This document provides an overview of how to analyze a patient's orthodontic history sheet. It discusses examining various parts of the patient's particulars including age, sex, occupation, address, dental history, medical history, family history, and soft tissue pattern. It also describes performing an extra oral examination to assess the patient's head shape, facial form, facial profile, chin position, breathing pattern, and speech. Taking a thorough history and performing a comprehensive extra oral exam are important for orthodontic diagnosis and treatment planning.
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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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
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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
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Oral Habits play a major role in determining the growth of the face by exhibiting their effect on the dentition. Learn about these harmful habits and the ways to correct them by suitable treatment plans.
Prevention, etiology, diagnosis and treatment of inappropriate oral habits that cause various problems and sometimes can lead to irreversible & serious Maxillofacial / mental / skeletal / occlusal malfunctions.
The used reference was contemporary orthodontics wrote by Dr. Ali Akbar Bahreman.
Tongue thrusting habit & other habits ,its management 2 /certified fixed ort...Indian dental academy
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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.
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Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
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management of vertical maxillary excess /certified fixed orthodontic courses ...Indian dental academy
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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
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
Oral Habits play a major role in determining the growth of the face by exhibiting their effect on the dentition. Learn about these harmful habits and the ways to correct them by suitable treatment plans.
Prevention, etiology, diagnosis and treatment of inappropriate oral habits that cause various problems and sometimes can lead to irreversible & serious Maxillofacial / mental / skeletal / occlusal malfunctions.
The used reference was contemporary orthodontics wrote by Dr. Ali Akbar Bahreman.
Tongue thrusting habit & other habits ,its management 2 /certified fixed ort...Indian dental academy
The Indian Dental Academy is the Leader in
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an any other group age
Poor oral hygiene among older people has traditionally been manifest in high level of tooth loss, dental caries, and periodontal disease as well as xerostomia and oral cancer
1- Bone:
= Increasing age is associated with progressive reduction in bone mass resulting in osteoporosis
= atrophy of alveolar bone is related mainly to tooth loss and increase by age that resulting in:
- Absence of denture
- Loss of facial height
- Upward and forward posturing of mandible
= loss of alveolar bone occurs more rapidly in mandible than maxilla
= level of cyclo-oxygenase 2(cox2) enzyme, which play essential role in bone repair, decline dramatically with age, this explain the delayed bone healing in older age
2- T M J:
= The main age changes related to remodeling of the articular surface and disc in response to functional changes following tooth loss
= remodeling may result in disc displacement, particularly anterior displacement
= the retrodiscal tissue may show decreased vascularity and cellularity and increased density of collagen
= in severe cases displacement may lead to perforation of the disc resulting in progressive damage
3- Nerve and musculature:
= continued muscle function in a major requirement for the maintenance of speech and mastication, in all patient with advancing age, there is reduction in total muscle mass which occurs through a reduction in the number of muscle fiber rather than a major reduction in muscle fiber size
= by age there is a loss of motor unit specially over 60 age
= manifestations:
- Reduced masticatory force
- Reduce muscle strength
- Lengthening of chewing process
- Changes in chewing behavior
4- Oral mucosa:
= the clinical appearance of the oral mucosa in older patients is indistinguishable from younger one, however changes by time as:
- Mucosal trauma
- Mucosal disease
- Salivary gland hypo-function
Can alter the clinical features and character of oral tissues
= the stratified squamous epithelium become thinner, loss of elasticity and atrophies with age with increased oral disorders
5- Sensory changes:
= it is known that taste and smell sensitives changes throughout life and often decline with aging
= these changes can make the foods become tasteless resulting in reduction in appetite
= diminution of taste results from degeneration of taste buds and reduction of their total numbers
= elderly people cannot detect the pleasantness of food compared with younger people, this can lead to the older people to added more ingredients such as sugar or salts to food stuff that can lead to adverse health effect
6- Salivary glands:
Dry mouth –xerostomia and diminished salivary glands output are common in older age, some cases have decreased salivary output due to high intake of drugs as:
- Anti-depressant
- Anti-hypertensive
- Cytotoxic and anti-parkinsonism
Some cases with neck cancer may exposed to irradiation which cause:
- Severe and permanent salivary hypo-function
- Xerostomia
Some disease as: Diabe
Cleft lip and palate management /certified fixed orthodontic courses by Indi...Indian dental academy
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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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
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Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
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4. Content of the history sheet
• Age, sex
• Occupation and
address
Particular of
patiant
• Dental history
• Medical history
• Family history
History
taking
• Extra oral examination
• Intra oral examinationexamination
• Radiography
• Chephalogram
radiograph
• Model analysis
Study modelshahajaman saju
6. It includes---
•Name of the patient
•Age
•Sex
•Address & occupation
•Medical, dental and family history
•Habit
shahajaman saju
7. Name of the patient---
For identification
For better communication
For medical record
shahajaman saju
8. Age ---
AGE TREATMENT RECOMMENDED
Primary and Mixed dentition
stage
Preventive and interceptive
procedures
Preadolescent patients in mixed
dentition
Growth modulation procedures
Young adolescent patients Comprehensive therapy with or
without Camouflage
Adult patients Orthognathic surgeries
shahajaman saju
9. sex---
This is important in planning
treatment, as the timing of growth
events such as growth spurts is
different in males and females
shahajaman saju
11. Address ---
Helps in determine ethnic pattern of oral
structure
Address helps in future correspondence
such as to intimate appointment.
Find out the epidemic and pandemic
outburst.
01
02
03
shahajaman saju
12. Occupation ---
Helps evaluation of socio economic status
of patient
Find out occupational hazards .e.g.
needle bite in taylor
Helps in selection of an appropriate
appliance.
01
02
03
shahajaman saju
13. Control of systemic disease
Control of acute conditions
Control of dental disease
Control of dental caries/ Endodontics Initial control of periodontal disease
Initial restorations like fillings Restoration of gingival health
Orthodontic Treatment
Final and permanent restorations
including cast restorations
Periodontal surgeries and
maintenance therapyshahajaman saju
15. Medical history
01 02 03
Diabetic patient
can taken
orthodontic
treatment if it is
control.
pneumonia,
tonsillectomy,
adenoidectomyshould
beexaminedfornasal
obstructionbefore
takingorthodontic
treatment;
Acute debilitating
diseases like
mumps, chicken
pox should be
allowed torecover
beforeorthodontic
treatment.
shahajaman saju
16. Medical history
04 05 06
Patient with
history of allergy
to acrylic resin
might be
managed with
fixed appliance
History of blood
dyscrasias may
need special
management if
extractions are
planned
Epilepsy
patient may
impede
orthodontic
treatment.
shahajaman saju
17. Medical history
07 08 09
History of
blood
dyscrasias may
need special
management if
extractions are
planned
Severely
handicapped child
either mentally or
physically may
require special
management.
Rheumatic fever
or cardiac
anomalies require
antibiotic
coverage.
shahajaman saju
19. Dental history
early fractures of the condylar neck of the mandible
trauma to the teeth
long-term medication
Osteoporosis , uncontrolled diabetes
contraindicates orthoodntic treatment
1
3
2
4
shahajaman saju
22. Habit history
Digits in Chronic
Thumb suckers
Hypotonic upper lip
Fibrous roughened callus
Clean and chapped
Reddened
Digits in acute
Thumb suckers
shahajaman saju
23. Habit history
Lip Sucking /lip biting Habit
indentation on lower lips and
hypertrophic vermillion border
Proclined maxillary anterior teeth and
retroclined mandibular anterior teeth
01
02
indentation on lower lips and
hypertrophic vermillion border
01
shahajaman saju
25. Mouth breathing
skeletal Skeletal Class II
Narrow palate
Hyperdivergent skeletal pattern
dental Posterior cross bite
Anterior open bite
Deep overjet
fascial Long face
Incompetent lips
Hyper-extended head
Narrow nostrils
shahajaman saju
26. Family history
01
Most of the number of
skeletal class II &
class III malocclusion
are inherited and
transmitted through a
dominant gene.
02
Congenital deformities
like cleft, lip & palate
are also transmitted.
shahajaman saju
27. Family history
The grandmother The father The son
Family history of Prominent mandible and
hypoplasia of maxilla with thicken lower lip
shahajaman saju
33. Color & texture:
Normally both the lips are same color &
texture.
Low active lips are chapped and light
color.
Heavy, reddish, smooth & moist lip,
lower lip is trapped behind the upper
anteriors.
Lowactivelips
TrappedlipNormallipcolour
Lips____
shahajaman saju
34. Normally upper lip covers labial surface
of upper anterior teeth except the incisal
2-3 mm.
the lower lip covers the labial surface of
lower anterior teeth & incisal third of the
upper anterior teeth.
NORMAL POSITION
Lips____
shahajaman saju
35. Competent lips
lip seal is maintain when muscle of facial
expression are relax position and
mandible in resting position
Incompetent lips
the lips are abnormally short and thus
inadequate to maintain lip seal at rest ,
this may be seen in Skeleton II & III
Potentially incompetent lips
normal lips but fail to form a lip seal
due to proclined upper incisors
shahajaman saju
36. Incompetent lips
the lips are abnormally short and thus
inadequate to maintain lip seal at rest ,
this may be seen in Skeleton II & III
seen in bimaxillary proclination
Everted lips
shahajaman saju
37. Breathing can be three types –
a. Nasal breathing: When a person
breaths normally through the nose.
b. Mouth breathing: When a
person normally breaths through
the mouth.
c. Oro-nasal breathing: When a
person breaths partly through the
nose &
shahajaman saju
38. Nasal breathers usually hold the lip contact lightly where as in mouth
breathers lips are apart.
Ask the patient to take a deep breath, nasal breathers inspire through the
nose & mouth breathers inspire through the mouth.
Ask the patient to take a deep breath, in case of nasal breathers external
nares of the nose is dialates. In case of mouth breathers no change in
external nares.
A double sided mirror is held between the nose & the mouth. Fogging on the
nasal side of the mirror indicates nasal breathing while fogging towards the oral
side indicates oral breathing.
shahajaman saju
39. Ask the patient to fill his mouth with water and retain in for a period of time.
A butterfly shaped piece of cotton is placed over the upper lip below the nostrils.
# No movement of cotton – it indicates mouth breather
# Cotton moves only one side – breathing through only that nostril
# Cotton moves on both sides – breathing through both of the nostrils.
shahajaman saju
40. EXAMINATION OFCHIN
MENTALISACTIVITY-
Normaly mentalisisnot activeat rest.
Hyperactive mentalis isseen in
CLASS11DIVISON1CASES.
CHIN POSITIONAND PROMINENCE-
. prominent chinisusually associated with
class 111malocclusion
shahajaman saju
41. MentolabialSulcus
Deep
It is a fold of soft tissue between lower lip & chin.
Affected by-
Facial Height
Overjet
Chin Projection.
Deep sulcus – Class II Div 1
Shallow sulcus – Bimaxillary protrusion
CoNntemoprormaryaorlthodontic 4th editSionhpraofflitlow
shahajaman saju
42. Basic units- 25 consonants, 14vowels.
A s k patient to count 1 to 10 or20.
Watch closely adaptation of lips &tongue
Listen to how sounds areproduced.
Speech/articulation
shahajaman saju
47. Profile Analysis
Goals of facial profile analysis:
1. Establishing whether the jaws are
proportionately positioned in the
anteroposterior plane of space.
2. Evaluation of lip posture and incisor
prominence
3. Re-evaluation of vertical facial
proportions and evaluation of mandibular
plane angle.
shahajaman saju
48. Straight Profile Convex Profile Concave Profile
Convex Profile-
Skeletal class II
Concave Profile-
Skeletal class III
N’
SN’
Pg’
shahajaman saju
49. ASSESSMENT OF ANTER-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.
shahajaman saju
50. • In apatient with CLASS1 skeletal patternthe
handisat aneven level.
shahajaman saju
51. • In askeletal CLASSII patient, the middle fingeris
aheadof the forefinger or the hand pointsupward.
shahajaman saju
52. Ina skeletal CLASS111patient, the middle finger is
ahead of the forefinger or the hand points
downwards.
shahajaman saju
53. FACIALSYMMETRY
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 resultof:
A. congenitaldefects
B.hemi-facial atrophy/hypertrophy
C.unilateral condylar ankylosisand hyperplasia
shahajaman saju
55. Composite photographs are the best way to indicate normal facial asymmetry.
For this boy, whose mild asymmetry rarely would be noticed and is not a
problem, the true photograph is in the centre. On the right is a composite of the
two right sides, While on the left is a composite of the two left sides. This
technique dramatically illustrates the difference in the two sides. Although the
normal asymmetry usually is less than in this boy, mild asymmetry is the rule
ratherthan the exception.Usually, the rightsideof the faceisalittle larger than
the left ,ratherthan the reverseasin this individual. 22
shahajaman saju
56. vertical facial thirds
• Distance from
• the hairline to the
base of the nose,
• base of nose to
bottom of nose,
• and nose to chin
should be the same.
shahajaman saju
57. Facialproportionsandsymmetry
thefrontal plane.
An ideally proportional face can be divided into
central, medial,andlateral equalfifths.
Theseparationof the eyesandthe width of the
eyes, which should be equal ,determine the
central and medial fifths .The nose and chin
shouldbecantered within the centralfifth, with
the width of the nose the same as or slightly
widerthan the centralfifth..
Theinter – pupillary distance(dotted lines)should
equal thewidth of themouth.
23
shahajaman saju
61. Oral hygine
Oral hygine means absence of any pathology related to
1. the teeth
2. their supporting structure
3. the soft tissue of the mouth
shahajaman saju
63. • The CPITN includes:
A. Code 0
No bleeding or pocketing detected
No treatment required
B. Code 1
Bleeding on probing;
no pockets >3.5 mm
OHI and prophylaxis
C. Code 2
Plaque retentive factors present (includes calculus);
No pockets > 3.5 mm.
OHI; removal of calculus and plaque retentive margins on restorations
D. Code 3
Pockets > 3.5 mm and < 5.5 mm in depth
Treatment involves OHI, prophylaxis, removal of plaque retentive factors and root
planning
E. Code 4
Pockets > 5.5 mm in depth
Treatment involves OHI, prophylaxis, removal of plaque retentive factors and root
planning and periodontal surgery.
shahajaman saju
64. Periodontal examination
by orthodontist
For each adult patient :
Cursory 5 minute periodontal screening examination .
Probingkey indicator teeth:
1. upper molar interproximal regions
2. buccal furcation
3.lower canine/lateral incisor area especially where
there is crowding.
Evaluating attached gingiva.
Studing appropriate radiograph.
1. vertical bitewing show crestal bone more clearly.
Parafunction:
screen for bruxing or clenchingshahajaman saju
65. Dentition---
Teeth present, unerupted, missing
Status of dentition
Caries, restorations, discolorations
Molar relation
Overjet, overbite, open bite, deep bite,
cross bite
Midline shift
Rotation, intrusion, extrusion
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77. Pre-normal occlusion
-mandibular dental arch is
placed anteriorly in centric
occlusion
Post-normal occlusion
-mandibular dental arch is
placed more posteriorly in
centric occlusion
SAGITTAL PLANE MALOCCLUSION
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78. VERTICAL PLANE MALOCCLUSION
Deep bite
Vertical overlap between the
maxillary & mandibular teeth
is in excess than normal
Open bite
Exist in anterior or posterior
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79. TRANSVERSE PLANE MALOCCLUSION
- includes various types of CROSS BITES
- mainly due to constriction of dental arches
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81. Class I canine relationship
the upper permanent
canine occludes in the
embrasure between the
lower permanent canine
and the firstpremolar.
Class II canine relationship
the canine occludes a whole
tooth width further
anteriorly and lies in the
embrasures between the
lower canine and lateral
incisor.
Class III canine relationship
the upper canine occludes a
whole tooth width further
posteriorly than normal and
occludes in the embrasure
between the lower first
and second premolar.
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83. Anterior gingivitis common in mouth
breathers due to dryness of mouth
caused by open lip posture.
Presence of traumatic occlusion
indicates localized gingival recession.
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84. Upper labial frenum Lower labial frenum Lower lingual freneum
Types of Frenum –
a. Upper labial frenum
b. Lower labial frenum
c. Lower lingual frenum
Examination of Frenal attachments
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85. Upper labial frenum :
Sometimes maxillary labial frenum can be thick, fibrous & attached
relative low. Such an attachment prevent the two maxillary Central
incisors from each other thereby causes midline diastema.
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86. Positive Blanch test
Abnormal frenal attachments are diagnosed by a blanch test where
upper lip is stretched upwards & outwards for a period of time. The
presence of blanching or whitish in the region of the inter-dental
papilla is diagnosed of an abnormal labial frenum or high frenum.
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87. Lower lingual frenum:
Lower lingual frenum is examined by asking the patient protrude
the tongue. If the patient is unable to protrude the tongue due to
abnormal lingual frenum & it is called Tongue tie or partial
Ankyloglossia.
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88. Examination of tongue:
Normal position of tongue :
Tongue rests at the occlusion level within the arches, dorsum touching the palate
and the tip of the tongue rests against the lingual surface of the anteroirs.
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89. Macroglossia
is indicated by –
Presence of imprints of the teeth on the lateral margin of the tongue
giving it a scalloped shape.
Generalized tooth proclination or generalized spacing
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90. A patient whose tongue reaches the
tip of the nose is said to have a long
tongue
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91. EXAMINATION OF PALATE :-
01
Variation in
palatal
depth
02
Presence of
swelling
03
Mucosal
ulceration
and
indentation
04
Presence of
cleft
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95. Examination of tonsils & adenoids :
Abnormally inflamed tonsils cause alteration in tongue & jaw
posture that causes the oro-facial imbalance leading to
malocclusion.
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99. The patient is examined for symptoms of temporo
mandibular joint problems such as clicking, crepitus, pain
in the masticatory muscles, limitation of jaw movement,
hyper mobility and morphological abnormalities.
Inspection
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101. The first step in functional analysis is examine the
patients maximum jaw opening
For adults – 45 mm
Children - < 45 mm
Mouth opening
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102. . Many authorities consider less
than 40 mm to represent restricted
jaw opening. Brandt considers this
an artificially high threshold for
determining restricted jaw
movements, suggesting that 35 mm
is more appropriate for children and
adolescents.
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103. EVALUATION OFPATHOFCLOSURE:-
Thepathofclosureisthemovementof themandiblefrom rest
positionto habitual occlusion.
Forwardpathofclosure
Occurs in patients
with mild skeletal
prenormalcy or
edge to edge
incisor contact.
Backwardpathofclosure
class II div.2 cases
exhibit premature
incisor contact
due to retroclined
maxillary incisors.
Lateralpathofclosure
it is associated
with occlusal
prematurity and a
narrow maxillary
arch
backwardpathofclosure
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104. Forward path of closure Backward path of closure
Lateral path of closure
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106. ASSESSMENTOF POSTURALRESTPOSITIONANDINTER-OCCLUSAL
CLEARANCE.
The postural restposition of the mandible at
which the muscles that closes the jawand those
that open them are, in state of minimal
contraction to maintain the posture of
mandible.
At postural restposition, a space existsbetween the
upper and lower jaws.
Thisspace isknown as FREEWAYSPACE.
FREEWAY SPACE is3mm in canineregion.shahajaman saju
107. Methodsusedtorecord
theposturalrest position
PHONETIC METHOD; the patient is asked to repeat
some consonants “m or c’’ or repeat a word like
Mississippi.
The mandible returns to postural rest position 1-2
seconds after theexercise.
The patient is told not to change the jaw, lip or
tongue position after phonation, as the dentist
parts the lips to study interocclusal space.
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108. COMMAND METHOD
The patient is asked to perfom
certain functions such as
swallowing.
The mandible tends to return to rest
position following this act.
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109. Non commandmethod
1 Thepatientisobservedashe speaks
orswallows.
Thepatientisno aware
thathe isbeing examined.
2 Thisisusuallybeing carriedoutby
talkingabout topics unrelated to
the patient while carefully
observing him ornot
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110. Methods to measureinter-occlusal clearance
VERNIER CALIPERS CAN BEUSED
DIRECTLYIN THEPATIENT’SMOUTHINTHE
CANINEOR
INCISALREGIONTOMEASUREFREEWAY
SPACE.
THIS IDIRECTINTRA ORAL METHOD.
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116. Periapical radiograph :
Importance of periapical radiograph –
1. Present or absent of permanent teeth.
2. Shape & position of teeth present.
3. In relative state of development of teeth,
4. Extent of calcification of teeth,
5. The path of eruption of permanent teeth,
6. The morphology & inclination of root of permanent teeth,
7. The periodontal ligament space & lamina dura,
.
Height &contour of alveolar
bone
Pattern or root resorption
Path of eruption Apical patology
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117. Periapical radiograph :
Importance of periapical radiograph –
8. The height & contour of the alveolar bone,
9. Dental caries,
10. Apical infection,
11. Root fractures,
12. Retained deciduous tooth,
13. Pattern & amount of root resorption,
14. The presence of supernumerary teeth.
Height &contour of alveolar
bone
Pattern or root resorption
Path of eruption Apical patology
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118. To detect periodontal change
To study height and contour of alveolar bone
To detect secondary caries
Bitewing radiograph
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120. Occlusal
view
OPG
Occlusal radiograph
They are useful in orthodontic to study the
effect of arch expansion procedure
To locate impacted or unerupted teeth
To study bucco-lingual expansion of cortical
bone
Supplementary projection tolocate
malposed unerupted teeth.
Palatal cleft shahajaman saju
123. Importance of Panoramic radiograph:
1. All present or absent of permanent teeth.
2. Shape & position of teeth present.
3. Extent of calcification of teeth,
4. The path of eruption of all permanent teeth,
5. The morphology & inclination of root of permanent
teeth,
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124. Importance of Panoramic radiograph:
6. The periodontal ligament space & lamina dura,
7. The height & contour of the alveolar bone,
8. Dental caries,
9. Apical infection,
10. Root fractures, jaw fracture
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125. Importance of Panoramic radiograph:
11. Retained deciduous tooth,
12. Pattern & amount of root resorption,
13. The presence & absent of multiple
supernumerary teeth
14. They are useful aids in serial extraction
procedures to study the status of erupting teeth.
15. Mixed dentition period to study the status of
unerupted teeth
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127. CEPHALOMETRIC RADIOGRAPHS
Specialized skull radiograph in
which the head is positioned in a
specially designed head holder
cephalostat.
Itisof two types
1. Lateral cephalogram
2. Postero-anterior cephalogram
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128. anterio posterior jaw relation
Growth pattern
Details of Maxilla and
mandible
Degree of proclination of
maxillary and mandibular
soft tissue analysis
CEPHALOMETRIC RADIOGRAPHS
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130. Facial Photograph :
A facial photograph indicates the soft tissue
morphology & facial expression. Both extra-oral
& intra-oral photograph are useful to diagnostic
records.
Three extra-oral views are taken –
Frontal view
Profile view
Oblique view
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136. Advantages
1. They are three dimensional records of the patients
dentition.
2. Occlusion can be visualized from lingual aspect.
3. They provide a permanent record of the
intermaxillary relationship.
4. Helps to motivate the patients as they can visualize
the treatment progress.
5. They are needed for comparison purposes at the
end of the treatment and act as a reference for post
treatment changes.
6. They serve as a reminder for the parent and the
patient of the condition present at the start of the
treatment.
7. In case the patient has to be transferred to another
clinician study model are an important record.
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