patient assessment Flashcards
parts of ortho pt assessment
history EO assessment IO assessment summary problem list tx aims tx plan
C/O
RFA - specific thing? level of concern is pt concerned? appearance dental health fct
aspects of MH that can affect ortho
epilepsy - avoid URAs
RAU - tend to manage
diabetes - diet
bisphosphonates - slow tooth movements and ext risk
latex allergy
Ni allergy - test with one bracket, check severity
DH
regular attender? prev tx - coped? prev ortho? - avoid retx if possible - RR caries risk - stabilise history of trauma - RR
what habits are important to note in the history?
digit sucking
lip sucking
features of lip sucking
retroclination L incisors
eczematous appearance L lip
SH
prior knowledge from friends/siblings?
can they commit to tx - exams, travel, parents/work
wind instruments - can still play but will be more difficult
occlusal features of a digit sucking habit
proclination U incisors
retroclination L incisors
localised AOB or incomplete OB
narrow upper arch +/- unilateral posterior CB
but superimposed on existing skeletal pattern and incisor relationship
EO assessment
skeletal pattern - AP, V, T
STs
TMJ
ways of assessing AP skeletal pattern
visual
palpate skeletal bases
lateral ceph
how should the head be positioned for visually assessing the AP skeletal pattern?
Frankfort plane parallel to floor
natural head posture
AP class 1
mandible 2-3mm behind maxilla
AP class 2
mandible >2-3mm behind maxilla
AP class 3
mandible <2-3mm or in front
ways of assessing V skeletal pattern
FMPA
vertical facial proportions
lat ceph
how to assess FMPA clinically
Frankfort and mandibular planes
meet at occiput ideally
how to assess FMPA radiographically
porion to orbitale = Frankfort plane
gonion to menton = mandibular plane
meet at occiput ideally
landmarks for clinical vertical facial proportions
glabella
subnasale
menton
clinical vertical facial ideal proportions
UAFH 50%
LAFH 50%
landmarks for cephalometric vertical facial proportions
nasion
ANS
menton
cephalometric vertical facial ideal proportions
UAFH 45%
LAFH 55%
transverse skeletal pattern
assess symmetry
view from front and above
occlusal cant?
ST features to assess
observe in fct as well as at rest lips competent? lip trap? lip form and tonicity nasolabial angle smile line tongue
competent lips
meet together at rest without any muscular activity
lip form
full/thin
lip tonicity
hyperactive or little tone
what group of patients often have hyperactive lip tonicity?
class 2 div 2 - will retrocline L incisors
nasolabial angle
angle formed by tangents to the U lip and columella of the nose
what does the nasolabial angle indicate?
upper lip position
increased nasolabial angle
protrusive - good for ext