Orhtodontic Examination & Diagnosis I

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Introduction to Orthodontics
Fifth Year

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Orhtodontic Examination & Diagnosis I

  1. 1. 10th Lecture Orthodontic Examination and Diagnosis
  2. 2. Definitions:  Orthodontic examination: It is a technique concerning with gathering data or information about an orthodontic case in order to reach diagnosis.  Diagnosis is determination of presence or absence of abnormality, In orthodontics it concerns establishing existence and nature of dentofacial deformity. April 28, 2012 Dr. Ahmed Basyouni 2
  3. 3. Orthodontic examination should include the following: I. History II. Clinical examination III. Study Cast analysis IV. Radiographic examination V. Facial photographs. April 28, 2012 Dr. Ahmed Basyouni 3
  4. 4. I. History Personal history: Name: Age: Address: Date: Sex: Date of Birth: Tel.: Chief Complain: Major reason for seeking Orthodontic treatment April 28, 2012 Dr. Ahmed Basyouni 4
  5. 5. I. History Past History: Past medical history: 1. Any birth defects: Yes No If yes, specify: ____________________________________ _____ 2. Any systemic diseases: ( Anemia, Arthritis, Asthma, Allergy, Bleeding, Cerebral palsy, Epilepsy, Heart, Major surgery, Rheumatic fever, lung, kidney, & Liver), … If there is any specify: ____________________________________ April 28, 2012 Dr. Ahmed Basyouni _________ 5
  6. 6. I. History 3. Are the patient’s tonsils/ or adenoids removed? Yes No If yes, at what age? _____________ 4. Is the patient receiving any medications? Yes No If yes, give reason for use: ____________________________________ ____ April 28, 2012 Dr. Ahmed Basyouni 6
  7. 7. I. History Past dental history: 1. Date of last dental examination: What was performed: _______________________________________________ _______________________________________________ 2. Injuries or trauma to the teeth or gums: Yes No If yes, specify: _________________________________________ 3. How often does the patient brush his / her teeth? 4. Has the patient ever had: a) Speech therapy Yes No b) Previous orthodontic consultation and / or treatment? Yes No April 28, 2012 Dr. Ahmed Basyouni 7
  8. 8. I. History 5. Does the patient: a) Grind his or her teeth at night? Yes b) Bite his / her fingernails? Yes c) Suck thumb, finger, blanket, etc. Yes If yes, at what age did he / she discontinue? ______Years. d) Breathe through: Nose Mouth When? Night Daytime April 28, 2012 Dr. Ahmed Basyouni No No No ? 8
  9. 9. II. Clinical Examination  General Examination: Weight Height comparable to his/her age April 28, 2012 Dr. Ahmed Basyouni 9
  10. 10. II. Clinical Examination  Extra-Oral Examination: Lateral View Straight Profile: either straight, convex or concave Vertical facial balance: LAFH/TAFH Ratio April 28, 2012 Dr. Ahmed Basyouni Convex Concave 10
  11. 11. The Facial Index: It is the proportional relationship of facial height and width. Vertically, the face is divided into three thirds: Upper third consists of the forehead. Middle third extends from supraorbital ridge to the base of the nose. Lower third extends from base of the nose to the soft tissue menton: In lower third, the upper lip occupies one third and the lower lip & chin occupy two thirds. April 28, 2012 Dr. Ahmed Basyouni 11
  12. 12. The Facial Index: April 28, 2012 Dr. Ahmed Basyouni 12
  13. 13. Extra-Oral Examination: Frontal View: Symmetry Transverse Competent lip Incompetent lip Soft tissue: Lips: upp. Short/Long/Normal low. Everted/Normal/flaccid At rest: Together/Apart On smile: Gingiva exposed/unexposed Lower lip everted April 28, 2012 Dr. Ahmed Basyouni 13
  14. 14. Extra-Oral Examination: Labiomental sulcus: Pronounced/Normal/Absent Labiomental sulcus absent Chin: welldeveloped/developed/underdeveloped Nose: Large/normal/small Nasal/Mouth breather April 28, 2012 Dr. Ahmed Basyouni 14
  15. 15.  Intra-Oral Examination: A. Exam. Of the soft tissue: Gingivae: Anterior marginal gingivitis usually occurs in mouth breathing and open mouth habit, While, generalized marginal gingivitis is usually found in cases with poor oral hygiene. Frenae: a persistent and thickened labial frenum may be present in 25% of children at age of 8 years. April 28, 2012 Dr. Ahmed Basyouni 15
  16. 16. A. Exam. Of the soft tissue: Palate: should be examined visually and by palpation. Asymmetrical contour are usually caused by unerupted teeth. Tongue: is a powerful combination of muscles around which dentition is shaped and molded.  Its size: large tongue cause generalized diastema,  Its action: forward positioned tongue cause openbite, backward positioned tongue may cause anterior crowding. April 28, 2012 Dr. Ahmed Basyouni 16
  17. 17.  Intra-Oral Examination: B. Examination of the teeth:  Number of teeth: i. Teeth present & erupted: Permanent or Deciduous ii. Teeth present & unerupted iii. Extracted teeth iv. Congenitally missing teeth v. Extra-teeth April 28, 2012 Dr. Ahmed Basyouni 17
  18. 18. B. Examination of the teeth:  Condition of the teeth: i. carious or sound ii. Non-vital or vital iii. Teeth with extensive restoration vi. Broken teeth (Trauma) v. Malformed or fused teeth April 28, 2012 Dr. Ahmed Basyouni 18
  19. 19. B. Examination of the teeth:  Proportion of tooth size to arch size: Crowding occurs where teeth are large compared to arch size.  Position of teeth: Any of Individual teeth malpositions. April 28, 2012 Dr. Ahmed Basyouni 19
  20. 20. Intra-Oral Examination: Malposition of individual teeth     Labioversion Supraversion Mesioversion Torsoversion April 28, 2012     Linguoversion Infraversion Distoversion Transversion Dr. Ahmed Basyouni 20
  21. 21. Intra-Oral Examination: C. Malrelation of the dental arches  Anteroposterior malrelationship  Vertical malrelationship  Transverse malrelationship April 28, 2012 Dr. Ahmed Basyouni 21
  22. 22. Intra-Oral Examination: Anteroposterior malrelationship Angle’s classification:  Class I  Class II: division 1 division 2 division 1 division 2 April 28, 2012 Dr. Ahmed Basyouni 22
  23. 23. Angle’s classification: • Class III: Class III April 28, 2012 Dr. Ahmed Basyouni 23
  24. 24. Intra-Oral Examination: Vertical malrelationship  Deep overbite  Edge to edge bite  Open bite April 28, 2012 Dr. Ahmed Basyouni 24
  25. 25. Intra-Oral Examination: Transverse malrelationship  Posterior crossbite: Unilateral Bilateral Unilateral, bilateral, or Telescoped bite  Midline shift Lingual crossbite (Scissor bite) April 28, 2012 Dr. Ahmed Basyouni 25
  26. 26. Intra-Oral Examination: D. Functional examination:  Path of closure of the mandible: As mandible closes, observe the chin for deviations laterally, and anteroposteriorly. Forward displacement occurs in postural or pseudo Class III, lateral displacement is associated with unilateral crossbite April 28, 2012 Dr. Ahmed Basyouni 26
  27. 27. D. Functional examination:      Breathing mode: Nose/Mouth Mode of Swallowing Behaviour of the tongue Speech Habits: Any of undesirable pressure habits April 28, 2012 Dr. Ahmed Basyouni 27
  28. 28. Summary Orthodontic Examination and Diagnosis  I. Definitions: History: Personal history: Chief Complain: Past History: Past medical history: Past dental history: April 28, 2012 Dr. Ahmed Basyouni 28
  29. 29. Orthodontic Examination and Diagnosis II. Clinical examination: General Examination: Extra-Oral Examination: Intra-Oral Examination: April 28, 2012 Dr. Ahmed Basyouni 29
  30. 30. April 28, 2012 Dr. Ahmed Basyouni 30

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