Diagnosis and Treatment Planning

Question 1

What should be included in your orthodontic diagnosis?

Answer 1

• description of the malocclusion
• ## determine the causes of the malocclusion (dentoalveolar or skeletal)

Question 2

Why is correct orthodontic diagnosis important?

Answer 2

• orthodontic appliances can move teeth very well but can modify skeletal relationship minimally
• a severe skeletal discrepancy may require surgical intervention

Question 3

How could you treat an anterior crossbite that is dental related?

Answer 3

orthodontics

Question 4

How could you treat an anterior crossbite that is skeletal related?

Answer 4

orthognathic surgery

Question 5

What are the objectives of orthodontic treatment?

Answer 5

To produce an occlusion which is:
- stable
- functional
- aesthetic

Question 6

What are the stages of treatment planning for orthodontic treatment?

Answer 6

1. Plan around the lower arch
2. Decide on treatment in lower
3. Build upper arch around lower (aim for class I incisor and canine relationship
4. Decide on molar relationship (class I or full unit class II molar relationship)

Question 7

When doing an orthodontic examination of the lower arch, what are you looking for?

Answer 7

• crowding
• angulation of incisors in the mandibular plane
• angulation of the canines
• centrelines
• Curve of Spee

Question 8

When doing an orthodontic examination of the upper arch, what are you looking for?

Answer 8

• crowding
• angulation of incisors
• angulation of canines
• centrelines

Question 9

What would be considered ‘mild’ in terms of space being required in the lower arch?

Answer 9

0-4mm required

Question 10

What would be considered ‘moderate’ in terms of space being required in the lower arch?

Answer 10

5-8mm

Question 11

What would be considered ‘severe’ in terms of space being required in the lower arch?

Answer 11

8mm+

Question 12

How is crowding assessed?

Answer 12

• measure space available and space required
  OR
• overlap technique

Question 13

If a patient requires 0-4mm of space in lower arch, what can be done to achieve this?

Answer 13

• stripping (non-extraction)
• extract 5s

Question 14

If a patient requires 4-8mm of space in lower arch, what can be done to achieve this?

Answer 14

• extract 5s
• extract 4s

Question 15

If a patient requires 8mm+ of space in lower arch, what can be done to achieve this?

Answer 15

extract 4s (extraction of 4s gives more space despite 5s being bigger due to mesial drift of 6s)

Question 16

If you extract teeth to make space in the lower arch you must…

Answer 16

extract in upper arch also (balancing)

Question 17

What is the ideal canine relationship that you try to achieve in orthodontics?

Answer 17

Class I canine relationship

Question 18

What is the function of a temporary anchorage device?

Answer 18

helps to prevent mesial drift of posterior teeth

Question 19

How long does orthodontic treatment typically take?

Answer 19

24 months

Question 20

What are the different treatment options available in orthodontics?

Answer 20

1. Accept malocclusion
2. Extractions only
3. URA
4. Functional appliance
5. Fixed appliance
6. Complex treatment (surgery usually)

Question 21

What are the limitations of orthodontic treatment?

Answer 21

• 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