Adventist University of the Philippines

COLLEGE OF DENTISTRY

Name of Student

Patient Name
:
Address
:
Birthday
:
School
:
Guardian
:
History of oral habits:

_____________________________

Date: ____________

___________________________ Nickname: _____________

__________________________________________________
______________________ Age: ________ Sex: __________
___________________________________________________
__________________________________
_____
(Specify oral habits): _______________________

Signature of Guardian: _________________________________

DENTAL CHART:
A. Study Cast Analysis
1. Classification of malocclusion
:
2. Overjet (in mm.)
:
3. Overbite (in mm.)
:
4. Upper & lower arch midline
:
5. Palatal Contour
:
a. Sagittal
b. Transverse
6. Teeth Clinically present :
__ __ __ __ __ __ I __ __ __ __ __ __
__ __ __ __ __ __ I __ __ __ __ __ __
7. Tooth measurement (mesiodistally )
__ I __ I __ I__ I __ I __ I __ I__ I __ I __ I __ I__
I
8. Arch form
a. Upper
b. Lower

: _____________
: _____________

9. Mesial displacement of posterior segment : (identify mesioverted permanent molars)

10. Tooth Malpositions (please identify and describe all tooth malpositions):
a. Upper: _______________________________________________________
b. Lower:_______________________________________________________

11. Abnormal tooth morphology (please identify all)

a. Upper : __________________
b. Lower : __________________
12. Arch dimensions (measurement should be in millimeters):
a. intercanine perimeter
upper : _________
lower : _________
b. intercanine width
upper : _________
lower : _________
c. arch length
upper : _________
lower : _________
d. Arch perimeter
upper : _________
lower : _________
e. Arch width
upper : _________
lower : _________
B. Photo Analysis
Intra/ extra oral photos should be attached
Determine the following: (a) facial type, (b) frontal facial symmetry and proportion, (c)
vertical facial proportion, (d) mandibular plane angle, (e) facial divergence, (f) lip
posture, (g) facial type, (h) nasolabial angle, (i) mento-labial angle

C. Panoramic Xray Analysis

Please describe the following based on the panoramic xray. (Please use a separate sheet)
1. Pattern and amount of resorption of roots of deciduous teeth
2. The state of development of permanent teeth (based on Nolas)
3. Congenital absence of teeth, presence of supernumerary or any pathologic oral
conditions (if present)
4. The character of alveolar bone and immediate lamina dura.
5. Presence of caries

D. MIXED DENTITION ANALYSIS

Objectives:
1. To compute for the arch length discrepancy
2. To predict if there will be enough space available to accomodate the eruption
of permanent canines, 1st & 2nd pre molars
Tooth measurement (mesiodistally)
__ I __ I __ I __ I __ I __ I __ I __ I __ I __ I __ I __ I __ I __
I I
I
I
I
I
I
I
I
I
I
I
I
Prerequisite: panoramic x-ray to make sure canines and premolars are not congenitally
missing
Procedure:

Measure individual mesiodistal width of 4 mandibular incisors and SUM them up.
This is your MDI.
Mark the midlines (upper & lower). This is your point A.
Per quadrant, add mesiodistal width of incisors, sum them up and align the
incisors. Mark the position of the distal surface of the aligned incisors. (point B)
Mark the mesial surface of 1st molars (point C)
Measure the space from point B to point C. this is your space available (SA) per
quadrant
Compute for the Space Required (SR) per quadrant. Use Go Method.
Male:
Maxillary cuspid & bicuspid (MxCB) = MDI / 2 + 12.2
Mandibular cuspid & bicuspid (MdCB) = MDI / 2 + 11.5
Female:
MxCB = MDI / 2 + 11.8
MdCB = MDI / 2 + 10.8

Compute for the Arch Length Discrepancy (ALD) Space available minus space
required (SA-SR=ALD) per quadrant

MDI =
Arch length discrepancy:
MAXILLARY
Right
Left
Space Available
Space Required
Discrepancy (ALD)
Prediction
Treatment

MANDIBULAR
Right
Left

D. CEPHALOMETRIC ANALYSIS (Scotts method)

Angular Measurements

SNA angle formed by joining SN & NA plane. Determines the protrusiveness /

retrusiveness of maxillary bone in relation to cranial base (prognathic,
normal,retrognathic)
SNB - angle formed by joining SN & NB plane. Determines the protrusiveness /
retrusiveness of mandible
in relation to cranial base (prognathic,
normal,retrognathic)
ANB difference of SNA & SNB. Determines the relationship of maxilla and
mandible ( class I, class II, class III )
UiSN angle formed by mx incisor long axis and SN plane. Measures mx incisors
inclination in relation to SN plane (proclined, normal, retroclined)
UiFH - angle formed by mx incisor long axis and FH plane. Measures mx incisors
inclination in relation to FH plane (proclined, normal, retroclined)
SNMP angle formed by SN & Mandibular plane. Measures and predicts
mandibular growth pattern (high angle,normal,low angle)(vertical,
normal,horizontal growth pattern)
FMA angle formed by Frankfurt plane and mandibular plane. Measures and
predicts mandibular growth pattern.
OMA- angle formed by the occlusal plane & mandibular plane. Measures and
predicts mandibular growth pattern.
Y axis angle formed by Y axis plane and FH plane. Determines the growth
potential in a child.
IMPA angle formed by mx incisor long axis & md incisor long axis. Determines
the inclination of mandibular incisor in relation to the mandibular plane
(proclined, normal, retroclined)
NAP angle formed by NA & APog plane. Determines the skeletal convexity.
(convex, normal, concave)
U1L1 (interincisal angle)angle fromed by Mx & Md long axis. Determines the
dental pattern. (obtuse, normal, acute)

Linear measurements:
U1NA distance (perpendicular) from facial surface of mx incisor to NA plane.
Determines the relative position of mx incisor in relation to NA plane (labially
positioned, normal, lingually positioned)
L1NB perpendicular linear distance from facial surface of md incisor to NB
plane. Measures the position of md incisor in relation to NB plane.
L1APog perpendicular linear distance from md incisor tip to APog plane.
PogNB - perpendicular linear distance from pogonion to NB plane. Measures the
chin position (prominent, normal, deficient chin)
EL-LP esthetic line, tip of nose to tip of chin. Measure position of lip in relation
to the line

MEASUREMENT

SNA (mx position)

SNB (md position)
ANB (skeletal pattern)
UiSN (mx incisor inclination)
UiFH
SNMP (growth pattern)
FMA
OMA
Y-axis
IMPA (md incisor inclination)
NAP (skeletal convexity)
UiLi (dental pattern)
UiNA (mx incisor position)
LiNB (md incisor position)
LiAPo
PogNB (chin position)
EL-LP (esthetic line)

NORMAL
RANGE

79-85deg
77-83deg
-0.5-4.5deg
96.5-109.5deg
110-120deg
30-40deg
20.5-29.5deg
11-21deg
54.5-63.5deg
83-97deg
0-6deg
121.5-140.5deg
1-7mm
1-7mm
-1-3mm
1-5mm
-1-1mm

DIAGNOSIS:
1. Skeletal pattern (ANB):
2. Jaw at fault (SNA/SNB):
3. Growth pattern (SNMP,FMA,OMA,Y-axis):
4. Dental pattern (UiLi):
5. Tooth at fault (Mx UiNA, UiSN,UiFH):
(Md LiNB,LiAPog, IMPA):
6. Skeletal convexity / Profile (NAP):
7. Chin point (PogNB):
NOTE: Please attach the following:
Properly based orthodontic diagnostic cast
Cephalometric xray film and tracing
Panoramic xray film and tracing

_____________________

GRADE
Approved:

_________________________
Dr. Walter R. Suarez, MPH

INTERPRETATION

Faculty in Charge