Orthodonticdiagnosis ThedevelopmentofaProblemList Operator ZhouLingSupervisor Prof LiDate 2013 6 6 1 5 3 4 DevelopmentofaProblemList TheProblem Orientedapproach ClinicalEvaluation AnalysisofDiagnosticRecords OrthodonticClassification Chapteroutline 2 SymmetrySpaceanalysisEstimatingofuneruptedpermanentteethToothsizeanalysis Dentalcastanalysis Symmetry TransparentruledgridplacedoverdentalcastOrientedtothemidpalatalrapheSpotasymmetriesinarchform andtoothposition Lateraldriftofincisors Crowding Clost3blockedout Symmetry Driftofposteriorteeth EarlylossofE Pendulum SymmetrySpaceanalysisEstimatingofuneruptedpermanentteethToothsizeanalysis Dentalcastanalysis Alignment Crowding SpaceAnalysis Dentalcast Computeralgorithm SpaceAnalysis Measuringarchperimeterfromthemesialofonefirstmolartotheother overthecontactpointsofposteriorteethandincisaledgeofanteriors Stepone Calculationofavailablespace 片段法 铜丝法 Steptwo Calculationofrequiredspace Measurethemesiodistalwidthofeacheruptedtoothfromcontactpointtocontactpoint SpaceAnalysis 01 Thespaceavailablewillnotchangebecauseofgrowth 02 Alltheteetharenormalinsize 03 Correctanteroposteriorpositionofincisors Threeassumptions Interaction Protrusion Retrusion Crowding Crowdingandprotrusionaredifferentaspectsofthesamephenomenon Ifthereisnotenoughroomtoproperlyaligntheteeth theresultcanbecrowding protrusion or mostlikely somecombinationofthetwo 01 Thespaceavailablewillnotchangebecauseofgrowth 02 Alltheteetharenormalinsize 03 Correctanteroposteriorpositionofincisors Threeassumptions Inachildwithawell proportionedface thereislittleornotendencyforthedentitiontobedisplacedrelativetothejawduringgrowth Buttheteethoftenshiftanteriorlyorposteriorlyinachildwithajawdiscrepancy 01 Thespaceavailablewillnotchangebecauseofgrowth 02 Alltheteetharenormalinsize 03 Correctanteroposteriorpositionofincisors Threeassumptions SymmetrySpaceanalysisEstimatingofuneruptedpermanentteethToothsizeanalysis Dentalcastanalysis MixDentitionEstimatingofUneruptedPermanentTeeth EstimatingofUneruptedPermanentTeeth Undistortedradiographicimage Compensateforenlargement Measurementoftheteethonradiographs TruewidthofprimarymolarApparentwidthofprimarymolar Measurementoftheteethonradiographs TruewidthofuneruptedPremolarApparentwidthofuneruptedpremolar Accuracyisfairtogooddependingonthequalityoftheradiographsandtheirpositioninthearch Thetechniquecanbeusedinmaxillaryandmandibulararchesforallethnicgroups Measurementoftheteethonradiographs EstimatingofUneruptedPermanentTeeth Moyersprediction Estimationfromproportionalitytables Measuringthemesiodistalwidthofthelowerincisors Predictionthesizeofboththelowerandupperuneruptedcaninesandpremolars Estimationfromproportionalitytables NorthernEuropeanwhitechildrenNoradiographsarerequired usedfortheupperorlowerarch Estimationfromproportionalitytables Estimationfromproportionalitytables EstimatingofUneruptedPermanentTeeth Combinationofradiographicandpredictiontable Itdepends Comparison Moyers Takana Johnston NorthernEuropeanwhitechildrenNoradiographs DependingonthequalityoftheradiographsandtheirpositioninthearchForallethnicgroups SymmetrySpaceanalysisEstimatingofuneruptedpermanentteethToothsizeanalysis Dentalcastanalysis Althoughthenaturalteethmatchverywellinmostindividuals approximately5 ofthepopulationhavesomedegreeofdisproportionamongthesizesofindividualteeth ToothSizeDiscrepancy TSD ToothSizeAnalysis ToothSizeAnalysis BoltonRatio ToothSizeAnalysis 78 8 1 72 91 5 1 51 Aquickcheckfor Anteriortoothsizediscrepancy 2 2Posteriortoothsizediscrepancy 5 5Atoothsizediscrepancyoflessthan1 5mmisrarelysignificant ToothSizeAnalysis SymmetrySpaceanalysisEstimatingofuneruptedpermanentteethToothsizeanalysis Dentalcastanalysis AnalysisofDiagnosticRecords Cephalometricanalysisofdentofacialrelationships Dentalcastanalysis toevaluatespaceexcessordeficiencyandsymmetrywithinthedentalarches Theintroductionofradiographiccephalometricsisin1934byHofrathinGermanyandBroadbentinUSA Cephalometricanalysis Function OriginalpurposeEvaluatingdentofacialproportionsandclarifytheanatomicbasisforamalocclusionObservingpathologicchanges Sometimes Researchingongrowthpatternsinthecraniofacialcomplex Thispatienthasfusionofthe1stand2ndcervicalvertebrae withtheodontoidprocessextendingintothemarginofforamen Function Function OriginalpurposeEvaluatingdentofacialproportionsandclarifytheanatomicbasisforamalocclusionObservingpathologicchanges Sometimes Recognizingandevaluatingchangesbroughtaboutbyorthodontictreatment Researchingongrowthpatternsinthecraniofacialcomplex Function Thegoalofcephalometricanalysisistoevaluatetherelationships bothhorizontallyandvertically ofthefivemajorfunctionalcomponentsoftheface Cephalometricanalysis Cephalometricanalysis CranialBaseS N Po Ba BoMaxillaOr Ptm ANS PNS A UIMandibularCo Go B LI Pog Me Gn CephalometricLandmarks S sellaN nasionPo porionBa basionBo CephalometricLandmarks Or orbitalePtm ANS AnteriornasalspinePNSPosteriornasalspineA subspinaleUI UpperIncisor CephalometricLandmarks Co condylionGo gonionPog