Diagnosis-orthodontic /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

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Diagnosis-orthodontic /certified fixed orthodontic courses by Indian dental academy

  1. 1. ORTHODONTIC DIAGNOSIS INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. DIAGNOSIS &TREATMENT PLANNING IS A SERIES OF LOGICAL STEPS www.indiandentalacademy.com
  3. 3. DIAGNOSIS is a comprehensive procedure focused on broad overview of the patients situation TREATMENT PLANNING is to maximize benefit for the patient www.indiandentalacademy.com
  4. 4. The field of orthodontics is in the midst of a knowledge explosion. www.indiandentalacademy.com
  5. 5. DIAGNOSIS ?  A good diagnosis is important to decide whether or not to treat ?  What the preferable method is ?  When it should be started ?  Therefore, it should be done with fully developed power of observation and an analytical mind. www.indiandentalacademy.com
  6. 6. THE OBJECTIVES OF DIAGNOSIS  Identify the normal and abnormal developmental changes in growing children.  Identify the dysfunction of the soft tissues.  Identify the relevant etiological factors.  Identify the interference in occlusion. www.indiandentalacademy.com
  7. 7. THE OBJECTIVES OF TREATMENT  Render the treatment at an early age and create a suitable environment and functional pattern so that the development is nearly as perfect as possible.  Render the treatment in deciduous and mixed dentition to intercept the developing problems by utilizing the growth.  Render the treatment in permanent dentition to achieve optimum esthetics, functional efficiency and long term stability.  Should be aware of limitations of treatment and the degree of compromise by weighing various factors. www.indiandentalacademy.com
  8. 8. Orthodontic Consultation Clinical Examination Data Base Diagnostic Records www.indiandentalacademy.com Provisional Diagnosis
  9. 9. ORTHODONTIC CONSULTATION www.indiandentalacademy.com
  10. 10. CHIEF COMPLAINT • Impaired dentofacial esthetics • Impaired function Objective is to find out what is important to the patient? www.indiandentalacademy.com
  11. 11. CASE HISTORY  NAME  AGE  SEX  ADDRESS & OCCUPATION  CHIEF COMPLAINT  MEDICAL HISTORY  DENTAL HISTORY  POST NATAL HISTORY www.indiandentalacademy.com  FAMILY HISTORY
  12. 12. www.indiandentalacademy.com
  13. 13. www.indiandentalacademy.com
  14. 14. CLINICAL EXAMINATION  FACIAL  OCCLUSAL FUNCTIONAL www.indiandentalacademy.com
  15. 15. CLINICAL EXAMINATION HEIGHT & WEIGHT GAIT POSTURE BODY TYPE ECTOMORPHIC MESOMORPHIC ENDOMORPHIC BUILD ASTHETIC PLETORIC ATHLETIC FACIAL DIVERGENCE ANTERIOR POSTERIOR STRAIGHT FACIAL FORM MESOPROSOPIC EURYPROSOPIC DOLICOPROSOPIC www.indiandentalacademy.com
  16. 16. EVALUATION OF FACIAL PROPORTIONS Esthetics is very much in the eye of the beholder  Profile view straight/convex/concave  Front view Front view- for bilateral symmetry - for dental/skeletal midline Facial index Cephalic index } To establish facial type www.indiandentalacademy.com
  17. 17. www.indiandentalacademy.com
  18. 18. PROFILE ANALYSIS • Fore head- Profile of face is determined by slant of forehead and nose. • Nose- Future nasal growth must be taken into consideration. • Lips- Length/ Thickness/ Curvature/ Competency. • Chin-Normally soft tissue is 10 – 12 mm thick on chin area. www.indiandentalacademy.com
  19. 19. Profile analysis –yields almost the same information as from lat.ceph. Poor man’s cephalometric analysis  To establish whether jaws are proportionately placed in A-P Plane  To establish profile convexity or concavity  To establish lip posture & incisor prominence  Bimaxillary protrusion www.indiandentalacademy.com
  20. 20. FUNCTIONAL ANALYSIS  Determination of postural rest position and freeway space.  Examination of TMJ and condylar position.  Assessment of functional status of lips, cheek and tongue.  Evaluation of path of closure from postural rest position to habitual occlusion; In AP plane In Vertical plane www.indiandentalacademy.com In Transverse plane
  21. 21.       Hereditary? Environmental? Trauma? Chronic diseases? Habits? etc……… www.indiandentalacademy.com
  22. 22. EVALUATION OF ORAL HEALTH • Health of oral hard and soft tissues • Dental caries • Periodontal evaluation www.indiandentalacademy.com
  23. 23. www.indiandentalacademy.com
  24. 24. Evaluation of individuals’ physical growth status www.indiandentalacademy.com
  25. 25. ASSESSMENT OF DEVELOPMENTAL AGE • Physical development • Chronologic age • Dental age • Sexual maturity By Clinical examination Hand wrist radiograph CVMI Calcification of canine www.indiandentalacademy.com
  26. 26. SOCIAL AND BEHAVIORAL EVALUATION  Motivation External Internal  Expectations  Co-operation www.indiandentalacademy.com
  27. 27. www.indiandentalacademy.com
  28. 28. • STUDY MODELS • OPG • PHOTOGRAPHS • CEPHALOGRAMS • OTHER ADVANCED DIAGNOSTIC AIDS www.indiandentalacademy.com
  29. 29. STUDY MODELS  Proclination of teeth  Width of the arch  Symmetry of the arch  Crowding/ Rotations/ Spacing  Arch length discrepancy  Bolton’s analysis www.indiandentalacademy.com  Classification of malocclusion
  30. 30. www.indiandentalacademy.com
  31. 31. ORTHOPANTAMOGRAPH www.indiandentalacademy.com
  32. 32. PHOTOGRAPHS www.indiandentalacademy.com
  33. 33. HARD TISSUE ANALYSES www.indiandentalacademy.com
  34. 34. MAND A-AXIS(LINEAR) PLANE ANGLE CANT 1 Y-FMIA(Angle) INTERINCISAL ANGLE U U to toANB 1 OFOFSNA ANGLEtoOCCLUSAL PLANE CONVEXITY FACIALPOG FMPA IMPA ANGLE L 1 SNB N-A N-B www.indiandentalacademy.com
  35. 35. The difference between SNA & SNB – the ANB angle indicates the magnitude of the skeletal jaw discrepancy. It is influenced by two factors:  The vertical height of the face As the vertical distance between nasion & point A & B increases, the ANB angle decreases.  The anteroposterior position of nasion. www.indiandentalacademy.com
  36. 36. The ANB angle can be misleading when nasion is displaced anteriorly. The ANB angle is only 70, but the A-B difference projected to the true horizontal is 14mm. ANB, at best, is an indirect measurement of the A-B difference & must be used with full awareness of its limitation. www.indiandentalacademy.com
  37. 37. WITS ANALYSIS In the Wits analysis, points A & B are projected to the functional occlusal plane, and the AB difference is www.indiandentalacademy.com measured.
  38. 38. STEINER ’S COMPROMISE If the ANB angle is different from 20, the different positioning of the incisors given by the inclination & protrusion figures will produce a dental compromise that leads to correct occlusion despite the jaw discrepancy. www.indiandentalacademy.com
  39. 39. TWEED′S METHOD OF CEPHALOMETRIC CORRECTION When the FMA is between 210 to 290, the FMIA should be 680. When the FMA is 300 or greater, the FMIA should be 650. When the FMA is 200www.indiandentalacademy.com is less the IMPA should not exceed 920.
  40. 40. SOFT TISSUE ANALYSES www.indiandentalacademy.com
  41. 41. SOFT CHINLABIAL ANGLE TISSUE CHIN NASO MENTAL ANGLE LOWER LIPLINE THICKNESS UPPER LIP PROMINENCE PROMINENCE H PROMINENCE S E (Bell et al) (Bell et al) www.indiandentalacademy.com
  42. 42. FUNCTIONAL ANALYSES www.indiandentalacademy.com
  43. 43. EFFECTIVE1 UPPERJARABAKANGLELENGTH & LOWER SN EFFECTIVE PLANE ANGLE ANGLE OFMANDIBULAR ANGLES POSTERIOR toANGLELENGTH ANTERIOR FACE HEIGHT BASALPOSTERIOR ARTICULAR GONIAL ANGLE SADDLE RATIO INCLINATION ANGLE SUMGONIALFACE HEIGHT OFU MAXILLARY N′ www.indiandentalacademy.com
  44. 44. ORTHODONTIC CLASSIFICATION An ideal classification should summarize the diagnostic data and imply the treatment plan, it can viewed as reduction of data base.  Skeletal jaw relationship with where exactly is the abnormality present. e.g. Skeletal class II with mandibular deficiency.  Dentoalveolar relationship Molar relationship Canine relationship Position of anterior teeth  Growth pattern www.indiandentalacademy.com
  45. 45. PROBLEM LIST It should include:  Those relating to disease or pathologic process. e.g. caries, perio etc.  Those relating to disturbances of development that created the patients malocclusion. Example of problem list  Mild gingivitis in upper anterior region  Maxillary incisor proclination with lip protrusion  Excessive overjet  Class II molar relationship  Skeletal class II with mandibular deficiency www.indiandentalacademy.com
  46. 46. TO SUMMARIZE WE SHOULD HAVE…  An interview data i.e., case history  Clinical examination  Complete analyses of all diagnostic record  Orthodontic classification  Problem list www.indiandentalacademy.com
  47. 47. Orthodontic Problems In priority order Possible Solution To Individual problem Optimal Treatment plan Mechano therapy www.indiandentalacademy.com
  48. 48. MAJOR STEPS  A description of an orthodontic data base and its analysis.  The development of patients problem list.  Determination of general treatment goals with more specific treatment objectives.  Design of the specific mechanotherapy needed to reach these goals www.indiandentalacademy.com
  49. 49. THREE DIMENSIONAL TREATMENT GOALS  Thorough analyses of orthodontic data base.  Creation of patients problem list.  Orthodontic mechanotherapy to achieve treatment goals. If the additional variations of time (growth) and function are considered, the approach becomes five dimensional. www.indiandentalacademy.com
  50. 50. TREATMENT PLANNING Clinical examination / Diagnostic records Data base Complete analyses Classification Problem list Treatment objectives Step by step progression of treatment Biomechanics Appliance design www.indiandentalacademy.com Appliance use
  51. 51. CONCLUSION CONCLUSION www.indiandentalacademy.com
  52. 52. www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com

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