Diagnosis and Treatment Planning

Question 1

what are the general principles of diagnosis and treatment planning

Answer 1

history
examination
diagnosis
treatment plan
treatment
outcome

Question 2

what occurs during diagnosis

Answer 2

description of malocclusion
determine causes of malocclusion
are causes dentoalveolar or skeletal
lateral cephalogram

Question 3

why is correct orthodontic diagnosis important

Answer 3

orthodontic appliances can move teeth very well but a skeletal discrepancy would require surgery

Question 4

if the diagnosis is dental what do we do

Answer 4

orthodontics

Question 5

if the diagnosis is skeletal what do we do

Answer 5

orthognathic surgery

Question 6

what are the objectives of orthodontic treatment

Answer 6

to provide an occlusion which is stable, functional and aesthetic

Question 7

what does the IOTN ensure

Answer 7

that orthodontics go to patients who are of greatest need of them

Question 8

what are the aims of treatment

Answer 8

full correction of malocclusion or compromise treatment

Question 9

what is compromise treatment

Answer 9

correct certain aspects but accept others

Question 10

what are the stages of treatment planning

Answer 10

plan around lower arch
decide on treatment in lower
build upper arch around lower and aim for class 1 incisor and canine relationship
decide on molar relationship

Question 11

what do you examine in the lower arch

Answer 11

crowding/angulation of incisors
angulation of canines/centrelines
curve of spee

Question 12

how do you examine the upper arch

Answer 12

crowding/angulation of incisors to max plane
angulation of canines/centrelines

Question 13

what do you look at when the teeth are in ICP

Answer 13

incisor relationship
OJ
OB (curve of spee)
centrelines
canine relationship
molar relationship

Question 14

what do you do when assessing crowding

Answer 14

do we need to extract teeth?
measure space available and space required
overlap technique

Question 15

what do you measure for space available

Answer 15

the arch length

Question 16

what do you measure for space required

Answer 16

the width of all anterior teeth to first permanent molars

Question 17

how do you estimate the degree of crowding

Answer 17

difference between space available and space required

Question 18

what factors come into how you plan treatment

Answer 18

aims of treatment
prognosis of individual teeth
future growth changes
aetiology of malocclusion
patients soft tissue profile
retention
stability
patient wishes
access to treatment
compliance
space requirements

Question 19

what is the overlap technique to estimate crowding

Answer 19

measure the overlap between each teeth which overlap and add together

Question 20

what would you do if you required 0-4mm space in the lower arch

Answer 20

extract 5s
or no extraction

Question 21

what would you do if you required 5-8mm space in the lower arch

Answer 21

extract 5s or 4s

Question 22

what would you do if you required 8+mm of space in lower arch

Answer 22

extract 4s

Question 23

what happens if canines are left in class 2

Answer 23

incisors form overjet

Question 24

what happens if canines are class 1

Answer 24

incisors are class 1

Question 25

what do we need to consider about reducing overjet

Answer 25

can it be done by tipping or will it require bodily movement

Question 26

what happens if all the space from extractions is to be used

Answer 26

you need to reinforce anchorage

Question 27

what is the retention phase

Answer 27

retainers are needed to hold teeth in position after active movement

Question 28

how do you write a treatment plan

Answer 28

diagnosis
problem list
treatment plan - list stages of tooth movement and appliances needed, estimate length of treatment

Question 29

what are the treatment options

Answer 29

accept malocclusion
extractions only
URA
functional appliance
fixed appliance
ortho and restorative/ortho and orthognathic surgery

Question 30

what are the limitations of orthodontic treatment

Answer 30

effects of orthodontic treatment almost purely dento-alveolar and tooth movement with small effect on skeletal pattern
tooth movement limited by shape and size of alveolar process
teeth only remain stable where there is equilibrium between forces of soft tissue, occlusion and periodontal structures

Question 31

what premolar would give you more space when extracting and why

Answer 31

4
this is because when extracting the 5 the 6 will move forward fast

Question 32

what would you do the upper when extracting from the lower arch

Answer 32

extract from upper arch

Question 33

what would you do in the upper arch when not extracting from lower arch

Answer 33

extract in upper arch
utilise UBS using headgear

Question 34

who does simple orthodontic treatment

Answer 34

GDP

Question 35

who does complex orthodontic treatment

Answer 35

specialist practitioner or hospital specialist

Question 36

what treatment should be carried out during the adolescent growth spurt and why

Answer 36

overbite reduction and functional appliance therapy
they rely on growth for success

Question 37

if a patient wants to accept malocclusion what do we warn them of

Answer 37

consequences

Question 38

when do we do extractions only

Answer 38

class 1 skeletal cases with crowding only

Question 39

what is a URA used for

Answer 39

tipping and tilting

Question 40

when is a functional appliance used

Answer 40

class 2 only