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4th Yr - CCD2 > Orthodontic assessment > Flashcards

Orthodontic assessment Flashcards

1
Q

How do we history take?

A
  • MH
  • PDH
  • trauma history
  • how old/ mature is pt?
  • their concerns and parents concerns
  • does family members concerns match with pt
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2
Q

what other factors do we need to consider before examining the pt?

A
  • does pt know what to expect
  • will the pt be able to tolerate braces: 2 yrs wear average, fixed or removable, appts every 6-8 weeks, excellent OH and safe diet
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3
Q

What things do we need to consider when taking social history/ family history?

A
  • are they/ family motivated to have tx
  • are they willing to wear braces
  • are they able to attend regular appts
  • what do they do? (school, uni, job)
  • family history for certain malocclusions eg. hypodontia, class 3
  • have other family members had orthodontist tx
  • for children, find out if they have right to consent
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4
Q

what things do we need to consider when taking dental history ?

A
  • regular attender?
  • any current dental issues
  • awaiting any dental tx?
  • past tx eg. extractions/ restorations = can tell if they can tolerate oath
  • trauma
  • TMJDS
  • developmental anomalies eg. hypodontia
  • habits eg. nail biting, pen chewing, = need to stop as it can damage teeth
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5
Q

other than teeth what else are we looking at?

A

extraoral
do the teeth look good within the pts face

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6
Q

how do we do an extra oral ortho assessment?

A
  1. view pts head from front and sides
  2. assessing hard and soft tissues in 3 planes of space= antereo-posterior, vertical and transverse
  3. TMJ = pain, clicks, locking, deviation of mandible on opening and closing
  4. skeletal = AP, class 1,2,3, symmetry, vertical (average, decreased, increased),
  5. soft tissues
  6. habits
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7
Q

how do we assess antero-posteriorly ?

A
  1. natural head position (eye looking straight into mirror)
  2. Frankfort plane (can be seen in xrays) maybe used as a substitute
    (anthropological measurement) we use ALR tarsal plane clinically
  3. assessed AP visually or by kettle method
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8
Q

what is the zero meridian line?

A
  • vertical imaginary point dropped from soft tissue nasion
  • should be perpendicular to the floor if pt in natural head position
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9
Q

what is the ideal AP relationship?

A
  • AP class1
  • face appears well balanced
  • mandible 2-4mm posterior to maxilla
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10
Q

how do we use kettles method to check skeletal pattern and its severity

A
  • palpate soft tissues A and B
  • A= most concave bit of maxilla when you’re looking you’re looking AP
  • B= most concave bit of mandible

class 1 class 2 class 3

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11
Q

what are the cons of using kettle method?

A
  • very arbitrary eg. depends of length of fingers
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12
Q

what is class 2 AP 3?

A
  • mandible more posterior (retruded) than class 1 cases
  • due to: maxilla being too far forward or more commonly mandible being too far back (retrognathia)
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13
Q

what is class 3 AP?

A
  • mandible is further anterior (protruded) than the maxilla
  • maybe due to: mandible being too large (prognathic), maxilla being too far back (retrognathic)/ too small (hypo plastic) or combination of 2
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14
Q

what is maxillary retrognathia/ hypo plastic ?

A
  • paranasal hollowing (hollowing on sides of face )
  • flat infraorbital margins, flat zygoma (cheekbones)
  • severe cases whites of eyes (sclera) visible below iris
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15
Q

How do we measure vertically?

A

Frankfort mandibular plane angle

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16
Q

how do we measure FMPA?

A
  • from bony infra orbital margin to external auditory meatus; visible on radiograph (clinically = alar-tragal line)
  • mandibular plane runs along the lower border of the mandible
  • we are seeing where the 2 points intersect
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17
Q

what is classed as average vertical FMPA?

A

meet at occiput

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18
Q

what is classed as increased FMPA ?

A

meet before occiput

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19
Q

what is classed as decreased FMPA?

A

meet behind occiput

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20
Q

what are the other ways in which w can measure vertically ?

A
  • face split into thirds
  • in well balanced face thirds are of equal measurement
  • Lower anterior face height (LAFH) is assessed in relation to upper anterior face height (UAFH)
  • Average: LAFH=UAFH
  • increased: LAFH>UAFH
  • decreased: LAFH<UAFH
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21
Q

what is transverse measurements?

A
  • symmetry
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22
Q

how do we assess transversely?

A
  • asses form above, below and in front
  • comparison to facial midline
  • companions between bilateral structures eg. eyes, ears
  • need to look at whole face (panfacial)
  • imagine drawing line in facial midline = if upper face symmetrical then identify mid point of chin if it censicdes with facial midline = mandible is symmetrical
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23
Q

what is the neutral zone?

A
  • bit in mouth in between lips tongue cheek and where the teeth naturally rest
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24
Q

what things affect neutral zone ?

A

thumb sucking
tongue thrust
sucking cheeks in
affects palate, development of teeth and neutral zone

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25
Q

how do we measure lips orthodontically?

A

1.are they competent (can bring lips together) or incompetent, children can but as they get older they can
2. lip length = from nasal to lip and lower lip
3. nasolabial angle = angle between nose and lip
4. relationship between lower lip and upper incisors
5. relationship between upper lip and upper incisors - at rest max 3mm incisor show, older you get less incisor show
6. tone = flaccid or strap like lower lip usually seen in class 2 div 2 (top teeth pushed back)
7. smile aesthetic = slight gingiva display in full smile considered attractive

26
Q

what does habitual competent lips mean?

A
  • puckering of the skin over the mentalis muscle is a sign of muscular activity to keep lips together
27
Q

how do we measure naso-labial angle?

A

between 90 to 110 degrees

28
Q

what is the lower lip trap ?

A
29
Q

what is a strap like lower lip?

A
30
Q

why is gingival show important?

A
  • can make person look older if not showing
31
Q

what can lip tone be described as?

A
32
Q

questions we ask when tongue is at rest?

A
  • does it rest against teeth or palate
  • If sits forward between the incisors can lead to = anterior open bite (AOB)
  • if it pushes against the palatal surfaces of the incisors can lead to = proclination and spacing
33
Q

questions we ask about the position of tongue when speaking ?

A
  • can you see tongue protruding when the patient is speaking?
  • if thrusts forwards between the teeth - can also lead to proclamation, spacing, AOB and lisping
34
Q

what is an adaptive tongue thrust?

A
  • when lips are incompetent, tongue thrusts forward to contact the lips and create an oral seal
  • can lead to reduced overbite/ anterior open bite
  • if tx can aid lip competence this usually ceases
35
Q

what is an endogenous tongue thrust?

A
  • habitual - correcting the Mal occlusion unlikely to change this
  • high risk of relapse even with retention
  • can’t always distinguish from adaptive
36
Q

tongue size

A
  • large tongues/ small arches may have similar implications to tongue thrust - look from crenelations (indentations along the borders
  • not a lot that can be done
37
Q

how do we examine TMJ in relation to ortho?

A
  • examine as normal - not any abnormal findings
  • assess signs and symptoms of TMD
  • ideally treat symptoms conservatively prior to orthodontist tx: refer for specialist advice if cons management ineffective
  • no strong evidence that ortho tx can either cause or cure TMJDS
38
Q

IOE esp in paeds pts

A
  • know eruption dates
  • know root formation
  • calcification dates
  • be aware of missing teeth and supernumeraries
39
Q

dental overview

A
40
Q

what are we looking for when assessing lower and upper arches ?

A
  • crowding/ spacing/ rotating
  • proclaimed/ retroclined
  • arch form
41
Q

what are we looking for when assessing occlusion?

A
42
Q

crowding

A
43
Q

what is class 1 ?

A
44
Q

what is class 2 div 1?

A
45
Q

what is a class 2 div 2?

A
46
Q

what is a class 3 ?

A
47
Q

what is an overjet?

A
48
Q

overbite?

A
49
Q

describe increased and complete Bite

A
50
Q

describe decreased and complete

A
51
Q
  1. increased overbite 2. average overbite 3. decreased overbite
A
51
Q

what are the different types of open bites ?

A
  • anterior can be due to habits such as thumb sucking or just skeletal development
52
Q

definition of centrelines and how we measure

A
53
Q

what is a buccal segment relationship ?

A
54
Q

what is the molar relationship ?

A
55
Q

What is angle’s molar classification: class 1 ?

A
56
Q

what is angle’s molar classification: class 2?

A
57
Q

what is angle’s molar classification:class 3?

A
58
Q

what is half unit class 2?

A
59
Q

how do we describe canine relationship?

A

4th Yr - CCD2 (12 decks)

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