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Orthodontic Diagnostic Form
Comprehensive clinical evaluation and treatment planning sheet
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General Information
Dental Chart
17
16
15
14
13
12
11
21
22
23
24
25
26
27
55
54
53
52
51
61
62
63
64
65
85
84
83
82
81
71
72
73
74
75
47
46
45
44
43
42
41
31
32
33
34
35
36
37
Left Click:
Normal
→
Mobility
→
✕ Ag (Agenesis)
→
✕ Loss (Premature loss)
Right Click: Recession
Ctrl + Right Click: Aberrant Frenum
Specific Clinical Findings
Therapeutic Options
Functional Assessment
Breathing Pattern
Swallowing Pattern
Parafunctions
SKELETAL DIAGNOSIS
Transverse Discrepancies
Maxillary transverse deficiency
Mandibular asymmetry
Sagittal Discrepancies
Skeletal Class (I, II, III)
Vertical Discrepancies
Skeletal divergence
Occlusal plane inclination
Growth pattern
Midline Asymmetry
Maxillary midline vs facial plane
Mandibular midline vs facial plane
DENTOALVEOLAR DIAGNOSIS
Transverse Discrepancies
Dental crowding
Spacing / Diastemas
Posterior crossbite
Sagittal Discrepancies
Molar relationship
Canine relationship
Overjet
Anterior crossbite
Maxillary incisor inclination
Mandibular incisor inclination
Vertical Discrepancies
Deep bite (Overbite)
Infraclusion / Ankylosis
Anterior open bite
Posterior open bite
ADDITIONAL DENTAL ANOMALIES
Tooth rotations
Ectopic eruption
Prescription & Clinical Notes
Diagnostic Summary
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