orthodontic records and diagnosis Flashcards
which records are needed
1) two purposes
- document starting point for tx
- add to the information gathered on clinical exam
2) three categories
- eval teeth
- eval occlusion
- eval facial and jaw proportions
standard records
1) questionnaire
2) clinical exam
3) photographs
4) radiographs (CBCT)
5) study cast with bite registration
- intraoral scanner => digital models
chief complaint
1) impaired dentofacial esthetics
2) impaired function
medical and dental history reviewed
1) trauma history
- condylar fracture
- trauma to teeth
medication
1) chronic systemic diseases and metabolic problem
- diabetes, osteoporosis, arthritis
- esp. bisphosphonates slow healing and movement
other dental history
1) previous ortho
2) dental and ortho conditions
3) general dental health
4) motivation for treatment
physical growth evaluation
1) physical growth status
- rapid growth during adolescent growth spurt facilitates tooth movement and growth modification of jaws
- to determine if a child with CI II skeletal jaw is a candidate for skeletal modification treatment
2) growth charts
- sexual maturity
- weight and height
3) cephalometric radiograph
- evaluate vertebrae maturation to predict remaining growth
4) hand wrist radiograph
5) serial cephs
- ceph at different time points
- superimposition to reveal whether growth has stopped or not
*most accurate to determine ^
hand wrist radiograph
1) used for eval of skeletal age and relate to growth status
2) evaluate ossification of the bones
- capping of the middle Phalynx (6 is most important)
3) gold standard
cervical vertebrae maturation
1) peak mandibular growth between CVMS II AND III
oral health eval
1) dental caries
2) periodontal eval
- active periodontal disease
- potential or actual mucogingival problem
- inadequate attached gingiva around crowded incisors indicates possibility of tissue dehiscence when teeth are aligned
evaluation of jaw and occusion
1) mastication
2) swallowing
3) speech
4) jaw function
facial proportions
1) symmetry and balance
2) divide face into fifths horizontally
3) divide into thirds vertically
bimaxillary protrusion
1) front teeth are far forward, teeth and jaw stick forward
divergence of the face
1) posterior divergent
2) anterior divergent
mini esthetics
1) posed or social smile
2) emotional smile
3) amount of incisor and gingival display
- full smile: want 100% incisal display (70% mm)
- reposed: want 1-2 mm incisal display
transverse dimensions of the smile
1) buccal corridor
- distance between Mx post teeth and inside of the cheek
- minimize buccal corridor
tooth lip relationships
1) the smile arc
- contour of upper anterior teeth incisal edge relative to the curvature of lower lip
2) goal: upper incisal edges should match lower lip contour
microesthetics
1) tooth proportions
2) golden proportion 1:0.62
3) height width proportions
- width should be 80% of the height
extraoral photos
1) frontal rest
2) frontal smiling
3) profile
4) profile smile
5) 3/4 view
intraoral photos
1) frontal
2) R and L buccal
3) max and mand occlusal
standard radiographs
1) FMX
2) pano
3) lateral ceph
radiographic assessment includes
1) dental age
2) missing teeth
3) caries
4) perio
5) impactions
5) root shape and length
6) other pathology
lateral ceph
1) evaluate dentofacial proportions and clarify the anatomic basis for a malocclusion
study casts
1 )verify clinical examination and photographs
2) arch length analysis
3) bolton analysis (tooth size discrepancy)
4) bite registration is wax
