from orthodontic textbooks sourse

2. CLINICAL EVALUATION
There are two goals of the
orthodontic clinical
examination:
(1) to evaluate and document
oral health, jaw function,
and facial esthetics .
(2) to decide which diagnostic
records are required.

3. Evaluation of Oral
Health
Medical and dental problems
under control before ortho
Treatment of active caries and
perio problems done before
ortho
Definitive restorations (crowns)
usually not placed until after
ortho
Check for mucogingival
problems
Often dealt with prior to ortho

4. Facial profiles can
sometimes reveal underlying
malocclusion problems.
Anteroposterior relations
between the maxilla and
mandible are observed in the
three basic types of profiles.
Patients with a straight
profile usually have normal
occlusions or Class I
malocclusions.

5. Those having convex
profiles have an
increased probability
of having a Class II
malocclusion
associated with a
retrusive mandible or
perhaps a protrusive
maxilla.

6. Patients with a concave profile
have an increased probability of
having a Class III malocclusion
associated with a retruded
maxilla, a protrusive
mandible, or both.
Facial profiles can also reveal
growth problems in the vertical
dimension. Excessive vertical
growth of the face can lead to an
anterior open bite
malocclusion, lips apart at
rest, a gummy smile, and an
increased angle between the
ramus and body of the

7. Insufficient vertical growth
of the face can produce a
deep overbite
malocclusion, with
redundant, overlapped lips
and decreased angle
between the ramus and
body of the mandible, but
the dentist should realize
that the presence of a
particular type of facial
profile is not always
indicative of the Angle
malocclusion class.

9. :

10. This can be
assess by:
1.facial profile
2.facial
divergenece
3.Palpation
4.cephalometri
c

11. Facial Divergence
The lower face may be
straight or inclined
anteriorly / posteriorly
relative to the forehead.
This inclination is also
termed as the facial
divergence, which may
be influenced by the
patient's ethnic or racial
background.

12. Vertical Dental
Relations
:
Overbite: is overlap of the
incisors in vertical plane
Open bite: there is no vertical
overlap of the incisors when the
buccal segment teeth are in
occlusion. Thumbsucking and
abnormal tongue resting
position, and abnormal facial
growth (excessive vertical growth)
may cause an open bite
malocclusion.

13. ASSESSMENT OF VERTICAL
SKELETAL RELATIONSHIP
A normal vertical relationship is
one where the distance between
the glabella and subnasale is equal
to the distance from the sub nasale
to the under side of the chin
.Reduced lower facial height is
associated with deep bites while
increased lower facial height is
seen in anterior open bites.

14. Or clinically by rular or hand of mirror at the
lower border of the mandibule and another
one on Frankfort and measure it which is
normal when ranged between 28_30

15. Thumb sucking

16. Horizontal dental
relation:
Overjet: is the
distance between
the upper and
lower teeth in
horizontal plane.

17. Crossbite: a
deviation from the
normal buccoligual relationship.
It may be anterior
or posterior and or
unilateral or
bilateral.
crossbite
normal

18. Anterior crossbite:
A malocclusion in
which one or more of
the upper anterior
teeth occlude
lingually to the
mandibular incisors.

19. Buccal cross bite: buccal cusp of
lower posterior teeth occlude
buccal to the buccal cusp of the
upper posterior teeth.
Lingual cross bite: buccal cusp of
lower posterior teeth occlude
lingually to the palatal cusp of the
upper posterior teeth.

20. Assessment of Facial
Symmetry
A certain degree of asymmetry between the right and
left sides of the face is seen in most individuals. The
face should be examined in the transverse and vertical
planes to determine
a greater degree of asymmetry than is considered
normal. Gross facial asymmetries may be
seen in patients with:

21. 1. Hemifacial hypertrophy
Iatrophy
ii. Congenital defects.
iii. Unilateral condylar
hyperplasia
iv. Unilateral Ankylosis, etc.

22. this can be assess by:
1.bird look(by looking from
above and behind)
2.compiste photogragh

23. Or by divide approximately
into fifths (each one the
width of the eye).
3.radoigraph(opg)
4.tongue spatula

24. Lips Lip length, width and curvature should be
assessed.
Lips can be classified into:
a. Competent lips
b. Incompetent lips
c. Potentially
competent lips

25. The Nasolabial angle
The nasolabial angle
is formed between
the upper lip and
base of the nose
(columella) and
should be between
90° and 110. It gives
an indication of
upper lip drape in
relation to the upper
incisor position.

27. cases

30. Lip competency:
Yes

32. Mandibular Plane Angle:
Increased