Diagnosis is very important in dental and as well as medical field also with proper diagnosis treatment planning also easy and prognosis rate high. In orthodontics proper diagnosis is major factor for successful outcome.
1. Arch space analysis methods estimate tooth size and jaw size relationships. Space analysis compares available space to required space for proper tooth alignment.
2. Methods are classified by tooth size estimation method, arch length estimation method, developmental stage, and estimation/digitization method.
3. Common methods include measurements from radiographs, prediction tables using erupted tooth sizes, and combinations of methods. Nance analysis accounts for space changes between deciduous and permanent dentitions.
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.for more details please visit
www.indiandentalacademy.com
This document discusses various methods of mixed dentition analysis used to predict the size and space needed for unerupted permanent teeth based on measurements of erupted primary and permanent teeth. It describes Nance analysis, Huckaba's method, Moyer's analysis, Tanaka Johnston analysis, Hixon-Oldfather prediction method, and Staley and Kerber method. The document emphasizes that mixed dentition analysis helps evaluate space availability and plan treatment during the transition from primary to permanent dentition.
THE USE OF HAND AND WRIST RADIOGRAPH, OPG AND CEPHALOMETRIC RADIOGRAPH FOR TH...Aghimien Osaronse
This document discusses the use of hand and wrist radiographs, cephalometric radiographs, and panoramic radiographs for assessing growth in orthodontic patients. It covers the indications, methods, and clinical relevance of each radiograph type. Hand-wrist radiographs can be used to determine skeletal maturity stages and predict timing of growth spurts. Cephalometric radiographs allow assessment of cervical vertebrae maturation stages, which correlate with remaining growth. Panoramic radiographs provide dental age by evaluating tooth calcification stages. Together these radiographs provide useful information for orthodontic treatment planning and timing.
Rakosi's analysis is an important diagnostic tool for planning functional appliance therapy. It involves analyzing three divisions: 1) the facial skeleton, 2) the jaw bones, and 3) the dentoalveolar relationship. Key measurements of the facial skeleton include saddle, articular, and gonial angles which provide information about cranial base orientation and mandibular positioning. Measurements of the jaw bones like SNA, SNB, and inclination angle describe the maxillary and mandibular skeletal bases. Dentoalveolar measurements such as upper and lower incisor angles indicate incisor inclinations. Rakosi's analysis provides a comprehensive evaluation of skeletal, dental, and soft tissue structures for orthodontic
This document provides an overview of rapid maxillary expansion (RME) in orthodontics. It discusses the history of RME dating back to 1860. It also covers anatomy related to RME, including the midpalatal suture. Key topics covered include indications and contraindications for RME, types of expansion screws used, jackscrew turn schedules, and different types of RME appliances such as the Haas expander and Hyrax expander. The document is an educational resource on the clinical use and mechanics of RME.
This document summarizes Tweed's analysis of cephalometric landmarks and angles used in orthodontic diagnosis and treatment planning. It describes Tweed's diagnostic facial triangle formed by the Frankfort horizontal plane, mandibular plane, and mandibular incisor plane. Norms for the angles FMA, FMIA, and IMPA are provided based on Tweed's studies. Shortcomings of the ANB angle in assessing jaw relationships are discussed. The Wits appraisal method is introduced as an alternative for measuring anteroposterior jaw disharmony. Related studies validating the Wits appraisal are summarized.
This document discusses the role of genetics in orthodontics. It begins with an introduction to genetics and molecular biology concepts like DNA, genes, and chromosomes. It then discusses several important figures in the history of genetics research. The document outlines several dentofacial disturbances that have a genetic influence, like cleft lip and palate. It also discusses Butler's field theory and methods used to study the role of genes, such as twin studies and polymerase chain reaction. The conclusion reflects on how genetics research has enhanced understanding of the dentofacial complex and hopes that future innovations can help answer remaining questions.
1. Arch space analysis methods estimate tooth size and jaw size relationships. Space analysis compares available space to required space for proper tooth alignment.
2. Methods are classified by tooth size estimation method, arch length estimation method, developmental stage, and estimation/digitization method.
3. Common methods include measurements from radiographs, prediction tables using erupted tooth sizes, and combinations of methods. Nance analysis accounts for space changes between deciduous and permanent dentitions.
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.for more details please visit
www.indiandentalacademy.com
This document discusses various methods of mixed dentition analysis used to predict the size and space needed for unerupted permanent teeth based on measurements of erupted primary and permanent teeth. It describes Nance analysis, Huckaba's method, Moyer's analysis, Tanaka Johnston analysis, Hixon-Oldfather prediction method, and Staley and Kerber method. The document emphasizes that mixed dentition analysis helps evaluate space availability and plan treatment during the transition from primary to permanent dentition.
THE USE OF HAND AND WRIST RADIOGRAPH, OPG AND CEPHALOMETRIC RADIOGRAPH FOR TH...Aghimien Osaronse
This document discusses the use of hand and wrist radiographs, cephalometric radiographs, and panoramic radiographs for assessing growth in orthodontic patients. It covers the indications, methods, and clinical relevance of each radiograph type. Hand-wrist radiographs can be used to determine skeletal maturity stages and predict timing of growth spurts. Cephalometric radiographs allow assessment of cervical vertebrae maturation stages, which correlate with remaining growth. Panoramic radiographs provide dental age by evaluating tooth calcification stages. Together these radiographs provide useful information for orthodontic treatment planning and timing.
Rakosi's analysis is an important diagnostic tool for planning functional appliance therapy. It involves analyzing three divisions: 1) the facial skeleton, 2) the jaw bones, and 3) the dentoalveolar relationship. Key measurements of the facial skeleton include saddle, articular, and gonial angles which provide information about cranial base orientation and mandibular positioning. Measurements of the jaw bones like SNA, SNB, and inclination angle describe the maxillary and mandibular skeletal bases. Dentoalveolar measurements such as upper and lower incisor angles indicate incisor inclinations. Rakosi's analysis provides a comprehensive evaluation of skeletal, dental, and soft tissue structures for orthodontic
This document provides an overview of rapid maxillary expansion (RME) in orthodontics. It discusses the history of RME dating back to 1860. It also covers anatomy related to RME, including the midpalatal suture. Key topics covered include indications and contraindications for RME, types of expansion screws used, jackscrew turn schedules, and different types of RME appliances such as the Haas expander and Hyrax expander. The document is an educational resource on the clinical use and mechanics of RME.
This document summarizes Tweed's analysis of cephalometric landmarks and angles used in orthodontic diagnosis and treatment planning. It describes Tweed's diagnostic facial triangle formed by the Frankfort horizontal plane, mandibular plane, and mandibular incisor plane. Norms for the angles FMA, FMIA, and IMPA are provided based on Tweed's studies. Shortcomings of the ANB angle in assessing jaw relationships are discussed. The Wits appraisal method is introduced as an alternative for measuring anteroposterior jaw disharmony. Related studies validating the Wits appraisal are summarized.
This document discusses the role of genetics in orthodontics. It begins with an introduction to genetics and molecular biology concepts like DNA, genes, and chromosomes. It then discusses several important figures in the history of genetics research. The document outlines several dentofacial disturbances that have a genetic influence, like cleft lip and palate. It also discusses Butler's field theory and methods used to study the role of genes, such as twin studies and polymerase chain reaction. The conclusion reflects on how genetics research has enhanced understanding of the dentofacial complex and hopes that future innovations can help answer remaining questions.
1) The document discusses different types of scissor bites (malocclusions where the maxillary teeth are positioned buccal to the mandibular teeth), including definitions, classifications, causes, and treatment options.
2) Scissor bites can be caused by factors like microglossia, abnormal tooth germ position, and skeletal Class II issues. Treatment depends on a patient's age and severity of the scissor bite, ranging from removable appliances to orthodontic devices to orthognathic surgery.
3) The document presents several case studies as examples. One case discusses using a bonded constriction quad-helix appliance to reduce the maxillary arch width in a growing patient with a bilateral scissor
Downs analyzed 20 individuals with excellent occlusions using cephalometric analysis. He identified 5 skeletal and 5 dental parameters to characterize facial patterns, including the facial angle, angle of convexity, A-B plane, mandibular plane angle, and Y axis. The analysis found normal ranges for each parameter and showed how deviations from these ranges indicate different facial types and relationships between the denture and skeletal pattern. Downs demonstrated how this analysis can be used to evaluate treatment outcomes and classify malocclusions.
This document discusses growth spurts and their significance in orthodontics. It begins by defining growth and development, and describing the major developmental growth periods. It then discusses methods for studying growth, including longitudinal, cross-sectional, and semi-longitudinal studies. Key factors that influence growth and maturation are genetic, hormonal, nutritional, environmental and socioeconomic factors. The document explores concepts of growth including normality, growth rhythms, differential growth, and growth spurts. It concludes by noting the significance of growth spurts is important for orthodontic treatment planning.
This document provides an overview of cephalometric analysis. It defines cephalometry as the scientific measurement of the bones of the cranium and face using lateral radiographs. Various cephalometric analyses are described, including landmarks, planes, and measurements used in Downs, Steiner, Tweed, and Ricketts analyses to evaluate the skeletal and dental relationships of the craniofacial structures. Limitations of cephalometric analysis are also discussed.
Tongue and its importance in orthodontic treatment /certified fixed orthodont...Indian dental academy
This document discusses the anatomy, development, functions and examination of the tongue. It notes that the tongue plays an important role in dental development and malocclusion through its pressures and posture. Abnormal tongue posture, like a forward resting posture, can exert pressures on teeth and affect their positions over time. The document examines tongue posture and functions like swallowing, and discusses conditions like tongue thrust and retained infantile swallowing that can influence malocclusion. Metric evaluation methods like cephalometry and palatography are presented for assessing tongue posture.
The document discusses orthodontic diagnosis and treatment planning. It defines diagnosis as identifying and describing a patient's orthodontic problems. Treatment planning involves outlining a strategy to address the problems while maximizing benefits and minimizing risks. It discusses indications for treatment including psychosocial, developmental, functional, and trauma/disease factors. It also addresses distinguishing moderate problems treated in general practice from more complex cases requiring referral to an orthodontic specialist.
This document provides an overview of model analysis for mixed dentition. It defines study models and their objectives. Various types of model analyses are described, including those for mixed dentition like Moyer's analysis, which uses measurements of erupted mandibular incisors to estimate the sizes of unerupted canines and premolars. The goals and procedures of mixed dentition analysis are outlined, such as determining if there is enough space for permanent teeth. Factors considered include tooth sizes, arch perimeter, and expected changes during development.
The document discusses orthodontic diagnosis and the essential and supplemental diagnostic aids used. It describes the key components of clinical examination including case history, medical history, dental history, and physical examination of the head, face, lips, nose, and chin. Clinical examination aims to evaluate oral health and function, identify the nature of malocclusions, and determine which diagnostic records are needed for diagnosis and treatment planning.
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.for more details please visit
www.indiandentalacademy.com
Dr. James McNamara developed a cephalometric analysis method in 1984 to evaluate orthodontic and orthognathic surgery patients. The analysis divides the craniofacial skeleton into five sections - maxilla to cranial base, maxilla to mandible, mandible to cranial base, dentition, and airway. Linear measurements of landmarks and planes are compared to normative standards to assess relationships. Advantages include using primarily linear measurements, being more sensitive to vertical changes, and providing growth guidelines that are easily explained.
This document summarizes Dr. Pratik Yadav's journal club presentation on Downs WB Analysis of the dento-facial profile. It discusses the 10 parameters in Downs analysis, which includes 5 skeletal and 5 dental measurements. The parameters are measured based on landmarks and reference planes on lateral cephalograms. Downs analysis is one of the most commonly used cephalometric analyses originally developed based on Caucasian patients with excellent occlusion.
“The study of orthodontia is indissolubly connected with that of art as related to the human face.” -Dr. Edward H. Angle.
Each person shares with the rest of the population a great many characteristics, but there are enough differences to make each human being a unique individual. Such limitless variation in the size, shape and relationship of the dental, skeletal and soft tissue facial structures are important in providing each individual with his or her own identity.
Face – Difficult object to measure accurately because of
– complex morphology
– sensitivity to eyes
– its soft nature.
One of goals of orthodontic treatment is creating a balanced & harmonious facial appearance. Craniofacial symmetry is one of the aspect of this harmony. Subject of symmetry or lack of symmetry of human face has been of considerable interest, particularly in the field of Orthodontics. Minor variation is a desirable variation of craniofacial structure which is perceived as esthetically pleasing and has no esthetic or functional significance. Asymmetry becomes important when it affects the function or esthetics of the person.
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
This document provides information on various methods for analyzing dental models and casts, including Pont's analysis, Linder Harth index, Chadda index, Korkhaus analysis, Korbitz estimate, Ashley Howe's analysis, Nance and Carey's analysis, Lundstorm segmental analysis, and Peck and Peck index. It describes how each method is used to assess characteristics like arch width, length, symmetry, tooth size, relationships, and space analysis to aid in orthodontic diagnosis and treatment planning. Mixed dentition analysis is also summarized as a way to evaluate space for permanent teeth.
Orthodontic diagnosis deals with recognition of the various characteristics of the malocclusion. It involves collection of pertinent data in a systemic manner to help in the identifying the nature and cause of the problem.
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.for more details please visit
www.indiandentalacademy.com
The document discusses theories of mandibular growth and the construction bite technique used in orthodontic appliances. It describes several theories of condylar growth including the genetic control theory, functional matrix hypothesis, and lateral pterygoid hyperactivity hypothesis. It also discusses the growth relativity hypothesis. The construction bite is critical for functional appliances to work properly and involves analyzing study models, function, and cephalometrics to determine the proper vertical and horizontal positioning of the mandible. The magnitude of correction depends on factors like the type of malocclusion and developmental state.
CASE HISTORY AND PHYSICAL EVALUATION OF DENTAL PATIENTS /prosthodontic coursesIndian dental academy
This document discusses the components of taking a patient's medical history and performing a physical examination for dental treatment. It covers gathering information on the chief complaint, history of present illness, past medical and dental history, family history, and personal history including oral habits and hygiene. The information obtained is used to make diagnoses, assess medical conditions, and plan safe dental care tailored to each patient's needs.
1) The document discusses different types of scissor bites (malocclusions where the maxillary teeth are positioned buccal to the mandibular teeth), including definitions, classifications, causes, and treatment options.
2) Scissor bites can be caused by factors like microglossia, abnormal tooth germ position, and skeletal Class II issues. Treatment depends on a patient's age and severity of the scissor bite, ranging from removable appliances to orthodontic devices to orthognathic surgery.
3) The document presents several case studies as examples. One case discusses using a bonded constriction quad-helix appliance to reduce the maxillary arch width in a growing patient with a bilateral scissor
Downs analyzed 20 individuals with excellent occlusions using cephalometric analysis. He identified 5 skeletal and 5 dental parameters to characterize facial patterns, including the facial angle, angle of convexity, A-B plane, mandibular plane angle, and Y axis. The analysis found normal ranges for each parameter and showed how deviations from these ranges indicate different facial types and relationships between the denture and skeletal pattern. Downs demonstrated how this analysis can be used to evaluate treatment outcomes and classify malocclusions.
This document discusses growth spurts and their significance in orthodontics. It begins by defining growth and development, and describing the major developmental growth periods. It then discusses methods for studying growth, including longitudinal, cross-sectional, and semi-longitudinal studies. Key factors that influence growth and maturation are genetic, hormonal, nutritional, environmental and socioeconomic factors. The document explores concepts of growth including normality, growth rhythms, differential growth, and growth spurts. It concludes by noting the significance of growth spurts is important for orthodontic treatment planning.
This document provides an overview of cephalometric analysis. It defines cephalometry as the scientific measurement of the bones of the cranium and face using lateral radiographs. Various cephalometric analyses are described, including landmarks, planes, and measurements used in Downs, Steiner, Tweed, and Ricketts analyses to evaluate the skeletal and dental relationships of the craniofacial structures. Limitations of cephalometric analysis are also discussed.
Tongue and its importance in orthodontic treatment /certified fixed orthodont...Indian dental academy
This document discusses the anatomy, development, functions and examination of the tongue. It notes that the tongue plays an important role in dental development and malocclusion through its pressures and posture. Abnormal tongue posture, like a forward resting posture, can exert pressures on teeth and affect their positions over time. The document examines tongue posture and functions like swallowing, and discusses conditions like tongue thrust and retained infantile swallowing that can influence malocclusion. Metric evaluation methods like cephalometry and palatography are presented for assessing tongue posture.
The document discusses orthodontic diagnosis and treatment planning. It defines diagnosis as identifying and describing a patient's orthodontic problems. Treatment planning involves outlining a strategy to address the problems while maximizing benefits and minimizing risks. It discusses indications for treatment including psychosocial, developmental, functional, and trauma/disease factors. It also addresses distinguishing moderate problems treated in general practice from more complex cases requiring referral to an orthodontic specialist.
This document provides an overview of model analysis for mixed dentition. It defines study models and their objectives. Various types of model analyses are described, including those for mixed dentition like Moyer's analysis, which uses measurements of erupted mandibular incisors to estimate the sizes of unerupted canines and premolars. The goals and procedures of mixed dentition analysis are outlined, such as determining if there is enough space for permanent teeth. Factors considered include tooth sizes, arch perimeter, and expected changes during development.
The document discusses orthodontic diagnosis and the essential and supplemental diagnostic aids used. It describes the key components of clinical examination including case history, medical history, dental history, and physical examination of the head, face, lips, nose, and chin. Clinical examination aims to evaluate oral health and function, identify the nature of malocclusions, and determine which diagnostic records are needed for diagnosis and treatment planning.
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.for more details please visit
www.indiandentalacademy.com
Dr. James McNamara developed a cephalometric analysis method in 1984 to evaluate orthodontic and orthognathic surgery patients. The analysis divides the craniofacial skeleton into five sections - maxilla to cranial base, maxilla to mandible, mandible to cranial base, dentition, and airway. Linear measurements of landmarks and planes are compared to normative standards to assess relationships. Advantages include using primarily linear measurements, being more sensitive to vertical changes, and providing growth guidelines that are easily explained.
This document summarizes Dr. Pratik Yadav's journal club presentation on Downs WB Analysis of the dento-facial profile. It discusses the 10 parameters in Downs analysis, which includes 5 skeletal and 5 dental measurements. The parameters are measured based on landmarks and reference planes on lateral cephalograms. Downs analysis is one of the most commonly used cephalometric analyses originally developed based on Caucasian patients with excellent occlusion.
“The study of orthodontia is indissolubly connected with that of art as related to the human face.” -Dr. Edward H. Angle.
Each person shares with the rest of the population a great many characteristics, but there are enough differences to make each human being a unique individual. Such limitless variation in the size, shape and relationship of the dental, skeletal and soft tissue facial structures are important in providing each individual with his or her own identity.
Face – Difficult object to measure accurately because of
– complex morphology
– sensitivity to eyes
– its soft nature.
One of goals of orthodontic treatment is creating a balanced & harmonious facial appearance. Craniofacial symmetry is one of the aspect of this harmony. Subject of symmetry or lack of symmetry of human face has been of considerable interest, particularly in the field of Orthodontics. Minor variation is a desirable variation of craniofacial structure which is perceived as esthetically pleasing and has no esthetic or functional significance. Asymmetry becomes important when it affects the function or esthetics of the person.
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
This document provides information on various methods for analyzing dental models and casts, including Pont's analysis, Linder Harth index, Chadda index, Korkhaus analysis, Korbitz estimate, Ashley Howe's analysis, Nance and Carey's analysis, Lundstorm segmental analysis, and Peck and Peck index. It describes how each method is used to assess characteristics like arch width, length, symmetry, tooth size, relationships, and space analysis to aid in orthodontic diagnosis and treatment planning. Mixed dentition analysis is also summarized as a way to evaluate space for permanent teeth.
Orthodontic diagnosis deals with recognition of the various characteristics of the malocclusion. It involves collection of pertinent data in a systemic manner to help in the identifying the nature and cause of the problem.
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.for more details please visit
www.indiandentalacademy.com
The document discusses theories of mandibular growth and the construction bite technique used in orthodontic appliances. It describes several theories of condylar growth including the genetic control theory, functional matrix hypothesis, and lateral pterygoid hyperactivity hypothesis. It also discusses the growth relativity hypothesis. The construction bite is critical for functional appliances to work properly and involves analyzing study models, function, and cephalometrics to determine the proper vertical and horizontal positioning of the mandible. The magnitude of correction depends on factors like the type of malocclusion and developmental state.
CASE HISTORY AND PHYSICAL EVALUATION OF DENTAL PATIENTS /prosthodontic coursesIndian dental academy
This document discusses the components of taking a patient's medical history and performing a physical examination for dental treatment. It covers gathering information on the chief complaint, history of present illness, past medical and dental history, family history, and personal history including oral habits and hygiene. The information obtained is used to make diagnoses, assess medical conditions, and plan safe dental care tailored to each patient's needs.
After a complete orthodontic diagnosis is made, the next important step is treatment planning. The main objective of treatment planning is to design a strategy to correct the problems. Good strategy helps to design the best appliance indicated for the patient.
Treatment planning is an outline of all the measures that can best instituted for a patient so as to offer maximum long term benefits.
Patients seeks Orthodontic treatment planning for a variety of reasons, most commonly- Esthetics and Function.
There is no simple or fixed formula or a cook book recipe to treat a Orthodontic problem.
Every case is assessed, analysed and and a customised treatment plan is formulated to best suit the individual patient.
This document provides definitions and guidelines for evaluating patients for complete denture therapy. It discusses examining various aspects of the patient's personal data, medical and dental history, clinical examination including extraoral and intraoral assessment, and classification systems for residual ridges and mucosa. The evaluations are meant to thoroughly understand the patient's existing conditions and needs to determine the appropriate treatment plan and prognosis.
Utilization of biostatistics in medicine and dentistryajazahmad51
This document discusses the utilization of biostatistics in dentistry. It begins by defining biostatistics as the application of statistical processes and methods to the collection, analysis, and interpretation of biological and medical data. It then discusses the history and branches of biostatistics. The document outlines many applications of biostatistics in fields like public health dentistry, various dental specialties, medicine, pharmacology, epidemiology, biotechnology, genetics, and nutrition. It also discusses how biostatistics is used in evidence-based dentistry, research study design, and evaluating health programs. Overall, the document provides an overview of how biostatistics is widely utilized across many areas of health research and practice.
Overview of Diagnostic Aids
Case History and Clinical Examination- General examination
Extra-oral examination
Functional examination
Photographic Analysis
This document discusses treatment planning in dentistry. It explains that treatment planning involves developing both short and long-term strategies to address a patient's dental needs holistically, while also gaining their cooperation. Treatment plans should be separated into phases including systemic care, acute issues, disease control, definitive treatment, and maintenance. When presenting plans, dentists should ensure patients understand all diagnosis, alternatives, risks, costs and provide opportunities for questions. Informed consent must be obtained that documents all discussed aspects of the proposed treatment plan.
This document discusses diagnosis and treatment planning for edentulous or nearly edentulous patients. It emphasizes that diagnosis and treatment planning are crucial for successful management of patients. The diagnosis involves a thorough patient evaluation including medical history, clinical examination, and radiographs to determine the nature of the patient's condition. The treatment plan is then developed based on the diagnosis and consists of procedures to best address the individual patient's needs. Key aspects of diagnosis and treatment planning discussed include taking a chief complaint and medical history, classifying patients based on factors like mental attitude and cosmetic expectations, and considering how medical conditions like diabetes may impact care.
Examination & diagnosis of edentulous patients Jehan Dordi
This document discusses the examination and diagnosis of edentulous patients. It emphasizes the importance of a thorough assessment, including gathering social, medical, and dental histories from the patient. A complete examination involves evaluating factors like facial form, ridge anatomy, muscle function, oral tissues, and saliva. The goals of diagnosis are to understand the patient's needs and develop a treatment plan that leads to a predictable outcome. Certain systemic diseases like diabetes can influence a patient's ability to wear dentures successfully. A multidisciplinary approach involving careful data collection and developing a rapport with the patient is essential for proper diagnosis and treatment planning.
3. risk assessment and medical historyLama K Banna
This document discusses the importance of the connection between oral and systemic health. It notes that oral health reflects overall health status, and that certain systemic conditions like diabetes can impact oral health. The mouth can also serve as a portal of infection. The document then discusses various occupational health problems faced by dentists, like exposure to infectious diseases, radiation, and musculoskeletal disorders. It emphasizes the importance of infection control practices and protective measures. Finally, the document outlines factors to consider when conducting a medical risk assessment for a dental patient, such as the patient's medical conditions, stability, and cardiopulmonary reserve as well as the proposed dental procedure.
This document summarizes evidence from several studies on various aspects of evidence-based prosthodontics. It discusses types of studies used in evidence-based dentistry including systematic reviews, randomized controlled trials, cohort studies, and case reports. It then examines specific evidence related to prosthodontic treatment planning, factors influencing single-tooth implant decisions versus endodontic therapy, decision-making approaches in implant dentistry, outcomes of implants in augmented bone, and survival rates of different prosthesis types. The conclusion emphasizes that a multidisciplinary approach and shared decision-making is important in prosthodontic treatment planning based on available evidence and individual patient factors.
The orthodontic assessment involves gathering information about the patient's orthodontic problems through taking a history, clinical examination, and records. This information is collected to accurately diagnose the patient's malocclusion. The assessment identifies the patient's orthodontic problems to form the basis of the diagnosis. It also identifies potential risks and benefits of treatment so the patient can provide informed consent. The assessment examines the patient's dentition and facial proportions in all three planes to evaluate their underlying skeletal pattern and soft tissues.
This document discusses factors to consider for case selection in endodontic treatment. Proper case selection is important to ensure successful treatment outcomes and avoid pitfalls. Key factors include those related to the tooth itself like root canal anatomy, restorability, and periodontal support. Patient health factors like medical history and physical status must also be evaluated. The clinician's skill and ability to handle different cases is another important consideration. Careful evaluation of all relevant factors helps determine if endodontic therapy is appropriate and predicts the difficulty level of the case.
diagnostic aids part 1 diagnosis, examination, BMR, EMG.docxDr.Mohammed Alruby
Introduction:
Proper treatment plane depends on prompt diagnosis, good clinician should have a bird’s eyes to first identify the problem and find its etiology
Definitions:
= Grabber and Rackosi: defined diagnosis as:
Recognition and systemic designation of anomalies, the practical synthesis of the finding, permitting therapy to be planned and identification to be determined
=a continuous evaluation process in orthodontics starting right from the first interaction with the patient continuing through different stages till end of treatment and course follow up visits
Goal of orthodontic diagnosis:
Is to produce a comprehensive description of the patient’s problem and then to synthesis the various elements of description into a rational problem list
Diagnostic aids:
Data required for orthodontic diagnosis are derived from routine essential diagnostic aids and also from supplemental aids when needed, Graber categorized the diagnostic aids into essential and supplemental aids
Essential:
- Case history
- Study models
- Certain radiographs: periapical, bite wing, panoramic radiograph
- Facial photographs
- Intra-oral photographs
Supplemental:
- Specialized radiographs: occlusal of maxilla and mandible, lateral cephalogram
- Hand &wrist radiograph
- Electromyography
- Endocrine test
- Basal metabolic rate
Case history:
Complete case history includes all the relevant information derived from the patient and parents and essential for planning
Personal details:
Name:
The patient’s name should be recorded for the purpose of identification and communications
Calling the patient by his/her name not only establishes a good report but also imparts confidence in the patient mind about treatment providers
In case of children, it might help to know their pet problems
Age:
= certain malocclusion occurring during growth period are transient and self-correcting
= growth modification procedures such as functional appliances can be carried out during growth periods
= surgical respective procedures such as orthognathic surgery are best carried out after cessation of growth
= chronological age is important for the maintaining of shedding and eruption time tables as well
Gender:
= recording gender of the patient is important for treatment planning, females are observed to precede males in growth related events such as onset of growth spurt, eruption of the teeth and onset of puberty
= gender may also have a bearing on patient’s compliance toward certain types of orthodontic treatment
Occupation and address:
Occupation of patient / or parents gives an idea about socioeconomic condition which might affect the selection of orthodontic appliances and can give an idea about awareness
Address of patient determine the sociality of the patient and this effect on the treatment because some countries have normally bi-maxillary protrusion and also determine the awareness of patient about treatment and oral hygiene
Patient behavior:
Behavior of patient depend on: patient
The document discusses case histories, which contain relevant information about individual clients maintained by various professional organizations. Case histories aim to achieve correct diagnoses, communicate with patients, inform them of their situation, design treatment plans, and determine prognoses. Taking a thorough case history through interview or questionnaire is important for assessing risks to the patient and dentist, and for establishing diagnoses to prevent issues. A case history includes statistics, chief complaint, history of present illness, medical history, dental history, personal history, examinations, diagnoses, treatment plan, and personal information.
The document outlines key considerations for developing an individualized treatment plan. It discusses that treatment plans should be customized for each patient based on a clinical summary and diagnosis of their specific problems. The ideal times to start orthodontic treatment versus growth modification are discussed. Setting goals, listing treatment objectives in priority order, and assessing a patient's growth potential are important parts of treatment planning. The concept of an "envelope of discrepancy" is introduced to illustrate how different treatment approaches can address skeletal discrepancies.
This document discusses utilizing patient care data from clinical settings for clinical research purposes. It describes the types of data available, common barriers faced, and the need to obtain proper permissions. A variety of research study designs are possible using this data, including descriptive studies, interventional studies, qualitative research, and quality improvement projects. Case studies, case series, surveys and collaboration are recommended approaches. Addressing barriers like permissions and developing research skills can help facilitate use of this valuable data source.
1. A study compared long-term stability of adolescent versus adult surgery for treatment of mandibular deficiency, finding that beyond 1 year post-surgery, younger patients showed significantly greater changes in horizontal and vertical positions of mandibular landmarks and angles.
2. Early mandibular advancement surgery may be less stable long-term than performing the same surgery on older, growth-completed patients.
3. Younger patients undergoing two-jaw surgery experienced even greater long-term changes than those receiving isolated mandibular advancement.
Many people assume that getting braces removed is the end of the orthodontic process but actually further care is required to avoid orthodontic relapse.
The Primary role of functional matrices in facial growth- Moss (Ajodo1969)Dr. mahipal singh
In the facial skull, this matrix is the functioning space of the oronasopharyngeal cavity. ... They do so by altering the volume of the capsules within which the functional cranial components are embedded. The effect of such growth changes is to cause a passive translation of these cranial components in space.
surgical and orthodontic management of impacted canines- jcDr. mahipal singh
After the third molar most common impaction is maxillary canines.
This article help to how to treat impacted maxillary canines by surgical and orthodontic.
The maxillary canine is the second most impaction of the oral cavity and this presentation I describe some etiology the interfere of normal eruption path of the maxillary canine.
1. Lawrence F. Andrews observed 120 non-orthodontic patient casts and identified six keys that define normal occlusion: molar relationship, crown angulation, crown inclination, rotations, spaces, and occlusal plane.
2. The six keys provide objective standards to diagnose optimal occlusion and proper treatment planning. They include specifications for the interarch relationship of molars, distal angulation and lingual inclination of crowns, lack of tooth rotations, tight contact points between teeth, and a flat occlusal plane.
3. Achieving all six keys through orthodontic treatment results in optimal occlusion and orofacial harmony according to Andrews' research. The keys establish natural occlusion standards to guide orthodont
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
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2. Contents
• Introduction
• Conventional Orthodontic diagnosis and treatment planning
• Problem Oriented Approach of diagnosis and treatment planning
1) Evolution
2) Principles
3) Formulation of data base
4) Factors to be considered in treatment planning
5) Drawbacks
• Recent advances in diagnosis and treatment planning methodologies
• Conclusion
• Refrenceces
3. INTRODUCTION
• Conventional orthodontic diagnosis is based on E.H Angles line of occlusion.
• Angle considered hard tissue rather than soft tissue and facial esthetics in
correcting a malocclusion.
• Angle solved problem by focussing on the ideal dental occlusion.( Angles
paradigm)
• Now a days diagnosis is based on soft tissue paradigm introduced by
J.L Ackerman.
4.
5. • Soft tissue paradigm states that both the goals and limitation of orthodontic and
orthognathic treatment are determined by the soft tissues of the face, not by the
teeth and bones.
• Focus on clinical examination rather than examination of dental cast and
radiographs
6.
7. DEFINITION
“The recognition and systematic designation of anomalies, the practical
synthesis of the findings, permitting therapy to be planned and indication to
be determined, thereby enabling the doctor to act”.- Thomas Rakosi
8. • Diagnosis, treatment planning, and treatment execution are the steps involved in
successful care of malocclusions.
• Diagnosis is the definition of the problem.
• Treatment planning is based on diagnosis and is the process of planning changes
needed to eliminate the problems.
• Treatment is execution of the plan.
9.
10. • Diagnosis must be comprehensive and not focused only on a single aspect of what
in many instances can be a complex situation.
• Orthodontic diagnosis requires a broad overview of the patient’s situation and
must take into consideration both objective and subjective findings.
• Prior to initiating treatment, orthodontists perform a comprehensive examination
consisting of medical and dental history and an intraoral examination.
11. • Diagnostic records are then collected which normally includes photographs, study
models, panoramic and cephalometric radiographs.
• The records provide clinicians with the necessary facial, dental and skeletal
information needed to thoroughly diagnose and plan the orthodontic treatment
12. COMPREHENSIVE DIAGNOSIS
• comprehensive diagnosis should be a summary of the most important facts and
should not take insignificant secondary symptoms into account as they are of no
relevance to the treatment.
• Essential orthodontic examinations include seven different analytical techniques
are all of the same relevance for orthodontic diagnosis.
• Computer analysis has also been employed for orthodontic diagnostics over the
past few years
16. • The problem-oriented approach to diagnosis and treatment planning has been
advocated in medicine and dentistry as a way to overcome tendency to
concentrate on only one part of patient problem.
• Problem oriented approach introduced into the medicine by Lawrence L. Weed in
1964.
• William Proffit introduced it into the dentistry.
• The essence of problem oriented approach is to develop a comprehensive data
base of pertinent information so that no problems will be overlooked.
17. • The goal of diagnostic process is to produce a complete description of the
patient’s problems and make a problem list
• To obtain a problem list , a collection of relevant information is required. This
collection is called DATABASE
• Comprehensive database of pertinent information that precludes the possibility of
problems being overlooked
(Contemporary Orthodontics: fifth Edition: William. R. Proffit, Henry .W
Fields,David M Sarver)
18.
19. Principles
⮚ Development of an adequate diagnostic database
⮚ Formulation of problem list which is the diagnosis from the database
⮚ Prioritization of the items on the orthodontic problem list, so that most important
problem receives highest priority for treatment.
⮚ Consideration of possible solutions to each problem list, to the individual
problems.
⮚ Evaluation of interaction among possible solutions to the individual problems.
⮚ Synthesis of optimal treatment plan calculated to maximize benefit to the patient
and minimizes risks, costs, and complexity.
⮚ Presentation of the plan to the patient in such a way that the informed consent is
obtained.
20. Development of problem list
• Pathological problems like gingivitis,caries etc must be controlled.
• Developmental problems related to malocclusion is the orthodontic problem list.
• Initial developmental problem list is made using Ackerman profit classification, which
characterises five dentofacial traits.
1) Dentofacial appearance
2) Alignment/symmetry
3) Anteroposterior plane of space
4) Transverse
5) Vertical
21. Setting priorities for the orthodontic problem list
⮚ Patients perception of his or her condition is important in setting priorities
⮚ Focus most important problem for a patient
⮚ Give importance to the chief complaint
⮚ focus of the plan is what he or she wants
22. Factors in evaluating treatment possibilities
• After making priority list, next step is list out all possible treatments to each and
every problem.
• Each problem must be considered individually
• No possibilities will be overlooked
23. Factors to be considered are,
• Interaction among possible solutions
• Compromise
• Analysis of benefit versus cost and risk
• Other considerations
24. Interaction among possible solutions
• Some possible solutions to high priority problem would also solve
other problems.
Compromise
• In patients with many problems, it may not be possible to solve them
all.
• Careful setting of priorities from the problem list is particularly
important.
• If any necessary compromises are made, patients most important
problems are solved while less important problems are left intreated.
• Goal with great importance should be favoured
25. Analysis of benefit versus cost and risk
• Cost- risk / benefit analysis
• Consider money, cooperation. discomfort, time
• Avoid burden of treatment
26. Other considerations
• Should the treatment time be minimized because of possible exacerbation of
periodontal disease?
• Should treatment option left open because of uncertainity of growth pattern?
• Visible orthodontic appliances be avoided?
27. Patient parent consultation : obtaining informed consent
• Paternalism versus autonomy
• Include patient in making final decision
• Explain about advantages and disadvantages of treatment approaches.
28. The detailed plan : specifying the treatment procedures
• Two criteria must meet
1) effectiveness
2) efficiency
• The treatment plan must specify which, and the effectiveness and efficiency of the
various possibilities must be considered.
30. • For orthodontic purposes, the database may be thought of as derived from three
major sources:
• (l) Questions of the patient (written and oral),
• (2) Clinical examination of the patient,and
• (3) evaluation of diagnostic records, including dental
casts, radiographs and photographs
31. 1. QUESTIONNAIRE OR INTERVIEW
• The goal is to establish the patient's chief complaint (major reason for seeking
consultation and treatment), usually by a direct question to the patient or parent.
• To obtain information,
a) Medical and dental history
b) Physical growth status
c) Social and behavioural factors
32. CASE HISTORY
• Case history is defined as a planned professional conversation which enables the
patient to communicate his/her symptoms, feelings, and fears to the clinician and
recorded in the patient’s own words so as to obtain an insight into the nature of the
patient’s illness and his/her attitudes to them .
• Purpose of case history is to understand the development of the malocclusion, so
that by early elimination of the causative factors, correct therapy can be
undertaken.
33. • Personel details like name, age, sex, address and occupation should be recorded.
34. CHIEF COMPLAINT
• Three major reasons for patient concern about the alignment and occlusion of the
teeth:
1. Impaired dentofacial appearance and a diminished sense of social well being,
2. Impaired function,
3. Impaired oral health
( The contemporary Orthodontics, 5th ed, W.R Proffit)
• Chief complaint emphasis on whether the patient is seeking functional or
esthetic improvement or both
35. MEDICAL HISTORY
⚫ Specific questions should include medical conditions which may limit orthodontic
treatment. E.g. diabetes mellitus, epilepsy
⚫ allergy specially LATEX & NICKEL(Latex gloves and elastics and wire and
bracket containing nickel)
36.
37. DENTAL HISTORY
• Patients or parents attitude.
• Indicator of patient’s susceptibility towards Periodontal disease or caries.
• H/O traumatic injury to teeth: orthodontic treatment exacerbate periapical
symptoms that are already present.
• Dental health awareness.
38. DRUG HISTORY
• reveals systemic disease or metabolic problems that the patient did not report in
any other way.
• Do not contraindicate orthodontic treatment if the medical problem is under
control, but special precautions may be necessary.
• For example, in a patient with controlled diabetes
• orthodontic treatment would be possible
• but would require especially careful monitoring, since the periodontal breakdown
that could accompany loss of control might be accentuated by orthodontic forces .
39. Physical growth evaluation
• Individuals physical growth status should be explored by asking questions to the
patient or parents.
• Adolescent growth spurt
• Skeletal class 2
• Vertebral maturation to assess skeletal age.
40.
41. Family History
• A family history can begin with an inquiry as to whether any sibling of patient
have required orthodontic treatment and a discussion about nature of problems.
• The position of child in family should be noted.
• A relatively large number of dysgnathias are inherited and transmitted through a
dominant gene eg.
• Skeletal open bites
• Bimaxillary protrusion
• Class III malocclusion
42. Common problems of familial origin/genetics affecting face and
jaw: Cleft lip/palate, syndromes
Common problems of familial origin affecting the dentition:
• Peg-shaped or missing lateral incisors
• Partial hypodontia of premolars
• Supernumerary teeth
• Macro or microdontia
43. Social and Behavioral Evaluation
• Explore several related areas:
✔the patient's motivation for treatment,
✔expectations as a result of treatment, and
✔ how cooperative or uncooperative the patient is likely to be
• Motivation for seeking treatment can be classified as
1. external or
2. internal
44. • External motivation is that supplied by pressure from another individual, as with
a reluctant child who is being brought for orthodontic treatment by a determined
parent.
• Internal motivation, on the other hand, comes from within the individual and is
based on his or her own assessment of the situation and desire for treatment.
46. • Two goals of the orthodontic clinical examination:
• ( 1) to evaluate and document oral health, jaw function, facial proportions and
smile characteristics; and
• (2) to decide which diagnostic records are required
47. • Health of oral hard and soft tissues must be assessed for potential orthodontic
patients
• Any medical problems, periodontal disease, caries, pulpal pathology must be
controlled.
• Among jaw and occlusal function mastication, speech, sleep apnea in mandibular
deficiency and the TMJ problems like click, noise, tenderness, opening should be
noted.
49. • General examination begins as soon as patient enters the clinic
• Includes examination of constitution and physique of the patient , height and
weight in relationship to the chronological age and development of the facial
skeleton .
• An evaluation of the somatogram provides an indication of the general growth
tendency.
• Height and weight provide a clue to the physical growth and maturation of
patient
50. GAIT
• It is the way a person walks
• Abnormalities of gait are associated with the neuromuscular disorders.
POSTURE
• Poor postural conditions either lead to malocclusion or accentuate it.
• A stoop shouldered child with the head hung, chin rests on the chest: Mandibular
retrusion.
51. • Evaluation of dental status is of great importance for the prognostic assessment of
dental development
• Chronological and dental age are synchronous in normal patient
• A child is labeled as early or late developer if there is difference of ± 2 years from
the average value
Dental age can be determined by two different methods
⮚Stage of eruption
⮚Stage of tooth mineralization in radiograph
52. EXTRAORAL EXAMINATION
• The head and face should be examined with the patient seated in an ordinary chair
with the head in natural head position
Natural head position
• Standardized and reproducible orientation of head in space when the subject is
focussing on a distant point at eye level.in NHP, the visual axis should be
horizontal and lips should be relaxed.
53. GENERAL BODY TYPE(PHYSIQUE) - Berger
⚫ ASTHETIC: Thin physique, possess narrow dental arches.
⚫ PLETORIC: Obese, have large square dental arches.
⚫ ATHLETIC: Normally built, being neither thin nor obese. Have normal sized
dental arches.
54. BODY BUILD- SHELDON
⚫ ECTOMORPHIC: Tall & thin physique.
⚫ MESOMORPHIC: Average physique.
⚫ ENDOMORPHIC: Short & obese.
55. CEPHALIC INDEX
• This index is based on the anthropometric determination of the maximum width of
the head and the maximum length
• Classification and index values according to Martin and Saller (1957)
56.
57. MORPHOLOGIC FACIAL INDEX
• Martin and Saller (1957)
• Morphological facial height is defined as the distance between nasion (N) and
gnathion (Gn) and bizygomatic width is defined as the distance between the
zygoma (Zy) points.
61. FACIAL FORM by Ricketts (AJO 1960)
• Dolicho facial: long and narrow
• Meso facial: average face
• Brachy facial: short and broad
Jaraback : Hyperdivergent, Hypodivergent, Neutral
62. EXAMINATION OF FACIAL AND DENTAL APPEARANCE
A systematic examination of facial and dental appearance should be done in the
following three steps
(i) Facial proportions in all three planes of space (Macro esthetics)
(ii) The dentition in relation to the face (mini esthetics)
(iii) The teeth in relation to each other (micro esthetics)
63. Arnett and Bergman (AJODO 1993) suggested systematic soft tissue clinical
examination using 19 facial traits known as “Facial keys for diagnosis and
treatment planning.”
• It involves examination of patient in 2 views for identification of problems in all
3 planes of space.
I. Frontal
A. Relaxed lip
B. Functional analysis
1. Closed lip
2. Smile
II. Profile
A. Relaxed lip
64. • 19 facial traits are examined
I. Frontal view
A. Outline form
B. Facial level
C. Midline alignments
D. Facial one-thirds
E. Lower one-third evaluation
1. Upper and lower lip lengths
2. Incisor to relaxed lip
3. Interlabial gap
4. Closed lip position
5. Smile lip level
65. II. Profile view
• A. Profile angle
• B. Nasolabial angle
• C. Maxillary sulcus contour
• D. Mandibular sulcus contour
• E. Orbital rim
• F. Cheek bone contour
• G. Nasal base – Lip contour
• H. Nasal projection
• I. Throat length
• J. Subnasale – pogonion line
67. (1) Assessment of developmental age
• examining him or her for developmental characteristics and a general impression.
• In a step particularly important for children around the age of puberty when most
orthodontic treatment is carried out the patient’s developmental age should be
assessed.
• The attainment of recognizable secondary sexual characteristics for girls and boys
and the correlation between stages of sexual maturation and facial growth
68. (1) Frontal Examination
• The first step in analyzing facial proportion is to examine face in the frontal view
• Low set ears or eyes that are usually far apart(hypertelorism) may indicate either
presence of a syndrome or a microform of a craniofacial anomaly
• If syndrome is suspected, the patient’s hands should be examined for syndactyly.
Since there are number of dental-digital syndromes
69. FACIAL PROPORTION : RULE OF FIFTH
• Introduced by Farkas and Monro
• For ideal proportions from the frontal view, an ideally proportional face can be
divided into central, medial and lateral equal fifths. The separation of eyes and
width of eyes should be equal and it determines central and middle fifths.
• The nose and chin should be centered with in the central fifth, with the width of
the nose the same as or slightly wider than the central fifth.
• The inter papillary distance should equal the width of the mouth (Ellenbogen et al
(1983)
70.
71. Vertical Facial Proportions (LAW OF THIRDS)
• The artists of the renaissance period, primarily da Vinci and Durer established the
proportions for drawing anatomically correct human faces.
• They concluded that the distance from the hairline to the base of the nose, base of
nose to bottom of the nose and bottom of the nose to chin should be the same
• The artists also saw that the lower third has a proportion of one third above the
mouth to two thirds below
72.
73. Facial Symmetry
• A small amount of facial asymmetry exists in essentially all normal individuals
• This can be appreciated most readily by comparing the real full face photographs
with composites consisting of two right or two left sides
74.
75. (2) PROFILE ANALYSIS
• “poor man’s cephalometric analysis”
• The three goals of facial profile analysis are
(i) Establishing whether the jaws are proportionately positioned in the
anterior posterior plane of space
(ii) Evaluation of lip posture and incisor prominence
(iii) Reevaluation of vertical facial proportions and evaluation of mandibular
plane angle
76. (i)Establishing whether the jaws are proportionately positioned in the anterior
posterior plane of space
• This step requires placing the patient in natural head position
either sitting upright or standing, with the head in this position,
note the relationship between two lines, one dropped from the
bridge of the nose to the base of the upper lip, and a second one
extending from that point downward to the chin .
77. Profile convexity or concavity results from a disproportion in the size of the
jaws, but does not by itself indicate which jaw is at fault. A convex facial
profile (A) indicates a Class II jaw relationship, which can result from either
a maxilla that projects too far forward or a mandible too far back. A concave
profile (C) indicates a Class III relationship, which can result from either a
maxilla that is too far back or a mandible that protrudes forward
78. Facial Divergence
• Term given by Milo Hellman.
• The anterior or posterior inclination of lower face to forehead is called facial
divergence which may be influenced by patient’s ethnic or racial background.
• A line drawn from forehead to chin is used to assess facial divergence.
(i)Anterior divergent: line inclined anteriorly
(ii) Posterior divergent: the line inclined posteriorly
(iii) Straight/orthognathic: straight line, no slant seen
80. (II) Evaluation of lip posture and incisor prominence
Lip posture and incisor prominence should be evaluated by viewing the
profile with the patient's lips relaxed.
Charles J Burstone(AJODO 1967) “Lip posture and its significance in
treatment planning”
- relaxed and closed lip position, upper and lower lip length, lip protrusion
relative to sn-pog line
81.
82. • Upper lip protrusion 3.5 mm
• Lower lip protrusion 2.2 mm
Charles J Burstone (AJODO 1967) “Lip posture and its
significance in treatment planning”
83. • This is done by relating the upper lip to a true vertical
line passing through the concavity at the base of the
upper lip (soft tissue point A) and by relating the lower
lip to a similar true vertical line through the concavity
between the lower lip and chin (soft tissue point B)
• lips fall forward from the line-PROMINENT
• Lips fall backward from the line-RETRUSIVE
• Both lips are prominent & incompetent- Anterior teeth
are protrusive.
84. • The teeth protrude excessively if (and only if) two conditions are met:
(1) the lips are prominent and everted, and
(2) the lips are separated at rest by more than 3 to 4 mm which is sometimes termed
lip incompetence .
85. • In the extreme case, incisor protrusion can produce ideal alignment of the teeth instead
of severely crowded incisors, at the expense of lips that protrude and are difficult to
bring into function over the protruding teeth. This is bimaxillary dentoalveolar
protrusion, meaning simply that in both jaws the teeth protrude
• Bimaxillary protrusion ; Samuel J. Lewis ;AJO 1943
• The treatment of bimaxillary protrusion ; P.J Keating; BJO
• Changes in facial profile during orthodontic treatment with extraction of four first premolars (AJO 1989)
86. • The soft tissue profile, growth, and treatment changes. J. Daniel subtelny
(1961 AO)
• emphasize that growth changes within the soft tissue profile will be expressed in
the area of nose , the chin, and the lips.
• Soft tissue changes following treatment will center around the lips, primarily in
the vermilion area.
• Lip posture was found to be correlated closely with the posture of underlying
dental and alveolar structures.
87. The diagnostic line ;Raleigh Williams ,AJO 1967
• There is one cephalometric criterion common to all normal dentitions associated
with harmonious or well-balanced lips, and that is the anteroposterior position of the
incisal edge of the lower incisor relative to the AP line.
• To create harmonious lip balance at the conclusion
of treatment, the tip of the lower incisor must be
brought to a position at or near the AP line
( point A to Pog line).
88. Throat form
• Evaluated in terms of the contour of the submental tissues (straight is better)
• chin throat angle (closer to 90 degrees is better) and throat length (longer is better
up to a point)
• Both submental fat deposition and a long tongue posture contribute to a stepped
throat contour which becomes a double chin.
89. (3) Reevaluation of vertical facial proportions and evaluation of mandibular plane
angle
• Vertical proportions which are evaluated in frontal examination can be reevaluated in
profile view
Evaluation of mandibular plane angle
• In the clinical examination, the inclination of the mandibular plane to the true horizontal
should be noted.
• This is important because a steep mandibular plane angle correlates with long anterior
facial vertical dimensions and anterior open bite malocclusion.
• Flat mandibular plane angle correlates with short anterior facial height and deep bite
malocclusion.
90. • The mandibular plane is visualized readily by placing a finger or mirror handle
along the lower border
91. • The inclination of mandibular plane to FH plane is measured
• An angle greater than 30 degree points to a vertical grower which signifies that
lower anterior face could be increased.
• Subject with 20 degree or less is designated as horizontal grower
• Children falling between 20 to 30 degrees is called neutral grower
92. • Schwartz profile anlysis (1929)
• It is a photographic method of profile analysis
• Based on relation ship of sub nasale to nasion perpendicular
• 3 types
• 1) Average face – sn on nasion perpendicular
• 2) Retro face – sn lies behind pn
• 3) Ante face – sn lies in front of pn
• Depending on relation of sub nasale to pogonion,lower facial profile divided into
3 types
1) Backward slant( pog behind sn)
2) Forward slant ( pog ahead sn)
3) Straight( pog on sn)
93. Nine profile variants acc. to classification by A.M. Schwartz
• In forward slant : normal , retro face and ante face
• Backward slant : normal , retro face and ante face
• Straight slant : normal , retro face and ante face
94.
95. TOOTH LIP RELATIONSHIPS (MINI AESTHTICS)
• Relationship of dental midline to skeletal midline of jaw
• Assessment of vertical relationship of teeth to lips at rest and on smile.
• Note whether up-down transverse rotation of dentition is revealed when at
rest or at smile.
• Dentists detect transverse roll at 1mm from side to side where as lay person
are forgiving and see it at 2-3mm
96. SMILE ANALYSIS
2 types of smile:
• Posed or social smile which is reproducible and present to world routinely
• Enjoyment smile (Duchenne smile) varies with emotions being displayed.
• Social smile is the focus of orthodontic diagnosis
97. • Following variables need to be considered during smile analysis:
(a) Amount of incisor and gingival display
(b) Transverse dimension of smile relative to upper arch( buccal corridor)
(c) The smile arc
(d) Smile Index
(e)Morley’s Ratio
98. (a) Amount of incisor and gingival display:
• Up to 4 mm display of gingiva in addition to the crown of the tooth or upto 4 mm
lip coverage of the incisor crown is acceptable. Beyond that the smile appearance
is less attractive.
(b) Transverse dimension of smile relative to upper arch( buccal corridor )
• Buccal corridor is the distance between maxillary posterior teeth (especially
premolars) and inside of the cheek
• Minimal buccal corridor is preferred
• Widening the maxillary arch can improve the appearance of the smile
• Too broad an upper arch so that there is no buccal corridor is unaesthetic
99. (c) The smile arc
• The smile arc is defined as the contour of the
incisal edges of the maxillary anterior teeth
relative to the curvature of the lower lip during
a social smile
• If lip and dental contours match, they are said
to be consonant
• A flattened (non consonant ) smile arc
100. (d) Smile Index
• It was given by Ackerman and Proffit
• Smile index describes the area with in the vermilion borders of upper and lower
lip during the social smile
• Smile index is determined by dividing the inter commissural width by the inter
labial gap during smile.
• It is increased where decreased incisor show is present and decreased where
increased incisal show is present
101. • Modified smile index by Vinod Krishnan et al (AJO 2008)
• Modified smile index= inter vermilon distance at midline *100
inter commissural width
102. `
(e)Morley’s Ratio
• It depicts the percentage of incisor show on posed smile with respect to the
clinical crown height
• Average ratio is 75-100%
• A greater ratio would necessitate appropriate measures to decrease the incisor
show
• Common contributors to increased incisor show are vertical maxillary excess,
palatal plane tipping downwards in anterior region, shorter upper lip or greater
crown height
• Smaller ratio depicts less than normal incisor show due to vertically deficient
maxilla, increased length of upper lip or short clinical crown height
103. DENTAL APPEARANCE (MICRO ESTHETICS)
(a) Width relationships(Golden Proportion)
• For best appearance the apparent width of lateral incisor
should be 62% of the width of central incisor
• Apparent width of canine should be 62% of width of lateral
incisor
• Apparent width of first premolar should be 62% width of
canine
• This value of recurring 62% is called golden proportion
104. b) Height -width relationships
• Width of a tooth should be about 80% of its height
• There are many reasons for decreased height of
tooth: incomplete eruption which gets corrected by
itself.
• Loss of crown height from attrition in older
patients which indicate restoration of missing part
of crown, excessive gingival height which is best
treated by crown lengthening etc.
105.
106. Classification of malocclusion
SAGITTAL/ A-P RELATIONSHIP
• 1) Angles classification of malocclusion
• 2) Deway modification of angles classification
• 3) KATZ classification of premolar occlusion
• 4) British incisor classification
• 5) Miguel neto & mucha proposed classification
107. VERTICAL RELATIONSHIP
A) Overbite
B) Deep bite
C) True deep bite
D) Pseudo deepbite
E) Open bite
TRANSVERSE RELATIONSHIP
A) Buccal crossbite
B) Scissor bite
C) Midline
108. Tongue
• Shape, size , posture and function.
• The diagnosis of a macroglossia require more detailed diagnostic
investigation(cine radiography) and can only be made after exact analysis of
tongue position.
• A rough assessment of tongue size can be made by lateral cephalometric
radiograph.
• Change in the tongue position and mobility are often associated with an
abnormal frenum.
109. FRENUM
• One of the most variable anatomical structures present in the oral cavity.
• LABIAL FRENUM-
Mandibular labial frenum is less often associated with midline diastema.
it can lead to gingival recession in anterior region.
LINGUAL FRENUM=
Its abnormal attachment – ankyloglossia or tongue tie
Associated with speech difficulties.
Sometimes produces a mandibular midline diastema.
110. (c) Gingival heights, shape and contour
Gingival height
• Generally the central incisors has the highest gingival level
• Lateral incisor is approximately 1.5 mm lower
• Canine gingival margin is at the level of centrals
Gingival shape
• Gingival shape refers to the curvature of gingival at the margins of tooth
• Maxillary lateral has gingival shape half oval or half circle symmetrically
• Maxillary centrals and maxillary canines have gingival shape that is more elliptical
and oriented distally to long axis of tooth
111. Gingival Zenith
• Most apical point of the gingival tissue
• It should be located distal to the long axis of
maxillary centrals and canines
• Gingival zenith of maxillary laterals should
coincide with their long axis
112. (d) Connectors and embrasures
• The connector is where adjacent teeth appear to touch
and may extend apically or occlusal from the actual
contact point
• The normal connector height is greatest between
centrals and diminishes from centrals to posterior
teeth
• Embrasures are larger in size than connectors and is
filled with interdental papillae
113. (e) Black triangles
• Short interdental papillae leave an open gingival embrasure above the connectors
and these black triangles can detract significantly from the appearance of tooth on
smile
• When crowded and rotated maxillary incisors are corrected orthodontically in
adults, the connector moves incisally and black triangles may appear
(f) Tooth shade and color
• The color and shade of the teeth changes with increasing age, and many patients
perceive this as a problem
• Teeth appear lighter and brighter at a younger age and darker as aging progress.
This is related to deposition of secondary dentine and thinning of facial enamel
• A normal progression of shade change from the midline posteriorly is an
important contributor to an attractive and naturally appearing smile
114. EXAMIANTION OF LIPS
COMPETENT: Slight contact of the lips when the musculature is
relaxed.
• Up to 4mm of lip separation is normal especially in young
children.
INCOMPETENT: Is defined as the inability to seal the lips without
excessive strain.
• • Anatomically short upper lip which do not contact when the
musculature is relaxed.
• Lip seal is achieved after active contraction of orbicularis oris &
mentalis muscle
115. Vig & Cohen “Vertical growth of the lips, A serial cephalometric study” A.J.O
75:405 1979
• Both upper & lower lip grew more than the skeletal lower face.
• The lower lip grew vertically more than the upper lip.
• Most children exhibited lip incompetence at age 6-8 yrs. This is due to incomplete
soft tissue growth & should be considered normal
116. `
POTENTIALLY INCOMPETENT LIPS
• Lip seal is prevented due to protruding max. incisors despite
normally developed lips
EVERTED LIPS
• These are hypertrophied lips with redundant tissue & weak
muscular tonicity
VERTICAL LIP RELATIONSHIP
• In a balanced face the length of the upper lip measures 1/3rd
the lower lip & the chin 2/3rd of the lower face height
117. LIP STEP(KORKHOUS)
• POSITIVE LIP STEP: Protrusion of the lower lip in
relation to the upper lip. Seen in class 3 malocclusion.
• NORMAL LIP PROFILE : Slightly negative lip profile.
The lower lip slightly behind the upper lip.
118. • NEGATIVE LIP STEP:Marked retrusion of the lower lip as a symptom of class 2
malocclusion
119. ANTONIOS H. MAMANDRAS “Linear changes of the maxillary &
mandibular lips” A.J.O 94:405,1988
• Max. lip length in females-14yrs.
• The mandibular vertical lip length growth -16yrs.They attained the max. Lip
thickness by age 14 followed by thinning.
• Males attained max lip length-18yrs,it was not complete. Max lip thickness was
attained by 16yrs.
• Thus the effect of extraction therapy would be more noticeable in females with
straight or convex profile than in males.
120. NASOLABIAL ANGLE
• Value of 110 degree
• Formed b/w a tangent to the lower border of the nose & a line joining the
subnasale with the tip of the upper lip. (Labrale Superius)
• Reduces: max. Prognathism, Proclined anteriors.
• Obtuse: Retrognathic maxilla
121. CHIN
• The bone structure
• Thickness & tone of the mentalis muscle
• Morphology & craniofacial relation of the mandible.
• Recessive, adequate or prominent.
HYPER MENTALIS ACTIVITY: The mentalis muscle becomes hyperactive.
• Seen in class 2 div 1 cases where puckering of the chin (Golf ball appearance) may be
seen.
MENTO LABIAL SULCUS
• It is the concavity present below the lower lip
• Mento labial sulcus is deepen in class II Div 1
• Mento labial sulcus shallow in bimaxillary protrusion
• Normal
123. CHIN FORMATION & PROFILE CONTOUR
• Protruded chin, marked mentolabial sulcus – retruded lip profile.
• Negative chin, absence of the mentolabial sulcus causing a protruded lip profile.
• Lip closure is difficult in this type of facial morphology.
• Hyperactivity of the mentalis muscle
• Genioplasty required to change the insertion of the mentalis muscle.
124. FOREHEAD
• Relationship of the forehead is considered to the bizygomatic width. It can be
described as Narrow or wide.
• The lateral forehead contour or the slope of the forehead could be Flat,
protruding, steep. The dental bases are more prognathic than in cases with a flat
forehead.
126. NASAL PROPORTIONS
• Powell et al (1986) ideal nasal width should be approximately 70% of nasal
height (nasion to nasal tip)
• Baum (1982) The nasal length in the mature face should equal the distance from
stomion to menton.
NOSE SIZE
• Normal, microrhinic (small), large
127. PITCH, ROLL, YAW
“Pitch, Roll And Yaw: Describing the spacial orientation of dentofacial traits”
(Ackerman et al, AJODO,2007)
• Three aeronautical rotational descriptors (pitch, roll and yaw) are used to
supplement the planar terms (anterioroposterior, transverse and vertical) in
orientation of the line of occlusion and the aesthetic line of the dentition.
•
128.
129. Pitch deformity
• Downward or upward displacement of dentition viewed along esthetic line is best
described as pitch upward or downward anteriorly or posteriorly
131. Yaw Deformity
• Rotation of the aesthetic line of dentition around vertical axis of rotation leads
either
• dental midline shift or unilateral class II or class III relationship. Unilateral
posterior crossbite accompanies more severe yaw
133. Determination of the postural rest position
▪ Patient’s orofacial musculature must be relaxed
▪ Muscle exercises(tapping test) can be used to help relax the musculature prior to
carrying out actual examination.
▪ When using tapping test patient is told to relax and the clinician opens and closes
the mandible passively and with constantly increasing frequency.
▪ When the mandible is in postural resting position,it is usually 2-3 mm below and
behind the centric occlusion(recorded in canine area)
▪ Space between teeth ,when mandible is at rest ,is referred to as freeway space or
interocclusal clearance.
134.
135. • METHODS USED TO DETERMINE THE REST POSITION DURING
CLINICAL EXAMINATION
• Phonetic method
• Command method
• Non-command method
• Combined method
136. Evaluation of temporomandibular joint and condylar movements
• Objective is to assess whether incipient symptoms of TMJ dysfunction are present.
• Early symptoms of TMJ problems include the following:
• Clicking and crepitus
• Sensitivity in the condylar region and masticatory muscles
• Functional disturbances (e.g. hypermobility,limitation of movement,deviation)
137. • Examined for joint sounds ;like click or crepitation
• Initial clicking is sign of retruded condyle in relation to the disc.
• Intermediate is a sign of unevenness of the condylar surface and of articular
disc,which slide over one another during the movements
• Terminal clicking occurs most commonly and is an effect of the condyle being
moved too far anteriorly,in relation to the disc,on maximum jaw opening.
138. CLINICAL FUNCTIONAL EXAMINATION FOR THE
TEMPOROMANDIBULAR JOINT AREA
• Consists of 3 steps:
1.Auscultation
2.Palpation
3.Functional analysis
139. AUSCULTATION
• A stethoscope is used to check for signs of clicking and crepitus.
• The examination is performed by having the patient open and close the jaw into
full occlusion.
140. PALPATION
• Lateral palpation for any joint pain
• Posterior surface of condyle using index fingers placed in the external auditory
meatus.
141. • Palpation for lateral pterygoid muscle
- at maxillary tuberosity area
- mouth is open and mandible displaced
laterally
• Palpation for temporalis muscle
- mouth should be half open
145. CBCT ( Cone Beam Computed Tomography)
• Cone beam computed tomography is a medical imaging technique
consisting X-rays which are divergent, forming a cone.
• two-dimensional (2D) representations of three dimensional (3D) objects
• Two dimensional radiographs are insufficient, especially in complex cases
like impacted teeth, supernumerary teeth and orthognathic surgeries. CBCT
images provide far more detailed information than conventional 2D
radiographs and are user friendly.
• Soft tissues, skull, airway and the dentition can be observed and measured
on CBCT images in a 1:1 ratio.
146. DIGITAL MODELS
• Produced by surface scanning of plaster models (Quick ceph) or
impressions(ORTHOCAD)
• Scanners used-
• Contact 3-d scanner (Nakasima et al)
• Oral scanner (Mah &Sachdeva)
• Non contacting digitizer (Nishi et al)
• The scanner is passed over the teeth in rocking motion to allow visualization of all
tooth surface including undercut areas
147. FABRICATION OF DIGITAL MODELS
1.High quality impressions-alginate-ORTHOPRINT (Zhermack,Rovigo,Italy) or
polyvinylsiloxane & polyether material (Impregnum,ESPE,Germany)
2.Optical scannig- of “Plaster equivalents”to produce 3-d models
3.Downloaded on clinician computer via e-mail
Features of digital softwares
• 3-d browsing
• jaw alignment tool
• color coded occluso grams
• virtual sectioning
• virtual measurements (0.1mm)
• instant model analysis
• easy storage ,transfer &retrieval
148. Limitations of digital models
• Expensive sophisticated equipment
• Supplier or technical support
• Cannot be articulated acc.to pt TMJ
• Loss of data due to degradation over time
• Accuracy questionable
• Comparative evaluation of plaster and digital models
149. Tomassetti et al (AO 2001) did a comparison of computerized Bolton analysis with
3 softwares and the manual method.
Accuracy : Vernier calipers was the most accurate while significant differences were
observed with the 3 softwares.
Speed : QuickCeph was the fastest and V calipers took the most time.
Kusnoto and Evans( AJO 2002) found that using a 3D surface scanner for
digitizing casts the measuring applications involving height and width was
accurate whereas the depth was increased due to the horizontal laser beam which
has to traverse vertically ( time lapse).
150. • Coslalos et al (AJO NOV 2005) using the Orthocad system found measurements
to be reliable in measuring malocclusion except for buccolingual inclinations of
teeth.
• Quimby et al ( AO 2004) compared the accuracy and reliability of
measurements made on computer and plaster models.
• They concluded that:
• 1) Accuracy( validity) : was comparable
• 2) Reproducibility ( reliability) : highly reproducible.
• 3) Efficacy : comparable
151. COMPUTER AIDED BRACKET PLACEMENT
• Virtual bracket placement-additional hardware required with computer aided
bracket placement device
• optimal bracket position
• alignment of teeth.
• virtual wire placement
• torque anticipation: different finishing wires
152. SURE SMILE TECHNOLOGY
• By Rohith sachdeva
• Sure smile is a type of bracket system used by orthodontists for alignment of teeth.
The technique utilizes 3D imaging ,treatment planning software and a robot to
create wires.
• The orthodontists uses digital images of patients mouth using either a white light
scanner or CBCT.
• Once the orthodontist has virtually designed the smile and bite, Sure Smile
software plans the most efficient and direct route for making tooth into the proper
place, and sends this information to a robot that bends and shapes the wire
specifically for that patient.
• The wire with all of the custom bends is then send back to the orthodontist and is
ready to place on the patient.
• The treatment is faster and the patient has only 1 to 2 wire changes when
compared with conventional system
153. CLEAR ALIGNERS
• Clear aligner treatment are orthodontic devices that uses incremental transparent
aligners to adjust teeth as an alternative to dental brackets.
• They are effective for moderate crowding of the front teeth but less effective than
conventional brackets for several other issues.
• they are indicated for mild to moderate crowding(1 -6 mm) and mild to moderate
spacing (1 -6 mm), in cases where there are no discrepancies of the jaw bone.
• Clear aligner treatment involves an orthodontist taking a mold of the patient’s
teeth, which is used to create a digital tooth scan.
154. • The computerized model suggests stages between the current and desired teeth
positions, and aligners area created for each stage. Each aligner is worn for 20
hours a day for 2 weeks.
• These slowly move the teeth into the position agreed between the orthodontist and
patient. The average treatment time is 13.5 months
156. RAPID PROTOTYPING
• It is a group of techniques used to quickly fabricate a scale model of a physical
part of assembly
• using 3D computer aided design(CAD). Construction of the part or assembly is
usually done
• using 3D printing or Additive layer manufacturing technology.
“Accuracy and reproducibility of dental replica models reconstructed by
different rapid prototyping techniques” Aletta Hazeveld, James J. R.
Huddleston Slater, and Yijin Ren (AJODO 2014)
158. • The plaster models were scanned to form high-resolution 3-dimensional surface
models in .still files.
• These files were converted into physical models using 3 rapid prototyping
techniques:
-digital light processing, jetted photopolymer, and 3-dimensional printing .
• Dental models reconstructed by the tested rapid prototyping techniques are
considered clinically acceptable in terms of accuracy and reproducibility and
might be appropriate for selected applications in orthodontics.
• Using this technology two normally separate process of bracket production and
bracket positioning are fused into one unit
159. • IMAGING SOFTWARE TO PREDICT THE SOFT TISSUE CHANGES AFTER
ORTHOGNATHIC SURGERY
“Comparison of an imaging software and manual prediction of soft tissue
changes after orthognathic surgery”- M.S Ahmad Akhoundi (journal of
dentistry)
• Dolphin imaging has become increasingly popular among surgeons and
orthodontists.
• After programming of the hard tissue movement into Dolphin system, the outline
of the soft tissue is changed based on ratios which have been included into the
software.
• Computer generated image prediction was suitable for patient education and
communication. However efforts are still needed to improve accuracy and
reliability of the prediction program and to include changes in soft tissue and
muscle strain
160.
161. CONCLUSION
• Observation is key of understanding.
• Proper diagnosis is must for treatment planning and final result.
• Proper knowledge of normal asethetic principle help to notice something
unusual.
162. References
• The emerging soft tissue paradigm in orthodontic diagnosis and treatment
planning 1999; Ackerman, Proffit, Sarver.
• Facial keys to orthodontic diagnosis and treatment planning Part 1 G. William
Arnett and Robert T. Bergman, AJO 1993.
• Contemporary Orthodontics: fifth Edition: William. R. Proffit, Henry .W
Fields,David M Sarver)
• Charles J Burstone(AJODO 1967) “Lip posture and its significance in treatment
planning”
• The soft tissue profile, growth, and treatment changes. J. Daniel subtelny (1961
AO)
• Medical Disorders and Orthodontics Anjli Patel 1, Donald J
Burden, Jonathan Sandler (2009)
163. • Vig & Cohen “Vertical growth of the lips, A serial cephalometric study” A.J.O
75:405 1979
• ANTONIOS H. MAMANDRAS “Linear changes of the maxillary &
mandibular lips” A.J.O 94:405,1988
• Pitch, Roll And Yaw: Describing the spacial orientation of dentofacial traits”
(Ackerman et al, AJODO,2007
• Tomassetti et al (AO 2001) did a comparison of computerized Bolton analysis
with 3 softwares and the manual method.
• Accuracy and reproducibility of dental replica models reconstructed by different
rapid prototyping techniques” Aletta Hazeveld, James J. R. Huddleston Slater,
and Yijin Ren (AJODO 2014)