Parcial 2 Flashcards
Diagnostic records include:
-lateral X-ray
- panoramic X-ray
-Extra Oral and Intra Oral Photographs
- Dental Casts
To diagnose correctly all cases of malocclusion it’s necessary to know the normal occlusion or the ideal position of the dental organs and normal facial lines. This knowledge is the basis of science and the most important thing for the orthodontist
Edward Angle
Is essential to carry out the correct treatment planning. This must be done based on a thorough study of the pacient and the problems they present, both bone and dental.
The orthodontic diagnosis
The time dedicated to the diagnosis will be the best spent, since a correct diagnosis represents _______ of the success of an orthoodntic treatment
80%
Orthodontics take care of:
- diagnosis, prevention, interception and treatment of all malocclusions. The design, application and control of functional and corrective devices
- the guide of the eruption and its supporting structures to achieve and maintain optimal occlusal relationships, physiological and aesthetic harmony between cranio-facial structures
The orthodontic diagnosis deals with recognition of the various characteristics of the maloclussion. Based on:
- patient interview
- clinical examination
- evaluation of the diagnostic records
Diagnosis
- Interpretation and presentation of the results
- Carry out the necessary exploration
- Problem formulation
- Recognition of the problem
Clinic history
- Medical history
- Interrogation (orthodontic history) (dental history)
In the interrogation
Orthoodntic history and dental history
Medical history
- osteoporosis
- cancer
- diabetes
- reumatic feber
Dental history
- age at which the deciduous dental erupted
- age at with permanent dental organs erupted
- dental trauma
To make a adequate diagnosis in orthodontic it’s necessary to carry out a correct history and a correct clinical examination of the patient:
- On a first visit, you should listen to the patient/ parents to find out what things worry them or what they don’t like and would like to change
- The patient should be asked about the disease they suffer or have suffered, consider whether the patient is receiving prolonged pharmalogical Tx of any type and if so, determine the cause
- Perform an examination of the patients oral cavity focusing attention on the dental bad positions and bite problems
- Assess the possible presence of cavities or periodontal disease pathologies that must be resolved before beginning orthodontic treatment.
- Once the examination is completed the patient must be guided about what their main problems are and how we can solve them. “However until exhaustive study has been carried out with x-rays and models of the teeth, the treatment plan and its duration cannot be exactly determine”
Mention the 4 medical condicions that contraindicate the use of orthodontic appliances:
Osteoporosis
Cancer
Diabetes
Reumatic feber
Prior to start the orthodontic treatment a ______ must be made to know the patients dental health status. An overview is required, it must be exhaustive and it should not be focused only on one aspect since in many cases it can be a complex situation
Diagnosis
A diagnosis allows:
- the development of a treatment plan that addresses the patients chief complaint
- medical and dental history
- dental, facial, skeletal and functional problems
Diagnosis process
- interview
- clinical examination
- analysis of diagnostic records
- data base
- control before orthodontic treatment
- list of diagnosis problems
Diagnosis récords
- identify the problems
- formulate the diagnosis
- allow the correct development of the treatment
May include digital and video images to supplement the clinical findings
Extraoral and intraoral images (photographic analysis)
The assess the Inter- arch and intra- arch relationship of the teeth, to help determine arch length and to assess arch symmetry
Dental casts (digital models)
To assess the condition and development status of the teeth and associated structures, and to identify any dental anomalies or pathology
Panoramic X-ray
Allow the evaluation of the size, shape and positions of the craniofacial structures and dentition, and in the identification of a skeletal anomalies or pathology
Cephalometric X-ray
May be used as a alternative source to obtain dentofacial information, but is not rountinely required for orthodontic X-rays
Cone- Beam Computer tomography (CBCT)
Assess the general condition of the hard and soft tissues of the mouth (including the periodontium) and the functional status of the patients occlusion
Intraoral pictures
Determine facial shape, symmetry, soft tissue harmony and the state of the perioral muscles. This determines deviations from normal with respect to a patients sagittal, vertical and transverse maxillofacial relationship and evaluates the relationship of the dentition and facial structures
Extraoral pictures
Facial shapes:
Oval
Round
Square
Profile types:
Straight, convex, concave
Indicates a class II jaw relationship, which may result from the maxilla that projects too far forward or mandible too far back
Convex profile
Indicates that the relationship of the maxilla and mandible is in harmony
Straight profile
Indicates a class III relationship, which may result from the maxilla that is too far back or a mandible that protrudes forwards
Concave profile
The radiologic projections indicated for the orthodontic diagnosis are divided into two categories:
Intraoral
Extraoral
X-ray to assess dental anomalies
Intraoral
X-ray to assess the dental condition and adjacent structures
Extraoral
Radiologic study: intraoral
- periapical
- occlusal
Radiologic study: extraoral
- lateral X-ray
- panoramic X-ray
- Carpal X-ray
- Postero- Anterior
Intraoral X- ray
- chronology of the eruption
- the degree of apical formation
- Shape, number, and size of roots
- agenesis
- Supernummerary
- Presence, position of third molars
- presence of retained teeth
Occlusal X-rays
- location of impacted tooth
- extension and shape of fissure
- Control of disjunctions