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BDS3 Orthodontics > Orthodontic Assessment > Flashcards

Orthodontic Assessment Flashcards

1
Q

When should an orthodontic assessment be carried out?

A
  • 9 years old
    • brief examination
  • 11-12 years
    • comprehensive examination
    • permanent premolars and canines erupted
  • older
    • malocclusion may develop in later life
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1
Q

What is the aim of orthodontic assessment?

A
  • determine if a malocclusion is present
  • identify the underlying causes
  • decide whether treatment is indicated
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2
Q

What is the ideal occlusion?

A
  • rarely found naturally
  • Andrews 6 keys
    • molar relationship
      - distal surface of distobuccal cusp of upper 6
      - occlude with medial surface of mesiobuccal of lower 6
    • crown angulation
      - mesio-distal tip
    • crown inclination
    • no rotations
    • no spaces
    • flat occlusal plane
      - no curve of spee
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3
Q

What is considered a normal occlusion and malocclusion?

A
  • normal occlusion
    • more commonly observed than ideal
  • minor deviations
    • do not constitute an aesthetic or functional problem
  • malocclusions
    • more significant deviations from ideal
    • may be unsatisfactory aesthetically or functional
    • may require treatment, patient influences decision
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4
Q

What does a history for orthodontic assessment include?

A
  • presenting complaint
  • how much it bothers the patient
  • history of presenting complaint
  • past medical history
  • past dental history
  • social/family history
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5
Q

What conditions contra-indicate orthodontic treatment?

A
  • allergies
    • nickel
      - more common in those with piercings
    • latex
      - present in elastic bands used
  • epilepsy
    • caution with removable appliances
  • drugs
    • can cause gingival hyperplasia
  • patients requiring MRI
    • missile injury possible
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6
Q

What past dental history is relevant for orthodontic assessment?

A
  • frequency of attendance
    • must be regular attenders
  • nature of previous treatment
    • cooperation with treatment
  • trauma to permanent dentition
    • can result in root resorption
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7
Q

What social/family history is relevant for orthodontic assessment?

A
  • travelling
    • distance and time to get to appointment
    • transportation
  • parents work
  • school exams
  • habits
    • thumb sucking
      - proclaimed upper teeth
    • lower lip sucking
      - proclaimed upper teeth
    • tongue thrusting
      - anterior open bite
    • chewing finger nails
      - resorption of upper central incisors
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8
Q

What extra oral examination is carried out specifically for orthodontic assessment?

A
  • facial skeletal patterns
    • antero-posterior
      - visual assessment
      - palpation of skeletal base
    • vertical
      - Frankfort mandibular planes angle (FMPA)
      - should meet at back of the head
    • transverse
      - asymmetry
      - mid-sagittal reference line
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9
Q

What could be expected when a high FMPA is measured?

A
  • limited overbite
  • anterior open bite
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10
Q

What could be expected when a low FMPA is measured?

A
  • deep bite
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11
Q

What are competent lips?

A
  • lips that meet at rest
  • related mentalis muscle
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12
Q

What are incompetent lips?

A
  • lips that do not meet at rest
  • relaxed mentalis muscle
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13
Q

What is a lip trap

A
  • upper teeth rest on lower lip
    • common with skeletal class II
    • can cause procaine of upper incisors
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14
Q

What is a hyperactive lower lip?

A
  • tense, strap like, lower lip
    • can retrocline lower incisors
  • indicates likely instability at end of treatment
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15
Q

What are the signs of a digit habit?

A
  • proclamation of upper anteriors
  • retroclination of lower anteriors
  • localised anterior open bite or incomplete open bite
  • narrow upper arch
    • sucking pulls cheeks in
    • molars meet edge to edge
  • possible unilateral posterior crossbite
  • thumb sucking
    • asymmetrical disruption of anterior occlusion
  • two digit sucking
    • symmetrical disruption of anterior occlusion
16
Q

At what age can the effects of a sucking habit be naturally reversed?

A
  • 8/9 years
    • lips will pull teeth down
17
Q

What is mandibular displacement?

A

displacement of the mandible moving from retruded contact position to intercuspal position

18
Q

What should be checked during intraoral examination of the lower arch?

A
  • degree of crowding
  • presence of rotations
  • inclination of canines
  • angulation of incisors to mandibular plane
19
Q

What should be checked during intraoral examination of the upper arch?

A
  • degree of crowding
  • presence of rotations
  • inclination of canines
  • angulation of incisors to Frankfort place
    • ~110 degrees
20
Q

What are the different types of incisor relationship?

A
  • class I
  • class II div. 1
  • class II div. 2
  • class III
21
Q

What is a class I incisor relationship?

A

lower incisor edges occlude with or lie immediately below the cingulum plateau of the central incisors

22
Q

What is a class II division 1 incisor relationship

A

lower incisor edges lie posterior to the cingulum plateau of the upper incisors.
upper incisors are proclined or of average inclination resulting in an increased overjet

23
Q

What is a class II division 2 incisor relationship?

A

lower incisor lie posterior to the cingulum plateau of the upper incisors
upper incisors are retroclined and overjet can be minimal or increased

24
Q

What is a class III incisor relationship?

A

lower incisor edges lie anterior to the cingulum plateau of the upper incisors resulting in a reduced or reversed overjet

25
Q

What are the different types of overbite?

A
  • increased, complete and in contact with tooth
  • increased, complete and in contact with palate
  • increased and incomplete
26
Q

What is a class I buccal segment relationship?

A
  • upper canine is distal to lower canine
  • mesiobuccal cusp of upper 6 lies in buccal groove of lower 6
27
Q

What is a class II buccal segment relationship?

A
  • upper canine mesial to lower canine
  • mesiobuccal cusp of upper 6 lies between lower 5 and 6
28
Q

What is a class III buccal segment relationship?

A
  • upper canine distal to lower 4
  • mesiobuccal cusp of upper 6 lies between 6 and 7
29
Q

What is a class III buccal segment relationship?

A
  • upper canine distal to lower 4
  • mesiobuccal cusp of upper 6 lies between 6 and 7
30
Q

What special investigations can be carried out for orthodontic assessment?

A
  • radiographs
    • OPT
    • maxillary anterior occlusal
    • lateral cephalogram
  • vitality tests
  • study models
  • photographs
31
Q

How is orthodontic treatment need assessed?

A
  • IOTN
    • index of orthodontic treatment need

BDS3 Orthodontics (5 decks)

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