Treatment Planning

Question 1

What are the stages of orthodontic treatment planning?

Answer 1

1. Plan around the lower arch
2. Decide on treatment in lower
3. Build upper arch around the lower, aiming for a class 1
4. Decide on molar relationship, class 1 or 2 is acceptable

Question 2

What would you examine in the lower arch?

Answer 2

Degree of crowding

Angulation of incisors : mandibular plane

Angulation of canines

Centrelines

Curve of spee

Question 3

What would you examine in the upper arch?

Answer 3

Crowding

Angulation of incisors : maxillary plane angle

Angulation of canines

Centrelines

Question 4

How do you take a crowding assessment?

Answer 4

Estimate space available, then estimate width of all teeth anterior to first permanent molars

Calculate the estimated discrepancy

Or

Calculate an estimate for total overlap between teeth

Question 5

What do when 0-4mm space required in lower arch?

Answer 5

Extract 5s or no extraction

If 5s extracted then extract in upper if class 1

If no extraction in lower, extract upper 5s if class 2

Question 6

What to do when moderate 5-8mm space required in lower arch?

Answer 6

Extract 5s or 4s on both upper and lower

Question 7

What to do when severe 8+mm space needed in lower arch?

Answer 7

Extract 4s in upper and lower

Question 8

What are the different treatment options?

Answer 8

1. Accept malocclusion
2. Extractions only
3. URA
4. Functional appliances
5. Fixed appliances

3,4,5 all with or without XLA

6. Complex treatment involving ortho, restorative or orthognathic surgery

Question 9

What are the limitations of orthodontic treatment?

Answer 9

Purely dental-alveolar and tooth movement orientated, little effect on skeletal pattern

Tooth movements limited by size of alveolar processes

Teeth only remain stable when in position in equilibrium between forces of soft tissues n occlusion and periodontal structures