Diagnostic-aids-in-orthodontics clinical practiceppt.pdf

Orthodontic diagnostic aid

1. DIAGNOSTIC AIDS IN
ORTHODONTICS
Ananya
Mohamed sajitha

2. Orthodontic diagnosis deals with the recognition of
the various characteristics of the malocclusion
Types:
A.Essential diagnostic aids
B.Supplemental diagnostic aids

5. CASE HISTORY
Case history is the information gathered from the
patient or the parent that aids in overall diagnosis of
the case
Personal details:
Name
Age
Sex
Address
Occupation

6. CHIEF COMPLAINT
The major reason is for seeking consultation and
treatment
Reasons: ( patient concern on alignment and occlusion
)
Impaired dentofacial esthetics that can lead to
psychosocial problems
Impaired function
Desire to enhance dentofacial esthetics and thereby
the quality of life

7. MEDICAL HISTORY
Very few medical conditions contraindicate the use of
orthodontic appliance
Some systemic condition and their orthodontic
considerations
Diabetes mellitus
Endocarditis
haemophilia A
Asthma
Epilepsy
Chronic renal failure

8. DENTAL HISTORY
Should include information on the age of eruption of
deciduous and permanent teeth, h/o extraction, decay,
restoration, and trauma to the dentition
It gives information about the attitude of the patient
towards dental treatment

9. PRENATAL HISTORY
Condition of the mother during pregnancy
Type of delivery, tmj injuries, mandibular growth retardation
POSTNATAL HISTORY
Type of feeding, presence of habits and h/o trauma

10. FAMILY HISTORY
Many malocclusion are inherited such as skeletal class
2 and class 3, congenital conditions such as cleft lip
and palate

11. GENERAL EXAMINATION
HEIGHT AND WEIGHT
Physical growth
Maturation of the patient
GAIT
It is the way a person walks
Usually associated with neuromuscular disorders that
may have dental correlation

12. POSTURE
It is the way a person stands
May cause alteration in maxilla-mandibular
relationship
BODY BUILT (physique)
Aesthetic: thin, narrow dental arches
Plethoric: obese, large square dental arches
Athletic: normally built, normal sized dental arches

13. Sheldon classification:
Ectomorphic- tall and thin physique
Mesomorphic- avg physique
Endomorphic- short and obese

14. EXTRAORAL EXAMINATION
SHAPE OF HEAD
Mesocephalic
Dolicocephalic
Brachycephalic

15. FACIAL FORM
Round, oval and square
Mesoproscopic
Euryproscopic
Leptoproscopic

16. FACIAL PROFILE
It is examined by viewing patient from side
Straight profile
Convex profile
Concave profile

17. FACIAL DIVERGENCE
An anterior or posterior inclination of the lower face
relative to the forehead
Anterior divergent
Posterior divergent
Straight or orthognathic

18. EXAMINATION OF LIPS
Competent lips
Incompetent lips
Potentially incompetent lips
Everted lips

19. EXAMINATION OF NOSE
Nose size
Nose contour
Nostrils

20. EXAMINATION OF CHIN
CHIN POSITION AND PROMINENCE
Prominent chin- class 3
Recessive chin- class 2

21. INTRAORAL EXAMINATION
Examination of,
tongue
palate
gingiva
Frenal attachment
Tonsils and adenoids
Assessment of dentition

22. FUNCTIONAL EXAMINATION
Assessment of postural rest position and interocclusal
space
Evaluation of path of closure
Assessment of respiration
Tmj examination
Evaluation of swallowing
Speech

23. ORTHODONTIC STUDY MODELS
These are the accurate plaster reproductions of teeth
and their surrounding tissues
A.plaster study model
B.Digital study model

24. It helps to study the arrangement of teeth and
occlusion from all directions
It enables accurate measurements to be made in
dental arch
It helps in assessment of treatment progress
It helps in assessing the nature and severity of
malocclusion

25. Facial photography:
Facial photographs provide a lot of information about
soft tissue morphology and facial
expression.Photographs should be taken in a
standardised manner so that they can be readily
compared with similar photographs taken during or
after treatment.

26. Both extra oral and intra oral photographs are taken
Three extra oral views are:
a.Frontal view
b.Profile view
c.Oblique facial view

27. Three intra oral views are:
a.Left and right lateral view
b.Frontal view
c.Maxillary and Mandibular occlusal view

28. Uses of photographs:
1.They are useful in assessment of facial
symmetry,facial type and profile
2.They serve as diagnostic records
3.They help in assessing the progress of the
treatment.

29. Electromyography:
Electromyograph-a machine used to recieve,amplify
and record the action potential during muscle activity
Electromyogram-It is a record obtained by such a
procedure (electromyograph)
It is a procedure used for recording the electrical
activity of the muscles.
The resting potential of a muscle fiber is 85-90mV

30. EMG is used to detect abnormal muscle activity associated
with certain forms of malocclusion
A.In severe class II,div 1-hypofunctional of upper lip
B.Class II,div 1-Abnormal buccinator activity
C.Overclosure of jaw- Accentuated temporalis activity

31. Radiographs used in orthodontics diagnosis:
1.Intra oral radiographs
2.Extra oral radiographs
Intra oral radiographs:
Three types are commonly used;
* Periapical
* Bitewing
* Occlusal projections

32. Intra oral periapical radiographs(IOPA):
Used to view teeth and supporting structures
Two intra oral projection techniques used are:
1.Paralleling technique
2.Bisecting Angle technique

33. Uses of intra oral periapical radiograph:
-To confirm the presence/absence of teeth
-To establish the presence/absence of supernumerary
teeth
-To assess the axial inclination of roots
-To determine the size and shape of unerupted teeth
-To study the alveolar bone and pdl space
-To detect retained root stumps and root fragments
-To assess the extend of calcification and root
formation of teeth

34. Bite wing Radiographs:
Bitewing radiographs record the coronal part of the
upper and lower dentition along with their supporting
structures .

35. Uses of bitewing radiograph :
- To detect proximal caries
-To study the height and contour of interdental
alveolar bone
-To detect secondary caries
-To detect overhanging proximal restorations
-To detect periodontal changes
-To detect interproximal calculus

36. Occlusal radiographs:
Intraoral occlusal radiograph enables viewing of a
relatively large segment of a dental arch,including
palate or floor of the mouth.
Occlusal radiograph are also useful in patients who
are unable to open the mouth wide enough for
periapical radiographs.

37. Uses of occlusal radiographs:
-To locate impacted or unerupted teeth
-To locate supernumerary teeth
-To locate foreign bodies in jaws and stones in salivary ducts
-To study bucco-lingual expansions of cortical plate due to
pathology of the jaw
-To diagnose the presence and extend of fractures

38. Extra oral Radiographs:
It includes all views made of the oro-facial region with
the film positioned extra-orally .Some of the extra oral
radiohraphs include:
-Panoramic radiographs
-Cephalometric radiographs

39. Panoramic Radiographs:
These radiographs enable viewing of both maxillary
and mandibular arches with their supporting
structures.
Uses:
•They can be used to visualize ankylosed and
impacted teeth
•To study the path of eruption of teeth
•To diagnose the presence/absence of multiple
supernumerary teeth
•They are useful in mixed dentition period to
study the status of unerupted teeth

41. Cephalometric radiographs:
They are specialized skull radiographs in which the
head is positioned in a specially designed head holder
called cephalostat by means of ear rods
Types of cephalometric radiographs:
-Lateral cephalogram
-Postero-anterior cephalogram

43. Recent advances in diagnostic aids:
-Xeroradiography
-Digi graph
-MRI
-Tomography
-Occlusograms
-Laser holography
-Digital subtraction radiography
-Photocephalometry
-Cone beam computed tomography
-Cineradiography