Orthodontic Diagnosis, Records and Treatment Planning
Orthodontic Diagnosis, Records and Treatment Planning tests a structured path from chief complaint to a defensible plan. The exam favors systematic problem lists over appliance-first thinking.
Core rules
- Collect complete records: extraoral and intraoral photographs, study models or intraoral scans, panoramic radiograph, lateral cephalometric radiograph, and CBCT when indicated. Add a functional examination for airway, swallowing, habits, and temporomandibular symptoms.
- Build a prioritized problem list covering health, skeletal pattern, dental alignment, transverse relationships, soft-tissue profile, function, and patient goals.
- Quantify crowding with space analysis, check Bolton tooth-size discrepancy, arch form, curve of Spee, and transverse width. Assess caries, periodontal status, third molars, and root morphology before promising tooth movement.
- Treatment planning must compare alternatives, including no treatment, and document risks, limitations, compliance demands, and retention.
Worked example
A 14-year-old has a Class I molar relationship, 6 mm of mandibular crowding, a missing 35, and mildly proclined incisors. Reasoning: the problem list includes crowding, a missing premolar, and profile risk. Space analysis shows whether the missing 35 space should be opened or closed. If the profile is acceptable, nonextraction treatment with interproximal reduction or slight expansion may work; if retraction is needed, close space and manage anchorage. Check third molars and the contralateral arch before deciding.
Traps
- Starting appliance design before completing the problem list.
- Missing a transverse discrepancy or functional shift.
- Ignoring periodontal health, caries, or root proximity.
- Promising a result without discussing compliance, retention, or alternatives.