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4th yr- CCD2- Ortho > orthodontic assessment > Flashcards

orthodontic assessment Flashcards

1
Q

What steps do we take before coming to a diagnosis

A
  1. History
  2. Extra oral exam
  3. Intra oral exam
  4. Special tests
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2
Q

What do we look for when we do our extra oral examination from an ortho point of view

A
  1. View patients head from front, side, above and below
  2. Assess hard and soft tissues in 3 planes
  3. TMJ
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3
Q

Name the 3 planes we assess the hard and soft tissues in in an extra oral exam

A
  1. Antero-posterior
  2. Vertical
  3. Transverse
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4
Q

How do we assess the anterior posterior plane

A
  1. Assess in natural head position

2. Cab use the kettle method or just visually assess

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5
Q

What is the kettles method

A

Using your index and pointing finger palpate patients upper and lower jaw and determine if your fingers are portioning straight, upwards or downwards

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6
Q

What does it mean if your fingers are pointing downwards when carrying out kettles method

A

Class 2 skeletal structure

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7
Q

What does it mean if your fingers are pointing upwards when carrying out kettles method

A

Class 3 skeletal base

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8
Q

What does it mean if your fingers are pointing straight when carrying out kettles method

A

Class 1 skeletal base

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9
Q

What is an alternative to the kettle method

A

The zero meridian line

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10
Q

What is the zeros meridian line also known as

A

True vertical line

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11
Q

How do we determine where the zero meridian line is

A
  1. Get patient to look forward
  2. Drop an imaginary line vertical from the soft tissue nasian (top of nose)
  3. Assess the relationship of the lower lip and chin to this line
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12
Q

Describe what you might see in a Class 1 skeletal base in relation to the zero meridian line

A
  1. A ‘balanced’ profile
  2. The upper lip rests on it slightly ahead of the zero meridian line
  3. Chin lies slightly behind the zero meridian line
  4. Mandible lies 2-4mm behind the maxilla on palpation
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13
Q

Describe what you would see in an class 2 skeletal base in relation to the zero meridian line

A
  1. Mandible appears further behind the maxilla
  2. Chin lies behind the zero meridian line
  3. Retrusive mandible
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14
Q

Describe a patient with a class 3 skeletal base in relation to the zero meridian line

A
  1. Mandible appears ahead of the maxilla
  2. Chin lies ahead of the zero meridian line
  3. The upper lip may be close to or behind the zero meridian line
  4. Protrusive mandible and/or retrusive maxilla
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15
Q

What do we look for if we suspect a retrusive maxilla

A
  1. Paranasal hollowing
  2. Flat infra-orbital margins
  3. Flat zygomas (cheekbones)
  4. In severe cases sclera (white part of eye) may be visible below iris
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16
Q

How do we assess the vertical plane of a patient

A
  1. Rule of equal thirds
  2. Frankfort Mandibular planes angle (FMPA)
  3. Centrelines
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17
Q

What is the rule of equal thirds

A

Approx equal thirds between:

  1. Hairline (trichion) to between the eyebrows (Glabella)
  2. Glabella to base of nose (subnasale)
  3. Subnasale to bottom of chin (menton)
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18
Q

What is the upper anterior face height

A

I he distance between the glabella (between eyebrows) and subnasale (base of nose)

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19
Q

What is the lower anterior face height

A

Distance between the subnasale (base of nose) and menton (bottom of chin)

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20
Q

How do we assess if the lower anterior face height is normal

A

Compare it to the upper anterior face height if they are approximately equal then that it average

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21
Q

Where does Frankfort’s plane run

A

From the bony infra orbital margin to external auditory Meatus

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22
Q

Where does the Mandibular plane run

A

Along the lower border of the mandible

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23
Q

What is an average Frankfurt Mandibular planes angle

A

Where they meet at the occiput

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24
Q

What is an increased Frankfurt Mandibular planes angle

A

Where they meet before the occiput

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25
Q

What is a decreased Frankfurt Mandibular planes angle

A

Where they meet behind the occiput

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26
Q

How do assess the transverse plane in a patient

A
  1. Assess from above below and in front
  2. Compare between bilateral structure
  3. Compare to facial Midline
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27
Q

Where may asymmetry be seen?

A
  1. Mandible
  2. Nose
  3. Maxilla and mandible
  4. Orbits
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28
Q

Give examples of soft tissues we loom at in our extra oral exam

A
  1. Lips

2. Tongue

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29
Q

What do we look at when examining the lips

A
  1. Are the competent?
  2. Length
  3. Naso-labial angle
  4. Relationship of lower lip to upper incisors
  5. Relationship of upper lip to upper incisors
  6. Smile aesthetics
  7. Tone / fullness
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30
Q

What is the average value of the Naso-labial angle

A

90-110 degrees

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31
Q

How much of the upper incisors is seen at rest

A

3mm on average but reduced with age

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32
Q

What is a lower lip trap

A

When the lower lip functions behind the upper incisors

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33
Q

In whom is a lower lip trap more common

A

Patients with class II division 1 malocclusion

34
Q

Why is a lower lip trap a concern

A

As the activity of the lower lip proclaimed the upper incisors further increasing the patients overjet

35
Q

What is a high lower lip line

A

Where the lower lip covers the upper central incisors and retroclines them

36
Q

What can a high lower lip line lead to

A

Class II division 2 malocclusion

37
Q

What is an adaptive tongue thrust

A

When the lips are incompetent and the tongue thrusts forward to contact the lips and create an oral seal

38
Q

What can an adaptive tongue thrust lead to

A

Reduced overbite/ anterior open bite

39
Q

How do we classify crowding

A

Mild medium and severe

40
Q

How do we define mild crowding

A

0-4mm crowding

41
Q

How do we define medium crowding

A

4-8mm crowding

42
Q

How do we define severe crowding

A

More than 8mm crowding

43
Q

How do we describe incisor relationship

A

Class I, II, III, IV

44
Q

Describe a class I incisor relationship

A

The lower Incisor edges occlude or lie immediately below the cingulum plateau of the upper central incisor

45
Q

Describe a class II division 1 incisor relationship

A

The lower incisor edges lie posterior to the cingulum plateau of the upper incisors
Generally incisors are proclined and there is an increased overjet

46
Q

Describe a class II division 2 incisor relationship

A

The lower incisor edges lie posterior to the cingulum plateau of the upper informs and upper central incisors are retroclined
Overjet usually minimal

47
Q

Describe a class III incisor relationship

A

When the lower incisor edges lie antihero to the cingulum plateau of the upper incisors

48
Q

What is an overjet

A

The distance between the lower and upper incisors in the horizontal plane

49
Q

State a normal overjet

A

2-4mm

50
Q

What is a reverse overjet

A

The lower incisors low anterior to the upper incisors

51
Q

What is an anterior cross bite

A

When only 1 or 2 incisors are involved in the occlusion

52
Q

What is an overbite

A

The vertical overbite of the upper and lower incisors

53
Q

What is the upper centreline determined by

A

The facial midline

54
Q

What is the lower centreline determined by

A

The chin point

55
Q

What is buccal segment relationship looking

A

The molar teeth

56
Q

How do we classify buccal segment relationships

A

Class I, II, III

57
Q

Describe a class I buccal segment relationship

A

The media buccal cusp of the upper 6 rests in the lower 6 anterior buccal groove

58
Q

Describe a class II buccal segment relationship

A

If the media buccal cusp of the upper 6 rests in front of the anterior buccal groove of the lower 6

59
Q

Describe a class III buccal segment relationship

A

The upper and lower 6 don’t occlude

60
Q

What does canine relationship tell us

A

Describes the relationship of the top of the upper canine to the embrasure space between the lower canine and first premolar

61
Q

How do we classify canine relationship

A

CLASS I, II, III

62
Q

Describe a class I canine relationship

A

Direct intercsupatuon of the upper canine and the embrasure between the lower canine and first premolar

63
Q

Describe a class II canine relationship

A

When the upper 3 tip is medial the embrasure Space between the lower 3 and 4

64
Q

Describe a class III canine relationship

A

When the U3 tip is distal to the embrasure space between the L3 and L4

65
Q

What is a posterior cross bite

A

Transverse discrepancy in the buccolingual relationship of the upper and lower teeth

66
Q

What is a buccal cross bite

A

When the buccal cusps of the lower teeth occlude buccal to the buccal cusps of the upper teeth

67
Q

What is a lingual crossbite

A

When the buccal cusps of the lower teeth occlude lingual to the palatial cusps of the upper teeth

68
Q

What do you usually find in a patients with a Mandibular crossbite

A

Mandibular displacement

69
Q

What is Mandibular displacement

A

On closure from the rest position there is a premature occlusal contact which causes the mandible to be displaced to the left or right

70
Q

What special tests can we take to assess orthodontics

A
  1. OPT
  2. Intraoral radiographs
  3. Lateral cephalogram
  4. Cone beam CT
71
Q

Why might we take an OPT to assess orthodontic need

A
  1. Screening for pathology
  2. Assessment of root form and length
  3. Assessment of bone levels
  4. Confirming the presence, position and morphology of unerupted teeth
72
Q

Why might we take a Lateral cephalogram to assess orthodontic need

A
  1. Assess skeletal relationship and incisor position
  2. Aid treatment planning
  3. Monitor treatment progress
  4. Monitor growth
73
Q

Why might we take a cone beam CT to assess orthodontic need

A
  1. More accurate localisation and assessment of unerupted teeth
  2. More accurate assessment of pathology
  3. TMJ
  4. Airway analysis
74
Q

After carrying out your investigations what do you want to come to

A

An index of orthodontic treatment needs

75
Q

What does the index of orthodontic need aim to do

A

Rank malocclusion in terms of the significance of various occlusal traits for a person dental health and perceived aesthetic impairment

76
Q

What are the two parts that make up the index of orthodontic need

A
  1. Dental health

2. Aesthetic component

77
Q

What does the dental health component of the index of orthodontic need sun to do

A

Categorise occlusal traits that could have a detrimental effect on the dentition and supporting structure

78
Q

How is the dental health component of the IOTN categorised

A

Five grades ranging from 1 (small deviations) to 5(severe malocclusion)
15 letters also assigned to Indicate specific occlusal abnormalities

79
Q

What does the mnemonic MOCDO stand for

A 
Missing teeth 
Overjet
Crossbite
Displacement
Overbite
80
Q

Why do we use the mnemonic MOCDO

A

If a patient has more than one malocclusion problem this mnemonic helps us prioritise which is the most detrimental

81
Q

What does the aesthetic component of the IOTN consist of

A

10 photographs showing different levels of dental attractiveness
1-10

4th yr- CCD2- Ortho (7 decks)

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