Orthodontic records create a baseline of the patient at the start of treatment and produces a facsimile of the patient for treatment planning study. Excellent orthodontic treatment outcomes develop from excellent orthodontic decision making. The foundation of excellent treatment planning is the orthodontic diagnostic record.
The examination starts with an assessment of the facial structure, profile, symmetry, lip esthetics and harmony with the underlying tooth and jaw structure. Think of the bizarre appearance of Hollywood stars attempting to improve the look of their lips with plastic surgery. Instead, orthodontics takes an inside out approach that sets the hard structure scaffolding for the best facial appearance. The jaw joints and related muscle will also be examined to detect facial pain and TMJ (temporomandibular joint pain) issues.
Dental examination: Dr. Bentele was a general dentist for 11 years prior to his orthodontic residency so he places great emphasis on a thorough dental examination to detect problems with the health or structure of the gum tissue, esthetics of the teeth and to think through factors which may affect the orthodontic plan such as aligning roots next to a missing tooth that needs an implant.
Panoramic x-ray: Your general dentist typically uses bite wing x-rays to detect dental decay between the teeth. A panoramic x-ray gives a broader overview of the facial structure to include the sinuses, temporomandibular joints (TMJ), bone structure and tooth position.
Cephalometric x-ray: This is a profile view of the facial structure. It used to determine the position of the jaws and their proportionality relative to each other. It also reveals the angulation of the incisors relative to each other and to the facial profile. The cephalometric film is analyzed in the Dolphin Imaging program. (www.dolphinimaging.com ) Structures within the head are plotted and a number of analyses may be produced. This amazing program even allows us to match the x-ray to the photo and make surgical predictions.
Facial and intraoral photos: These create a record of the patient’s appearance at a point in time and allow study of the profile, gum tissue and esthetics of the teeth. These will be repeated at the end of treatment for a Before/After view and will be viewed many times during treatment as a reference to the starting point. The photos are essential for patient education during the treatment planning conference.
Dental study models: Impressions of the teeth and supporting structures are taken for a 3-dimensional reference. These are used to measure the space available for alignment and are essential to visualizing the desired outcome. In this office, and in a small percentage of high quality oriented orthodontic offices, a centric relation mounting of the models is also accomplished. The relationship of the upper jaw to the skull is measured and the lower jaw is mounted to this in a device called an articulator.
( www.sam-dental.de) This extra step shows the orthodontist how the jaws would fit together if the crooked teeth didn’t cause the jaw to slide around in an attempt to compensate for a bad bite.