Treatment Planning

Question 0

What is it important to ask th patient when treatment planning?

Answer 0

What they want from the treatment

Question 1

What are the four areas that need to be considered when treatment planning in ortho?

Answer 1

Aesthetics
Dental health
Function
Stability

Question 2

What are the feature of a normal smile?

Answer 2

Whole of the upper incisor are showing with interproximal gingiva
Upper Incisors not touching the lower lip but run parallel to it
Width of smile displays at least upper first premolars

Question 3

What is the process called where terming the amount of space available in a crowded case?

Answer 3

Space analysis

Question 4

Once you have got all the relevant information about the case what is then the next stage in treatment plan?

Answer 4

List of aims of treatment

Question 5

What follows the aims of treatment?

Answer 5

Options for treatment

Question 6

What are the tree options for managing skeletal problems?

Answer 6

Ortho camouflage
Growth modification
Combined ortho and surgery

Question 7

What does ortho camouflage mean? When is this most possible?

Answer 7

• The underlying skeletal discrepancy is accepted but the teeth are then moved into class 1
• when the underlying skeletal problems are small

Question 8

In which types of skeletal abnormality is it easiest and most difficult to camouflage?

Answer 8

Easier : AP discrepancy
Mid: vertical
Hardest: transverse

Question 9

What appliances can be used for growth modification?

Answer 9

• head gear

- functional

Question 10

What is the disadvantage of using surgery to aid correction of malocclusion?

Answer 10

Pt needs to have stopped growing

Question 11

Which arch should be treatment planned first and why?

Answer 11

• Treatment planning should revolve around the lower labial segment
• Because if too much movement occurs here then it will be out of the neutral zone and thus less stable leading to relapse

Question 12

Which two features of lower incisors needs to be conformed to?

Answer 12

• AP position

- Inclination

Question 13

Once the lower labial segment has been planned, what is then the next stage and how is this achieved best?

Answer 13

Get the upper incisors into class 1
first stage of this is getting the canines into class 1

Question 14

Which rule is used when planning the labial segment?

Answer 14

The canine rule

Question 15

Which class 1 relationship, incisor, canine, molar must sometimes be compromised so that it is class 2 or 3?

Answer 15

Molar 
-depends upon extractions eg extracting uppers and not lowers then class 2

Question 16

When is space required?

Answer 16

To correct

1. Crowding
2. Correct incisor AP relationship
3. Levelling occlusal curves
4. Arch contraction
5. Correct mesiodistal tip upper
6. Correct inclination upper

Question 17

For every mm of incisor retraction,how much space is required and why?

Answer 17

For every mm 2mm space needed

Because jaws are arched

Question 18

How much space would be needed to reduce an overjet of 6mm to normal overjet ?

Answer 18

Normal overjet : 2mm
6mm overjet-2mm overjet= 4mm difference
4mm *2mm = 8mm needed

Question 19

How can space be created?

Answer 19

Extractions
Distal movement of molars
Enamel stripping
Expansion
Procline incisors

Combine any of the above

Question 20

Why are incisors not usually the teeth of choice to be extracted?

Answer 20

1. Aesthetics

2. Difficult to fit four incisors around only 3 incisors

Question 21

Which circumstances would you extract incisors?

Answer 21

1. Incisor has poor prognosis eg periodontally compromised
2. Buccal segment class 1 and incisor crowded
3. Adult pt with mild class 3 with well aligned buffalo segment

Question 22

Which premolars are usually treatment planned to be extracted?

Answer 22

4’s

1. Closest to whether the problems are
2. Gives chance of spontaneous alignment

Question 23

How much enamel can be removed with interproximal stripping?

Answer 23

Anterior teeth: 0.5mm without compromising health

Question 24

When should expansion usually be reserved for and why?

Answer 24

Should be reserved where there is a buccal crossbite this because expanding the arch where there is no xbite increase chance of instability and risk of perforating buccal plate

Question 25

Which arch, upper or lower is usually the arch if expansion is taking place?

Answer 25

Upper

Question 26

What is the problem with expanding lower arch and when would you do it and who should do it!

Answer 26

Specialist
Premolars in Lingual cross bite

Increase in intercanine width is very unstable

Question 27

Proclination of upper incisors creates how much space?

Answer 27

Every mm creates 2mm of space

Question 28

What are the broad stages to treatment planning?

Answer 28

Collect data
Compile a problem list
Make a plan: treatment aims and means

Question 29

What are the advantages of having a problem list?

Answer 29

Short relevant list
No problems forgotten
Focuses on real problems
Records negative aims (problems we will accept)

Question 30

What is the aetiology of malocclusion ?

Answer 30

Soft tissues
Skeletal
Dental
Local