diagnosis /fixed orthodontic courses by IDA

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats. Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics, Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call 0091-9248678078

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INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com ORTHODONTIC DIAGNOSIS

DIAGNOSIS &TREATMENT PLANNING IS A SERIES OF LOGICAL STEPS:

DIAGNOSIS &TREATMENT PLANNING IS A SERIES OF LOGICAL STEPS www.indiandentalacademy.com

DIAGNOSIS is a comprehensive procedure focused on broad overview of the patients situation TREATMENT PLANNING is to maximize benefit for the patient :

DIAGNOSIS is a comprehensive procedure focused on broad overview of the patients situation TREATMENT PLANNING is to maximize benefit for the patient www.indiandentalacademy.com

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The field of orthodontics is in the midst of a knowledge explosion. www.indiandentalacademy.com

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A good diagnosis is important to decide whether or not to treat ? What the preferable method is ? When it should be started ? Therefore, it should be done with fully developed power of observation and an analytical mind. DIAGNOSIS ? www.indiandentalacademy.com

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THE OBJECTIVES OF DIAGNOSIS Identify the normal and abnormal developmental changes in growing children. Identify the dysfunction of the soft tissues. Identify the relevant etiological factors. Identify the interference in occlusion. www.indiandentalacademy.com

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THE OBJECTIVES OF TREATMENT Render the treatment at an early age and create a suitable environment and functional pattern so that the development is nearly as perfect as possible. Render the treatment in deciduous and mixed dentition to intercept the developing problems by utilizing the growth. Render the treatment in permanent dentition to achieve optimum esthetics, functional efficiency and long term stability. Should be aware of limitations of treatment and the degree of compromise by weighing various factors. www.indiandentalacademy.com

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Orthodontic Consultation Clinical Examination Diagnostic Records Data Base Provisional Diagnosis DIAGNOSIS www.indiandentalacademy.com

ORTHODONTIC CONSULTATION:

ORTHODONTIC CONSULTATION www.indiandentalacademy.com

CHIEF COMPLAINT:

CHIEF COMPLAINT Impaired dentofacial esthetics Impaired function Objective is to find out what is important to the patient? www.indiandentalacademy.com

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CASE HISTORY NAME AGE SEX ADDRESS & OCCUPATION CHIEF COMPLAINT MEDICAL HISTORY DENTAL HISTORY POST NATAL HISTORY FAMILY HISTORY www.indiandentalacademy.com

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CLINICAL EXAMINATION FACIAL OCCLUSAL FUNCTIONAL www.indiandentalacademy.com

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CLINICAL EXAMINATION HEIGHT & WEIGHT GAIT POSTURE BODY TYPE ECTOMORPHIC MESOMORPHIC ENDOMORPHIC BUILD ASTHETIC PLETORIC ATHLETIC FACIAL DIVERGENCE ANTERIOR POSTERIOR STRAIGHT FACIAL FORM MESOPROSOPIC EURYPROSOPIC DOLICOPROSOPIC www.indiandentalacademy.com

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Profile view straight/convex/concave Front view Facial index Cephalic index } To establish facial type Front view- for bilateral symmetry - for dental/skeletal midline Esthetics is very much in the eye of the beholder EVALUATION OF FACIAL PROPORTIONS www.indiandentalacademy.com

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PROFILE ANALYSIS Fore head- Profile of face is determined by slant of forehead and nose. Nose- Future nasal growth must be taken into consideration. Lips- Length/ Thickness/ Curvature/ Competency. Chin-Normally soft tissue is 10 – 12 mm thick on chin area. www.indiandentalacademy.com

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To establish whether jaws are proportionately placed in A-P Plane To establish profile convexity or concavity To establish lip posture & incisor prominence Bimaxillary protrusion Profile analysis – yields almost the same information as from lat.ceph. Poor man ’ s cephalometric analysis www.indiandentalacademy.com

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FUNCTIONAL ANALYSIS Determination of postural rest position and freeway space. Examination of TMJ and condylar position. Assessment of functional status of lips, cheek and tongue. Evaluation of path of closure from postural rest position to habitual occlusion; In AP plane In Vertical plane In Transverse plane www.indiandentalacademy.com

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Hereditary? Environmental? Trauma? Chronic diseases? Habits? etc……… What may be the etiology? www.indiandentalacademy.com

EVALUATION OF ORAL HEALTH :

EVALUATION OF ORAL HEALTH Health of oral hard and soft tissues Dental caries Periodontal evaluation www.indiandentalacademy.com

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Evaluation of individuals’ physical growth status :

Evaluation of individuals’ physical growth status www.indiandentalacademy.com

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Physical development Chronologic age Dental age Sexual maturity By Clinical examination Hand wrist radiograph CVMI Calcification of canine ASSESSMENT OF DEVELOPMENTAL AGE www.indiandentalacademy.com

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SOCIAL AND BEHAVIORAL EVALUATION Motivation Expectations Co-operation External Internal www.indiandentalacademy.com

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COLLECTION OF DIAGNOSTIC RECORDS www.indiandentalacademy.com

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STUDY MODELS OPG PHOTOGRAPHS CEPHALOGRAMS OTHER ADVANCED DIAGNOSTIC AIDS www.indiandentalacademy.com

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Proclination of teeth Width of the arch Symmetry of the arch Crowding/ Rotations/ Spacing Arch length discrepancy Bolton’s analysis Classification of malocclusion STUDY MODELS www.indiandentalacademy.com

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ORTHOPANTAMOGRAPH www.indiandentalacademy.com

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PHOTOGRAPHS www.indiandentalacademy.com

HARD TISSUE ANALYSES:

HARD TISSUE ANALYSES www.indiandentalacademy.com

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SNA INTERINCISAL ANGLE L 1 to N-B (Angle) U 1 to N-A (Angle) ANB SNB FMPA FMIA IMPA FACIAL ANGLE ANGLE OF CONVEXITY MAND PLANE ANGLE Y- AXIS CANT OF OCCLUSAL PLANE U 1 to A- POG (LINEAR) www.indiandentalacademy.com

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The difference between SNA & SNB – the ANB angle indicates the magnitude of the skeletal jaw discrepancy. It is influenced by two factors: The vertical height of the face As the vertical distance between nasion & point A & B increases, the ANB angle decreases. The anteroposterior position of nasion. www.indiandentalacademy.com

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The ANB angle can be misleading when nasion is displaced anteriorly. The ANB angle is only 7 0 , but the A-B difference projected to the true horizontal is 14mm. ANB, at best, is an indirect measurement of the A-B difference & must be used with full awareness of its limitation. www.indiandentalacademy.com

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In the Wits analysis, points A & B are projected to the functional occlusal plane, and the AB difference is measured. WITS ANALYSIS www.indiandentalacademy.com

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STEINER ’ S COMPROMISE If the ANB angle is different from 2 0 , the different positioning of the incisors given by the inclination & protrusion figures will produce a dental compromise that leads to correct occlusion despite the jaw discrepancy. www.indiandentalacademy.com

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TWEED′S METHOD OF CEPHALOMETRIC CORRECTION When the FMA is between 21 0 to 29 0 , the FMIA should be 68 0 . When the FMA is 30 0 or greater, the FMIA should be 65 0 . When the FMA is 20 0 is less the IMPA should not exceed 92 0 . www.indiandentalacademy.com

SOFT TISSUE ANALYSES:

SOFT TISSUE ANALYSES www.indiandentalacademy.com

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S LINE E LINE H LINE NASO LABIAL ANGLE NASO MENTAL ANGLE SOFT TISSUE CHIN THICKNESS UPPER LIP PROMINENCE (Bell et al) LOWER LIP PROMINENCE (Bell et al) CHIN PROMINENCE (Bell et al) www.indiandentalacademy.com

FUNCTIONAL ANALYSES:

FUNCTIONAL ANALYSES www.indiandentalacademy.com

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SADDLE ANGLE ARTICULAR ANGLE GONIAL ANGLE UPPER & LOWER GONIAL ANGLE SUM OF POSTERIOR ANGLES ANGLE OF INCLINATION N ′ BASAL PLANE ANGLE ANTERIOR FACE HEIGHT POSTERIOR FACE HEIGHT JARABAK RATIO U 1 to SN EFFECTIVE MAXILLARY LENGTH EFFECTIVE MANDIBULAR LENGTH www.indiandentalacademy.com

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ORTHODONTIC CLASSIFICATION An ideal classification should summarize the diagnostic data and imply the treatment plan, it can viewed as reduction of data base. Skeletal jaw relationship with where exactly is the abnormality present. e.g. Skeletal class II with mandibular deficiency. Dentoalveolar relationship Molar relationship Canine relationship Position of anterior teeth Growth pattern www.indiandentalacademy.com

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PROBLEM LIST It should include: Those relating to disease or pathologic process. e.g. caries, perio etc. Those relating to disturbances of development that created the patients malocclusion. Example of problem list Mild gingivitis in upper anterior region Maxillary incisor proclination with lip protrusion Excessive overjet Class II molar relationship Skeletal class II with mandibular deficiency www.indiandentalacademy.com

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An interview data i.e., case history Clinical examination Complete analyses of all diagnostic record Orthodontic classification Problem list TO SUMMARIZE WE SHOULD HAVE… www.indiandentalacademy.com

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Orthodontic Problems In priority order Possible Solution To Individual problem Optimal Treatment plan Mechano therapy TREATMENT PLANNING www.indiandentalacademy.com

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A description of an orthodontic data base and its analysis. The development of patients problem list. Determination of general treatment goals with more specific treatment objectives. Design of the specific mechanotherapy needed to reach these goals MAJOR STEPS www.indiandentalacademy.com

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Thorough analyses of orthodontic data base. Creation of patients problem list. Orthodontic mechanotherapy to achieve treatment goals. THREE DIMENSIONAL TREATMENT GOALS If the additional variations of time (growth) and function are considered, the approach becomes five dimensional. www.indiandentalacademy.com

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Clinical examination / Diagnostic records Data base Complete analyses Classification Problem list Treatment objectives Step by step progression of treatment Biomechanics Appliance design Appliance use TREATMENT PLANNING www.indiandentalacademy.com

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CONCLUSION CONCLUSION www.indiandentalacademy.com

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Thank you www.indiandentalacademy.com www.indiandentalacademy.com Leader in continuing dental education

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