Patient Exam

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Author:
thezidane
ID:
44560
Filename:
Patient Exam
Updated:
2010-10-24 14:22:07
Tags:
orthodontics
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Description:
extra/intraoral exam, skeletal/dental malocclusion, cephalometric analysis, space analysis
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  1. list 4 ways to assess growth
    • 1. interview information
    • 2. clinical height/weight
    • 3. adolescent changes (secondary sex characteristics, facial hair, voice change)
    • 4. radiographically (ceph)
  2. define lip incompetence
    separation of the lips at rest more than 3-4mm. indicates dentoalveolar protrusion
  3. define the "abnormal" mandibular plane angles
    • steep: long vertical face with anterior open bite
    • flat: short vertical face with deep bite
  4. how is the maxilla's position evaluated with a profile analysis?
    a line from the bridge of the nose to the base of the upper lip
  5. how is the mandible's position evaluated in a profile anaylsis?
    a line from the base of the upper lip downward
  6. how does the nasolabial angle relate to lip protrusion?
    lip protrusion = nasolabial angle > 90 degrees, < 109 degrees
  7. how is the vertical facial relationship evaluated in a profile analysis?
    dividing the face into 3rds
  8. define E-line and how it is used
    a reference line used to judge lip protrusion drawn from the tip of the nose to the pogonion
  9. what are the normal vertical lip to tooth relationships during smiling and repose?
    • smiling: lips to gingival margin and dental midline along the long axis
    • repose: 2-3mm of max. incisors showing
  10. what are the normal measurements of an overbite?
    3mm or 50% of mandibular incisors covered by max. incisors
  11. define overjet
    and overbite of >3mm. (class III usually have a negative overjet)
  12. what radiographs are required for the primary dentition?
    BW and Pano
  13. what radiographs are required during a late mixed dentition?
    evaluation of canines with occlusal or PA radiograph
  14. what radiographs are required for the permanent dentition?
    pano and PBW or FMS
  15. what methods are used to measure space in the permanent and mixed dentitions?
    • permanent: direct measurement
    • mixed: tanaka-johnston method
  16. list 2 ways that space analysis is useful for prediction
    • 1. a way to quantify the amount of crowding within the arches by comparing the space available vs amount of space required
    • 2. predict if there will be enough space in the arch without growth modification or surgery
  17. list the 6 assumptions underlying space analysis
    • 1. all permanent teeth are developing normally
    • 2. width of mand. inc. correlates with width of perm. teeth
    • 3. prediction tables are valid
    • 4. mesial molar shift is predictable
    • 5. AP position of inc. is correct
    • 6. space available will not change due to growth
  18. how is the amount of space available determined?
    • 1. arch perimeter is measured from first molar to first molar along contact points.
    • 2. subtract size of incisors and predicted size of canines/premolars from space available
  19. why are sizes of permanent teeth always predicted from lower incisors?
    they are the most consistent teeth in the mouth and correlate best with upper canines/PM. upper laterals are extremely variable.
  20. how is the tanaka-johnston analysis used to predict mandibular canine/pm in one quadrant?
    [(MD width of the 4 lower incisors)/2] + 10.5mm
  21. how is the tanaka-johnston analysis used to predict maxillary canine/pm in one quadrant?
    [(MD width of the 4 lower incisors)/2] + 11mm
  22. define Bolton Analysis
    Tooth-size analysis: comparison of MD widths of max teeth to mand teeth
  23. which teeth are analyized using the bolton analysis?
    max to mand canine, pm, and m
  24. which teeth usually account for discrepancies in the bolton analysis?
    upper laterals and lower 2nd pm (termed bolton discrepancy)
  25. what angular method is used to evaluate the AP position of the maxilla? what are the average angles for each class?
    • SNA
    • Ave: 84
    • Class II: >84
    • Class III: <84
  26. What angular method is used to evaluate the AP position of the mandible?
    • SNB
    • Ave: 80
    • Class II: <80
    • Class III: >80
  27. what angular method is used to evaluate the AP position of the maxilla to the mandible?
    • ANB = SNB - SNA
    • Ave: 2-4
    • Class II: >4
    • Class III: negative
  28. what angular method is used to evaluate the vertical face
    • mandibular plane angle to FH
    • Ave: 25
    • FH to UI: normally 110
    • FH to LI: normally 90
    • Long face: >25
    • Short face: <25
  29. what are the proportional methods to evaluate the vertical face?
    • % face height
    • Ave: 55% NA to A
    • Ave: 45% A to P
  30. what is the interincisal angle?
    formed by the long axis of both upper and lower incisors. greater angle = more upright incisors. Smaller angle = protrusion
  31. define bimaxillary protrusion
    both jaws have protruding teeth
  32. at what points are two ceph radiographs compared?
    lined up on S and N points.

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