ORTHODONTIC ASSESSMENT Flashcards
Why would an orthodontic assessment be undertaken?
- determine if any malocclusion is present
- identify any underlying causes
- decide if treatment is indicated
When is the best time to do an orthodontic assessment?
- Brief exam at 9/10 YEARS OLD (mixed dentition stage)
- COMPREHENSIVE EXAM AT 11-12 YEARS OLD (when premolars and canines erupt)
What is the IDEAL OCCLUSION?
The ‘Gold Standard’ hypothetical perfect occlusion
What is a malocclusion?
Significant deviations from the ‘ideal’ that may be considered unsatisfactory (aesthetically or functionally)
What are Andrews 6 Keys (1972)?
- Molar relationship
- Crown angulation
- Crown Inclination
- No rotations
- No spaces
- Flat occlusal planes
Describe the molar relationship in the ideal occlusion:
Molar relationship = the distal surface of the disto-buccal cusp of the upper first permanent molar occludes with the mesial surface of the mesio-buccal crust of the lower second permanent molar
What medical condition may contra-indicate getting removable ortho appliances?
Epilepsy
Can patients getting MRI scans get braces?
NO
how can PDH affect orthodontic treatment?
- frequency of attendance
- nature of previous treatment
- co-operation with previous treatment
- trauma to permanent dentition (take radiographs in these patients)
how can social/family history affect orthodontic treatment?
- travelling/distance time
- car owner/public transport
- parent work
- school exams
What are the effects of a digit sucking habit in a patient?
Malocclusion!!!
What habits can have an effect on Ortho Treatment?
- thumb sucking
- lower lip sucking
- tongue thrust
- chewing finger nails
When performing an extra-oral orthodontic exam, what is involved?
- skeletal bases
- soft tissue
- TMJ
What can be a good guide when looking at a paediatric orthodontic patient?
Look at parent!
How do you asses the skeletal bases CLINICALLY in a pateint?
Visual assessment (orientate patient to look straight ahead) and look to see where soft tissue A point & B point are
Palpate skeletal bases (point A & B)
How can Class I occlusion be described?
maxilla 2-3mm in front of mandible
How can Class II occlusion be described?
maxilla more than 3mm in front
How can Class III occlusion be described?
mandible in front of maxilla
What vertical measurements are taken in an extra-oral orthodontic examination?
- Frankfort Mandibular Planes Angle
In patients with an increased FMPA angle, what might you see?
Anterior open bite
In patients with an reduced FMPA angle, what might you see?
Deep bite
what assessment may be taken in an extra-oral orthodontic exam?
Look at the mid sagittal reference line
What are competent lips?
Lips that meet at rest (with no mentalis muscle activation)
What are incompetent lips?
Lips that do not meet at rest
What can happen as a result of a lip trap?
Proclined upper incisors
What can a tongue thrust cause?
Anterior open bite
What are the occlusal effect of a thumb sucking habit?
- proclination of upper anteriors
- retroclination of lower anteriors
- localised anterior open bite or incomplete open bite
- narrow upper arch
If a patient is still sucking their thumb at 9 years old and you get them to stop what will happen?
teeth with correct themselves
What is involved in the TMJ examination during an orthodontic assessment?
- path of closure
- range of movement
- pain
- click from joint
- deviation on opening
- muscle tenderness
What is assessed in the intra-oral orthodontic exam?
- oral hygiene & periodontal health
- teeth present
- quality of teeth
