ORTHO treatment planning Flashcards
(24 cards)
what are the full diagnostic records needed for treatment planning in ortho?
- history and examination
- study models
- photographs
- radiographs
how do you assess whether the pt needs treatment?
clinical judgement
IOTN
how do you assess if the patient wants treatment?
cooperation
motivation
what factors contribute to the timing of ortho tx?
dental stage
growth
motivation
how do you decide what type of ortho tx if required?
visualise tooth movements required
space analysis
appliance type
what is CAP?
clear aligner treatment
what are ways to gain space in ortho?
extractions
non-extractions:
- increase arch length with distal movement of posterior teeth or anterior movement of incisors
- increase arch width
- interproximal reduction
what is molar distalisation?
increasing the arch length with distal movement of posterior teeth (upper molars)
what are the space requirements for extraction and non extraction cases?
0-4mm space = non extraction
4-8mm space = borderline
8+mm space = extractions
what is the historical perspective on extractions or non extraction for space in ortho tx?
Angle vs Case
what factors will you take into consideration for borderline XLA cases?
profile
skeletal pattern
class II div II/ deep bite/ retroclined incisors
MH
why is the profile a consideration for extraction cases?
when you start to close the upper arch after XLA, the upper incisors will move back and drop the lip - this may worsen the profile
what teeth are the favourite choice for orthodontic xla?
premolars
- no aesthetic impact on smile
- space near to crowding
- straightforward extraction (usually)
- molars provide good anchorage for appliances
when would you want to ortho xla a 4 over a 5 for crowding?
when most space is required
when canines are crowded
when would you rather xla a 5 over a 4 for crowding?
less anterior crowding
allows molars to move forwards
in what cases would you xla a first permanent molar?
caries or large restoration
when would you ortho xla a lower incisor?
- class III malocclusion
- lower incisor crowding only problem (in adults)
- severe rotation
- severe displacement
when would you ortho xla an upper lateral?
- palatally displaced
- trauma
- contralateral tooth congenitally absent/ peg
- canine has good shape/ size/ colour
when would an upper central incisor be xla?
trauma
dilaceration
ectopic
what guidelines should you follow for removal of third molars?
SIGN guidelines
what is the role of the GPD in regards to ortho treatment planning?
identify - examination/ refer (IOTN)
maintain OH
orthodontic first aid
retention
what information should be included in a ortho referral letter?
- pt name, address, postcode, age, DOB, contact details
- reason for referral and what the pts complaints are
- MH
- how long they have been a pt with you and whether they attend regularly?
- standard of OH; has been OHI and diet advice been given and adhered to?
- previous dental tx, how tolerant pt was, any previous ortho?
- HX of trauma
- SH
- motivation for tx, have family received ortho tx and where?
how would you summarise your pts malocclusion in a referral letter?
- skeletal and relevant soft tissue pattern
- stage of occlusal development
- teeth present/ absent
- crowding/ spacing
- incisor and molar relationship
- measurement of overjet and assessment of overbite
- presence of a mandibular displacement
- radiographic features including path
- highlight any teeth of poor prognosis
what additional documents should always be included in an ortho referral letter?
a copy/ print out of any recent/ relevant radiographs
any study models/ photographs
