THE PLACE OF DIAGNOSIS IN THE TREATMENT PLAN IN DENTO-FACIAL ORTHOPEDICS.
- Introduction
- Definition of diagnosis
- The diagnostic approach
- Interest and importance of each diagnosis in establishing a treatment plan:
- The positive diagnosis
- The etiological diagnosis
- The synthetic diagnosis
- Differential diagnosis
- Diagnosis and treatment success in ODF
- Conclusion
- Introduction:
The first consultation in ODF aims to get to know each other, to discuss the expectations and desires of the patient and his parents, if he is young. But above all, it will allow to make an initial clinical diagnosis of dental malpositions and maxillofacial disharmonies.
This diagnosis, combined with the study of the patient’s medical history and the study and analysis of additional examinations, will provide an initial approach to the treatment to be proposed, which will subsequently be confirmed and then initiated by the practitioner.
- Definition of diagnosis:
According to LAROUSSE , diagnosis : is a stage of the medical act allowing the nature and cause of the condition from which a patient is suffering to be identified.
In dentofacial orthopedics, diagnosis is a very important step that should not be neglected either by the examinations requested or by the time elapsed to establish it because the proper progress and success of a treatment results from a complete and correct diagnosis.
- The diagnostic approach:
Diagnosis is the interpretation of data collected following a certain number of systematic and ordered examinations.
Considering each patient as a particular case, it is important to follow all these steps in order to make an individual and personalized diagnosis.
- Clinical examination: which includes
- Anamnesis
- Morphological clinical examination:
- Exo oral clinical examination
- End-of-mouth clinical examination:
- Hygiene and dental condition
- Periodontal status:
- Musculature examination
- Examination of teeth and occlusion
- Review of functions
- Additional examinations:
- The casts
- The photographs
- The X-ray:
- Panoramic radiography
- The lateral teleradiography.
THE PLACE OF DIAGNOSIS IN THE TREATMENT PLAN IN DENTO-FACIAL ORTHOPEDICS.
- Interest and importance of each diagnosis in establishing a treatment plan:
- The positive diagnosis: or also called morphological diagnosis:
Hierarchical and three-dimensional, it gives a complete and precise description of all the anomalies that the patient presents but describes in detail the state of each structure studied (physiological or pathological), it results from the clinical approach and includes the diagnoses:
- Skeletal and facial,
- Alveolar
- occlusal and dento-skeletal,
- dental
- periodontal.
- Skeletal and facial diagnosis: It is based on the evaluation of
- of the skeletal class,
- facial divergence
- maxillary transverse insufficiency or any other transverse discrepancy between the two jaws;
- the patient’s asymmetry, physiological or to be treated.
This determines the bone structure involved and therefore to be treated (maxillary or mandibular or both), therapeutic sequence by the affected senses, and the choice of devices indicated according to the facial divergence.
- Alveolar diagnosis:
Established in the three directions of space in search of an isolated anomaly to be treated alone or associated with another anomaly which attenuates or aggravates it and on which the treatment depends (example skeletal CLIII with upper proalveolus)
- Occlusal and dento-skeletal diagnosis: interest:
- search for or establish canine and molar class I
- Restore correct dento-dental relationships
- Dental and periodontal diagnosis: Interest:
- Possibility of starting orthodontic treatment or need for prior preparation (caries treatment or periodontal treatment) or even sometimes impossibility of ODF treatment in an unfavorable periodontal environment.
- Functional diagnosis
Determine any parafunction or dysfunction that must first be addressed to ensure stability of the ODF result.
- Etiological diagnosis
Of paramount importance in establishing a treatment plan (remove the etiology: avoid recurrences and also determine the time of intervention based on the etiology.
- Synthetic diagnosis
It is a synthesis or summary of data to find the clinical picture that best corresponds to the patient.
Determine skeletal Class I, Class II, Class III with all associated anomalies (alveolar and dental in all three spatial directions), growth direction and skin profile.
From this diagnosis come the objectives of orthodontic treatment (correction of pathological elements)
The synthetic diagnosis alone sometimes allows the case to be identified and the treatment plan established to be understood. An incomplete or incorrect synthetic diagnosis will necessarily give a treatment plan which will in no case be satisfactory, therefore the correction of the anomalies that the patient presents will not be done.
- Evolutionary diagnosis (prognosis)
allows us to have a certain vision, optimistic and honest in the face of the case in order to be able to treat orthodontically or direct cases where the prognosis remains poor towards surgery.
- Differential diagnosis:
Allows to differentiate between two similar and almost similar but different anomalies which will be treated differently.
- Diagnosis and treatment success in ODF
After the clinical examination, and the diagnosis and before starting the orthodontic treatment , treatment objectives are established which all arise from the diagnosis, in particular the synthetic diagnosis, the choice of the device, the time of intervention, the sequence of the treatment, all these elements are very important for the success of the treatment and especially for its stability, without a complete and correct diagnosis this remains impossible.
THE PLACE OF DIAGNOSIS IN THE TREATMENT PLAN IN DENTO-FACIAL ORTHOPEDICS.
- Conclusion
The key to successful orthodontic treatment is a complete and correct diagnosis that opens up possible therapeutic solutions but also eliminates any treatment possibilities doomed to failure.
In orthodontics, each patient is considered a special case and therefore represented
through an individual diagnosis is a personalized treatment plan.
THE PLACE OF DIAGNOSIS IN THE TREATMENT PLAN IN DENTO-FACIAL ORTHOPEDICS.
Wisdom teeth can be painful if they are misplaced.
Composite fillings are aesthetic and durable.
Bleeding gums can be a sign of gingivitis.
Orthodontic treatments correct misaligned teeth.
Dental implants provide a permanent solution for missing teeth.
Scaling removes tartar and prevents gum disease.
Good dental hygiene starts with brushing twice a day.