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DENTAL ASSISTING SPECIALTIES II DENT 172 FOGLIA ORTHODONTICS Chapter lectureModern Dental Assisting, 10th Edition, chapter 60,

pages 1026-1054 At the end of this lecture series, the successful student will be able to:
1. 2. 3.


Identify (Angles) Classification of occlusion and malocclusion Identify the 4 causes of malocclusion Identify the terms used in orthodontics to describe malalignment problems Describe the role of cephalometric and panoramic radiographs in orthodontics and identify the landmarks of the skull that are important in cephalometrics

***Orthodontics is the specialty of dentistry concerned with the prevention, interception, and correction of the growing and mature dentofacial structures (teeth, jaws, and surrounding facial bones).

The Orthodontist Another 3 years of education after dental school to study orofacial growth and development. The Orthodontic Assistant Able to participate in many hands-on procedures involving diagnostic records, preliminary appointments and adjustment visits. The state in which you practice dictates which expanded functions are permissible. The Orthodontic Office Sectioned off to provide three functions: (1) To obtain records and create a more private setting, (2) To take radiographs (3) To provide patient care for all stages of treatment. The orthodontist is concerned with teeth that do not occlude together properly due to the size of the jaws, crowding or displacement of teeth. I. Understanding Occlusion Individuals have differences in the size and shape of the jaws, occlusions and the reasons that some teeth become crowded.

***In most cases malocclusion and dentofacial deformities result from moderate distortions of normal development. A. Developmental Causes 1. Congenitally missing teeth 2. Malformed teeth 3. Supernumerary teeth 4. Interference with eruption (e.g., and impaction in which eruption is blocked or the tooth is forced to erupt into an abnormal position) 5. Ectopic eruption Genetic Causes 1. Discrepancies in the size of the jaw and/or the size of the teeth a. Child inherits a small jaw from one parent and larger teeth from the other parent b. If one of your parents or grandparents has a missing tooth it is likely you will have a missing tooth Environmental Causes 1. Birth Injuries a. Fetal Molding ***when an arm or leg of the fetus is pressed against another part of the body, (e.g., arm pressed against the mandible) can lead to distortion b. Trauma During Birth ***Injury to the jaw, particularly with the use of forceps in delivery 2. Injury Throughout Life Damage to permanent tooth buds when an injury to primary teeth has occurred b. Movement of a tooth or teeth as a result of the premature loss of a primary tooth c. Direct injury to permanent teeth a.




Functional Causes (Habits) ***Beyond Primary Dentition (age 5) 1. Sucking Habits a. Finger b. Tongue c. Lip d. Thumb 2. Tongue Thrust 3. Bruxism 4. Mouth Breathing


Angles Bite Classifications A. B. Class I Mesiobuccal cusps of maxillary first molar articulates in the buccal groove of mandibular first molar. Class II Mesiobuccal cusp of maxillary first molar articulates between mandibular second bicuspid and mesiobuccal cusp of mandibular first molar. Class III Mesiobuccal cusp of maxillary first molar articulates with (or between) distobuccal cusp of mandibular first molar and the mesiobuccal cusp of mandibular second molar.



Classification of Facial Profiles

A. B. C.

Mesognathic: Class I Retrognathic: Class II (Retro-Back in the day) chin set back Prognathic: Class III (Progress, to move forward) chin is forward


Terms of Malposition A. B. C. D. E.
F. G.

Crossbite 1. Anterior 2. Posterior Overjet Overbite Open bite Underjet Edge-to-Edge (anterior) End-to-End (posterior)


Orthodontic Radiographs A. Cephalometric 1. Scientific System a. measurement of the cranial bones b. growth patterns c. pathologic factor 2. Analysis a. Pattern of growth b. Arch length c. Relative position of the dental arches to the remainder of the facial and skull measurements d. Gross inspection of hard and soft tissue e. Aids in a plan of treatment


g. B. Panoramic 1. 2.

Consecutive cephalometric radiograph will provide a study of progress in growth and treatment Tracing provides a means of mathematical description and measurement of the status of the skull

Primary a. Growth and Development Overall Survey a. Condyles b. Alveolar height c. Impactions d. Missing teeth e. Root development f. Transposition of teeth g. Ectopic eruption

C. Benefits of Orthodontics a. Psychosocial b. Oral Function c. Dental Disease, Caries & Periodontal