Diagnostic setup. opg, xeroradiography,clarks technique /certified fixed orthodontic courses by Indian dental academy

Seminar on,

Diagnostic Set up
Panoramic Radiography
Xeroradiography
Clark’s technique
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

DIAGNOSTIC SET UP
 Practical aid in treatment planning and
diagnosis.

 Proposed by H.D. Kesling
 It’s a procedure in which teeth are
removed and replaced in positions they
will occupy after experiencing mesial
migration in an orthodontic environment.

Advantages –
1. To determine and visualise the resultant
occlusion before the teeth have been extracted
2. Possible to change the treatment plan on the
model by replacing some and removing other
teeth so that one can thoroughly examine all
possible occlusions.
3. Mainly useful in asymmetric extraction and
combined surgical orthodontic treatment.

4. Tooth size – arch length discrepancies can be
visualised by means of set up.
5. Also a step in construction of tooth positioner.
6. Patient can be motivated .


Procedure
A set of well trimmed models made of deep
impressions of teeth and soft tissues.
Lines are drawn through buccal groove on the
mandibular first molars on to the soft tissue.
This act as a reference point.
A . 004 inch ribbon saw blade is used to cut
through the contact areas and separate teeth.

 The lower first permanent molars are replaced to a new
position they will occupy by mesial migration.
 Deciding lower first molar position is the most important
decision in constructing the set up.
 Factors influencing position of first molar set up
are –
– Size of the teeth
– Presence or absence of tooth crowding mesial to anchor
molars.
– Procumbency of anterior teeth.
– Missing teeth
– Age of the patient
– Treatment plan
– Tooth size related to jaw size.

 After all the above points have been considered, the
orthodontist must anticipate the behaviour of anchor
molar during treatment.
 It again depends on –
–
–
–
–

Technique employed
The time requirement
Orthodontist’s ability
Patient’s cooperation

 At this stage by studying the set up one can analyse that If anterior teeth – too far forward – Extraction – If
already extracted – more extraction.
 If anterior teeth – lingual – Eliminate planned
extraction.

 Maxillary teeth are arranged according to mandibular
teeth to obtain best possible occlusion.

 In most cases, same no. and type of teeth are removed
from maxillary arch as mandibular arch.

 Exception –
– Badly broken down teeth
– Congenitally missing or deformed teeth.
– Single tooth extraction in lower arch

‘A Simplified wax set up technique’
by R.W. Knierim JCO- 1975
According to his procedure –
 Plaster is filled to about 4 mm over gingival margin of
impression.
 As the plaster sets rough grooves are made in near set
plaster to depth of 2mm.

 When plaster is set it is removed and teeth are
numbered.

 Teeth are then separated using discs on a lathe to
slice root area, most teeth will now snap apart.
 Root areas are then trimmed.
 The impression are saved and kept moist.

 The trimmed dies are then reinserted in air dried alginate
impression


 Melted wax is then poured in impression holding the
dies, it should flow well in grooves.

.


 Similar grooves are then placed in surface of wax
as it hardens

 Plaster is poured over wax surface to make base for model.

‘A simplified Diagnostic set up technique.’ by Dr.
Barry N. Resnick; 1979 JCO
 According to his procedure –
 The plaster is poured in impression only to the extent of
clinical crown.
 Soft wax of 5 mm thickness is poured over crown dies.
 Remainder of impression is poured with plaster and
allowed to set.
 After separation from impression, the model consists of
two plaster section connected by wax.
 Teeth are marked and can be repositioned in desired way

 Original study model.


 Alginate impression with
selected teeth poured up
in stone to the extent of
their clinical crowns.


 Dental units and model
base connected by
periphery wax.


 Diagnostic set up with
mandibular left lateral
incisor removed and
remaining teeth aligned.


Panoramic
Radiography


Panoramic Radiography
 Also called as Ortho pantomograph (OPG)
 Rotational Radiography.
 It is a radiographic technique for producing
single image of facial structures that includes
both maxillary and mandibular arches and
their supporting structures.

Advantages1. Broad anatomic coverage
2. Simple procedure
3. Better tolerated by pts with gagging problems
4. Low radiation dose
5. Convenience of the examination.
6. Useful in pts who are unable to open their mouth
7. Full mouth IOPA – 15 mins and OPG – 3-4
mins.

Disadvantages
1.

Magnification, Geometric distortion and overlapped
images.

2.

Resolution of fine anatomic details of peri-apical area
and periodontal structures is less.

3.

Poor image is obtained when sharp inclination of
anterior teeth towards labial or lingual side.

4.

The spinal cord superimpose on anterior region.

5.

Common to have overlapped teeth images ,
particularly in premolar area.

6.

Artifacts are common and may easily be
misinterpreted.

7.

Expensive

Indications
1.
2.
3.
4.
5.
6.

To assess pattern and amount of root resorption of
deciduous teeth.
Useful in mixed dentition period to study the status of
unerupted teeth.
Presence or absence of permanent teeth: their size,
shape, position and relative state of development.
To view ankylosed and impacted teeth.
To diagnose presence of supernumerary teeth or
congenital absence of teeth.
To study the character of alveolar bone and
immediate lamina dura and periodontal membrane.

7. To study morphology and angulations of roots of
permanent teeth.
8. To study the path of eruption of teeth.
9. To diagnose fractures or pathologies of jaw.
10. To diagnose caries, periapical infections root
fractures etc.
11. Useful aid in serial extraction to study status of
eruption of teeth.
12. Can assess TMJ and Sinuses.
13. Assess shape, size and symmetry of condyles.

 To interpret OPG competently one
must have a thorough understanding
of the following :
1. Principles of Panoramic image formation.
2. Techniques for Patient positioning with head
alignment and their rationale.
3. Radiographic appearance of normal anatomic
structures.

Principles of Panoramic image formation
 First described by Numata and independently by
Paatero in late 1940s.

Movement of the film and objects about 2 fixed
centers of rotation.


Movement of film and X- ray source about one
fixed center of rotation.

 While disc 2 moves, the film on this disc rotates past the
slit.
 It is critical that speed of the film passing the collimator
slit is maintained equal to the speed at which x-ray beam
sweeps through the object of interest.

Movement of the film and x-ray source
about the shifting center of rotation.

 Structures near the film will be sharply imaged.
 Structures which are near x-ray source get magnified
and distorted and resultant image is not discrete.

Rotational Panaromic radiographic
machines.


Focal Trough
 It’s a 3-D curved zone or image layer in which
structures are reasonably well defined on OPG.
 The images seen on OPG consists largely of anatomic
structures located within the focal trough.
 Objects out of focal trough are blurred
magnified/ reduced or distorted.
 The shape of focal trough varies
with brands of machines used.


 Ring at center
of FT.

 Ring 5mm
anterior to FT

 Ring 5 mm
posterior to FT


Patient positioning and Head alignment.
 Prepration of Patients.
– Removal of earrings or any other metallic objects in head and
neck region.
– Instruct patients to remain still.
– Drape with lead apron.

 Patient Positioning
– Place the pt so that dental arches are located in middle of focal
trough.
– A-P positioning – by biting at bite block.
– Proper mid sagittal plane –proper head positioning –
cephalostat.
– Occlusal plane and chin must be properly positioned – FH plane
parallel with floor..
– Back and spine be erect with neck extended.

If anterior teeth are located behind the FT
- Blurred
- Wide anterior teeth

If anterior teeth are located infront of the FT
-Blurred
-Narrow anterior teeth


If skull tipped too far backward

Position the skull according to FH plane and check for
occlusal plane

Correct position using bite block


If skull tipped too far forward

Position the skull according to FH plane and check for
occlusal plane

Deviation in mid sagittal plane

Asymmetric image


Positioning of the Tongue

Pt should press tongue against palate

Radiation dose reduction
 By using rare-earth intensifying screens.
 Reduce the output by using filters infront of x-ray tube.
Eg. Lanex screens.


Positioning in mixed dentition stage
•The tooth buds should be in FT
•If additional supernumerary teeth
or impacted teeth has to be shown the
pt must be positioned with occlusal
plane steeply dorsally


Radiographic appearance of
normal Anatomy


The four Diagnostic regions in OPG
Dentoalveolar region

Mandibular region

TMJ,including retromaxillary
and cervical region

Maxillary region

Maxillary
region


Mandibular
region


Dentoalveolar region

• Shape and angulation of roots.
• Alveolar bone and periodontium
• Shows gentle curve of occlusal plane
• Missing 3rd molars and
• Presence of metallic restorations.

Soft tissue images


Air spaces


Xeroradiography


Xeroradiography


Xeroradiography is the recording of
radiologic images by a photoelectric process
rather than the photochemical one used in
conventional radiography.

An electrostatic image of object is formed on a
‘ Xeroplate’ , a metallic plate
coated with Selenium.
An electrostatic image is printed on a paper in
such a manner that xeroradiograph is obtained.

Advantages
Pronounced edge enhancement
A choice of positive and negative display
Good detail
Wide exposure latitude
No need of silver halide coated films.

Disadvantages
High radiation exposure

Types of Xeroradiographic systems
 Two types –
1. The Medical 125 system
– Used since 1970s.
– Used manly in Mammography and general
radiography.
– Also been used for Cephalometric
radiography and Tomography of TMJ

1. The Dental 110 system
 Designed for dental Xeroradiographs

Medical Xeroradiography
Conventional X-ray source is needed.
Image is recorded on Selenium coated plate.
Before use, Selenium photoreceptors which are
stored in a unit called conditioner are given a
uniform electrostatic charge


Processing of Xeroplate before exposure


Exposure of Xeroplate

Latent image

Latent image is converted to visible image by
process called Development, in unit called
Processor

Development of Image


Positive Image
 Darkest areas corresponds to most dense parts of anatomy.


Negative image
 Darkest areas corresponds to least dense parts of anatomy
and dense objects appear white.


Dental Xeroradiography
 Dental 110 xeroradiogrphic unit system is similar to
medical 125 system in concept but its design is
physically different.
 The image receptor plates are the size no. 1 and no. 2
films and fit well in oral cavity.


Dental xeroradiographic processor.


Dental Xeroradiographic procedure.


Radiologic exposure conditions and resultant skin doses
in application of Xeroradiography to Orthodontic
diagnosis. AJO-DO, 1980 by Akihiko Nakasima (Japan )

Minimum xeroradiologic exposure conditions
for Skull projections, Schuller’s and TMJ
projections and Hand projections were
established by 13 examiners.
 Relation b/w image production and radiation
dose was discussed in comparison with
conventional film techniques.

 The advantages were–

finer and clearer images due to edge effect and wider
latitude.

– Landmarks on cephlaogram such as Sella,
ANS,Basion, etc were more clear and exactly set.
– Outline of condylar process and articular fossa, the
trabecular pattern of mandible and interdental crestal
bone edges were more clear and distinct.
 The main hazard was unavoidable larger skin radiation
dose . It was 2.4 to 16.2 times larger than conventional
film techniques.

A cephalometric appraisal of Xeroradiography
by Chate – AJO-DO 1980
Aim : To estimate the effect of xeroradiographic technique on the
degree of inter and intra observer error in cephalometric landmarks
identification.
Method
This study involved identification by four observers of 16
cephalometric landmarks on 12 xeroradiographs & on 12
radiographs, on 2 separate occasions.
Conclusion
 Neither technique provided a significant decrease in interobserver
differences.
 However, for 8 of 32 variables, xeroradiography produced a
significant reduction in intraobserver error in comparison to
radiography.

Clark’s technique


Localization technique
 Two methods are used in dentistry to obtain
3-D information –
1. To employ two films projected at right angle
to each other.
2. Tube shift/cone shift principle or Clark’s
technique or buccal object rule or SLOB rule.
 Mainly used in Orthodontia to locate position
of impacted canine.

Clark’s technique
C.A Clark described it in 1910.
Its based on Parallax principle.
In this , 2 periapical films are taken,
– First, standard orthoradial projection,
– Second, employs a vertical or horizontal change in
central ray projection.


The apparent movement of the object in this
radiograph will provide clue to its exact
location.
According to rule of thumb objects which
moves with central ray movement are actually
behind the reference object.
Its basis of SLOB rule, that is Same side
Lingual Opposite side Buccal


Horizontal shift of central ray
Distal shift of cone

Cone shift

Cone shift

Standard

Standard

Vertical shift of central ray

Standard

Standard

Vertical shift

Vertical shift

INDICES


Index
According to Russell, an index is defined as
‘A numerical value describing the relative status
of the population on a graduated scale with definite
upper and lower limits which is designed to permit and
facilitate comparison with other population classified
with the same criteria and the method.’
In the orthodontic context index is described as –
‘A rating or categorizing system that assigns a
numeric score or alpha numeric label to a person’s
occlusion.’

Requirements of ideal orthodontic index are –
(Jamison H.D. and Mc Millan R.S )
1. Simple, reliable and reproducible.
2. Objective and yield quantitative data.
3. Differentiate b/w handicapping and non
handicapping malocclusions.
4. Measure degree of handicap.
5. Quick examination.
6. Amenable to modifications.
7. Usable either on patient or on study model.

Types of Indices ( according to WHO)
 Occlusal Classification
– Angle’s classification by Angle in 1899
– Incisor classification by Ballard and Wayman, 1964
 Skeletal classification by Houston et al, 1993
 Malocclusion
– Occlusal index by Summers 1966
– Handicapping Malocclusion Assessment Record
(HMAR) by Salzmann, 1968
– Index of Treatment Need by Evans and Shaw 1987

 Treatment assessment
– Little’s irregularity index by Little 1975
– Peer Assessment rating by Richmond et al, 1992
 Cleft Outcome
– Goslon Yardstick by Mars et al, 1987
– 5Year olds’ Index by Atack et al ,1997
 Periodontal
– Plaque Index by Stilness & Loe , 1964
– Gingival Index. by Loe & Stilness, 1963


Types Of Indices
According to Shaw , Richmond and O’Brien
 Diagnostic Classification
– Angle’s classification
– Incisor classification
 Epidemiologic indices
– Study prevalence of malocclusion in population.
– Eg 1.Summer’s occlusal index.
2. Registration of malocclusion described by
Bjork, Krebs and Solow


 Treatment need ( Treatment priority) indices.
– Categorize malocclusion according to levels of treatment
needs.
– Eg 1. Index Of Treatment Need (IOTN)
2. Draker’s Handicapping Labio – Lingual Deviation
index (HLD)
3. Grainger’s Treatment Priority Index.(TPI)
4. Salzmann’s Handicapping Malocclusion Index

 Treatment outcome indices.
– Assesssment of changes resulting from treatment
– Eg 1. Peer Assessment Rating index
2. Summer’s index

 Treatment complexity index
– Index of Complexity Outcome and Need (ICON)

Various indices of Occlusion
Master and Frankel (1951)
– Count the number of teeth displaced or
rotated
– Qualitative assessment
Malalignment Index byVankrik and Pennel
(1959)
– Tooth displacement and rotations were
measured.

Handicapping Labio – Lingual deviation index
 Proposed to select subjects with severe or handicapping
malocclusions and dentofacial anomalies.
 Applicable only to permanent dentition
 First Orthodontic index to meet administrative needs of
programme planners.
 Made use of weighting factors developed by trial and
error.
 Had 9 components

Conditions observed
1.
2.
3.
4.
5.
6.
7.
8.
9.

Cleft palate
Severe Traumatic deviations
Overjet in mm
Overbite in mm
Mandibular protrusion in mm
Open bite in mm
Ectopic eruption ,Anteriors only
Anterior crowding : Maxilla
Anterior crowding : Mandible

TOTAL


HLD score
Score 15
Score 15

x5
x4
x3

Handicapping Labio – Lingual deviation index
by Draker (1960)
 Modification of earlier used HLD index
 Main aim is to find presence or absence and degree
of handicap caused by components of index.
 Has 7 components.
 All measurements are made with Boley gauge scaled
in mm.
 A score of 13 and over constitutes physical handicap

7 conditions of HLD index are 1.
2.
3.
4.
5.
6.
7.

Cleft palate
Traumatic deviations
Overjet
Overbite
Mandibular protrusion
Open bite
Labio Lingual spread

Following codes are used –
 ‘O’ = condition present
 ‘X’ = condition absent
 ‘M’= mixed dentition
 ‘A’= Clinical approval
 ‘D’=Clinical disapproval

Occlusal index by Summers (1966)


Used to assess severity of malocclusion in population



Nine weighted and defined measurements –
Molar relation
Over jet
Overbite
Posterior cross bite
Posterior open bite
Tooth displacement
Midline relation
Maxillary median diastema
Congenitally missing maxillary incisors.

1.
2.
3.
4.
5.
6.
7.
8.
9.


 Seven malocclusion syndromes defined
1.
2.
3.
4.
5.
6.
7.



Overjet and open bite
Distal molar relation, overjet, overbite, posterior
crossbite, midline diastema and mid line deviation.
Congenitally missing maxillary incisors.
Tooth displacement.
Posterior open bite.
Mesial molar relation, overjet, overbite, posterior
crossbite, midline diastema and mid line deviation.
Mesial molar relation, mixed dentition analysis
(potential tooth displacement) and tooth displacement.
Different scoring schemes and forms for different
stages of dental development: Deciduous, Mixed &
Permanent dentition.

Treatment priority index by Grainger
(1967)
 The precursor of the TPI was the Malocclusion Severity
Estimate (MSE) developed by Grainger at the
Burlington Orthodontic Research Center in 1960-61
 Unlike the TPI, the MSE score was that of the
syndrome with the largest value, regardless of the scores
of the other syndromes.
 The TPI also differed from the MSE by deleting
potential tooth displacement (mixed-dentition space
analysis) and by rating distoclusion and mesioclusion
equally.

Treatment priority index by Grainger (1967)

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.

11 weighted and defined measurements –
Upper anterior segment overjet.
Lower anterior segment overjet.
Overbite
Anterior openbite.
Congenital absence of incisors.
Distal molar relation
Mesial molar relation
Posterior cross bite (max. teeth buccal to normal).
Posterior cross bite (max. teeth lingual to normal).
Tooth displacement
Gross anomalies.

Seven malocclusion syndromes were defined 1.
2.
3.
4.
5.
6.
7.

Prognathism
Retrognathism
Overbite
Openbite
Maxillary expansion syndrome
Maxillary collapse syndrome
Congenitally missing incisors


 TPI is based on a scale of
1.
2.
3.
4.

0 (near ideal occlusion)
1 - 3 ( mild malocclusion)
4 – 6 ( Moderate malocclusion)
Over 6 ( severe malocclusion)

 TPI scores only occlusal characteristics, excluding
skeletal and facial components.
 TPI is used in national studies of orthodontic needs for
children. Eg. USPHS study in USA of childeren aged
b/w 6-11 yrs in year 1967

Handicapping malocclusion assessment
records by Salzmann (1968)


1.

The purpose of HMAR – To establish priority for
treatment according to severity as shown by score.
Weighted measurements consists of 3 parts –
Intra arch deviations
Missing teeth
Crowding
Rotation
Spacing

1.

Interarch deviations
Overjet
Overbite
Crossbite
Openbite
Mesiodistal deviations

3. Six handicapping dento-facial deformities
1.
2.
3.
4.
5.
6.

Facial and oral clefts
Lower lip palatal to maxillary incisors.
Occlusal interferences
Functional jaw limitations
Facial asymmetry
Speech impairment.

 Score 8 points for each deviation.

Instruction for Scoring


Peer assessment rating Index (PAR index)
Index of orthodontic treatment outcome



Developed by 10 experienced British orthodontists.



Its developed mainly to assess effectiveness of
Orthodontic treatment .



Assigns scores to different occlusal traits.



Study models used.



A scoring system was developed and a ruler designed
to allow analysis of a set of study casts in 2 minutes.

5 components-

Weighting
1. Upper & lower anterior segment - 1
2. Left and right buccal segments 1
3. Over jet
- 6
4. Overbite
- 2
5. Centerlines
- 4
 Individual scores are summed to get a final score..
 Index is applied to both the start and end of treatment
study casts, and change in total score reflects the success
of treatment.


1.
2.




Change expressed as:
Reduction in weighted PAR score : 22 point
reduction – Greatly improved
% reduction in weighted PAR score:
< 30% reduction – worse/ no better
> 30% reduction – Improved.
Indicator of clinical performance.
Limitations of PAR
1. Generic weightings of Over jet and overbite.
2. Sensitive to malocclusion with high over jet.
3. Overbite low weighting.
4. Zero weighting for displacements.
5. Facial profiles not considered Eg. Bimaxillary
protrusion

TheValidation of PAR for Malocclusion severity
and Treatment Difficulty
De Guzman,bahiraei, Vig, Weyant and O’Brien – AJO-DO 1995

 11 American Orthodontists examined a sample of 200
sets of study casts and rated them for malocclusion
severity and perceived treatment difficulty.

 The results of this study made it possible to derive a set
of weightings for the PAR index that would represent
groupings of malocclusion severity and treatment
difficulty, according to perceptions of panel of
Orthodontists.

Index of Treatment Need (IOTN)
by Shaw
 Index has two components1.
2.



Dental Health component – derived from occlusion
and alignment.
Aesthetic component – Derived from comparison of
dental appearance to standard photographs.
Aesthetic component is calculated by direct
examination, but dental health component can be
studied by dental casts.

A special ruler summarizes the information
needed for dental health component.
 Assessed in order :
1. Missing teeth
2. Overjet
3. Crossbites
4. Displacements (Contact point)
5. Overbite


Esthetic Index
 Grades 8 – 10 =
definite need for
treatment.
 5 – 7 = moderate/
borderline need
 1 – 4 = No/ slight
need


Limitations
1.
2.
3.

In aesthetic component ,Class III not considered.
Facial profile not considered.
Class I bimaxillary protrusion not considered.


Index of Complexity Outcome and Need
(ICON)


Based on expert opinions of 97 orthodontists from
various countries.



For use on patients and Dental casts.



A single assessment method to record complexity,
outcome and need.


 5 components taking about 1 min to measure.
1. Aesthetic component
 10 pictures

1. Upper arch Crowding/ Spacing
 Score according to amount of crowding or spacing
 Impacted teeth in either arch immediately scored 5
 Spacing in one part can cancel out crowding elsewhere.

1. Crossbite
2. Incisor open bite/ overbite
 Open bite measured at mid incisal edges
 Deep bite is measured at deepest part of overbite.

1. Buccal segment Antero posterior
 Quality of buccal segment interdigitation is measured
(not Angles Classification)

1. Aesthetic component


ICON Scoring Method


Limitations
1.
2.
3.

Overjet not considered.
Lower anterior crowding not considered.
Midline shift not taken in account.


A dental-facial attractiveness
scale
Tedesco, Albino, Cunat AJO-DO 1983
 The purpose of this study was to develop a valid and
reliable index that provides relatively objective
judgments of dental-facial attractiveness.
 The subjects in this study were eighth- and ninth-grade
children. Few were seeking orthodontic treatment and
few were not seeking treatment.
 Photographs of the children were rated for dental-facial
attractiveness by lay and dental judges.

Standard photographs of white males for points 1 (most
attractive) through 5 (least attractive) on the dental-facial
attractiveness scale.
Point 2

Point 1

Point 3

Point 4


Point 5

.
 Children were also assessed for severity of malocclusion
by means of the Treatment Priority Index
 Children seeking treatment were perceived as
significantly less attractive than children not seeking
treatment.
 The relationship between dental-facial attractiveness and
overall severity of malocclusion is also established as
proved by TPI scores.


Goslon yardstick :A new system of assessing
dental arch relationships in childeren with UCLP – Michael
Mars, Dennis A. Plint : 1987 A cleft Palate journal
 The Goslon Yardstick is a clinical tool that allows
categorization of the dental relationships in the late
mixed and or early permanent dentition in to 5 discrete
categories.
 Objective : 1. To categorize malocclusions in patients
with UCLP to represent severity of malocclusion and the
difficulty of correcting it.
2. To compare long term results of different approaches
to the early treatment of children with UCLP.


1.
2.
3.




Development of Yardstick – Clinical features
considered most important in characterizing
malocclusion in children with UCLP are –
A- P arch relationship –Class III incisor relationship>
class II div I
Vertical labial segment relationship – Open bite>
Reduced overbite > deep overbite.
Transverse relationship – Canine crossbites > molar
crossbites.
To test the application of these subjective criteria
study models of 30 cases were taken.
These models were ranked by 4 orthodontists and
separated in 5 groups , which then formed basis for
yardstick.

 Group 1 – excellent





Group 2 – good
Group 3 – fair
Group 4 – poor
Group 5 – very poor

 Group 1 or 2 - simple orthodontic treatment/ no
treatment
 Group 3 – complex orthodontic treatment
 Group 4 – limit of orthodontic treatment without
orthognathic surgery
 Group 5 – Orthognathic surgery

References (Diagnostic set up)
1.
2.
3.
4.

Begg Orthodontics Theory & Technique – Kesling
Diagnosis and treatment planning
in Orthodontics – Van der Linden
A Simplified wax set up technique by Dr. R.W.
Knierim JCO-1975.
A simplified Diagnostic set up technique by Dr. Barry
N. Resnick; 1979 JCO.


References (Radiology)
1.
2.
3.
4.
5.
6.

7.

Oral radiology – Goaz & White.
A Colour Atlas of Dental Radiology – Friedrich A
Pasler.
Essentials of Dental Radiography – Orien N Johnson.
Principles of Dental Imaging – Langland.
Orthodontics - T. M .Graber.
Radiologic exposure conditions and resultant skin
doses in application of xeroradiography to
Orthodontic diagnosis by Akihiko Nakasima AJODO, 1980 .
A cephalometric appraisal of Xeroradiography
by Chate AJO-DO 1980.

References ( indices)
1.
2.
3.

Contemporary Orthodontics – Proffit
M Ortho Journal – Bristol University
Longitudinal evaluation of the Treatment Priority
Index (TPI) AJO-DO 1989

:

4.

Goslon yardstick A new system of assessing dental
arch relationships in childeren with UCLP – Michael
Mars, Dennis A. Plint : 1987 A cleft Palate journal

5.

A dental-facial attractiveness scale Tedesco , Albino,
Cunate AJO-DO 1983
The Development of PAR Index – S. Richmond

6.


7. Handicapping Malocclusion assessment to establish
treatment Priority J A Salzmann – AJO –1964
8. The use of Occlusal Indices : A European prospective –
AJO-DO 1995
9. The validation of PAR for malocclusion severity and
treatment difficulty AJO-DO 1995
10. The effectiveness of ClassII div I treatment – AJO-DO
1995


Thank you
For more details please visit


Diagnostic setup. opg, xeroradiography,clarks technique /certified fixed orthodontic courses by Indian dental academy

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Viewers also liked

Viewers also liked (20)

Similar to Diagnostic setup. opg, xeroradiography,clarks technique /certified fixed orthodontic courses by Indian dental academy

Similar to Diagnostic setup. opg, xeroradiography,clarks technique /certified fixed orthodontic courses by Indian dental academy (20)

More from Indian dental academy

More from Indian dental academy (20)

Recently uploaded

Recently uploaded (20)

Diagnostic setup. opg, xeroradiography,clarks technique /certified fixed orthodontic courses by Indian dental academy