Transcript Diagnostic Opinion: BIOMECHANICS

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Patient Name (first name only)
Age
Occupation
Personality Type
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NOTE: edit as appropriate (# and description), ie:
01: hospitalization for Illness or injury
09: high blood pressure
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(Duplicate slide if necessary, or delete if not needed)
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MEDICATIONS:
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NOTE: edit as appropriate (# and description)
Immediate Concern:
PERSONAL HISTORY
01: Fear of Dentist
GUM AND BONE
07: Gums Bleed / Painful when brushing
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TOOTH STRUCTURE
14: Cavities in past 3 years
BITE AND JAW JOINT
21: Having problems with jaw joint
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SMILE CHARACTERISTICS
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Gingivitis (AAP I)
Modified by:
Attachment Loss / Chronic Periodontits (Bone Loss)
Mild (AAP II)
Moderate (AAP III)
Severe (AAP IV)
Site Specific Bone Loss:
Horizontal Bone Loss:
Aggressive Periodontitis:
Secondary Occlusal Traumatism:
Apical Root Resorption:
Abrasion:
Recession:
Missing Teeth (due to Perio):
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GOOD
FAIR
POOR
HOPELESS
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Caries:
Defective Restorations:
Questionable Restorations:
Structural Compromises:
Erosion:
Margin Location Concerns:
Root Resorption:
Other:
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Completed Root Canal Acceptable:
Completed Root Canal Questionable:
Completed Root Canal Unacceptable:
Irreversible Pulpal Pathology:
Questionable Pulpal Pathology:
Future Risk for Endodontic Therapy:
Missing Teeth (Biomechanics):
Other:
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GOOD
FAIR
POOR
HOPELESS
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Attrition (Wear) Normal Force:
Abnormal Attrition (Wear) /
Excessive Force:
Abfraction:
Primary Occlusal Traumatism:
Abnormal Neuromuscular Habits:
Compromised OVD:
Missing Teeth (due to Function):
Other:
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Norm
SNA
82° (+/- 3)
SNB
79° (+/- 3)
ANB
3° (+/- 2)
SN-MP
32° (+/- 5)
UAFH / LAFH (N-ANS / ANS-Me)
.8
Upper Central to SN
103° (+/- 6)
Lower Incisor to MP
90° (+/- 5)
Interincisal Angle
Actual
135° (+/- 11)
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GOOD
FAIR
POOR
HOPELESS
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Color
Developmental Disturbances
Facially Related Tooth Position
1. Maxillary Incisal Edge Position
2. Maxillary Posterior Occlusal Plane
3. Mandibular Incisal Edge Position
4. Mandibular Posterior Occlusal Plane
5. Intra-arch Tooth Position (Arrangement and Form)
Midline
Left
Right
Axially Inclined
Crowding / Overlap:
Diastema:
Rotations:
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Gingival Tissue Assessment
MAXILLA
MANDIBLE
MAXILLA
MANDIBLE
MAXILLA
MANDIBLE
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GOOD
FAIR
POOR
HOPELESS
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