Kỹ thuật chẩn đoán của William Clark trong chỉnh nha

Diagnostic Set up Panoramic Radiography Xeroradiography Clark’s technique www.dainha.com DIAGNOSTIC SET UP  Practical aid in treatment planning and diagnosis  Proposed by H.D Kesling  It’s a procedure in which teeth are removed and replaced in positions they will occupy after experiencing mesial migration in an orthodontic environment www.dainha.com Advantages – To determine and visualise the resultant occlusion before the teeth have been extracted Possible to change the treatment plan on the model by replacing some and removing other teeth so that one can thoroughly examine all possible occlusions Mainly useful in asymmetric extraction and combined surgical orthodontic treatment www.dainha.com Tooth size – arch length discrepancies can be visualised by means of set up Also a step in construction of tooth positioner Patient can be motivated www.dainha.com Procedure  A set of well trimmed models made of deep impressions of teeth and soft tissues  Lines are drawn through buccal groove on the mandibular first molars on to the soft tissue This act as a reference point  A 004 inch ribbon saw blade is used to cut through the contact areas and separate teeth www.dainha.com www.dainha.com www.dainha.com www.dainha.com www.dainha.com www.dainha.com Standard photographs of white males for points (most attractive) through (least attractive) on the dental-facial attractiveness scale Point Point Point Point www.dainha.com Point  Children were also assessed for severity of malocclusion by means of the Treatment Priority Index  Children seeking treatment were perceived as significantly less attractive than children not seeking treatment  The relationship between dental-facial attractiveness and overall severity of malocclusion is also established as proved by TPI scores www.dainha.com Goslon yardstick :A new system of assessing dental arch relationships in childeren with UCLP – Michael Mars, Dennis A Plint : 1987 A cleft Palate journal  The Goslon Yardstick is a clinical tool that allows categorization of the dental relationships in the late mixed and or early permanent dentition in to discrete categories  Objective : To categorize malocclusions in patients with UCLP to represent severity of malocclusion and the difficulty of correcting it To compare long term results of different approaches to the early treatment of children with UCLP www.dainha.com    Development of Yardstick – Clinical features considered most important in characterizing malocclusion in children with UCLP are – A- P arch relationship –Class III incisor relationship> class II div I Vertical labial segment relationship – Open bite> Reduced overbite > deep overbite Transverse relationship – Canine crossbites > molar crossbites To test the application of these subjective criteria study models of 30 cases were taken These models were ranked by orthodontists and separated in groups , which then formed basis for yardstick www.dainha.com www.dainha.com www.dainha.com www.dainha.com www.dainha.com www.dainha.com  Group – excellent     Group – good Group – fair Group – poor Group – very poor  Group or - simple orthodontic treatment/ no treatment  Group – complex orthodontic treatment  Group – limit of orthodontic treatment without orthognathic surgery  Group – Orthognathic surgery www.dainha.com References (Diagnostic set up) Begg Orthodontics Theory & Technique – Kesling Diagnosis and treatment planning in Orthodontics – Van der Linden A Simplified wax set up technique by Dr R.W Knierim JCO-1975 A simplified Diagnostic set up technique by Dr Barry N Resnick; 1979 JCO www.dainha.com References (Radiology) Oral radiology – Goaz & White A Colour Atlas of Dental Radiology – Friedrich A Pasler Essentials of Dental Radiography – Orien N Johnson Principles of Dental Imaging – Langland Orthodontics - T M Graber Radiologic exposure conditions and resultant skin doses in application of xeroradiography to Orthodontic diagnosis by Akihiko Nakasima AJODO, 1980 A cephalometric appraisal of Xeroradiography by Chate AJO-DO 1980 www.dainha.com References ( indices) Contemporary Orthodontics – Proffit M Ortho Journal – Bristol University Longitudinal evaluation of the Treatment Priority Index (TPI) AJO-DO 1989 : Goslon yardstick A new system of assessing dental arch relationships in childeren with UCLP – Michael Mars, Dennis A Plint : 1987 A cleft Palate journal A dental-facial attractiveness scale Tedesco , Albino, Cunate AJO-DO 1983 The Development of PAR Index – S Richmond www.dainha.com Handicapping Malocclusion assessment to establish treatment Priority J A Salzmann – AJO –1964 The use of Occlusal Indices : A European prospective – AJO-DO 1995 The validation of PAR for malocclusion severity and treatment difficulty AJO-DO 1995 10 The effectiveness of ClassII div I treatment – AJO-DO 1995 www.dainha.com Thank you www.dainha.com ... to cut through the contact areas and separate teeth www.dainha.com www.dainha.com www.dainha.com www.dainha.com www.dainha.com www.dainha.com  The lower first permanent molars are replaced to... desired way www.dainha.com  Original study model www.dainha.com  Alginate impression with selected teeth poured up in stone to the extent of their clinical crowns www.dainha.com  Dental units... by periphery wax www.dainha.com  Diagnostic set up with mandibular left lateral incisor removed and remaining teeth aligned www.dainha.com Panoramic Radiography www.dainha.com Panoramic Radiography