Diagnosis

Overjet

The overjet is the distance that the upper teeth have passed the lower teeth. It is the horizontal overlap. Before taking this record, make sure the patient is in "Centric Relation" ( biting down normally).

How do you measure this? Take the plastic ruler or perio prob from the anterior surface of the lower incisor and its distance to the incisal edge of the most protruded upper incisor in millimeters.

Overbite

The overbite is the vertical overlap of the upper teeth to the lower teeth.

Deep overbites are one of the main reasons for lower crowding. This could also lead to upper spaces or both upper spacing and lower crowding.

Deep overbite

Open Bite

Molar Classification

Molar and Canine Classification: In a class I occlusion, the upper molar’s most anterior cusp will be in the buccal grove of the lower molar. In a class I occlusion, the upper canine lie between the lower canine and the lower 1st premolar. Record in millimeters the deviation toward class II or class III.

o Molar (Class I,II,III – In mms) R/L

o Canine(Class I,II,III – in mms) R/L

Crossbites:

Anterior Crossbite

Posterior Crossbite

Crowding:

Spacing:

Profile:

Convex Profile

Straight Profile

Concave Profile

Face Height:

Evaluating face height: When evaluating face height, it is also important to take into considerations features such as the mandibular plane angle and lips.

- Mandibular plane angle: In a normal face height, the mandibular plane line should point posteriorly towards the hairline or somewhere close to it. For Brachyfacial, the plane line may lead below the hairline. For dolichofacial patients, the mandibular plane line may lead above the hairline.

- Lips: In brachyfacial patients, the vertical may be limited causing the lips to protrude outward or inward upon closing. In Dolichofacial patients, the increased vertical may contribute to lip incompetence.

Short Face Height

Brachyfacial

Hypodivergent

Normal Face Height

Mesofacial

Normodivergent

Long Face Height

Dolichofacial

Hyperdivergent

Lip opening:

Lip Incompetence:

1. With ruler in hand, have the patient bite down with the back teeth relax his/her lips. Note any strain of the chin or the lips.

2. If you sense that the patient is straining to close, have the patient open up and bite down with the back teeth. Usually, they will bite down showing all their front teeth. Then have them relax.

3. If they proceed to strain closed, use your gloved hand to gently open his/her lips.

4. Once the patient is relaxed, use the ruler to measure the amount of lip incompetence.

Notice the lip and chin strain

When relaxed, the patient is lip incompetent

Canting of Occlusal Plane

1. Have the patient open

2. Gently place tongue blade up against the upper occlusal surface.

3. Begin to slide back and have the patient relax while you slide posteriorly.

4. When you have the tongue blade as far as you can, have the patient bite down gently on the tongue blade.

5. Observe any cant in occlusion by comparing the tongue blade with the interpupillary line (an imaginary line linking the patient’s pupils.

Maxillary Lip Length

using the plastic ruler, have the patient relax and open slightly. Then measure from the nasolabial fold to the bottom of the upper lip in millimeters.

Resting Maxillary Incisor to Lip

using the plastic ruler, have the patient relax and open slightly. Then measure from the bottom of the upper lip to the incisal edge of the upper incisors

Gummy Smile

Have the patient smile. Locate the cervical margin, which is the junction between the gums and the tooth. Using the plastic ruler, measure either the gingiva exposed or the tooth covered up by the lip in millimeters. If needed, the upper lip can be lifted up to examine how much of the incisor is covered by the upper lip.

Exposed gingiva

Covered tooth

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