Need and demand for orthodontic treatment Flashcards
What is treatment NEED?
An objective evaluation of the malocclusion by the clinicians
What is treatment DEMAND
Generally subjective - arises from the patient’s perception of issues with aesthetics and/or function (awareness)
How do people make decisions about whether or not to seek orthodontic care?
Upstream in treatment chain
When do patients have a preference for treatment by orthodontists?
- Children’s treatment
- Functional concerns
- Cases that might involve complications
What are the characteristics of malocclusion?
VENN DIAGRAM
Intra-arch:
- Symmetry
- Ideal
- Crowding
- Spacing
Profile:
- Anterior divergent
- Posterior divergent
- Convex
- Straight
- Concave
Transverse Deviation (Lateral)
- Buccal
- Palatal
(Unilateral/Bilateral)
- Dental
- Skeletal
Sagittal Deviation (AP):
- Class I
- Class II Div 1
- Class II Div 2
- Class III
- Dental
- Skeletal
Vertical Deviation
- AOB
- POB
- Deep bite (Anterior)
- Collapsed bite (Posterior)
- Dental
- Skeletal
Is malocclusion a disease?
NO
What is malocclusion?
- Discrete but inter-related anomalies (born with) and abnormalities (developed overtime)
- Displacement of anatomy in three planes (vertical, sagittal, transverse)
- May affect aesthetics and/or function negatively (perceived by individuals differently)
What are the roles played by the general dentist and orthodontist?
- Know the level and severity of a malocclusion (Objective)
- Appreciate the level of difficulty in managing a malocclusion (Subjective - dependent on clinician)
- Design plan and implement treatment and options
- Recognize and communicate the limits of different treatment options
- Assess the outcome of treatment
How to determine the SEVERITY of a malocclusion
Spatial Displacement
1. Amount of spatial displacement between the maxilla and mandible from the ideal relationship
2. Amount of spatial displacement between the maxillary teeth and mandibular teeth from an ideal relationship
3. Amount of spatial displacement of teeth from its ideal position within the dental arch
4. Number of teeth involved in the spatial displacement
5. Sites of teeth displacement
6. Amount of crowding and/or spacing within the dental arch
7. Arch form - degrees of asymmetry and degree of distortion of arch form relative to an ideal arch form
How to determine the level of difficulty of a case?
Movement and Space
1. Amount of movement needed for the maxilla and mandible to attain ideal relationship
2. Amount of movement needed for the maxillary teeth and mandibular teeth to attain ideal occlusal relationship
3. Amount of movement needed for teeth to move into ideal; position within the dental arch
4. The direction of these movements
5. The amount of space available within dental arch and alveolar bone for teeth to move into ideal position
What is the Envelope of discrepancy for max teeth with
- Ortho only
- Ortho + Functional Appliance
- Ortho + Orthognathic Surgery
- Ortho only
Post: 2
Sup: 4
Ant: 7
Inf: 2 - Ortho + Functional Appliance
Post: 5
Sup: 6
Ant: 12
Inf: 5 - Ortho + Orthognathic Surgery
Post: 10
Sup: 10
Ant: 15
Inf: 15
What is the Envelope of discrepancy for manteeth with
- Ortho only
- Ortho + Functional Appliance
- Ortho + Orthognathic Surgery
- Ortho only
Post: 5
Sup: 4
Ant: 3
Inf: 2 - Ortho + Functional Appliance
Post: 10
Sup: 6
Ant: 5
Inf: 5 - Ortho + Orthognathic Surgery
Post: 12
Sup: 10
Ant: 25
Inf: 15
What are the orthodontic tooth movements in the 3 planes?
Vertical:
- Intrusion
- Extrusion
Saggital:
- Proclination
- Retraction
- Distalisation,
- Mesialisation
- Crown tipping/root torque
Transverse:
- Expansion
- Constriction
- Root tipping/root torque
What is orthodontic treatment difficulty influenced by?
- Number of teeth to be moved
- Distance teeth need to be moved
- Direction of tooth movement (intrusion most difficult)
- Jaw movements needed
- Biological tissue response (not within control)
- Patient’s compliance eg. OH (not within control)
Why is tooth intrusion the most difficult?
Requires reorganization of fibroblasts/PDL + blood vessels
