Basic Dental Terminology PDF

Basic Dental Terminology 1st Year Dental Students Prepared by Dr. Mohamed Taha  ANATOMY OF SKULL The skull is composed of two main parts: the cranium and the facial bones. Cranium The cranium (KRAY-nee-um) is the portion of the skull that encloses the brain. Eight bones make u...

Basic Dental Terminology 1st Year Dental Students Prepared by Dr. Mohamed Taha  ANATOMY OF SKULL The skull is composed of two main parts: the cranium and the facial bones. Cranium The cranium (KRAY-nee-um) is the portion of the skull that encloses the brain. Eight bones make up the cranium: 1. Temporal (TEM-pore-al) bones: which are two fan-shaped bones, one on each side of the skull, above each ear. 2. Parietal (pah-RYE-eh-tal) bones: which are two bones, one on each side, that are considered the roof and side walls of the brain. 3. Frontal (FRON-tal) bone: which is a single bone in the frontal region that makes up the forehead. 4. Occipital (ock-SIP-ih-tahl) bone: which is a single large, thick bone in the lower back of the head that forms the base of the skull and contains a large opening (foramen magnum) for the spinal cord passage to the brain. 5. Ethmoid (eth-moyd) bone: a spongy bone located between the orbits that are considered the roof of the anterior nasal fossa of the skull. 6. Sphenoid (SFEE-noyd) bone: which is a large bat-shaped bone at the base of the skull between the occipital and ethmoid in front, and the parietal and temporal bones at each side. 2  Figure 1:Bones of cranium Facial bones The facial bones are composed of 14 bones. All are paired with one on each side, except there is only one vomer in the nose and one mandible. The facial bones are: 1. Zygomatic (zye-goh-MAT-ick) bones: which are two facial bones, one under each eye, that form the cheekbone and give character to the face. The zygomatic bones are also called the malar (MAY-lar) bones. 2. Maxilla (MACK-sih-lah): which are two large facial bones, one under each eye, that unite in the center in the median suture to form the upper jaw that supports the maxillary teeth in the alveolar process. Also, this bone contains the maxillary sinus. 3. Palatine (PAL-ah-tine) bone: which are two bones, one left and one right, that unite at the median palatine suture to form the hard palate of the mouth and the nasal floor. The incisive foramen is a large foramen in the palatine bone that is exactly located behind and between the central incisors 3  4. Nasal (NAY-zal) bone: two bones, one left and one right, that join side by side to form the arch or bridge of the nose. 5. lacrimal (LACK-rih-mal): two small bones, one each on the inner side or nose site of the orbital cavity, that make up the corner of the eye where the tear ducts are located. 6. Inferior concha (KONG-kah): two thin scroll-like bones that form the lower part of the interior of the nasal cavity. 7. Mandible (MAN-dih-bull): a horseshoe-shaped bone that forms the lower jaw. 8. Vomer (VOH-mer): a single bone that forms the lower posterior part of the nasal septum and separates the nose into two chambers. Figure 2: Facial bones Anatomy of Mandible 4 The mandible is the largest and strongest bone in the face. It is the only mobile bone in the skull. The mandible consists of two main anatomical parts: a body and 2 rami A. Body of mandible It is the horizontal portion of mandible and consist of two parts: the alveolar part and base of mandible 1. The alveolar part is the superior portion of the body of mandible. The lower teeth are housed in this part. 2. The base part is the inferior portion of the body of mandible. B. Ramus It is the vertical part of mandible and have two vertical processes: 1. Coronoid process: which is the anterior process of ramus 2. Condylar process: which is the posterior process of ramus. The incisure between the coronoid process and condylar process is called sigmoid or mandibular notch The mandible has also the following important anatomical landmarks: 1. Angle of the mandible: area along the lower edge of the mandible where the body of mandible and ramus are connected 2. Mylohyoid ridge (my-loh-HIGH-oyd): bony ridge on the lingual surface of the mandible. 3. Oblique (oh-BLEEK) ridge: slanted, bony growth ridge on the facial side of the mandible. 4. Retromolar (ret-trow-MOLE-ar) area: space located to the rear of the mandibular molars. 5. Symphysis: center of mandible at chin area. The mandible articulates or comes together as a joint with the temporal bone of the cranium. This temporomandibular joint is commonly abbreviated as TMJ. The condyle (KON-dial) of the mandible rests in a depression in the temporal bone called 5 the glenoid (GLEE-noyd) or mandibular fossa (FAH-sah). The articular eminence (ar-TICK-yoular EM-in-ence) of the temporal bone forms the anterior boundary of the fossa and helps maintain the mandible in position. Between the contact area of these two bones is the articular disc, a meniscus (men-IS-kus) and synovial (sin- OH-vee-al) fluid that cushions and lubricates the joint that works in a hinge-action movement. Figure 3: Anatomy of mandible: (a) Lateral view and (b) Medial view Muscles of Mastication Mastication (mass-tih-KAY-shun = chewing) is controlled by paired (left-right) muscles which are associated with movement of jaws. The four major muscles of mastication are: 1. Temporal muscle: which is a fan-shaped muscle on each side of the skull; elevates and lowers the jaw and can draw the mandible backward. 2. Masseter (mass-SEE-ter) muscle: which is the muscle that closes the mouth; the principal mastication muscle. 6  3. Medial pterygoid muscle: which is wing shaped muscle that raises the mandible to close the jaw. 4. Lateral pterygoid muscle: which opens the jaw and thrusts the mandible forward; assists with lateral movement. Several other essential muscles of the head are important to dentistry which include: 1. orbicularis oris (or-bick-you-LAIR-iss OR-is) muscle: Also known as the “kissing muscle,” a circular muscle surrounding the mouth that compacts, compresses, and protrudes the lips. 2. Buccinator (BUCK-sin-ay-tore) muscle: which is the principal cheek muscle; compresses the cheek, expels air through the lips, and aids in food mastication. 3. Mentalis (men-TAL-iss) muscle: which is the muscle of the chin (mental) that moves the chin tissue and raises or lowers the lower lip. 7 Figure 4: muscles of mastication and facial muscles: (A) Superficial lateral view and (B) Deep lateral view The tongue The tongue is an important organ in the oral cavity that performs many necessary functions. The tongue, or glossa (GLOSS-ah = Latin for tongue), is a strong muscular organ that is important in chewing, talking, deglutition (dee-glue-TISH- un = swallowing), and tasting. The tongue papillae (pah-PILL-lie = tissue growths) situated on the dorsal (DOOR-sal = back) surface of the tongue and are responsible for the tasting and many of them contain taste buds. The major papillae are: 8  1. Circumvallate (sir-kum-VAL-ate) papillae: the largest, V-shaped papillae, situated on the dorsal aspect of the tongue; sense bitter tastes. 2. Filiform (FIL-ih-form) papillae: the smallest, hair-like papillae covering the entire dorsal aspect of the tongue; do not sense taste. 3. Fungiform (FUN-jih-form) papillae: small, dark red papillae on the middle and anterior dorsal surface and along the sides of the tongue; sense sweet, sour, and salty tastes. 4. Foliate (FOE-lee-ate) papillae: present on the posterior lateral borders of the tongue; sense sour tastes. Muscles of tongue The muscles of the tongue are classified into intrinsic muscles and extrinsic muscles, each comprising 4 muscles: A. Intrinsic muscles of tongue do not have attachments to any bones and are responsible for changing and altering the shape of the tongue: Intrinsic muscles include the following: 1. Superior longitudinal muscle 2. Inferior longitudinal muscle 3. Transverse muscle 4. Vertical muscle 9 B. Extrinsic muscles of the tongue have attachments to bones and are responsible for altering the position of the tongue: Extrinsic muscles include the following: 1. Genioglossus muscle 2. Hyoglossus muscle 3. Styloglossus muscle 4. Palatoglossus muscle Figure 5: Muscles of tongue 10 Palate structure The palate (PAL-utt) is the roof of the mouth and is divided into hard palate and soft palate: 1. hard palate: composed of the palatine processes of the maxillae bones; covered with mucous membrane and has the following features: a. Rugae (RUE-guy): irregular folds or bumps on the surface. b. Incisive papilla: an oval midline mucosal prominence overlying the incisive fossa and is situated at the anterior portion of the palate behind the maxillary centrals; the site for infiltration injection of local anesthesia. c. Palatine raphe (RAH-fay = ridge between the union of two halves): white streak in the middle of the palate. 2. Soft palate: flexible portion of the palate without bone; area where the gag reflex is present. The soft palate is movable and closes off the nasal passage during swallowing. Figure 6: Anatomy of palate 11  Tooth origin and formation Classification of the Human Dentition Human Dentition: o Two sets of teeth:  First set: Deciduous teeth (commonly called "baby teeth" or primary teeth).  20 deciduous teeth that erupt first.  Second set: Permanent dentition (also called secondary teeth).  32 permanent teeth replace deciduous teeth.  Permanent teeth, except molars, are termed succedaneous because they replace deciduous teeth when they exfoliate. o Mixed dentition occurs from age 6 to 16 when both deciduous and secondary teeth are present. Specialized Cells Odontoclasts: Absorb primary tooth roots. Cementoclasts: Destroy cementum. Osteoclasts: Destroy or absorb bone tissue. Tooth Abnormalities Amelogenesis Imperfecta: Genetic disorder resulting in defective enamel formation. Anodontia: Absence of teeth. Dens in Dente: Tooth enfolds on itself, forming a small cavity. 12  Dentinogenesis Imperfecta: Genetic disorder resulting in weakened or gray-colored teeth. Fluorosis: Mottled enamel caused by overfluoridation. Fusion: Union of tooth buds resulting in large crowns or roots. Germination: Single tooth germ separating to form two crowns on a single root. Hutchinsonian Incisors: Saw-like incisal edges of maxillary incisors caused by maternal syphilis. Hypocalcification: Lack of hardening of tooth tissue, resulting in weak teeth. Hypoplasia: Underdevelopment of enamel. Macrodontia: Abnormally large teeth. Microdontia: Unusually small teeth. Peg-shaped Teeth: Small, rounded teeth, usually in maxillary lateral incisors. Supernumerary Teeth: Extra teeth. Tooth Eruption Eruption of teeth follows a general pattern or schedule. General patterns include: o Lower teeth erupt before their maxillary counterparts. o Primary teeth shed approximately 3-6 months before replacement teeth appear. o Permanent teeth require about 2+ years after eruption for full calcification. A general erup on patern in orderly sequence is shown in the following table. Months Tooth Primary Den on Mandibular central incisor, 6–10 months 6–12 months Maxillary central incisor, 6–10 months Mandibular lateral incisor, 7–10 months Maxillary lateral incisor, 9–12 months 13 12–18 months Mandibular first molar, 12–18 months Maxillary first molar, 12–18 months 16–22 Mandibular cuspid/canine, 16–22 months Maxillary cuspid/canine, 16–22 months 20–32 months Mandibular second molar, 20–32 months Maxillary second molar, 24–32 months Permanent Den on Mandibular first molar, 6–7 years 6–8 years Maxillary first molar, 6–7 years Mandibular central incisor, 6–7 years Maxillary central incisor, 7–8 years 9–12 years Mandibular cuspid/canine, 9–10 years Maxillary cuspid/canine, 11–12 years 10–12 years Mandibular first premolar/bicuspid, 10–11 years Maxillary first premolar/bicuspid, 10–11 years Mandibular second premolar/bicuspid, 11–12 years Maxillary second premolar/bicuspid, 11–12 years 11–13 years Mandibular second molar, 11–13 years Maxillary second molar, 12–13 years 17–21 years All third molars (if present and erup ng) 14 Tissue Structure of the Teeth Enamel: o Hard tooth covering, 96% inorganic. Dentin: o Main tooth tissue surrounding the pulp. o 70% inorganic, softer than enamel but harder than pulp.  Types of dentin:  Primary dentin: Original dentin in newly formed tooth.  Secondary dentin: Occurs during regular development.  Tertiary dentin (reparative dentin): Forms in response to decay, trauma, etc. Pulp: o Soft, vascular tissue in the center of the tooth. o Performs functions of nourishment, defense, sensation, and dentin protection. o Includes:  Pulp horns: Pointed edges of the pulp chamber. o Common pulp diseases include:  Pulpitis: Inflammation of the pulp.  Pulp stone (denticle): Small growth in a tooth.  Pulp cyst: Fluid-filled sac within the pulp tissue.  Granuloma: Tumor found in the root area. Cementum: o Tissue covering the tooth root, 55% inorganic. o Primary cementum: Acellular, forms uniformly. o Secondary cementum: Cellular, forms in response to wear or stimulation. *Hypercementosis: Overgrowth of cementum, caused by stress or trauma. 15 Tissue Composition of the Periodontium Periodontium: Tissues surrounding and supporting the teeth. Composed of: o Periodontal membrane/ligament: Connective tissue that anchors the tooth in the socket.  Types of fibers:  Alveolar crest fibers: Help retain the tooth in its socket.  Horizontal fibers: Connect the alveolar bone to the root.  Oblique fibers: Attach the socket to the root cementum.  Apical fiber bundles: Prevent tipping and protect the tooth's nerve supply.  Interradicular fibers: Found in multirooted teeth, prevent tipping and turning. o Alveolar bone: Bone supporting the teeth, composed of alveolar socket and compact bone. o Gingiva: Gum tissue surrounding the teeth.  Includes:  Attached gingiva: Firm, dense tissue bound to the bone.  Keratinized gingiva: Hard tissue at the gingival margin.  Marginal gingiva: Unattached tissue forming the gingival crevice.  Papillary gingiva: Occupies interproximal spaces. 16 Odontology/Morphology Odontology: Study of the structure, development, and diseases of teeth. Morphology: Study of tooth form and shape. o Divisions:  Maxillary: Upper teeth.  Mandibular: Lower teeth.  Arch: Half of the mouth.  Quadrant: Half of an arch.  Anterior: Front of the mouth (canine to canine).  Posterior: Back of the mouth (molars and premolars). Types of teeth: o Incisors: Cutting teeth. 17  o Cuspids (canines): Single-rooted, longest teeth. o Premolars (bicuspids): Posterior teeth with multiple cusps. o Molars: Largest grinding teeth with multiple roots. Tooth Anatomy/Morphology Tooth Anatomy: o Crown: Top part of the tooth containing the pulp chamber, dentin, and enamel covering.  Anatomical crown: Covered with enamel, may not be fully visible, but remains present throughout the life of the tooth.  Clinical crown: The visible surface in the oral cavity, which may be reduced due to conditions like impaction, hyperplasia, or malposition. o Root: The bottom part of the tooth, which can have a single root, be bifurcated (two roots), or, in maxillary molars, trifurcated (three roots). o Cervical line: Where the enamel of the crown meets the cementum of the root; also called the cementoenamel junction or the cervix (neck) of the tooth. 18  o Apex: The tip end of a tooth; one apex is present at each root tip. o Contact area: The point or surface where two teeth meet side by side; if no contact occurs, the space is called a diastema. o Embrasure: A V-shaped area between the contact point of two teeth and the gingival crest. o Proximal surface: The side wall of a tooth that meets or touches the side wall of another tooth. o Axial surface: The long-length surface of the tooth. o Line angle: The junction of two tooth surfaces, such as mesial and incisal surfaces. o Point angle: The junction of three surfaces, such as mesial, incisal, and labial. o Midline: An imaginary vertical line bisecting the head at the center; divides the right and left sides of the mouth. o Antagonist: The opposing tooth that contacts with another tooth in the opposite arch. Tooth Surfaces A tooth has six major surfaces: 1. Facial surface: The surface of all teeth facing the cheeks or lips; includes:  Buccal surface: The posterior tooth surface toward the cheeks; abbreviated as B or Buc.  Labial surface: The anterior tooth surface toward the lips; abbreviated as La or Lab. 2. Lingual surface: The surface of all teeth facing the tongue; abbreviated as Li. 3. Mesial surface: The side surface closest to the midline; abbreviated as M. 4. Distal surface: The side surface farthest from the midline; abbreviated as D. 19  5. Incisal surface: The cutting edge of anterior teeth (centrals, laterals, cuspids/canines); abbreviated as I. 6. Occlusal surface: The grinding or chewing surface of posterior teeth (premolars/bicuspids and molars); abbreviated as O or Occ. 7. Apical surface: The surface relative to the root tip end of the tooth (apex); the apical foramen is the opening in the root tip used for the passage of nerves and vessels. Tooth Landmarks Cingulum: A smooth, convex, or rounded bump on the lingual surface near the cervical line on anterior teeth; less noticeable on mandibular anteriors compared to maxillary anteriors. Ridge: A linear elevation on teeth named for its location: o Marginal ridges: Rounded enamel elevations on the occlusal surface of posteriors, linguals of anteriors, and the mesial and distal surfaces of all teeth. o Transverse ridge: Found on the occlusal surface of posterior teeth, where two triangular ridges meet. o Triangular ridge: Runs from the cusp tips to the central groove on the occlusal surface of posterior teeth. o Oblique ridge: A slanting ridge on maxillary molars, more prominent on the first molar than the second. Fissure: A groove or natural depression, slit, or break; may also result from incomplete lobe union in the enamel surface of a tooth. Fossa: A shallow, rounded, irregular depression or concavity on the lingual surface of anterior teeth and the occlusal surfaces of posterior teeth. 20  Pit: A pinpoint depression located at the junction of developed grooves or at the end of a groove. Sulcus: A long depression between ridges and cusps on the tooth surface. Groove: A rut, furrow, or channel on the tooth surface: o Developmental groove: Appears during tooth development between the crown or root parts. o Surface groove: A supplemental groove on the occlusal surface of posterior teeth. Cusp: An elevation or mound on the biting surface of a tooth; the cusp of Carabelli is an extra cusp found on the lingual surface of the maxillary first molar. Eminence: A high projection or prominence on a tooth. Furcation: The area where tooth roots branch apart. Mamelon: Bumps forming a scalloped border on the incisal edge of newly erupted anterior teeth; usually worn away by attrition shortly after eruption 21  Dental Professionals Each profession speaks a language of its own, using terms or words connected with its common procedures, personnel, techniques, and instrumentation. People involved with, use the language of, and participate in each of these occupations are said to be professionals of that occupation. Others who are not related to or familiar with this profession are called lay people. Different types of personnel associated with the dental profession perform special functions or meet particular needs. Some are directly involved with the practice, while others provide support. Dentist The dentist, who is a Doctor of Dental Surgery (DDS) or a Doctor of Medical Dentistry (DMD), diagnoses, performs, and monitors the dental care of patients. Various specialists, who complete extended studies, training, and testing, perform specific duties or skills of their particular specialty. The official ADA-recognized special areas are: o Prosthodontist (prahs-thoh-DOHN-tist): Replaces missing teeth with artificial appliances such as dental crowns, full mouth dentures, or partial bridgework. o Periodontist (pear-ee-oh-DOHN-tist): Treats diseases of periodontal (gingiva and supporting) tissues. o Orthodontist (or-thoh-DON-tist): Corrects malocclusion and improper jaw alignment. o Pediatric dentist (pee-dee-AT-trick): Performs dental procedures for the child patient, also called pedodontist (PEE-doh-don-tist). o Endodontist (en-doh-DAHN-tist): Treats the diseased pulp and periradicular structures. o Oral and maxillofacial surgeon (mack-sill-oh-FAY-shal): Performs surgical treatment of the teeth, jaws, and related areas. 22  o Public health dentist: Works on causes and prevention of common dental diseases and promotes dental health to the community or general population. o Oral pathologist: Studies the nature, diagnosis, and control of oral diseases. o Oral and maxillofacial radiologist: Is concerned with the production and interpretation of radiant energy images or data regarding the oral and maxillofacial regions. o Forensic dentist (for-EN-sick): Discovers and uses pathological evidence for legal proceedings; forensic dentistry is not yet established as a recognized specialty but is organized and related to a particular type of dental care. Each licensed dentist is permitted to perform general dental procedures in any or all of the various areas of dentistry. Some dentists may limit their practice to only one specialty area such as oral surgery or orthodontics, servicing only those type of patients. Other dentists may advertise and perform procedures in special dental areas of interest, such as amalgam-free, cosmetic, diagnostic, implant, sedation, TMJ, holistic dentistry, and so forth. Registered Dental Hygienist The hygienist is concerned with the prevention of dental disease, specializing in the cleaning, polishing, and radiographing of teeth, periodontal treatment, fluoride and sealant application, and patient education. The hygienist, if educated, tested, and certified as state approved, may also perform some operative or supportive procedures such as nitrous oxide and/or anesthetic injection administration, application of microbial agents, patient assessment, and interpretation of X-rays and testing results. 23 Dental Assistant The dental assistant aids the dentist in diagnosis, treatment, dental care, and general duties. Dental Laboratory Technician The dental laboratory technician performs dental lab procedures under written orders from a licensed dentist. Denturist The denturist (DEN-ture-ist) independently specializes in the construction of dentures and may practice only in those states that recognize, license, and permit this profession. Other Dental Professionals Other related dental professionals include dental supply/detail persons, dental equipment technicians, and dental manufacturers and suppliers. Some dental professionals dedicate their careers to research, education, and the development of oral medicine. Places of Employment Qualified and interested parties may work in various places and organizational structures in the field of dentistry, as described in the following list: 24  Solo: Dental practice owned and operated by a single dentist or a practice that is owned by a dentist who contracts with another dentist (an associate) to work in the establishment with the owner. Partnership: Dental practice owned and operated equally by two or more dentists. Group: Dental practice employing a multitude of dentists; may be incorporated and owned by the working dentists or owned and operated by an outside corporation or dental health plan. Clinics and hospitals: A clinic setting or hospital care center that offers dentistry services. Many hospitals grant privileges to dentists to bring difficult or compromised patients for dental care using hospital services; oral surgeons may be staff members and work in the hospital and in their private offices. Specialty practice: Various specialists work in private offices or facilities concerned with their training. Public health specialists may work in outpatient clinics, field establishments, schools, and offices. Forensic specialists may work in the lab, field, and court. Miscellaneous practice sites: Includes research, insurance companies, education, publication, specialty houses, employment and recruiting agencies, charity clinics, and other areas 25  Orthodontic Practice and Malocclusion Classifications Orthodontia: The branch of dentistry that focuses on the prevention and correction of abnormally positioned or misaligned teeth. An orthodontist is a dental professional who has completed additional specialized training (2-3 years) in orthodontics. Orthodontists address malocclusion, which can involve treatment for conditions like TMJ dysfunction, cleft palate, and facial reconstruction. Classification of Malocclusion Dr. Edward Angle classified malocclusion into three main categories based on the centric relationship of the teeth: 1. Neutroclusion: o Class I: Normal anteroposterior and mesiodistal relationships of the teeth, but individual teeth may be misaligned (e.g., crowding, crossbites). 2. Distoclusion: o Class II: The mesiobuccal cusp of the maxillary first molar is anterior to the buccal groove of the mandibular first molar, resulting in a retruded mandible.  Division 1: Protruded maxillary incisors and a V-shaped arch with increased overjet.  Division 2: Maxillary incisors with a lingual incline, excessive overbite, and a wider than normal arch. 3. Mesioclusion: o Class III: The mesiobuccal cusp of the maxillary first molar occludes in the interdental space of the mandibular first molar’s distal cusp, leading to a protruded mandible. 26 Individual Tooth Position Classifications Mesioversion: Positioned more mesial than normal. Distoversion: Positioned more distal than normal. Labioversion: Anterior tooth positioned toward the lips. Buccoversion: Posterior tooth positioned toward the cheek. Linguoversion: Positioned toward the tongue. Infraversion: Tooth not fully erupted. Supraversion: Tooth over-erupted. Torsoversion: Tooth rotated on its axis. Transversion: Tooth in the wrong order. Causes of Malocclusion Malocclusion can arise from various factors, including: Trauma: Injuries affecting the teeth or jaw. Habits: Actions like thumb sucking or prolonged pacifier use. Poor Oral Conditions: Poor dental hygiene or untreated dental issues. Congenital Factors: Supernumerary teeth or ectopic tooth eruption. 27 Common Types of Malocclusion: Open Bite: Anterior teeth fail to meet; posterior teeth occlude. Overjet: Increased horizontal distance between maxillary and mandibular incisors. Deep Overbite: Excessive vertical overlap of incisors. Crossbite: Reverse bite of incisors or posterior teeth. End-to-End Bite: Edges of maxillary and mandibular incisors meet. Types and Methods of Orthodontic Treatment 1. Preventive Orthodontics: Preserving the integrity of normal occlusion through interventions such as caries correction, space maintainers, or muscle exercises. 2. Interceptive Orthodontics: Reducing existing malocclusions with appliances to correct growth patterns (e.g., tongue retainers). 3. Corrective Orthodontics: Eliminating malocclusion using various appliances and forces, including: o Rotation: Altering tooth position around its axis. o Translation: Moving teeth bodily. o Tipping: Changing tooth position upright. o Intrusion/Extrusion: Moving teeth into/out of the alveolus. o Torque: Moving the root without moving the crown. Treatment Factors: Age, severity of malocclusion, cause, patient’s health, and orthodontist expertise determine the treatment plan. Orthodontic Appliances Types of Appliances: Banding: Metal bands around teeth for attaching brackets and wires. 28  Direct Bonding: Brackets cemented directly onto teeth. Indirect Bonding: Brackets placed via a tray delivery system. Invisalign: Custom clear trays for mild malocclusion cases, requiring frequent changes. Lingual Braces: Placed on the tongue side of the teeth. Accelerated Osteogenic Orthodontics: Surgical method to facilitate faster tooth movement. Other Appliances: Hawley Appliance: Retainer to maintain tooth position. Palatal Expanders: Fixed devices to widen the upper jaw. Temporary Anchoring Devices (TADs): Titanium screws for anchoring teeth during movement. 29 Diagnosis and Treatment Planning for Malocclusion Diagnosis Steps: Medical and Dental History: Overview of health and dental hygiene. Clinical Examination: Inspection and charting of teeth. Photographs: Extraoral and intraoral records for treatment planning. Impressions: To create study models. Radiographs: Full mouth series and specialized imaging for growth projections. 30