Orthodontic Diagnosis Flashcards
What would PMH establish?
- Contra-indications to prolonged tx
- Possible difficulties associated with xla - GA, LA, removable or fixed appliances
Why does Family History need to be assessed?
- Note any similar dental irregularities
- Familial skeleteal discrepancies
- History or prior Ortho tx for other family members helping to assess co-operation
What is assessed during EO examination?
What should be noted about each aspect?
- Antero-posterior (A and B points assessed and discrepancy noted using skeletal I, II or III, mild, moderate, severe)
- Vertical (FMPA assessed. 27 degrees normal, note if average, increased or decreased)
- Lateral (note and gross asymmetry)
What should be noted about the lips?
- Form and posture of lips at rest
- Note whether the lower lip covers 1/3 of the upper incisor teeth
- Type of anterior oral seal (lip to lip, lower lip to palate, lower lip to tongue)
- Competency (NB: that if lips are separated by proclined upper incisor and are of adequate length to come together when the dental interference is removed it is termed ‘potentially competent’)
In what cases is mandibular deviation usually displayed?
- Certain Class II div 1 and div 2 cases habitually posture their mandibles in a forward position
- Pts showing lateral narrowness of the max arch may have initial contact of the cheek followed by lateral and/or forward mandibular displacement
- Class III incisor relationships may have initial contact of the incisor teeth followed by lateral and/or forward mandibular displacement
What is assessed in the IO exam?
- Teeth present (supplemental/missing etc.)
- Caries (estimate the prognosis of teeth which can affect tx planning)
- OH (poor OH is a contra-indication to Ortho tx)
5 things to mention when describing an anterior picture of teeth
- Incisor relationship
- OJ
- OB
- Centre line
- Anterior crossbites
5 things to mention when describing a posterior pictures of teeth
- Canine relationship RHS (if any deviation, by how many units?)
- Canine relationship LHS (with units)
- Molar relationship RHS (with units)
- Molar relationship LHS (with units)
- Posterior crossbites (bilateral or unilateral)
5 things to mention when describing a occlusal view pictures of teeth
- Teeth present (permanent, mixed, primary dentition)
- Arch form (U, V?)
- Symmetrical
- Labial segment (proclination, crowding, spacing, rotations)
- Buccal segment (proclination, crowding, spacing, rotations)
What to mention when describing a full facial picture (7 points)
Skeletal pattern
- AP and whether it is mild, moderate or severe
- Vertical (FMPA or look at glabella, A point and B point and compare upper face height to lower)
Lips
- Competency
- Lip form (thin or thick)
- nasolabial angle
- nasomenlal fold
- Lips in relation to E line
Objective of Radiographs (5 points)
- Whether full dentition is developing (look for missing 8s, 5s, 2/2 or lower incisors and note supernumerary/supplemental teeth)
- The position, angulation and form of unerupted teeth (e.g. upper 3s, dilacerations)
- Presence of active caries
- Bone levels and root form
- Other conditions - pathology
What to mention when summarising a case (8 points)
- Age, RMH or RDH
- Skeletal pattern, vertical dimension and soft tissue pattern
- Teeth present
- Crowding (with units) and other local factors (e.g. missing teeth)
- Incisor relationship
- Molar relationship
- IOTN
- Any other relevant factors
4 main aetiological factors contributing to malocclusion
- Skeletal
- Soft tissues
- Local factors e.g. supernumeraries, habits etc.
- Dental
- Tooth tissue disproportion - generalised crowding
- Assessment of potential crowding - localised (if there has been any premature loss of deciduous teeth and mesial space closure by posterior teeth and some migration round arch of anterior teeth
