ORTHODONTIC CHART

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PROFILE .

FACIAL PHOTOS • Profile Straight Convex Concave .

straight Anterior Straight Posterior Divergent Divergent . FACIAL PHOTOS • Profile .

FACIAL PHOTOS • Lip posture Competent lips .slight contact when muscles are relaxed .

FACIAL PHOTOS • Lip posture Incompetent lips -short lips. do not form lip seal in a relaxed state -lip seal achieved by active contraction of perioral and mentalis muscles .

FACIAL PHOTOS • Lip posture Everted lips .Hypertrophied lips with weak muscular tonicity .

Females slightly greater . FACIAL PHOTOS • Nasolabial angle (aesthetic. open.Angle formed by the columella and philtrum of the upper lip at subnasale (mean = 100 ±10 degrees) . closed) .

FACIAL PHOTOS • Chin Acceptable Chin .

FACIAL PHOTOS • Chin Small chin .

FACIAL PHOTOS • Chin Large Chin .

FACIAL PHOTOS • Chin Large Chin .

Should be gently curved (mean = 120 ±10°) .Angle formed by the intersection of the lower lip and chin measured at soft tissue B point . FACIAL PHOTOS • Mentolabial angle .

FACIAL PHOTOS • Mentolabial sulcus (deep. shallow) • Mentalis activity – hyperactivity causes puckering of the chin (strained. relaxed) .

FRONTAL .

FACIAL PHOTOS .

FACIAL PHOTOS • FACIAL TYPE MESOCEPHALIC BRACHYCEPHALIC DOLICOCEPHALIC MESOPROSOPIC EURYPROSOPIC LEPTOPROSOPIC .

Head and facial findings • Length-width (Cephalic) Index of the Head • I = greatest MD width of head x 100 greatest length of the head .

4 • Hyperbrachycephalic = 85.9 • Mesocephalic = 76 – 80.9 • Brachycephalic = 81 – 85.5 – x . Length-width Index of the Head • Dolicocephalic = x – 75.

Gn • Bizygomatic width = zy – zy (zygomion) (cheekbone) . Morphological Facial Index • I = morphological facial height x 100 bizygomatic width • Facial height = N .

Morphological Facial Index • Hypereuryprosopic = x .9 • Hyperleptoprosopic = 93 .9 • Euryprosopic = 79 – 83.87.9 • Leptoprosopic = 88 .x (long and narrow) .78.9 (short and broad) • Mesoprosopic = 84 .92.

Short and broad .

Long and Narrow .

FACIAL PHOTOS • FACIAL SYMMETRY Symmetric Assymetric .

small. large) . FACIAL PHOTOS • Nose (acceptable.

FACIAL PHOTOS .

FACIAL PHOTOS • FRONTAL TO SMILING • GINGIVAL DISPLAY Excessive Moderate Acceptable Excessive Deficient .

FACIAL PHOTOS • SMILE LINE HIGH NORMAL LOW .

INTRA-ORAL PHOTOS .

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ABNORMAL . INTRA-ORAL PHOTOS • TOOTH COLOR: NORMAL.

SLIGHT. NONE . INTRA-ORAL PHOTOS • DECALCIFICATION: SEVERE.

INTRA-ORAL PHOTOS • TONSILS / ADENOIDS: PRESENT REMOVED .

MODEL ANALYSIS .

MODEL ANALYSIS .

MODEL ANALYSIS • DENTAL CLASSIFICATION CLASS I CLASS II DIV 1 CLASS II DIV 2 CLASS III (SUBDIVISION R/L) .

CLASS I (Angle) SAGITTAL PLANE .

Class II division 1 (Angle) Class II division 2 (Angle)

SAGITTAL
MIXED DENTITION

Class III (Angle)

SAGITTAL
PERMANENT DENTITION

MODEL ANALYSIS
• OVERJET, OVERBITE (mm)

MODEL ANALYSIS • DEEP BITE (mm) .

MODEL ANALYSIS • OPEN BITE (mm) .

MODEL ANALYSIS • CURVE OF SPEE .

MODEL ANALYSIS • ARCH SHAPE .

MODEL ANALYSIS • ARCH LENGTH (mm) .

MODEL ANALYSIS • ROTATIONS .

MODEL ANALYSIS • CROWDING / SPACING .

MODEL ANALYSIS • LOCKED OUT TEETH .

MODEL ANALYSIS • PEG LATERALS .

POSTERIOR . MODEL ANALYSIS • CROSSBITE: ANTERIOR.

MODEL ANALYSIS • MIDLINE DISCREPANCY .

MODEL ANALYSIS • FRACTURED TEETH .

MODEL ANALYSIS • ARCH LENGTH DISCREPANCY • Measure MD diameter = space required .

MODEL ANALYSIS • ARCH PERIMETER • 4 Linear measurements = space available .

MODEL ANALYSIS .

MODEL ANALYSIS • ARCH CIRCUMFERENCE .

CASE ANALYSIS .

CASE ANALYSIS .

Skeletal classification • Skeletal pattern. jaw relationship N • ANB = 2 • Range 0 – 5 • <0 – Class III tendency A • >5 – Class II tendency B .

4 – Low angle.4 – 38.2 • <24.3 S N • Range 24. Go skeletal open bite (long) Gn . skeletal deep bite (short) • >38.Skeletal deep (low angle)/ open bite (high angle) • Vertical Growth • SN-GoGn = 31.2 – High angle.

2 – retrognathic • >89.8 – prognathic A . Maxillary position • Maxillary position • SNA = 84.8 • <79.5 S N • Range 79.2 – 89.

86. Mandibular position • Mandibular position • SNB = 82 S N • Range 77.1 – retrognathic • >86.9 • <77.9 – prognathic B .1.

Upper incisor position • Maxillary incisor inclination N • 1-NA (°) = 24.6 – Retroclined UR A • >31.8 • <7.8 – Proclined UI .6 .31.7 • Range 7.

5 – 109.Upper incisor position UI-SN angle = upper incisor position R = 96.5 N = 103 .

Upper incisor position UI.FH angle = upper incisor position R = 110 – 120 N = 115 .

2 .8 • <23.8 • Range 23.35.8 – Proclined LI LR B . Lower incisor position • Mandibular incisor inclination N • 1-NB (°) = 29.2 – Retroclined • >35.

Lower incisor position IMPA angle = lower incisor position R = 83 – 97 N = 90 .

Interincisal angle UI – LI angle (interincisal angle) = dental pattern R = 121 – 140 N = 131 .

Profile soft tissue analysis • Soft tissue profile • S line • Lips should fall within the line • Before the line – concave profile S line • Beyond the line – convex profile Chin point .

IBO CEPHALOMETRIC DATA SHEET .

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GROWTH STAGE .

C3. Cervical Vertebrae Maturation • Cervical Vertebrae Maturation (C2. but becomes concave as a person reaches maturity – 6 stages of vertebral development . C4) – Shapes of the cervical vertebrae differ at each level of skeletal development – C3 and C4 change from wedge shaped. to square – Become taller as skeletal maturity progresses – Inferior borders are flat when immature. to rectangular.

6 Stages of Vertebral Development .

100% of adolescent growth expected – Inferior borders flat – Vertebrae wedge-shaped – Superior vertebral border tapered from posterior to anterior .6 Stages of Vertebral Development • Stage 1 Initiation – Beginning of adolescent growth with 80% .

6 Stages of Vertebral Development • Stage 2 Acceleration – Growth acceleration begins – 65 – 85% of adolescent growth expected – Concavities develop in inferior borders – Inferior of C4 still flat – Bodies nearly rectangular in shape .

6 Stages of Vertebral Development • Stage 3 Transition – Acceleration of growth towards peak height velocity – 25% . C4 rectangular in shape .65% of adolescent growth expected – Distinct concavities seen in inferior borders of C2 and C3 – Concavity beginning to develop in inferior border of C4 – Bodies of C3.

C4 becoming square in shape . C3 and C4 – Bodies of C3.6 Stages of Vertebral Development • Stage 4 Deceleration – Deceleration of adolescent growth spurt with 10%-25% of adolescent growth expected – Distinct concavities seen in inferior borders of C2.

6 Stages of Vertebral Development • Stage 5 Maturation – Final maturation of the vertebrae with 5% to 10% of adolescent growth expected – More accentuated concavities seen in inferior borders of C2. C3 and C4 – Bodies of C3. C4 nearly square in shape .

C4 square in shape – Greater in vertical than in horizontal dimension .6 Stages of Vertebral Development • Stage 6 Completion – Completion of growth – Little or no adolescent growth could be expected – Deep concavities seen in inferior borders of C2. C3 and C4 – Bodies of C3.

6 Stages of Vertebral Development .

6 Stages of Vertebral Development .

6 Stages of Vertebral Development .

Handwrist radiograph .

Widening .

Capping .

Union .

Handwrist Radiograph widening. union . capping.

growth before growth starts growth growth spurt over growth attained ends Maximum Duration of Growth . Handwrist Radiograph Skeletal maturity indicators (7) Phalanges of the Hand Ossification of sesamoid Stages Long Shortly Pubertal Maximum before Growth Rapid Growth Pre.

Handwrist Radiograph .

or forward S position of the chin in FH relation to upper face Sella-Gnathion to FH Plane Mean: 59 Horizontal growth Gn Vertical growth . rearward. Growth Direction Y (growth) Axis -degree of downward.

or forward S position of the chin in relation to upper face Sella-Gnathion to SN Plane Mean: 66 Horizontal growth Gn Vertical growth . N rearward. Growth Direction Y (growth) Axis -degree of downward.

Facial Axis
• Facial Axis = 90° ±3
• protrusive chin
• retrusive chin

Airways

Airways
A. Upper airway =
8-18mm
B. Lower airway =
10-12mm

measured from a point on the posterior outline of the soft palate to the closest point of pharyngeal wall .measurement is taken on the anterior half of the soft palate outline B. Upper airway = 8-18mm . Lower airway = 10-12mm . Airways A.

measured from the point of intersection of the posterior border of the tongue and the inferior border of the mandible to the closest point on the posterior pharyngeal wall . Upper airway = 8-18mm B. Lower airway = 10-12mm . Airways A.

Airways A. Upper airway = 8-18mm B. Lower airway = 10-12mm .

Skeletal .Vertical .

high angle Horizontal grower. low angle .Skeletal FMA – Frankfort to mandibular plane angle = 25° Vertical grower. Vertical .

Lower Anterior Facial Height
• 58 – 72 mm
• ANS – Me
• Correlates with
maxillary length
and backward/
forward
positioning
of chinpoint

Upper facial height /
Lower facial height
• 45:55% adult
• 50:50% child
N
• N–ANS:ANS-Me

ANS

Me

SN - GoGn
• Vertical Growth
• SN – GoGn = 32 S N
• Range 24.4 – 38.2
• <24.4 – Low angle,
skeletal deep bite
(short)
• >38.2 – High angle, Go
skeletal open bite
Gn
(long)

Sagittal .Skeletal .

Length of Maxilla and Mandible • Cond to A (Maxillary length) • Cond to Gn (Mandibular length) .

Dental .

IMPA • Lower incisor to mandibular plane angle • 90° .

Wits • Point A to occlusal plane (perpendicular) • B point to occlusal plane • Measure distance • Class 1 = 1 ±1 mm • Class 2 = 3 mm • Class 3 = -3 mm .

Interincisal angle • Upper and lower incisor long axis • 1 – ī = 131 • <acute dental pattern UR • >obtuse dental pattern UI LI LR .

Sagittal Skeletal • ANB • Class I = 0-5 N • Class II > 5 • Class III < 0 A B .

Mx Incisor to SN • Upper incisor to SN • 103° S N .

3 to 3 mm A Pog . Mn Incisor to A-Pog • Lower incisor to A-Pog plane • .

Soft tissue .

Ricketts esthetic line • Soft tissue tip of the nose to soft tissue chinpoint • -2mm ±2 mm .

Nasolabial angle • Line tangent to base of nose and line tangent to upper lip • 96 .118° .

Steiner’s S line • Upper and lower lips even to line .

TREATMENT OBJECTIVES / GOALS .

TREATMENT OBJECTIVES / GOALS .

TREATMENT PLAN AND MECHANOTHERAPY .

etc) Vertical Control before ortho TX Orthodontic A A Patient. perio. Effective- (developmental) parent Evaluate Informed ness Problems B B consult Treatment Treatment Possible solutions plan plan C C Alternative details Priority plans concept Interaction consent Efficiency order etc etc Compromise Cost/benefit Patient input Other factors .Interview History Reason for Tx Clinical exam Health of tissues DATA CLASSIFICATION Problem list Jaw function Facial proportions BASE = diagnosis Analysis of Dx records Alignment Protrusion / esthetics Transverse Pathology Antero-posterior (caries.

END .

FACIAL PHOTOS • Nose (acceptable. large) Size: 1/3 of total facial height (from hair to lower border of chin) . small.

23 mm • Medium sized: 27. 30 mm • Large sized: 30. Maxillomandibular differential • Effective mandibular length minus midfacial (maxillary) length • Mixed dentition: 20. 33 mm IDEAL: • Small: 20mm • Medium: 20-27mm • Large: 30-33 mm .