Orthotown November 2022 - 51
Fig. 8
is evaluated. Loose, missing and problem teeth are noted for
confirmation on the X-rays.
* Face appearance is examined for dark circles, symmetry, etc.
* Assessment of habits is made, looking at fingernails and
asking the patient to swallow while very gently holding
the lower lip, looking for tongue position and thrusting.
Although tongue ties (Fig. 5) are not routinely categorized,
their appearance is noted. It is amazing how many mothers
confirm difficulty in nursing and speech issues or therapy
once this finding is brought up to them.)
* Attention is then directed to all the digital material gathered.
Parents and patients are directed to view the exam on the
wall-mounted digital monitor (Figs. 6 and 7).
The entire composite record screen from the patient chart is
Fig. 9
visible for review with the patient, including the ABO composite
with the two-dimensional panoramic and cephalometric view. We
begin by enlarging the smile photo (Fig. 8) and describing the jaw
bones of the face and smile bones supporting the teeth. The corners
of the mouth are identified, and it is explained that the smile should
reach those landmarks. The anterior view of teeth in occlusion is
enlarged (Fig. 9) and a delineation between the smile and jaw bones
is made at the mucogingival junction. Center lines are mentioned,
as is the condition of the gingiva.
If the patient has a shift of the mandible, the parent is asked
to stand behind the seated doctor and in front of the patient as the
shift is demonstrated from first contact into occlusion. Seating the
condyle and positioning the mandible often demonstrates the shift
in the bite, as seen in Fig. 10. The right and left buccal views are
shown to confirm the Class I, II or III molar relationships. Occlusal
views are visualized to confirm crowding and frenum attachments
or tongue abnormalities such as tongue ties.
Attention is then drawn to the panoramic film (Fig. 11), where
Fig. 10
teeth are counted and relative space is evaluated. I start in the 12-year
molar area, explaining that growth occurs here and that space or
upright molars in that area is a good sign. Most of the time in this
two-dimensional view, the upper and lower cuspids look crowded.
Symmetry of eruption is noted and age-appropriate patterns are
discussed and highlighted in a take-home form for the patients.
Roots that do not appear to be dissolving in a timely manner are
noted; suggestions about removal would be made at the conclusion
of the exam or at a recall or recheck appointment.
Next, the two-dimensional cephalometric creation (Fig. 12)
from the CBCT is enlarged and the first thing noted is the torque
Fig. 11
Fig. 12
orthotown.com \\ NOVEMBER 2022 51
http://www.orthotown.com
Orthotown November 2022
Table of Contents for the Digital Edition of Orthotown November 2022
Orthotown November 2022 - Cover1
Orthotown November 2022 - Cover2
Orthotown November 2022 - 1
Orthotown November 2022 - 2
Orthotown November 2022 - 3
Orthotown November 2022 - 4
Orthotown November 2022 - 5
Orthotown November 2022 - 6
Orthotown November 2022 - 7
Orthotown November 2022 - 8
Orthotown November 2022 - 9
Orthotown November 2022 - 10
Orthotown November 2022 - 11
Orthotown November 2022 - 12
Orthotown November 2022 - 13
Orthotown November 2022 - 14
Orthotown November 2022 - 15
Orthotown November 2022 - 16
Orthotown November 2022 - 17
Orthotown November 2022 - 18
Orthotown November 2022 - 19
Orthotown November 2022 - 20
Orthotown November 2022 - 21
Orthotown November 2022 - 22
Orthotown November 2022 - 23
Orthotown November 2022 - 24
Orthotown November 2022 - 25
Orthotown November 2022 - 26
Orthotown November 2022 - 27
Orthotown November 2022 - 28
Orthotown November 2022 - 29
Orthotown November 2022 - 30
Orthotown November 2022 - 31
Orthotown November 2022 - 32
Orthotown November 2022 - 33
Orthotown November 2022 - 34
Orthotown November 2022 - 35
Orthotown November 2022 - 36
Orthotown November 2022 - 37
Orthotown November 2022 - 38
Orthotown November 2022 - 39
Orthotown November 2022 - 40
Orthotown November 2022 - 41
Orthotown November 2022 - 42
Orthotown November 2022 - 43
Orthotown November 2022 - 44
Orthotown November 2022 - 45
Orthotown November 2022 - 46
Orthotown November 2022 - 47
Orthotown November 2022 - 48
Orthotown November 2022 - 49
Orthotown November 2022 - 50
Orthotown November 2022 - 51
Orthotown November 2022 - 52
Orthotown November 2022 - 53
Orthotown November 2022 - 54
Orthotown November 2022 - 55
Orthotown November 2022 - 56
Orthotown November 2022 - 57
Orthotown November 2022 - 58
Orthotown November 2022 - 59
Orthotown November 2022 - 60
Orthotown November 2022 - 61
Orthotown November 2022 - 62
Orthotown November 2022 - 63
Orthotown November 2022 - 64
Orthotown November 2022 - Cover3
Orthotown November 2022 - Cover4
https://www.nxtbook.com/farran/orthotown/orthotown-september-2024
https://www.nxtbook.com/farran/orthotown/orthotown-july-august-2024
https://www.nxtbook.com/farran/orthotown/orthotown-june-2024
https://www.nxtbook.com/farran/orthotown/orthotown-may-2024
https://www.nxtbook.com/farran/orthotown/orthotown-april-2024
https://www.nxtbook.com/farran/orthotown/orthotown-march-24
https://www.nxtbook.com/farran/orthotown/orthotown-january-february-2024
https://www.nxtbook.com/farran/orthotown/orthotown-december-2023
https://www.nxtbook.com/farran/orthotown/orthotown-november-2023
https://www.nxtbook.com/farran/orthotown/orthotown-october-2023
https://www.nxtbook.com/farran/orthotown/orthotown-september-2023
https://www.nxtbook.com/farran/orthotown/orthotown-july-august-2023
https://www.nxtbook.com/farran/orthotown/orthotown-june-2023
https://www.nxtbook.com/farran/orthotown/orthotown-may-2023
https://www.nxtbook.com/farran/orthotown/orthotown-april-2023
https://www.nxtbook.com/farran/orthotown/orthotown-march-2023
https://www.nxtbook.com/farran/orthotown/orthotown-january-february-2023
https://www.nxtbook.com/farran/orthotown/orthotown-december-2022
https://www.nxtbook.com/farran/orthotown/orthotown-november-2022
https://www.nxtbook.com/farran/orthotown/orthotown-october-2022
https://www.nxtbook.com/farran/orthotown/orthotown-september-2022
https://www.nxtbook.com/farran/orthotown/orthotown-july-august-2022
https://www.nxtbook.com/farran/orthotown/orthotown-june-2022
https://www.nxtbook.com/farran/orthotown/orthotown-may-2022
https://www.nxtbook.com/farran/orthotown/orthotown-april-2022
https://www.nxtbook.com/farran/orthotown/orthotown-march-2022
https://www.nxtbook.com/farran/orthotown/orthotown-january-february-2022
https://www.nxtbook.com/farran/orthotown/orthotown-december-2021
https://www.nxtbook.com/farran/orthotown/orthotown-november-2021
https://www.nxtbook.com/farran/orthotown/orthotown-october-2021
https://www.nxtbook.com/farran/orthotown/orthotown-september-2021
https://www.nxtbook.com/farran/orthotown/orthotown-july-august-2021
https://www.nxtbook.com/farran/orthotown/orthotown-june-2021
https://www.nxtbook.com/farran/orthotown/orthotown-april-2021
https://www.nxtbook.com/farran/orthotown/orthotown-march-2021
https://www.nxtbook.com/farran/orthotown/2021JanuaryFebruary
https://www.nxtbook.com/farran/orthotown/December2020
https://www.nxtbook.com/farran/orthotown/2020November
https://www.nxtbook.com/farran/orthotown/2020October
https://www.nxtbook.com/farran/orthotown/2020September
https://www.nxtbook.com/farran/orthotown/2020JulyAugust
https://www.nxtbook.com/farran/orthotown/2020June
https://www.nxtbook.com/farran/orthotown/2020May
https://www.nxtbook.com/farran/orthotown/2020April
https://www.nxtbook.com/farran/orthotown/2020March
https://www.nxtbook.com/farran/orthotown/2020JanuaryFebruary
https://www.nxtbook.com/farran/orthotown/2019December
https://www.nxtbook.com/farran/orthotown/2019November
https://www.nxtbook.com/farran/orthotown/2019October
https://www.nxtbook.com/farran/orthotown/2019September
https://www.nxtbook.com/farran/orthotown/2019JulyAugust
https://www.nxtbook.com/farran/orthotown/2019June
https://www.nxtbook.com/farran/orthotown/2019May
https://www.nxtbook.com/farran/orthotown/2019April
https://www.nxtbook.com/farran/orthotown/2019March
https://www.nxtbook.com/farran/orthotown/2019JanFeb
https://www.nxtbook.com/farran/orthotown/2018December
https://www.nxtbook.com/farran/orthotown/2018November
https://www.nxtbook.com/farran/orthotown/2018October
https://www.nxtbook.com/farran/orthotown/2018September
https://www.nxtbook.com/farran/orthotown/2018August
https://www.nxtbook.com/farran/orthotown/2018June
https://www.nxtbook.com/farran/orthotown/2018May
https://www.nxtbook.com/farran/orthotown/2018April
https://www.nxtbook.com/farran/orthotown/2018March
https://www.nxtbook.com/farran/orthotown/2018February
https://www.nxtbook.com/farran/orthotown/2017December
https://www.nxtbook.com/farran/orthotown/2017November
https://www.nxtbook.com/farran/orthotown/2017October
https://www.nxtbook.com/farran/orthotown/2017September
https://www.nxtbook.com/farran/orthotown/August_2017
https://www.nxtbook.com/farran/orthotown/2017June
https://www.nxtbook.com/farran/orthotown/2017May
https://www.nxtbook.com/farran/orthotown/2017April
https://www.nxtbook.com/farran/orthotown/March2017
https://www.nxtbook.com/farran/orthotown/2017JanFeb
https://www.nxtbook.com/farran/orthotown/2016_December_Orthotown
https://www.nxtbook.com/farran/orthotown/2016November
https://www.nxtbook.com/farran/orthotown/2016October
https://www.nxtbook.com/farran/orthotown/2016september
https://www.nxtbook.com/farran/orthotown/2016august
https://www.nxtbook.com/farran/orthotown/2016june
https://www.nxtbook.com/farran/orthotown/2016may
https://www.nxtbook.com/farran/orthotown/2016april
https://www.nxtbook.com/farran/orthotown/2016march
https://www.nxtbook.com/farran/orthotown/2016february
https://www.nxtbook.com/farran/orthotown/2015december
https://www.nxtbook.com/farran/orthotown/2015november
https://www.nxtbook.com/farran/orthotown/2015october
https://www.nxtbook.com/farran/orthotown/2015september
https://www.nxtbook.com/farran/orthotown/2015august
https://www.nxtbook.com/farran/orthotown/2015june
https://www.nxtbook.com/farran/orthotown/2015may
https://www.nxtbook.com/farran/orthotown/2015april
https://www.nxtbook.com/farran/orthotown/2015march
https://www.nxtbook.com/farran/orthotown/2015february
https://www.nxtbook.com/farran/orthotown/2014december
https://www.nxtbook.com/farran/orthotown/2014november
https://www.nxtbook.com/farran/orthotown/2014october
https://www.nxtbook.com/farran/orthotown/2014september
https://www.nxtbook.com/farran/orthotown/2014august
https://www.nxtbook.com/farran/orthotown/2014june
https://www.nxtbook.com/farran/orthotown/2014may
https://www.nxtbook.com/farran/orthotown/2014april
https://www.nxtbook.com/farran/orthotown/march2014
https://www.nxtbook.com/farran/orthotown/2014february
https://www.nxtbook.com/farran/orthotown/2013december
https://www.nxtbook.com/farran/orthotown/2013november
https://www.nxtbook.com/farran/orthotown/2013october
https://www.nxtbook.com/farran/orthotown/2013september
https://www.nxtbook.com/farran/orthotown/2013august
https://www.nxtbook.com/farran/orthotown/2013june
https://www.nxtbook.com/farran/orthotown/2013may
https://www.nxtbook.com/farran/orthotown/2013april
https://www.nxtbook.com/farran/orthotown/2013march
https://www.nxtbook.com/farran/orthotown/2013janfeb
https://www.nxtbook.com/farran/orthotown/2012december
https://www.nxtbook.com/farran/orthotown/2012november
https://www.nxtbook.com/farran/orthotown/2012october
https://www.nxtbookmedia.com