The document outlines the general examination procedures in orthodontics, including assessments of patient height, weight, gait, posture, body build, and facial symmetry. It categorizes various physical forms and abnormalities that may have dental correlations, along with methods for evaluating jaw relationships and facial proportions. Additionally, it describes specific features such as lip competence and nose symmetry that can affect overall facial aesthetics.

1. R.Kavitha
4th yr

2. GENERAL
EXAMINATION
The general examination comprises of the general
assessment of the patient. An observant clinician
usually begins his general examination as soon as
the patient enters the clinic.
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3. 1.Height and weight
• The height and weight of the patient are recorded as they provide a clue to the
physical growth and maturation of the patient which may have dento- facial
correlation.
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5. Gait
It is the way a person walks.
Abnormalities of gait are usually associated with
neuromuscular disorders which may have a dental co-
relation.
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6. Types of gait
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7. Posture
Posture refers to the way a person stands.
Abnormal postures can predispose to malocclusion due to
alteration in maxillo- mandibular relationship.
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8. Types of posture
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9. Body build (physique)
It is possible to classify the physique into one of the
following three types:
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10. a. Aesthetic
They have a thin physique
and usually posses narrow
dental arches.
b. Plethoric :
They are persons who are
obese. They generally have
large, square dental arches.
c. Athletic :
They are considered
normally built being neither
thin nor obese. They have
normal sized dental arches.
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11. General body build
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12. Sheldon has classified the general body
build into three types :
a. Ectomorphic :
Tall and thin physique
b. Mesomorphic :
Average physique
c. Endomorphic :
Short and obese physique
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13. EXTRA - ORAL
EXAMINATION

14. Shape of the head
The head can be classified into one of the following Three types
Mesocephol
ic: Average
shape of
head.
They
posses
normal
dental
arches.
Dolicocepha
lic Long
and narrow
head.
They have
narrow
dental
arches.
Brachyceph
alic
Broad and
short head.
They have
broad
dental
arches.
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15. Facial form
A simple way of describing the face is to classify it as either round, oval or square.
A more scientific classification is to classify face into the following three types:
a. Mesoprosopic :
It is an average or
normal face form.
b. Euryprosopic:
This type of face is
broad and short.
c. Leptoprosopic: It
is a long and
narrow face form.
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16. Assessment of
facial symmetry
The patient's facial symmetry is examined to
determine disproportions of the face in
transverse and vertical planes.
In most people the right and left sides are
not identical .
Thus some degree of asymmetry is
considered normal.
Asymmetries that are gross and are
detected easily should be recorded

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Gross facial
asymmetries
can occur as
a result of:
a.
Congenital
defects
b. Hemi-
facial
atrophy /
hypertrophy
c. Unilateral
condylar
ankylosis
and
hyperplasia

18. Facial profile
The facial profile is examined by
viewing the patient from the side. The
facial profile helps in diagnosing gross
deviations in the maxillo- mandibular
relationship.
The profile is assessed by joining the
following two reference lines :

19. • 1. A line joining the forehead and the soft tissue point A (deepest point in curvature of upper lip).
• 2. A line joining point A and the soft tissue pogonion (most anterior point of the chin).
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20. Based on the relationship between these two lines, three types of profiles
exist.
Straight profile : The two lines form a
nearly straight line
Convex profile : The two lines form an
angle with the concavity facing the
tissue. This kind of profile occurs as a
result of a prognathic maxilla or a
retrognathic mandible as seen in a
Class II, Division 1 malocclusion
Concave profile : The two reference
lines form an angle with the convexity
towards the tissue This type of profile
is associated with a prognathic
mandible or a retrognathic maxilla as
in a Class III malocclusion
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21. Facial divergence
Facial divergence is defined as an anterior or
posterior inclination of the lower face relative
to the forehead.
Facial divergence can be of three types :

22. Anterior divergent ; A line drawn
between the forehead and chin is
inclined anteriorly towards the chin
Posterior divergent : A line drawn
between the forehead and chin slants
posteriorly towards chin
Straignt or orthognathic ; The line
between the forehead and chin is
straight or perpendicular to the floor
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23. Assessment of Antero -
posterior Jaw relationship
The antero-posterior relationship
between the upper and lower jaw
can be assessed to a certain extent
clinically.

24. Ideally the maxillary skeletal base is 2 - 3 mm
forward of the mandibular skeletal base when
the teeth are in occlusion.
Estimation is done by placement of the index
and the middle fingers at the soft tissue point A
and point B respectively.
This can also be done in the same way after
retracting the lips.
In skeletal Class II patients ,the index finger is
anterior to the middle finger or the hand points
upwards
In a skeletal Class III patient the middle finger
is ahead of the forefinger or the hand points
downwards.
In a patient with Class I skeletal pattern the
hand is at an even level.
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25. Assessment of vertical
skeletal relationship
Normally, the distance from a point
between the eyebrows to the
junction of the nose with upper lip
will be equal to the distance from the
latter point to the under side of the
chin.

26. • A markedly reduced lower facial height is associated with deep bites while increased lower facial height is
associated with anterior open bites.
• The vertical skeletal relationship can also be assessed by studying the angle formed between the lower border
of the mandible and the Frankfort horizontal plane (a line between the most superior point of external auditory
meatus and inferior border of orbit)
• Normally the two planes intersect at the occipital region.
• In case the two planes meet beyond the occipital region, it indicates a low angle case or a horizontal growing
face.
• If the two planes meet anterior to the occipital region it indicates a high angle case or a vertical growing face
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27. Evaluation of
facial proportions
A well proportioned face can be divided into three
equal vertical thirds using four horizontal planes
at the level of the hair line, the supraorbital
region, the base of the nose and the inferior
border of chin.

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29. Examination of
Lips
Normally the upper lip covers the
entire labial surface of upper anterior
except the incisal 2-3 mm.
The lower lip covers the entire labial
surface of the lower anterior and 2 -
3 mm of the incisal edge of the
upper anterior.

31. Lips can be classified into the following four
types :
Competent Zips ;
The lips are in slight
contact when the
musculature is
relaxed
Incompetent lips :
They are
morphologically short
lips which do not form
a lip seal in a relaxed
state. The lip seal con
only be achieved by
active contraction of
the perioral and
mentalis muscles(fig
8.b).
Potentially
incompetent lips :
They are normal lips
that fail lo form a lip
seal due to proclined
upper incisors.
Everted lips :
They are
hypertrophied lips
with weak muscular
tonicity
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32. Examination of the
nose

33. Extent contributes to the esthetic appearance of a face.
Size : Normally the nose
is one third of the total
facial height (from hair
line to lower border of
chin).
Contour : The shape of
the nose can be straight,
convex or crooked as a
result of nasal injuries.
Nostrils : They are oval
and should be bilaterally
symmetrical. Stenosis of
the nostrils may indicate
impaired nasal breathing.
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34. Examination
of chin

35. Mento labial sulcus : The
mento-labial sulcus is a
concavity seen below the
lower lip .Deep mento-labial
sulcus is seen in Class II,
Division 1 malocclusion while it
is shallow in bimaxillary
protrusion.
Mentalis activity : Normally
the mental is muscle does
not show any contraction at
rest. Hyperactive mentalis
activity is seen in some
malocclusions such as
Class II, division 1 cases. It
causes puckering of the
chin.
Chin position and
prominence:
Prominent chin is
usually associated
with Closs III
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36. Thank you