Diagnosis in orthodontics /certified fixed orthodontic courses by Indian dental academy

DIAGNOSIS IN
ORTHODONTICS
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com


The first step towards cure is to know what
the disease is.
- Latin

proverb


Diagnosis
Treatment is secondary…..

Primary task

PROBLEM

PLAN A TREATMENT…

Diagnosis
Diagnosis involves development of a
comprehensive & concise database of pertinent
information, sufficient to understand the
patients problem.
•The DATA can be derived from….

Diagnostic- aids

Diagnosis
Diagnostic- aids
Essential
•Case history
•Clinical examination
•Study models
•Radiographs
•IOPA
•OPG
•Lateral ceph
•Facial photographs

Supplemental
•Specialized radiographs
•P-A Ceph
•Occlusal
•Shift –cone technique
•TMJ X-ray
•Hand and wrist X-ray
•Electromyography
•Diagnostic set-up


Essential diagnostic aids
Case history
Personal details
 Chief complaint
 Medical history
 Dental history
 Pre-natal history
 Post-natal history
 Family history



CASE HISTORY
Prenatal and Natal history
Placental transfer of drugs
Forceps injury,
Congenital anomalies
Childhood medical history
Respiratory obstruction
Tonsillectomy,
Childhood diseases,

History of habits :
Thumb sucking , tongue thrusting , lip and
nail biting , mouth breathing .


Family history :
Genetic influence on malocclusion
Maturational status :
Increase in height ,
Change of voice in males ,
Menarche in females .
Past dental history :
Caries, Restorative treatment, Extraction of
deciduous / permanent teeth , periodontal
problems , history of trauma .

Essential diagnostic aids
Clinical examination

General- physical
•Ht & wt
•Gait
•Posture
•Body-build

Extra-oral
Intra-oral
•Tongue
•Head shape
•Palate
•Facial form
•Facial symmetry •Gingiva
•Facial proportion •Frenal attachment
•Tonsils & adenoids
•Facial profile
•Facial divergence •Assessment of dentition
•Functional examination
•Growth pattern
•Examination of lip, nose & chin

CLINICAL EXAMINATION
General examination :
Gait
Posture
Body type
Height
Weight


General physical examination
Body-build (physique)
Aesthetic-THIN: narrow dental arches.
 Pletoric -OBESE: large square dental arches
 Athletic –NORMAL: normal sized dental arches


•Sheldon's classification:
•Ectomorphic
•Mesomorphic
•Endomorphic

Extra – oral examination
Shape of the head
Mesocephalic: average shape of head- normal
dental arches.
 Dolicocephalic: long and narrow head- narrow
dental arches.
 Brachycephalic: broad and short head- broad dental
arches.



Facial form
Mesoprosopic: normal face form
 Euryprosopic: broad & short
 Leptoprosopic: long & narrow.



Facial symmetry
examine the facial proportion in transverse and
vertical planes.
 Example:







Congenital defects
Hemifacial hypertrophy
Unilateral condylar ankylosis
Unilateral condylar hyperplasia.


Vertical facial- proportion

“Vertical thirds of face”

Long face
Short face


Long face& short face


Transverse facial- proportion
“Rule of fifths”




Middle fifth
Medial two fifths
Outer two fifths


Facial profile
Straight
 Convex
 concave



Facial divergence


Facial angle. i.e. angle bw N- Pog line to FHplane.




Straight/ orthognathic face :90*
Anterior divergent face: more than 90*
Posterior divergence: less than 90*


Growth pattern


FMPA- Frankfurt mandibular plane angle


Examination of lips

Incompetent

Potentially incompetent


Competent

Examination of nose
Nose size, contour
 Nasolabial angle: 98*



Examination of chin


Smile elements
Extent of the smile is outlined by
Curvature of the upper & lower lip
 Position of the angle of mouth
 Degree of exposure of both anterior & posterior
teeth,gingiva,width of the buccal corridor.


Smile can be classified as
Passive
 Active (moderate)
 laugh



Smile element


Smile elements
Lower lip line
Smile line
Negative space


THANK YOU

RADIOGRAPHS

OPG

PAs
IO

Late
ral
ceph

Diagnosis in Orthodontics

Recent advances in diagnosis.
1. Digital Photography
2. Digital Radiographs

a) Degiceph and Degigraphs
b) Denofacial Planner
c) Vistadent – For surgical VTO
d) Dentoptix


3. Computerized tooth width analysis.
GATWD- Graphical Analysis of Tooth
Width Discrepancy ( Ho-freer)
4. Arthrography – For TMJ
5. TMJ Leaser arthroscopy
6. MRI – Magnetic Resonance Imaging

LATERAL CEPHALOGRAMS
TRACING



7. Computed Tomography
8. Micro Computed Tomography

9. DICOM

–

Digital

Imaging

Communication in Medicine.


and

Thank you
For more details please visit


Diagnosis in orthodontics /certified fixed orthodontic courses by Indian dental academy

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