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BDS3 CLINICAL Ortho > Orthodontic Assessment > Flashcards

Orthodontic Assessment Flashcards

1
Q

Why do we do an orthodontic assessment?

A

to determine if any malocclusions are present

identify any underlying causes

decide if treatment is indicated (either refer or devise treatment plan)

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2
Q

What age do we do a brief ortho exam

A

9 years old

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3
Q

What age do we do a comprehensive examination

A

when the premolars/canines erupt so 11/12 years

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4
Q

When do we do an ortho examination

A

when older patients first present

if a malocclusion develops later in life

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5
Q

What is the ideal occlusion

A

hypothetical

rarely found in nature

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6
Q

What are Andrews 6 keys for ideal occlusion

A 
Molar relationship
crown angulation (mesio-distal top)
crown inclination
no rotations
no spaces
flat occlusal planes
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7
Q

Describe the molar relationship seen in Andrews 6 keys

A

the distal surface of the disto-buccal cusp of the upper first permanent molar occludes with the mesial surface of the mesio-buccal cusp of the lower second permanent molar

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8
Q

What is a normal occlusion

A

more commonly observed than ideal occlusion

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9
Q

What is a minor deviation occlusion

A

do not constitute an aesthetic or functional problem

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10
Q

What is a malocclusion

A

more significant deviations from the ideal that may be considered unsatisfactory (aesthetically or functionally)

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11
Q

What are significant factors in the past medical history

A

allergy (Ni or Latex)
epilepsy/drugs
drugs
imaging

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12
Q

What are significant factors in the past dental history

A

frequency of attendance
nature of previous treatment
co-operation with previous treatment
trauma to permanent dentition

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13
Q

What are habits that are relevant to ortho

A

thumb sucking
lower lip sucking
tongue thrust
chewing finger nails

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14
Q

When doing an extra oral exam what do we look at

A

skeletal bases
soft tissues
TMJ

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15
Q

What do we compare the patient to parent for

A 
malocclusion - especially class III
growth potential
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16
Q

What do the teeth sit on

A

individual skeletal bases which are connected to the skull bases

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17
Q

What happens if you have an increased cranial base angle

A

then the posterior and anterior cranial bases are at a higher angle and there is a tendency for a large overjet as the mandible is further back

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18
Q

What planes is a facial skeletal pattern considered in (looking at the skeletal bases)

A

antero-posterior
vertical
transverse

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19
Q

How is the skeletal assessment done in the anteroposterior plane

A

via visual assessment

palpate the skeletal bases

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20
Q

How should the head be positioned for an extra oral examination

A

Frankfurt plane horizontal to the floor

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21
Q

What is a class I (AP skeletal assessment)

A

maxilla 2-3mm in front of mandible

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22
Q

What is a class II (AP skeletal assessment)

A

maxilla more than 3mm in front

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23
Q

What is a class III (AP skeletal assessment)

A

mandible in front of the maxilla

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24
Q

What is the function of direct palpation of the skeletal bases

A

can see how bases relate to one another

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25
Q

How is the vertical skeletal assessment done

A

by look at the angle between the frankfort plane and the mandibular plane angle

want to see where these two lines meet - should meet at the back of the head

26
Q

What is the mandibular plane angle

A

it is the lower border of the mandible

27
Q

What should be expected if the FMPA meets before the back of the head

A

will be expecting minimal overbite or an anterior open bite inside the mouth

would expect no contact with the front teeth as the back teeth meet first

28
Q

If there’s a reduced FMPA angle what is expected

A

the two lines don’t meet at the back fo the head

expect them to have a deep bite, the jaws are too close together

29
Q

How is the skeletal assessment done laterally

A

look at the mid saggital reference line

can pick up mandibular asymmetry

30
Q

What should we look at when looking at the lips in the EO exam

A

competent/incompetent
lower lip level
lower lip active

31
Q

What should we look at when examining the tongue in the EO exam

A

position, habitual and swallowing

32
Q

What should we look at with speech

A

lisping

33
Q

What are competent lips

A

meet at rest

relaxed mentalis muscle

34
Q

What are incompetent lips

A

do not meet at rest

relaxed mentalis muscle

35
Q

What is a tooth trap

A

upper teeth rest on lower lip so are proclined forward slightly

36
Q

What is the effect of a hyper active lower lip

A

may retrocline lower incisiors

indicates likely stability at the end of tx

37
Q

What is a tongue thrust associated with

A

tongue thrust on swallow is associated with anterior open bite

can be endogenous or adaptive tongue thrust

38
Q

What is the issue sometimes with treating AOB from tongue thrust

A

may cause relapse of the AOB at the end of the treatment if its endogenous

39
Q

What are the two main ways of sucking digits

A

if its a thumb it causes asymmetrical problem

if two digits causes symmetrical problem

40
Q

What is the occlusal effect of sucking a thumb

A

proclamation of upper anteriors
retroclincation of lower anteriors
localized AOB or incomplete OB
narrow upper arch with or without a unilateral posterior cross bite

these effects will be superimposed by the existing skeletal pattern and incisors relationship which can make the issue worse

41
Q

When examining the TMJ what should we examine

A 
path of closure
range of movement
pain, click from joint
deviation on opening
muscle tenderness
42
Q

What should we look out for when examining the TMJ

A

mandibular displacement

discrepancy in RCP and ICp

43
Q

What should we check for the intra oral examination

A 
OH and periodontal health
count teeth 
teeth of poor prognosis
assess crowding/spacing/rotations 
inclination/angulation
palpate for canines if not erupted
note teeth fo abnormal shape or size
44
Q

What should we look at in the IO exam for the lower arch

A

degree of crowding
presence of rotations
inclination of canines
angulation of incisors to mandibular plane

45
Q

What should we look at in the IO exam for the upper arch

A

degree of crowding
presence of rotations
inclination of canines
angulation of incisors to frankfort plane

46
Q

What kind of angle do we want for the angulation of incisors to the frankfurt plane

A

110 degrees

47
Q

What do we look at when the teeth are in occlusion when the teeth are in maximum interdigitation or Rcp

A 
incisor relationship 
over bite/open bite
molar relationship (angle's classification)
canine relationship
cross bites
centre lines
48
Q

What are the different incisor relationships

A

Class I
Class II - div 1 and div 2
Class III
overjet, overbite, centrelines

49
Q

What is a class I incisor relationship

A

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

50
Q

What is a class I incisor relationship

A

the lower incisor edges lie posterior to the cingulum plateau of the upper incisors

51
Q

What is a class II incisor relationship

A

the lower incisor edges lie posterior to the cingulum plateau of the upper incisors

52
Q

What is a class II div 1 incisor relationship

A

the upper incisors are proclined or of average inclination and there is an increase in overjet

53
Q

What is a class II div 2 incisor relationship

A

the upper central incisors are retroclined

the overjet is usually minimal or may be increased

54
Q

What is a class III incisor relationship

A

the lower incisor edges lie anterior to the cingulum plateau of the upper incisors

overjet is reduced or reversed

55
Q

What is an overbite

A

overlap of the teeth

56
Q

What is an average overbite

A

upper incisors cover 1/3 to 1/2 of lower incisor crowns

57
Q

What are the diff types of overbites

A 
average
reduced
AOB
increased and complete contacts tooth 
increased and complete contacts palate 
increased but incomplete
58
Q

What is Angles classification

A

buccal segment

class I 
class II
class III

crossbones

59
Q

What are the different canine relationships

A 
class II 
class II 
class III

won’t get good ortho results if canine relationship is not class I

60
Q

What are special investigations that can be done prior to ortho

A 
OPT
maxillary anterior occlusal
lateral ceph 
vitality tests
study models
photographs
61
Q

What do we do from the info we got in the assessment

A

summarise important points
assess treatment needs
devise treatment aims if appropriate
plan treatment

62
Q

Describe an ortho summary

A

name, age, sex

HPC, RMH, RDH

incisor relationship, skeletal base, ST

teeth present/absent, OH, poor prognosis

lower arch, incisor inclination, crowding

upper arch, incisor inclination, crowding

OJ, OB, centrelines, molar relationship, crossbones, miscellaneous

IOTN score

BDS3 CLINICAL Ortho (11 decks)

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