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MCG School of Dentistry Quality Assurance Manual

Orthodontics

General Guidelines
By general definition orthodontics is that branch of dentistry concerned with the growth of the craniofacial complex, the development of functional occlusion and the treatment of dentofacial abnormalities. In particular, Orthodontics is that area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures. Orthodontic treatment involves the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and the associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physi- ologic and esthetic harmony among cranial and facial structures.”

Orthodontic services include preventive, interceptive and corrective considerations. Therefore, orthodontic treatment deals directly or indirectly with the following:

  1. Guidance of occlusal development.

  2. Elimination of impairment of masticatory function related with dental malocclusion.

  3. Reduction of periodontal disease and caries associated with malocclusion.

  4. Correction of dentofacial abnormalities.

  5. Improvement of dentofacial esthetics.

  6. Correction of temporomandibular joint abnormalities.

  7. Elimination of harmful dentofacial habits.

  8. Correction of malposed teeth preparatory to construction of fixed or removable prostheses.

The general goals and primary objectives of orthodontic treatment are as follows:

  1. Preserve hard and soft tissue integrity.

  2. Attain alignment of teeth of both dental arches, with condyles in functional harmony with the temporomandibular joint.

  3. Achieve satisfactory occlusion, both static and dynamic.

  4. Modify favorably dentofacial esthetics.

  5. Attain acceptable stability of result of treatment.

Orthodontics - Quality Evaluation Criteria

ITEM

RATING AND EXPLANATION

 

ACCEPTABLE

NOT ACCEPTABLE

EXAMINATION AND PERSONAL HISTORY

Refer to section“Examination, Diagnosis and Treatment Planning,”  and add family history. History and clinical examination findings recorded.

Inadequate history or clinical examination, insufficient needed data.

DIAGNOSTIC AIDS

Adequate diagnostic aids which may or may not include, depending on the complexity of the case:

  1. Occluded dental casts
  2. Complete intraoral or Panorex radiograghs
  3. Cephalometric radiographs and analysis
  4. Photographs

Evidence that diagnostic aids essential to support diagnosis absent. Dental cast ground to centric occlusion where discrepancy exists between centric occlusion and centric relation.

DIAGNOSIS AND TREATMENT PLAN
  1. Written treatment plan with stated objectives of treatment.
  2. Consideration of growth and development as related to and if pertinent to the individual case.

Treatment plan in conflict with diagnosis and objectives of treatment.

CASE PRESENTATION (CONSULTATION)

Consultation with patient, parents, or guardian.

No consultation and/or no case presentation.

EXECUTION OF TREATMENT PLAN

Treatment plan as executed compatible with diagnosis  and treatment objectives.

  1. Appliance of choice and indications.
  2. Tissue considerations in selection of appliance design.
  3. Appliance maintenance.
  4. Post-treatment records.

Treatment plan not compatible with treatment objectives.

  1. Poor choices of appliance.
  2. Tissue abuse apparent.
  3. Poor management of appliance.

RETENTION AND PLANNED RECALL
  1. A retention plan:
    1. Appliance best suited to result
    2. Management of appliance

        2.     Planned recall.

1. Inadequate retention plan or poorly    designed retentive appliance.

2. Recall plan nonexistent or inadequate.

EVALUATION OF RESULT

1.   Patient benefited from treatment.

2.   Objectives of treatment attained.

a.   Tissue integrity preserved.

b.   Alignment, with condyles in functional harmony with the temporomandibular joint.

c.   Functional occlusion.

d.   Dentofacial esthetics improved.

e.    Stability of result.
  1. No apparent benefits from treatment.
  2. Irreversible changes to patient’s disadvantage.
  3. Objectives of treatment not attained.

The Medical College of Georgia is an Equal Opportunity Educational Institution.

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Patient Services
 School of Dentistry | Medical College of Georgia
 Please email comments, suggestions or questions to:
Linda Kimberly,

December 19, 2005