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BDS3 CLINICAL Ortho > Orthodontic Assessment > Flashcards

Orthodontic Assessment Flashcards

(62 cards)

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1
Q

Why do we do an orthodontic assessment?

A

to determine if any malocclusions are present

identify any underlying causes

decide if treatment is indicated (either refer or devise treatment plan)

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2
Q

What age do we do a brief ortho exam

A

9 years old

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3
Q

What age do we do a comprehensive examination

A

when the premolars/canines erupt so 11/12 years

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4
Q

When do we do an ortho examination

A

when older patients first present

if a malocclusion develops later in life

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5
Q

What is the ideal occlusion

A

hypothetical

rarely found in nature

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6
Q

What are Andrews 6 keys for ideal occlusion

A 
Molar relationship
crown angulation (mesio-distal top)
crown inclination
no rotations
no spaces
flat occlusal planes
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7
Q

Describe the molar relationship seen in Andrews 6 keys

A

the distal surface of the disto-buccal cusp of the upper first permanent molar occludes with the mesial surface of the mesio-buccal cusp of the lower second permanent molar

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8
Q

What is a normal occlusion

A

more commonly observed than ideal occlusion

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9
Q

What is a minor deviation occlusion

A

do not constitute an aesthetic or functional problem

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10
Q

What is a malocclusion

A

more significant deviations from the ideal that may be considered unsatisfactory (aesthetically or functionally)

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11
Q

What are significant factors in the past medical history

A

allergy (Ni or Latex)
epilepsy/drugs
drugs
imaging

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12
Q

What are significant factors in the past dental history

A

frequency of attendance
nature of previous treatment
co-operation with previous treatment
trauma to permanent dentition

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13
Q

What are habits that are relevant to ortho

A

thumb sucking
lower lip sucking
tongue thrust
chewing finger nails

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14
Q

When doing an extra oral exam what do we look at

A

skeletal bases
soft tissues
TMJ

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15
Q

What do we compare the patient to parent for

A 
malocclusion - especially class III
growth potential
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16
Q

What do the teeth sit on

A

individual skeletal bases which are connected to the skull bases

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17
Q

What happens if you have an increased cranial base angle

A

then the posterior and anterior cranial bases are at a higher angle and there is a tendency for a large overjet as the mandible is further back

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18
Q

What planes is a facial skeletal pattern considered in (looking at the skeletal bases)

A

antero-posterior
vertical
transverse

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19
Q

How is the skeletal assessment done in the anteroposterior plane

A

via visual assessment

palpate the skeletal bases

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20
Q

How should the head be positioned for an extra oral examination

A

Frankfurt plane horizontal to the floor

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21
Q

What is a class I (AP skeletal assessment)

A

maxilla 2-3mm in front of mandible

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22
Q

What is a class II (AP skeletal assessment)

A

maxilla more than 3mm in front

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23
Q

What is a class III (AP skeletal assessment)

A

mandible in front of the maxilla

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24
Q

What is the function of direct palpation of the skeletal bases

A

can see how bases relate to one another

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25
How is the vertical skeletal assessment done
by look at the angle between the frankfort plane and the mandibular plane angle want to see where these two lines meet - should meet at the back of the head
26
What is the mandibular plane angle
it is the lower border of the mandible
27
What should be expected if the FMPA meets before the back of the head
will be expecting minimal overbite or an anterior open bite inside the mouth would expect no contact with the front teeth as the back teeth meet first
28
If there's a reduced FMPA angle what is expected
the two lines don't meet at the back fo the head expect them to have a deep bite, the jaws are too close together
29
How is the skeletal assessment done laterally
look at the mid saggital reference line can pick up mandibular asymmetry
30
What should we look at when looking at the lips in the EO exam
competent/incompetent lower lip level lower lip active
31
What should we look at when examining the tongue in the EO exam
position, habitual and swallowing
32
What should we look at with speech
lisping
33
What are competent lips
meet at rest | relaxed mentalis muscle
34
What are incompetent lips
do not meet at rest | relaxed mentalis muscle
35
What is a tooth trap
upper teeth rest on lower lip so are proclined forward slightly
36
What is the effect of a hyper active lower lip
may retrocline lower incisiors indicates likely stability at the end of tx
37
What is a tongue thrust associated with
tongue thrust on swallow is associated with anterior open bite can be endogenous or adaptive tongue thrust
38
What is the issue sometimes with treating AOB from tongue thrust
may cause relapse of the AOB at the end of the treatment if its endogenous
39
What are the two main ways of sucking digits
if its a thumb it causes asymmetrical problem if two digits causes symmetrical problem
40
What is the occlusal effect of sucking a thumb
proclamation of upper anteriors retroclincation of lower anteriors localized AOB or incomplete OB narrow upper arch with or without a unilateral posterior cross bite these effects will be superimposed by the existing skeletal pattern and incisors relationship which can make the issue worse
41
When examining the TMJ what should we examine
``` path of closure range of movement pain, click from joint deviation on opening muscle tenderness ```
42
What should we look out for when examining the TMJ
mandibular displacement | discrepancy in RCP and ICp
43
What should we check for the intra oral examination
``` OH and periodontal health count teeth teeth of poor prognosis assess crowding/spacing/rotations inclination/angulation palpate for canines if not erupted note teeth fo abnormal shape or size ```
44
What should we look at in the IO exam for the lower arch
degree of crowding presence of rotations inclination of canines angulation of incisors to mandibular plane
45
What should we look at in the IO exam for the upper arch
degree of crowding presence of rotations inclination of canines angulation of incisors to frankfort plane
46
What kind of angle do we want for the angulation of incisors to the frankfurt plane
110 degrees
47
What do we look at when the teeth are in occlusion when the teeth are in maximum interdigitation or Rcp
``` incisor relationship over bite/open bite molar relationship (angle's classification) canine relationship cross bites centre lines ```
48
What are the different incisor relationships
Class I Class II - div 1 and div 2 Class III overjet, overbite, centrelines
49
What is a class I incisor relationship
the lower incisor edges occlude with or lie immediately below the cingulum plate of the upper central incisors
50
What is a class I incisor relationship
the lower incisor edges lie posterior to the cingulum plateau of the upper incisors
51
What is a class II incisor relationship
the lower incisor edges lie posterior to the cingulum plateau of the upper incisors
52
What is a class II div 1 incisor relationship
the upper incisors are proclined or of average inclination and there is an increase in overjet
53
What is a class II div 2 incisor relationship
the upper central incisors are retroclined | the overjet is usually minimal or may be increased
54
What is a class III incisor relationship
the lower incisor edges lie anterior to the cingulum plateau of the upper incisors overjet is reduced or reversed
55
What is an overbite
overlap of the teeth
56
What is an average overbite
upper incisors cover 1/3 to 1/2 of lower incisor crowns
57
What are the diff types of overbites
``` average reduced AOB increased and complete contacts tooth increased and complete contacts palate increased but incomplete ```
58
What is Angles classification
buccal segment ``` class I class II class III ``` crossbones
59
What are the different canine relationships
``` class II class II class III ``` won't get good ortho results if canine relationship is not class I
60
What are special investigations that can be done prior to ortho
``` OPT maxillary anterior occlusal lateral ceph vitality tests study models photographs ```
61
What do we do from the info we got in the assessment
summarise important points assess treatment needs devise treatment aims if appropriate plan treatment
62
Describe an ortho summary
name, age, sex HPC, RMH, RDH incisor relationship, skeletal base, ST teeth present/absent, OH, poor prognosis lower arch, incisor inclination, crowding upper arch, incisor inclination, crowding OJ, OB, centrelines, molar relationship, crossbones, miscellaneous IOTN score

BDS3 CLINICAL Ortho (11 decks)

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