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Hypodivergent x Hyperdivergent
Hi,
I have a general question, not specifically about one case, but I have seen often practicing for the exam.
Whenever we have a case where cephalometric values show clearly that patient is hypodivergent, but patient does not have the “usual” facial characteristics of a hypodivergent patient (such as deep bite, short lower facial third, etc) should we diagnose based on the cephalometric values if they ask what is the skeletal diagnosis? Taking in consideration that sella-nasio is not steep and FMA also is low.
I have seen some patients like that where just by looking the ceph it doesn`t strike as a classic hypodivergent, but the values show different. And if I would not have the ceph and only looking to the facial characteristics I would describe even as a hyperdivergent.
Thank you for the help!
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2 Replies
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Maria,
Great question here!
You bring a great point here about the classic “clusters” of diagnoses that typically present together.
1) Those are great things to keep in mind and can help you rattle off common things when you see an item that triggers thoughts for you.
2) Be mindful that the ABO examples and directions say to list things out individually. These are essentially bullet points. So I would caution you to not right “Hypodivergent” only and assume that includes “deepbite; short lower 1/3; etc.” Each of those items are their own bullet point.
3) Remember to separate items using the Ackerman/Proffitt scheme of 3 Dimensions and 3 Tissues. So comment on Skeletal Vertical and Dental Vertical separately. So if the FMA / SN-MP is hypodivergent then they are hypodivergent (a skeletal vertical term). Now as a mentor has said “Patients can have as many diseases as they pleases”… so they could have either a “deepbite”, “openbite” or “normal overbite” as their dental vertical diagnosis.
Does that help?
I know in some folks practices they will simply write for a patient “Class II Div 2, hypodivergent, moderate crowding max/man” and that is all the diagnostic narrative that is in a patient’s chart because it gives them all the information they need for treatment with their systems/mechanics. This is more detailed and systematic so that the orthodontists reviewing your answers understand your diagnosis.
Thanks! Keep it up!
Carter
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Thank you so much for your detailed answer!
Yes that helps a lot! I will definitely separate the thoughts in bullet points.
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