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 diagnosis of orthodonticاحمد حمودي جديد1
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diagnosis of orthodonticاحمد حمودي جديد1

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from orthodontic textbooks sourse

from orthodontic textbooks sourse

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  • 1. CLINICAL EVALUATION There are two goals of the orthodontic clinical examination: (1) to evaluate and document oral health, jaw function, and facial esthetics . (2) to decide which diagnostic records are required.
  • 2. Evaluation of Oral Health Medical and dental problems under control before ortho Treatment of active caries and perio problems done before ortho Definitive restorations (crowns) usually not placed until after ortho Check for mucogingival problems Often dealt with prior to ortho
  • 3. Facial profiles can sometimes reveal underlying malocclusion problems. Anteroposterior relations between the maxilla and mandible are observed in the three basic types of profiles. Patients with a straight profile usually have normal occlusions or Class I malocclusions.
  • 4. Those having convex profiles have an increased probability of having a Class II malocclusion associated with a retrusive mandible or perhaps a protrusive maxilla.
  • 5. Patients with a concave profile have an increased probability of having a Class III malocclusion associated with a retruded maxilla, a protrusive mandible, or both. Facial profiles can also reveal growth problems in the vertical dimension. Excessive vertical growth of the face can lead to an anterior open bite malocclusion, lips apart at rest, a gummy smile, and an increased angle between the ramus and body of the
  • 6. Insufficient vertical growth of the face can produce a deep overbite malocclusion, with redundant, overlapped lips and decreased angle between the ramus and body of the mandible, but the dentist should realize that the presence of a particular type of facial profile is not always indicative of the Angle malocclusion class.
  • 7. :
  • 8. This can be assess by: 1.facial profile 2.facial divergenece 3.Palpation 4.cephalometri c
  • 9. Facial Divergence The lower face may be straight or inclined anteriorly / posteriorly relative to the forehead. This inclination is also termed as the facial divergence, which may be influenced by the patient's ethnic or racial background.
  • 10. Vertical Dental Relations : Overbite: is overlap of the incisors in vertical plane Open bite: there is no vertical overlap of the incisors when the buccal segment teeth are in occlusion. Thumbsucking and abnormal tongue resting position, and abnormal facial growth (excessive vertical growth) may cause an open bite malocclusion.
  • 11. ASSESSMENT OF VERTICAL SKELETAL RELATIONSHIP A normal vertical relationship is one where the distance between the glabella and subnasale is equal to the distance from the sub nasale to the under side of the chin .Reduced lower facial height is associated with deep bites while increased lower facial height is seen in anterior open bites.
  • 12. Or clinically by rular or hand of mirror at the lower border of the mandibule and another one on Frankfort and measure it which is normal when ranged between 28_30
  • 13. Thumb sucking
  • 14. Horizontal dental relation: Overjet: is the distance between the upper and lower teeth in horizontal plane.
  • 15. Crossbite: a deviation from the normal buccoligual relationship. It may be anterior or posterior and or unilateral or bilateral. crossbite normal
  • 16. Anterior crossbite: A malocclusion in which one or more of the upper anterior teeth occlude lingually to the mandibular incisors.
  • 17. Buccal cross bite: buccal cusp of lower posterior teeth occlude buccal to the buccal cusp of the upper posterior teeth. Lingual cross bite: buccal cusp of lower posterior teeth occlude lingually to the palatal cusp of the upper posterior teeth.
  • 18. Assessment of Facial Symmetry A certain degree of asymmetry between the right and left sides of the face is seen in most individuals. The face should be examined in the transverse and vertical planes to determine a greater degree of asymmetry than is considered normal. Gross facial asymmetries may be seen in patients with:
  • 19. 1. Hemifacial hypertrophy Iatrophy ii. Congenital defects. iii. Unilateral condylar hyperplasia iv. Unilateral Ankylosis, etc.
  • 20. this can be assess by: 1.bird look(by looking from above and behind) 2.compiste photogragh
  • 21. Or by divide approximately into fifths (each one the width of the eye). 3.radoigraph(opg) 4.tongue spatula
  • 22. Lips Lip length, width and curvature should be assessed. Lips can be classified into: a. Competent lips b. Incompetent lips c. Potentially competent lips
  • 23. The Nasolabial angle The nasolabial angle is formed between the upper lip and base of the nose (columella) and should be between 90° and 110. It gives an indication of upper lip drape in relation to the upper incisor position.
  • 24. cases
  • 25. Lip competency: Yes
  • 26. Mandibular Plane Angle: Increased