Ortho treatment planning

Question 1

What are the general principles of a treatment plan

Answer 1

History

Examination

Diff. diagnosis (list of probables)

Special tests

Diagnosis (description/IOTN)

Treatment plan

Treatment

Outcome

Question 2

What do you do in the diagnosis stage

Answer 2

Description of the malocclusion
-e.g. class II div I incisor relationship

Determine the causes of the malocclusion
-small teeth = spacing,
-early loss of deciduous teeth = crowding
-digit sucking = proclination and increased OJ

Are the causes dentoalveolar or skeletal?

Question 3

How do you get a diagnosis

Answer 3

Lateral Cephalogram
 AP skeletal
 Vertical skeletal
 Class III incisors

Cephalometry

Question 4

Whis the correct orthodontic diagnosis important

Answer 4

Orthodontic appliances can move teeth very well,
but can modify skeletal relationship minimally

A severe skeletal discrepancy may require
surgical intervention

Question 5

What is the objectives of ortho treatment

Answer 5

To create a occclusion that is:

Stable

Functional

Aesthetic

Question 6

What are the stages of treatment planning

Answer 6

1. Plan around the lower arch (angulation of LLS is stable)
2. Decide on treatment in lower (ext/nonext)
3. Build upper arch around lower, aim for class I incisor and canine relationship
4. Decide on molar relationshipClass I or full unit class II molar relationship

Question 7

Wha are the aims of treatment

Answer 7

Full correction of malocclusion

-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’s six keys)

Question 8

When examining the lower arch what are you looking for

Answer 8

Crowding / Angulation of incisors Mand plane

Angulation of the canines / Centrelines

Curve of Spee

Question 9

When examining the upper arch what are you looking for

Answer 9

Crowding /Angulation of incisors to the Max Plane

Angulation of the canines / Centrelines

Question 10

When loking at teeth in ICP what are you looking for

Answer 10

Incisor relationship

OJ

OB (curve of Spee)

Centrelines

Canine relationship

Molar relationship

Question 11

When assessing crowding what do you do

Answer 11

Measure space available and space required

Question 12

How do you measures space available when assessing crowding

Answer 12

by examining the size and shape of the dental arch, the position of the teeth, and the amount of space between the teeth

A+B+C+D= arch length or space available

Question 13

How do you measures space required when assessing crowding

Answer 13

By estimating thr width of all the teeth anterior to first permanent molars

1+2+3+4+5+6+7+8+9+10 = space required

Question 14

Estimate the degree of crowding if:

 Space available = 69mm
 Space required = 74mm

Answer 14

Discrepancy= -5mm

Question 15

What other ways is there to estimate crowding

Answer 15

overlap technique

Question 16

What is the overlap technique

Answer 16

It involves measuring the amount of overlap between the mandibular teeth in the anterior region of the mouth, typically from canine to canine then adding it up

e.g. the 32 and 31 overlap by 0.5mm

Question 17

If there is space required in the lower arch what are the general principles of treratment

Answer 17

Depens ofn the degree of space required

Mild (0-4mm)= stripping or XLA of 5’s

Moderate (5-8mm)= XLA of 4 or 5’s

Severe (8+mm)= XLA of 4’s

Question 18

What is stripping in ortho

Answer 18

also known as interproximal reduction (IPR), is a technique used in orthodontics to create space between teeth. It involves removing a small amount of tooth enamel from the sides of adjacent teeth, typically in the interproximal areas (between the teeth), using a special dental strip or a rotating disc

Question 19

If you carried out lower arch XLA what do you do

Answer 19

Extract in upper arch
(MR class I)

Question 20

If didn’t you carried out lower arch XLA what do you do

Answer 20

Extract in upper arch(MR class II)

Distalise UBS using headgear(MR Class I)

Question 21

What are the treatment options

Answer 21

1. Accept malocclusion
2. Extractions only
3. URA (+/- extractions)
4. Functional appliances (+/- extractions)
5. Fixed appliances (+/- extractions)
6. Complex treatment involving orthodontics
   and restorative treatment or orthodontics
   and orthognathic surgery