Diagnosis-orthodontic /certified fixed orthodontic courses by Indian dental academy
INDIAN DENTAL ACADEMY
Leader in continuing dental education
PLANNING IS A SERIES OF
DIAGNOSIS is a comprehensive
procedure focused on broad overview of
the patients situation
TREATMENT PLANNING is to
maximize benefit for the patient
The field of orthodontics
in the midst of a
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
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.
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.
HEIGHT & WEIGHT
FACIAL DIVERGENCE ANTERIOR
EVALUATION OF FACIAL PROPORTIONS
Esthetics is very much in the eye of the beholder
Profile view straight/convex/concave
Front view- for bilateral symmetry
- for dental/skeletal midline
To establish facial type
• Fore head- Profile of face is determined by slant of
forehead and nose.
• Nose- Future nasal growth must be taken into
• Lips- Length/ Thickness/ Curvature/ Competency.
• Chin-Normally soft tissue is 10 – 12 mm thick on chin
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
Determination of postural rest position and freeway
Examination of TMJ and condylar position.
Assessment of functional status of lips, cheek and
Evaluation of path of closure from postural rest position
to habitual occlusion;
In AP plane
In Vertical plane
In Transverse plane
ASSESSMENT OF DEVELOPMENTAL AGE
• Physical development
• Chronologic age
• Dental age
• Sexual maturity
Hand wrist radiograph
Calcification of canine
SOCIAL AND BEHAVIORAL EVALUATION
• STUDY MODELS
• OTHER ADVANCED DIAGNOSTIC
Proclination of teeth
Width of the arch
Symmetry of the arch
Crowding/ Rotations/ Spacing
Arch length discrepancy
Classification of malocclusion
CANT 1 Y-FMIA(Angle)
U U to toANB
L 1 SNB
The difference between SNA & SNB – the ANB
angle indicates the magnitude of the skeletal jaw
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.
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.
In the Wits analysis, points A & B are projected to the
functional occlusal plane, and the AB difference is
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.
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.
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
e.g. Skeletal class II with mandibular deficiency.
Position of anterior teeth
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
Class II molar relationship
Skeletal class II with mandibular deficiency
WE SHOULD HAVE…
An interview data i.e., case history
Complete analyses of all diagnostic
A description of an orthodontic data base and its
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
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
Clinical examination / Diagnostic records
Step by step progression of treatment