Clinical Examination( Status And Amnesis)

Question 1

Amamnesis is subjective/objective

Answer 1

🔸Subjective
🔸 Facts reported by patient and are frequently imprecise

Question 2

Anamnesis provides information about

Answer 2

🔸Origin of malocclusion and how it developed
🔸 Inheritable nature of orthodontic problem and how to access it
🔸Clinical and paraclinical evaluation that needs to be implemented
🔸Patients attitude and expectations

Question 3

Specific areas of orthodontic anamnesis

Answer 3

🔸Earn trust of patient by being calm and professional
🔸Identify contributing etiological factors that are no longer present
🔸Confidentiality
🔸Avoid anxiety by hiding instruments

Question 4

Anamnesis elements

Answer 4

🔸Identification data
🔸Anamnesis Morbi- history of malocclusion
🔸Anamnesis vitae-History of life
🔸Family history

Question 5

Identification data of patient

Answer 5

🔸Name
🔸Age
🔸Date of birth
🔸Address
🔸Telephone number

Question 6

Anamnesis Morbi-History of the present malocclusion

Answer 6

🔸Chief complaint and reason for visit
🔸Onset of malocclusion and how it has developed in time
🔸Reason to seek treatment
🔸Previous consultations
🔸Previous treatment and outcomes

Question 7

Anamnesis vitae- history of life

Answer 7

🔸Pregnancy - diseases, medications
🔸Neonatal nutrition- breast feeding/complimentary feeding or both. Type and duration of pacifier use
🔸Eruption time of primary and permanent teeth
🔸Onset of speech and beginning of verbal communication
🔸Oral habits- pacifier, digit sucking, mouth breathing
🔸Systemic conditions- allergies, respiratory diseases, endocrine diseases, hypovitaminosis, immunological diseases

Question 8

Examples of hereditary malocclusions

Answer 8

🔸Diastema
🔸Hypodontia
🔸Hyperdontia
🔸Impacted maxillary canines
🔸Mandibular prognathism
🔸Cleft lip and palate

Question 9

Estimation methods of inheritance

Answer 9

🔸Horizontal inheritance pattern- Examination of siblings and cousins
🔸Vertical inheritance pattern- Parents, grandparents, uncles and aunts

Question 10

Parts of Status(Clinical examination of patient)

Answer 10

🔸General status
🔸Status Localis- Extraoral, intraoral

Question 11

General status

Answer 11

🔸Appearance of Patient
🔸Body buildup and musculature
🔸Age appearance
🔸Posture
🔸Hygiene

Question 12

Extraoral examination divided into

Answer 12

🔸Frontal view
🔸Profile view

Question 13

Frontal view

Answer 13

🔸Symmetry of face
🔸Proportionality of face
🔸Horizontal lines connecting eyebrow s, pupils of eyes and corners of mouth should be parallel
🔸Contact point between upper lip in physiological rest position of mandible
🔸Nasolabial and supramental folds

Question 14

Symmetry of face

Answer 14

🔸Divided into right and left halves by midline
🔸Made up of Nasion and Subnasale
🔸The two halves compared visually

Question 15

Proportionality of face

Answer 15

🔸3 vertical facial heights
🔸Upper third- Point Trachion to soft tissue Nasion
🔸Middle third- Soft tissue Nasion to Subnasale
🔸Lower-Subnasale to soft tissue Gnathion

Question 16

According to Schwartz regarding the lower facial third

Answer 16

It is 5-10 mm higher than the middle face height

Question 17

Contact point between the upper and lower lip

Answer 17

🔸Lips ideally in contact in rest position
🔸Upper incisor display of over a third clinical crown means lip is hypotonic

Question 18

Nasolabial and supramental folds

Answer 18

Underlined or smoothened

Question 19

Profile view

Answer 19

🔸Consists of estimating facial profile by appearance- correlation between tip of nose, upper lip, chin prominence-concave(prognathic), straight and convex(retrognathic)
🔸Mandibular angle examined w/ two rulers-one on ramus and one on body to make angle- decreased or increased

Question 20

Upper lip is ideally

Answer 20

Ahead of Lower lip

Question 21

Positive lip step

Answer 21

Protrusion of lower lip in relation to upper lip

Question 22

Negative lip step

Answer 22

Retrusion of lower lip

Question 23

Intraoral status features of examination

Answer 23

🔸Present teeth
🔸Dentition-intact or caries prone
🔸Arch form
🔸Symmetry of arches
🔸Tongue- size and pathology
🔸Oral hygiene
🔸Frenulae

Question 24

If frenulum linguae is short and thick

Answer 24

Decreases mobility of tongue tip

Question 25

Swallowing test

Answer 25

🔸Index and middle fingers under inner margin of mandibular body 🔸Patient swallows 🔸Infantile swallowing if- contraction of extrinsic tongue muscles, tongue thrusts forward against anterior teeth and patient protrudes neck forward (duck)

Question 26

Breathing tests

Answer 26

🔸Physiological rest position and lips in contact- cotton under nostrils and patient breaths in and out- positive if moves during breathing 🔸Patient holds mouth of water for 1 minute without spitting 🔸Patient squats w/ mouth closed and lips in contact- positive if doesn’t open mouth

Question 27

Speech tests

Answer 27

🔸Assess phonation of patient during speech 🔸Speech therapist consultation if problem

Question 28

Eschler-Bittner test

Answer 28

🔸For facial asymmetry 🔸Maximum opening of mouth then slow closing 🔸Assessing if facial asymmetry restored during opening and in what moment it occurs during closing 🔸Morphological discrepancy of mandible of asymmetry maintained during opening and closing 🔸Functional deviation of mandible if asymmetry occurs and restores during closing