Ortho treatment planning Flashcards
What are the general principles of a treatment plan
History
Examination
Diff. diagnosis (list of probables)
Special tests
Diagnosis (description/IOTN)
Treatment plan
Treatment
Outcome
What do you do in the diagnosis stage
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?
How do you get a diagnosis
Lateral Cephalogram
AP skeletal
Vertical skeletal
Class III incisors
Cephalometry
Whis the correct orthodontic diagnosis important
Orthodontic appliances can move teeth very well,
but can modify skeletal relationship minimally
A severe skeletal discrepancy may require
surgical intervention
What is the objectives of ortho treatment
To create a occclusion that is:
Stable
Functional
Aesthetic
What are the stages of treatment planning
- Plan around the lower arch (angulation of LLS is stable)
- Decide on treatment in lower (ext/nonext)
- Build upper arch around lower, aim for class I incisor and canine relationship
- Decide on molar relationshipClass I or full unit class II molar relationship
Wha are the aims of treatment
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)
When examining the lower arch what are you looking for
Crowding / Angulation of incisors Mand plane
Angulation of the canines / Centrelines
Curve of Spee
When examining the upper arch what are you looking for
Crowding /Angulation of incisors to the Max Plane
Angulation of the canines / Centrelines
When loking at teeth in ICP what are you looking for
Incisor relationship
OJ
OB (curve of Spee)
Centrelines
Canine relationship
Molar relationship
When assessing crowding what do you do
Measure space available and space required
How do you measures space available when assessing crowding
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
How do you measures space required when assessing crowding
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
Estimate the degree of crowding if:
Space available = 69mm
Space required = 74mm
Discrepancy= -5mm
What other ways is there to estimate crowding
overlap technique
What is the overlap technique
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
If there is space required in the lower arch what are the general principles of treratment
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
What is stripping in ortho
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
If you carried out lower arch XLA what do you do
Extract in upper arch
(MR class I)
If didn’t you carried out lower arch XLA what do you do
Extract in upper arch(MR class II)
Distalise UBS using headgear(MR Class I)
What are the treatment options
- Accept malocclusion
- Extractions only
- URA (+/- extractions)
- Functional appliances (+/- extractions)
- Fixed appliances (+/- extractions)
- Complex treatment involving orthodontics
and restorative treatment or orthodontics
and orthognathic surgery
