Orthodontic diagnosis for undergraduate students

1. Orthodontic Diagnosis
and Clinical Examination

2. ESSENTIAL DIAGNOSTIC AIDS
1. Case history
2. Clinical examination
3. Study models
4. Certain radiographs
• Periapical
• Bitewing
• OPG (screening radiograph)
5. Facial photographs

4. Supplemental diagnostic aids
1. Specialized radiographs;
1. cephlometric radiographs
2. occlusal intra-oral films
3. selected lateral jaw view
2. Electromyographic examination of muscle activity
3. Hand wrist radiographs to assess bone age or maturation
age
4. Endocrine tests
5. Occlusograms

6. History
• Age
• Gender
• Chief Compliant
• Habits
• Medical History
• Dental History

7. MEDICAL HISTORY
• Epilepsy
• History of blood dyscrasias
• Diabetic patient
• Rheumatic fever
• Cardiac anomalies
• Physically and mentally handicapped children

8. Social and Behavioral Evaluation
• Social Circumstances
• Family support
• Motivation
• Compliance
– Hygiene
– Removable appliances
– Elastics
• Cooperation
– Appointment Scheduling

9. Examination
• Extra oral
• Intraoral
• ORAL and CRANIOFACIAL HEALTH
• FUNCTION
– TMJ
– Mastication
– Speech
– Breathing

12. Speech Problems

13. • Sunday Bite
• Pseudo Class III

14. Macroesthetics
• Face!
• Age
• Sexual Charactersitics
• Disease
• Syndrome
• Asymmetry

15. Facial Proportions!

16. Enlow’s Counterpart Analysis

24. Mesocephalic,dolicocephalic,brachycephalic

25. FACIAL FORM
• A)MESOPROSOPIC-average or normal
face form
• B)EURYPROSOPIC-face is broad and
short
• C)LEPTOPROSOPIC-long and narrow face
form

26. FACIAL SYMMETRY
• The patient’s facial symmetry is examined
to determine disproportions of the face in
transverse and vertical planes.
• Gross facial asymmetry can occur as a result
of:
– A. congenital defects
– B.hemi-facial atrophy/hypertrophy
– C.unilateral condylar ankylosis and hyperplasia

27. FACIAL DIVERGENCE
• STRAIGHT/ORTHOGNATHIC
• The line between the forehead
and the chin is straight or
perpendicular to the floor.

28. FACIAL DIVERGENCE
• Facial divergence is
defined as anterior or
posterior inclination of
the lower face relative
to the forehead.
• ANTERIOR DIVERGENT-
a line drawn between
the forehead and the
chin is inclined
anteriorly towards the
chin..

29. POSTERIOR DIVERGENT
• A line drawn between the forehead and
chin slants posteriorly towards chin.

30. ASSESSMENT OF ANTERO-POSTERIOR JAW
RELATIONSHIP
• Ideally maxillary skeletal base is 2-3 mm
ahead of the mandibular skeletal base when
the teeth are in occlusion.
• Estimation is done by placement of index and
middle fingers at the soft tissue point A and
point B respectively.

31. • In a patient with CLASS 1 skeletal pattern the
hand is at an even level.

32. • In a skeletal CLASS II patient, the middle
finger is ahead of the forefinger or the hand
points downwards.

33. • In skeletal CLASS III PATIENTS, the index
finger is anterior to middle finger or the hand
points upwards.

35. Skeletal Malocclusions
Skeletal Class I Skeletal Class II Skeletal Class III

36. Sassouni Analysis

37. Facial Divergence

44. Tooth–Lip Relationships: Mini-Esthetics
• Midline
• Incisal Display
• Lip Length
• Transverse Cant (Roll)
• Buccal Corridors
• Smile Arc

45. Soft Tissue Components
• Upper Lip Height

46. Micro Esthetics
– Tooth Size and Shape
– Tooth Proportions
– Gingival Margins
– Black Triangles
– Tooth Shade

47. QUESTIONS?