available in orthodontics?
- Accept malocclusion
- Extractions only
- URA
- Functional appliance
- Fixed appliance
- Complex treatment (surgery usually)
What are the limitations of orthodontic treatment?
- limited affect on skeletal pattern
- tooth movements limited by shape and size of alveolar processes
- teeth will only remain stable in a position where there is equilibrium between the forces of the soft tissues, occlusion and periodontal structures
