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Let's get this straight: A students guide to the orthodontic assessment

BDJ Student volume 29, pages 20–21 (2022)Cite this article

The management of malocclusion amounts to the practice of orthodontics, a speciality which primarily aims to improve dentofacial appearance and correct occlusal function,1 via the provision of various appliances and force vectors to achieve a desired movement. The General Dental Council (GDC) Scope of Practice document enables any dentist to carry out orthodontic treatment,2 however, more complex cases will require timely referral to an orthodontic specialist. Thus, the importance of grasping the fundamental principles of an orthodontic assessment enables the clinician to decipher whether a deviation from the norm exists - which may warrant further investigation and referral.

In order to deduce any skeletal discrepancies, an extraoral examination must be carried out in three planes: anterior posterior (AP), vertical and transverse. Firstly, the patient should be orientated in the 'Natural Head Position'.3 The Gonzalez-Ulloa method of assessing the AP involves dropping a zero-degree meridian line down vertically from soft tissue nasion,4 and evaluating the position of the mandible relative to the maxilla, whereby a class I skeletal relationship would present with the mandible positioned 2-4mm posterior to the maxilla, a class II with the mandible greater than 4mm posterior to the maxilla and class III less than 2mm posterior.5

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References

  1. Roberts-Harry D, Sandy J. Orthodontics. Part 1: Who needs orthodontics?. Br Dent J 2003; 195: 433.

  2. General Dental Council. Scope of practice. 2013. Online information available at www.gdc-uk.org/docs/default-source/standards-and-guidance/scope-of-practice/scope-of-practice-september-2013.pdf (accessed February 2022).

  3. Moorrees C, Kean M. Natural head position, a basic consideration in the interpretation of cephalometric radiographs. Am J Phy Anthropo 1958; 16: 213-234.

  4. Naini F. The Origin of the Zero-Degree Meridian Used in Facial Aesthetic Analysis. Aesthetic Surg J 2014; 34: NP72-NP73.

  5. Andrew T. DiBiase and Martyn T. Cobourne. Handbook of orthodontics. 2nd Ed. Pp 171. August 17, 2015.

  6. Rhodes G. The Evolutionary Psychology of Facial Beauty. Ann Rev Psychol 2006; 57: 199-226.

  7. Perrett D, Burt D, Penton-Voak I, Lee K, Rowland D, Edwards R. Symmetry and Human Facial Attractiveness. Evol Hum Behav 1999; 20: 295-307.

  8. Haynes S. The Lower Lip Position and Incisor Overjet. Br J Orthod 1975; 2: 201-205.

  9. Royal College of Surgeons. Management of the Palatally Ectopic Maxillary Canine. England: Faculty of Dental Surgery; 2016.

  10. Ericson S, Kurol J. Resorption of Incisors After Ectopic Eruption of Maxillary Canines: A CT Study. Angle Orthodontist 2000; 70: 6.

  11. Royal College of Surgeons. Management of Unerupted Maxillary Incisors. England: Faculty of Dental Surgery; 2016.

  12. Flett A, Sandler J. The role of the GDP in assessment and management of the early orthodontic referral. Dent Update 2016; 43: 706-720.

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  1. University of Plymouth, Plymouth, UK

    Kouthar Salih

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  1. Kouthar Salih
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Correspondence to Kouthar Salih.

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Salih, K. Let's get this straight: A students guide to the orthodontic assessment. BDJ Student 29, 20–21 (2022). https://doi.org/10.1038/s41406-022-0317-8

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