Introduction to Orthodontics Fifth Year

1. 10th Lecture
Orthodontic Examination
and Diagnosis

2. Definitions:
 Orthodontic examination:
It is a technique concerning with gathering
data or information about an orthodontic case
in order to reach diagnosis.
 Diagnosis is determination of presence or
absence of abnormality, In orthodontics it
concerns establishing existence and nature of
dentofacial deformity.
April 28, 2012
Dr. Ahmed Basyouni
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3. Orthodontic examination should include the
following:
I. History
II. Clinical examination
III. Study Cast analysis
IV. Radiographic examination
V. Facial photographs.
April 28, 2012
Dr. Ahmed Basyouni
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4. I. History
Personal history:
Name:
Age:
Address:
Date:
Sex:
Date of Birth:
Tel.:
Chief Complain:
Major reason for seeking Orthodontic treatment
April 28, 2012
Dr. Ahmed Basyouni
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5. I. History
Past History:
Past medical history:
1. Any birth defects:
Yes
No
If yes, specify:
____________________________________
_____
2. Any systemic diseases:
( Anemia, Arthritis, Asthma, Allergy,
Bleeding, Cerebral palsy, Epilepsy, Heart,
Major surgery, Rheumatic fever, lung,
kidney, & Liver), …
If there is any specify:
____________________________________
April 28, 2012
Dr. Ahmed Basyouni
_________
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6. I. History
3. Are the patient’s tonsils/ or adenoids removed?
Yes
No
If yes, at what age? _____________
4. Is the patient receiving any medications?
Yes
No
If yes, give reason for use:
____________________________________
____
April 28, 2012
Dr. Ahmed Basyouni
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7. I. History
Past dental history:
1. Date of last dental examination:
What was performed:
_______________________________________________
_______________________________________________
2. Injuries or trauma to the teeth or gums:
Yes
No
If yes, specify:
_________________________________________
3. How often does the patient brush his / her teeth?
4. Has the patient ever had:
a) Speech therapy
Yes
No
b) Previous orthodontic consultation and / or treatment?
Yes
No
April 28, 2012
Dr. Ahmed Basyouni
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8. I. History
5. Does the patient:
a) Grind his or her teeth at night?
Yes
b) Bite his / her fingernails?
Yes
c) Suck thumb, finger, blanket, etc.
Yes
If yes, at what age did he / she discontinue?
______Years.
d) Breathe through:
Nose
Mouth
When?
Night
Daytime
April 28, 2012
Dr. Ahmed Basyouni
No
No
No
?
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9. II. Clinical Examination
 General Examination:
Weight
Height
comparable to his/her age
April 28, 2012
Dr. Ahmed Basyouni
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10. II. Clinical Examination
 Extra-Oral
Examination:
Lateral View
Straight
Profile: either straight,
convex or concave
Vertical facial
balance: LAFH/TAFH
Ratio
April 28, 2012
Dr. Ahmed Basyouni
Convex
Concave
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11. The Facial Index:
It is the proportional relationship of facial height and
width.
Vertically, the face is divided into three thirds:
Upper third consists of the forehead.
Middle third extends from supraorbital ridge to the base
of the nose.
Lower third extends from base of the nose to the soft
tissue menton:
In lower third, the upper lip occupies one third and the
lower lip & chin occupy two thirds.
April 28, 2012
Dr. Ahmed Basyouni
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12. The Facial Index:
April 28, 2012
Dr. Ahmed Basyouni
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13. Extra-Oral Examination:
Frontal View:
Symmetry
Transverse
Competent lip
Incompetent lip
Soft tissue:
Lips: upp. Short/Long/Normal
low. Everted/Normal/flaccid
At rest: Together/Apart
On smile: Gingiva exposed/unexposed
Lower lip everted
April 28, 2012
Dr. Ahmed Basyouni
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14. Extra-Oral Examination:
Labiomental sulcus:
Pronounced/Normal/Absent
Labiomental
sulcus absent
Chin:
welldeveloped/developed/underdeveloped
Nose:
Large/normal/small
Nasal/Mouth breather
April 28, 2012
Dr. Ahmed Basyouni
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15.  Intra-Oral Examination:
A. Exam. Of the soft tissue:
Gingivae: Anterior marginal gingivitis usually occurs
in mouth breathing and open mouth habit, While,
generalized marginal gingivitis is usually found in cases
with poor oral hygiene.
Frenae: a persistent and thickened labial frenum may
be present in 25% of children at age of 8 years.
April 28, 2012
Dr. Ahmed Basyouni
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16. A. Exam. Of the soft tissue:
Palate: should be examined visually and by
palpation. Asymmetrical contour are usually caused
by unerupted teeth.
Tongue: is a powerful combination of muscles
around which dentition is shaped and molded.
 Its size: large tongue cause generalized diastema,
 Its action: forward positioned tongue cause
openbite, backward positioned tongue may cause
anterior crowding.
April 28, 2012
Dr. Ahmed Basyouni
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17.  Intra-Oral Examination:
B. Examination of the teeth:
 Number of teeth:
i. Teeth present & erupted: Permanent or Deciduous
ii. Teeth present & unerupted
iii. Extracted teeth
iv. Congenitally missing teeth
v. Extra-teeth
April 28, 2012
Dr. Ahmed Basyouni
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18. B. Examination of the teeth:
 Condition of the teeth:
i. carious or sound
ii. Non-vital or vital
iii. Teeth with extensive restoration
vi. Broken teeth (Trauma)
v. Malformed or fused teeth
April 28, 2012
Dr. Ahmed Basyouni
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19. B. Examination of the teeth:
 Proportion of tooth size to arch size:
Crowding occurs where teeth are large compared to
arch size.
 Position of teeth:
Any of Individual teeth malpositions.
April 28, 2012
Dr. Ahmed Basyouni
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20. Intra-Oral Examination:
Malposition of individual teeth




Labioversion
Supraversion
Mesioversion
Torsoversion
April 28, 2012




Linguoversion
Infraversion
Distoversion
Transversion
Dr. Ahmed Basyouni
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21. Intra-Oral Examination:
C. Malrelation of the dental arches
 Anteroposterior malrelationship
 Vertical malrelationship
 Transverse malrelationship
April 28, 2012
Dr. Ahmed Basyouni
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22. Intra-Oral Examination:
Anteroposterior malrelationship
Angle’s classification:
 Class I
 Class II:
division 1
division 2
division 1
division 2
April 28, 2012
Dr. Ahmed Basyouni
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23. Angle’s classification:
• Class III:
Class III
April 28, 2012
Dr. Ahmed Basyouni
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24. Intra-Oral Examination:
Vertical malrelationship
 Deep overbite
 Edge to edge bite
 Open bite
April 28, 2012
Dr. Ahmed Basyouni
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25. Intra-Oral Examination:
Transverse malrelationship
 Posterior crossbite:
Unilateral
Bilateral
Unilateral, bilateral, or
Telescoped bite
 Midline shift
Lingual crossbite (Scissor bite)
April 28, 2012
Dr. Ahmed Basyouni
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26. Intra-Oral Examination:
D. Functional examination:
 Path of closure of the mandible:
As mandible closes, observe the chin for deviations laterally, and
anteroposteriorly. Forward displacement occurs in postural or
pseudo Class III, lateral displacement is associated with unilateral
crossbite
April 28, 2012
Dr. Ahmed Basyouni
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27. D. Functional examination:





Breathing mode: Nose/Mouth
Mode of Swallowing
Behaviour of the tongue
Speech
Habits:
Any of undesirable pressure habits
April 28, 2012
Dr. Ahmed Basyouni
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28. Summary
Orthodontic Examination and
Diagnosis

I.
Definitions:
History:
Personal history:
Chief Complain:
Past History:
Past medical history:
Past dental history:
April 28, 2012
Dr. Ahmed Basyouni
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29. Orthodontic Examination and Diagnosis
II. Clinical examination:
General Examination:
Extra-Oral Examination:
Intra-Oral Examination:
April 28, 2012
Dr. Ahmed Basyouni
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30. April 28, 2012
Dr. Ahmed Basyouni
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