Orthodontic Case Analysis正畸病例分析.ppt

Orthodontic Case Analysis Dr. Perucchini Dr. Featheringham Dent 657 THE PROBLEM-ORIENTED APPROACH Comprehensive way of looking at patient’s problem Involves development of a database Patient interview / questionnaire Clinical exam Diagnostic records I. QUESTIONNAIRE / PATIENT INTERVIEW I. QUESTIONNAIRE / PATIENT INTERVIEW Chief complaint Patient’s subjective assessment of problem Impaired function vs. impaired esthetics Establish relative importance of each to the patient I. QUESTIONNAIRE / PATIENT INTERVIEW Physical Growth Evaluation I. QUESTIONNAIRE / PATIENT INTERVIEW Physical Growth Evaluation I. QUESTIONNAIRE / PATIENT INTERVIEW Physical Growth Evaluation I. QUESTIONNAIRE / PATIENT INTERVIEW Physical Growth Evaluation I. QUESTIONNAIRE / PATIENT INTERVIEW Social / Behavioral Evaluation Motivation Internal vs. External Expectation Realistic? Cooperation Some forms of treatment are cooperation - dependent May delay treatment altogether, or modify treatment plan to decrease need for patient compliance II. CLINICAL EXAM II. CLINICAL EVALUATION 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 II. CLINICAL EVALUATION Evaluation of Jaw / Occlusal Function TMJ evaluation History or TMD? TMD signs / symptoms? Evaluation for CR - CO shifts Presence of shift may alter diagnosis II. CLINICAL EVALUATION Evaluation of Facial Esthetics Evaluate facial proportions and symmetry Disproportion / asymmetry contribute to esthetic problems FRONTAL VIEW Symmetry Dental vs. skeletal midlines Width of eyes, nose, mouth Lip competence, gingival display, etc. II. CLINICAL EVALUATION Evaluation of Facial Esthetics Evaluate facial proportions and symmetry Disproportion / asymmetry contribute to esthetic problems FRONTAL VIEW Symmetry Dental vs. skelet