diagnosis and tx planning Flashcards
(85 cards)
general principles of tx planning and dx
history
examinaiton
differential diagnosis
special tests
diagnosis
tx plan
tx
outcome
history consists of
CO/ PMH/ PDH/ SH
examination consists of
extra and intra oral exams
differential diagnosis is
list of probables
special tests can be
radiographs
photos
3D lat cephs or CBCT
diagnosis is
decription of pathology/issue
IOTN
2 possible tx routes for ortho
accept
appliance
outcome for ortho tx measured with
PAR index
impact and success of tx, score before and after and assess reduction
differential diagnosis for oral ulceration
- Traumatic
- ROU – major or minor
- Behcet’s disease
- Stephen Johnson syndrome
- Viral causes – varicella zoster, primary herpetic or secondary herpetic stomatitis, pemphigoid
- Crohn’s
- Squamous cell carcinoma
Can narrow down from history.
difference between orthodontic and other dental dx
different describing what is there no real input into origin of malocclusion
importance of IOTN
index of orthodontic treatment need
NHS funded or not
dx in ortho
description of malocclsuion
determine the cause of the malocclusion
- are the causes dentoalveolar or skeletal?
- ortho tx alone or need surgical
e.g. class II div 1 incisor relationship
small teeth =
spacing
early loss of deciduous teeth=
crowding
digit sucking=
proclination and increased OJ
majority of cases cause of malocclusion
uncertain
lateral cephalogram looks at (3)
AP skeletal
vertical skeletal
class III incisors

cephalometry aids us as it
inform clinical impression
analyse better OJ, reverse OJ, high or low angle etx

why is the correct orthodontic dx important
- Orthodontic appliances can move teeth very well, but can modify skeletal relationship minimally
- A severe skeletal discrepancy may require surgical intervention
Careful planning is essential to ensure we don’t make mistakes

anterior x bite
dental or skeletal

dental
URA
z spring move 21 forward
6 weeks approx to end tx
anterior xbite
dental or skeletal

Maxilla hypoplasia and mandibular prognathism
braces won’t be effective – front teeth bite too forward, lowers too back.
Need to wait to fully grown and then do surgery

objective of orthodontic tx
To produce an occlusion which is:
- Stable
- Functional
- Aesthetic
And facilitate other forms of dentistry (crowns, bridges etc)
tx planning
- aim of tx
- tx plan in stages
- complex procedural
- Take time – do whilst pt not there so can think of multiple ideas and pros and cons
better with practice
- every pt is unique
- Realistic dentistry – bespoke to pt, fully aware of tx, risks and benefits (consent)*
tx plan should consider (11)
- future growth changes
- aetiology of malocclusion
- pts soft tissue profile
- retention
- stability
- pt wishes
- access to tx
- compliance
- space requirements
- aims of tx
- prognosis of individualised teeth
creates a priortised problem list –> definitive tx plan


























