Examination and diagnosis of dentofacial deformities

In addition to the routine medical history data, we should also deeply understand the patient's chief complaint, treatment requirements, psychological state, age, professional and social activities, family and activities. You should carefully ask about your past illness, bleeding tendency and family history.

Second, check

1. In addition to routine physical examination, clinical examination should focus on the shape, size and number of teeth; Whether there are lesions in teeth and periodontal tissue; The shape of the dental arch, whether the relationship between the upper and lower dental arches is coordinated and whether the midline is aligned; Tooth arrangement, anterior-posterior (occlusal) relationship, occlusion curve is normal. Maxillofacial region should focus on the size and proportion of temporomandibular joint, maxilla, jaw and skull base. And comprehensively evaluate the front, side contour, lip shape, mandibular relationship and so on. And the outline impression of the patient's craniofacial deformity is preliminarily outlined.

2. Special inspection

The occlusal model can truly reflect the shape and position of teeth, alveolar process, gums and buccal sulcus (oral vestibular folds or migrating folds), labial and buccal frenulum, dental arch, basal bone and palatal lid. Obtaining the patient's occlusal model is an indispensable and important data for the diagnosis, analysis, treatment and curative effect evaluation of dentofacial deformity. In addition to recording models, research models and working models should be prepared according to treatment needs.

3.X-ray examination X-ray film is an important step and basis for determining the diagnosis and treatment plan, which usually includes root cusp film, full jaw curved section film, lateral skull film and frontal skull film; X-rays of temporomandibular joint and wrist bone should be taken when necessary. For some patients with jaw deformities, mental X-ray examination is still needed. If necessary and conditions permit, three-dimensional CT photos of skull and jaw can be taken to show jaw and temporomandibular joint respectively, or computer-aided cephalometric analysis, or facial photogrammetry and facial moire fringe measurement can be used to observe subtle spatial structure changes as more accurate measurement and analysis.

Craniofacial and dental (occlusal) photography includes frontal and lateral images of craniofacial and dental (occlusal) relationship, so as to observe the frontal and lateral appearance, proportion and symmetry of facial soft tissue, and the relationship between lips and dentition and occlusion.

4. The functional examination of oral and maxillofacial system includes the functional examination of masticatory muscles, facial muscles and labial muscles; Mandibular movement examination (mouth opening, lateral extension and forward extension); Occlusal and occlusal function examination; Clinical and imaging examination of temporomandibular joint.

5. Other inspections are determined as needed.