Case history

In this intraoral and extraoral examination is done for record taking in aligner treatment.

Intraoral examination:

In intra oral examination soft tissue and hard tissue examination is done.

In intra oral examination soft tissue and hard tissue examination is done.
-Soft tissue examination: Condition and position of the soft tissues like gums, tongue, frenum and palate is seen.

–Hard tissue examination: In this, Number of teeth, Condition of teeth, Position of the teeth, Bite relation and Midline shift is seen.

Extraoral examination:

Shape of the head, Facial form, Facial profile, Examination of lip and chin is seen.

-X-rays:

X-rays like OPG (orthopantomagram) and lateral cephalogram are taken for examination of the length of the roots of the teeth, bone height, to see the relation of upper and lower jaw.

-Intraoral and extraoral photographs:

• Intra-oral photograph
  The main purpose of intraoral photographs is to view the hard and soft tissues at clinical examination and to report hard and soft tissue condition as they exist before treatment.
  It is important to get patients permission before taking photographs.
  Patient’s dentition should be perfectly seen in all three space i.e frontal view and both the right and left side view. Occlusal view of upper and lower jaw is taken. Cheek retractors are used to retract cheeks during photographs.
• Extra-oral photographs
  In extra-oral photographs patients head should be accurately seen in all three planes of space and in frontal horizontal plane.
  Lateral view on the right and left side with lips close tightly to reveal muscle imbalance and disharmony and one with smiling.
  Anterior view with serious expressions and one with smiling. Ears should be exposed for purpose orientation and eyes should be open and looking straight.

• Impression taking and wax bite
  After the intraoral and extraoral photographs impressions of the upper and lower jaw is taken using a soft material.
  Wax bite is needed in each and every case of clear aligner treatment as it gives the exact occlusal relationship for proper guidance.
  When taking wax bite centric position is checked and desired degree of activation is decided. The wax is softened in water bath and adapted, patient is then instructed to bite in accurate position. After the wax has hardened properly, it is removed and chilled. Wax bite is very important in clear aligner treatment.

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