DIAGNOSTIC DILEMMAS AND THERAPEUTIC OPTIONS IN ORTHODONTICS

Proper diagnosis is especially important in order to achieve the correct and wished orthodontic treatment outcome. Diagnostic procedures in orthodontics usually include a detailed medical and dental history, clinical and functional examination, radiological examination, and cephalometric and model cast analysis. In addition, and depending on the needs of each patient, other diagnostic procedures may be (and sometimes must) be used, such as cone beam computed tomography (CBCT) and 3D imaging. Depending on the diagnostic parameters of the various orthodontic problems there are interventions that either have to be performed or should be avoided. Failure to receive or/and analyze diagnostic data can lead many times to failure or even worse in iatrogenic effects. Further, it is also very important to take into consideration the fact that actually diagnosis should be considered as a continuous process in orthodontics, which should be repeated at each patient appointment. Of course, not all diagnostic information should be obtained each time, but the orthodontist should evaluate the patient’s clinical status at each visit, and check if all is going well and according to the original treatment plan, or if adverse effects have begun to occur, for which the relevant treatment measures or alternatives should be taken immediately. This lecture will present and discuss by means of several clinical cases the proper use and interpretation of diagnosis and the corresponding treatment alternatives, which may occur in the everyday clinical practice.