Diagnosis and tx planning

Question 1

What are the general principles of diagnosis

Answer 1

history
examination
diff diagnosis
special tests
diagnosis
treatment plan
treatment 
outcome

Question 2

How do we get the history off of a patient

Answer 2

CO
PMH
PDH
SH

Question 3

How do we do an examination

Answer 3

extra/intra oral

Question 4

How do we get a diagnosis

Answer 4

description

IOTN

Question 5

How can we measure the outcome

Answer 5

PAR index

Question 6

When doing a diagnosis what info do we want in it

Answer 6

description of malocclusion
determine the case of malocclusion
are the causes dent-alveolar or skeletal

Question 7

What do we look at on a lateral cephalogram

Answer 7

AP skeletal
vertical skeletal
class III incisors

Question 8

Why is a correct orthodontic diagnosis important

Answer 8

orthodontic appliances can move teeth very well but can modify skeletal relationship minimally

a severe skeletal discrepancy may require surgical intervention

Question 9

What are the objectives of orthodontic treatment

Answer 9

to produce an occlusion which is 
stable
functional
aesthetic 
and to facilitate other forms of dentistry such as crowns and bridges

Question 10

What things should be considered when making a tx plan

Answer 10

px wishes
stability
access to tx
compliance
space requirements
aims of tx
prognosis of individual teeth 
feature growth changes
etiology of malocclusion
px soft tissue profile
retention
stability

Question 11

What are the 2 different aims of treatment

Answer 11

full correction of malocclusion

compromise treatment

Question 12

What is a full correction of malocclusion consist of

Answer 12

class I incisor relationship (OJ/OB normal)
class I canine relationship 
class I molar relationship (can accept class II)
no rotations, spaces, flat occlusal plane (andrew six keys)

Question 13

What does compromise treatment consist of

Answer 13

correct certain aspects and accept others
e.g accept buccal cross bite with no displacement
may have to do work within adverse skeletal pattern and leave residual OJ particularly in adults

Question 14

What are the stages of tx planning

Answer 14

plan around the lower arch (angulation of LLS is stable)

decide on tx in lower (extraction or non extraction)

build upper arch around lower aim for class I incisor and canine relationship (OJ and OB normal)

decide on molar relationship (class I or full unit class II molar relationship)

Question 15

What do we look at when examining the lower arch

Answer 15

crowding/angulation of incisors and plane
angulation of the canines/centre lines
curve of speech 
space required?
what are the options?
extraction or non extraction

Question 16

What is the examination of the upper arch

Answer 16

crowding / angulation of incisors to the maxillary plane

angulation of the canines/centrelines

Question 17

What should we look at when the teeth are in ICP

Answer 17

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

Question 18

When looking at crowding assessment what can we do to

Answer 18

measure the space available and space required

overlap technique

Question 19

How do we measure the arch length / space available

Answer 19

by measuring distal of 2 to mesial of 6 + distal of 2 to mesial of 1 and do this both sides and add together

Question 20

If we estimate the width of all teeth anterior to first permanent molars what does this tell us

Answer 20

space required

Question 21

What is the overlap technique

Answer 21

looking at how far teeth are out of alignment

doesn’t have to be that accurate

Question 22

What is mild crowding

Answer 22

only 0-4mm required

Question 23

What is moderate crowding

Answer 23

5-8mm required

Question 24

What is severe crowding

Answer 24

8+ mm required

Question 25

What are the options for mild crowding

Answer 25

non extraction (stripping)
extract 5

Question 26

What are the options for moderate crowding

Answer 26

extract 5 or 4s

Question 27

What is done for severe crowding

Answer 27

extract 4

Question 28

If you extract from lower arch what must you do

Answer 28

extract upper or u get MR class III

Question 29

If you only extract an upper tooth what do u get

Answer 29

MR II

Question 30

What are other considerations regarding overjet

Answer 30

if the overjet needs to be reduced can it be done by tipping movement or by bodily movement

Question 31

What are considerations for the molar relationship

Answer 31

will there be residual space in the buccal segments at the end of treatment

what will the final molar occlusion be (class I or II)

Question 32

What is the retention phase

Answer 32

retainers are needed to hold the teeth in position after active movement

Question 33

When writing a tx plan what should we put down

Answer 33

diagnosis
problem lost
treatment plan

Question 34

What should your treatment plan consist of

Answer 34

list of successive stages stating tooth movements to be carried out and appliances to be used
estimate length of tx
if it is not possible to give a detailed plan, indicate when it will be reviewed (i.e following eruption of teeth)

Question 35

What are the 6 treatment options

Answer 35

1. accept malocclusion
2. extractions only
3. URA
4. functional appliance
5. fixed appliance
6. complex treatment involving orthodontics and restorative treatment or orthodontics and orthographic surgery

Question 36

What are the limitations of orthodontic treatment

Answer 36

effect of orthodontic treatment are almost purely dento-alveolar and tooth movement with little effect on skeletal pattern

tooth movements are limited by shape and size of alveolar processes

teeth will only remain stable in a position where there is equilibrium between forces of the soft tissues, the occlusion and the periodontal structures. All other positions are unstable and will be prone to relapse

Question 37

Who will do the treatment for ortho

Answer 37

single treatment - GDP

complex tx - specialist practitioner or hospital specialist

Question 38

What is the best timing of ortho tx

Answer 38

some tx rely on the grow for success and should be used during the adolescent growth spurt for maximal effect (e.g overbite reduction and functional appliance therapy)