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Treatment planning by almuzian ok ok

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  • 1. UNIVERSITY OF GLASGOW Orthodontic Treatment Planning Mohammed Almuzian 1/1/2013 .
  • 2. Mohammed Almuzian, 2013, University of Glasgow1 Contents Orthodontic Treatment Planning..................................................................................................... 0 Indications for Orthodontic Treatment............................................................................................ 2 Contraindication for Orthodontic Treatment................................................................................... 2 Problem list...................................................................................................................................... 2 Aims of the treatment...................................................................................................................... 3 Factor to be considered before developing the treatment plane ...................................................... 4 The treatment plan........................................................................................................................... 4 Method of providing space.............................................................................................................. 5 Technique........................................................................................................................................ 5 Contraindication.............................................................................................................................. 6 Factors to be considered in deciding the treatment option (it is the same for the contraindications for surgical option) .......................................................................................................................... 7 Contraindication for Camouflage Treatment (it is the same for the Indications for surgical option) ......................................................................................................................................................... 8
  • 3. Mohammed Almuzian, 2013, University of Glasgow2 Orthodontic Treatment Planning Indications for Orthodontic Treatment  Aesthetic & Psychosocial  Functional  Interceptive  Dental and oral health  Adjunctive Treatment Indications, Contraindication for Orthodontic Treatment 1. Factors related to patient A. Dental health B. Age of patient C. Compliance D. Medical condition 2. Factors related to malocclusion A. Skeletal problem severity B. Trauma (LIMITED) Problem list After completing the examination, the problem list will be developed. The patient problem list could be located in any of these categories:
  • 4. Mohammed Almuzian, 2013, University of Glasgow3 1. Patient concern 2. Social Factors 3. Facial and smile esthetic 4. Dental and skeletal relationship in AP, vertical and transverse direction. 5. Alignment of the dental arch 6. Symmetry in the dental arch 7. Dentoalveolar including Tooth size discrepancies Aims of the treatment McLaughlin, 2001 1. Facial aims A. Proposed incisor position (PIP) by positioning the upper incisor in the face in a such way that  vertically there is 4mm incisor show at rest & smile arc parallel to lip curvature,  AP wise labial surface parallel to true vertical, good support of the lip,  Transversely coincident UML with face B. Maintain LI position 2. Occlusal aim –static and dynamic -. These aims include I. Static: Andrews six keys, II. Dynamic :
  • 5. Mohammed Almuzian, 2013, University of Glasgow4  Mutually protected occlusion including canine guidance, incisor guidance, gp function,  RCP coincident with RCP 3. Health  PD  Bone  TMJ 4. Stability Factor to be considered before developing the treatment plane 1. The patient's (and parents') goals and desires 2. The timing of treatment 3. The complexity of the treatment that would be required, 4. The predictability of success with a given treatment approach. The treatment plan Then the treatment plan should be designed which should be in this way: 1. Achieving optimal oral health through appropriate diet and plaque control as well as motivation. 2. First determine if skeletal problem is present and need to be addressed either camouflage, growth modification or surgery or only compromised
  • 6. Mohammed Almuzian, 2013, University of Glasgow5 3. The lower arch: if the lower incisor will be moved then decide what u need to achieve that (method to provide space) and then predict the final position of lower canine 4. Upper incisor: Build upper incisors around the lower to achieve Cl1 canine with consideration of the PIP, then decide what u need to achieve that (method to provide space) 5. Appliance and mechanics required. 6. Determine the type of anchorage. 7. Type of retention Method of providing space A. Extraction of teeth B. Distal movement of molars C. Arch lengthening D. Expansion E. Enamel interproximal reduction Technique  Each tooth has 0.75 to 1.25 mm of interproximal enamel surface  It is safe to remove 0.25mm of enamel from the contact areas of these teeth
  • 7. Mohammed Almuzian, 2013, University of Glasgow6  In theory, 22 tooth surfaces available from mesial of the first molar on one side to the other, a total of 5.5mm of space can be gained. However, in practice, interproximal reduction is usually performed on upper and lower incisors only. Indications 1. Space provision. 2. Treat black triangle 3. Improve stability of lower incisors 4. Reshape a tooth 5. IDS 6. Reduce intercanine width Contraindication 1. Poor OH 2. High caries rate index 3. Big space required 4. Rectangular shape teeth 5. Broad contact points 6. Small teeth 7. Large pulp chamber 8. Teeth with restoration or hypoplasia
  • 8. Mohammed Almuzian, 2013, University of Glasgow7 9. Severely rotated teeth Factors to be considered in deciding the treatment option (it is the same for the contraindications for surgical option) 1. General factors  Patient concern and expectation  Cooperation  Age  Medical condition 2. Malocclusion factors A. Profile:  Jaw relation in 3D  Soft tissue feature: A relatively prominent appearance of the nose, Nasolabial angle, Chin prominence B. Severity of malocclusion in three plane of space C. Type of malocclusion D. Presence and severity of crowding E. Biological limit of alveolar and PD apparatus  A lack of palatal bone into which to retract the upper incisors.  Proclination of the lower incisors may result in the loss of labial bony support and labial gingival recession.
  • 9. Mohammed Almuzian, 2013, University of Glasgow8 Contraindication for Camouflage Treatment (it is the same for the Indications for surgical option) 1. Growing patient who, perhaps, would be most appropriately managed with growth modification. 2. Medical contraindication 3. Uncooperative patient 4. Poor oral hygiene 5. Sever skeletal discrepancy in three plan of space, who perhaps would best be managed with orthognathic surgery. 6. Patient with facial concern that cannot be addressed by camouflage 7. Patients with severe crowding combined with maximum dentoalveolar compensation.

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