KESLING DIAGNOSTIC SETUP

DEEPTHI P.R. IV YEAR BDS

CONTENTS

Introduction Requirements Procedure Uses Conclusion Bibliography

INTRODUCTION

Diagnosis

Correct determination, discrimination, estimation & logical appraisal of conditions found during examination as evidenced by distinctive signs, marks & symptoms

INTRODUCTION

Comprehensive database: Case history Clinical examination Study casts Radiographs Photographs

Diagnostic aids: Essential & Supplemental

DIAGNOSTIC SETUP

H.D. Kesling (1956) Supplemental diagnostic aid Practical aid in treatment planning Derive maximum clinical information A set of trimmed & polished casts

DIAGNOSTIC SETUP

Individual teeth & associated alveolar processes- sectioned off & replaced in desired positions

Simulate the various planned tooth movements

Not necessary to coordinate with cephalometric tracing

Allowance for inevitable anchorage loss

REQUIREMENTS

Well trimmed casts Fret saw with blades Modelling wax Wax knife Alcohol torch/ Spirit lamp

PROCEDURE

Maxillary & mandibular study casts prepared

Bases trimmed parallel to the occlusal plane

Horizontal cuts made in the mandibular cast 3mm below the gingival margin using

Fretsaw blade

PROCEDURE

Vertical cuts are made to separate individual teeth

All teeth except second & third molars are removed

Mesial & distal ends of roots of teeth are trimmed – seating in new position

PROCEDURE

Wax blocks placed in the slits formed while cutting the teeth away

Mandibular incisors arranged on the study cast at an angle of 65 degrees to the Frankfort Horizontal plane

Canines & premolars are placed in the correct contact relationships

PROCEDURE

If the remaining space is inadequate to receive the first molars extraction indicated

Eliminate 1st premolars from the setup & place 2nd premolars in contact with canine or perform incisor or proximal stripping

Maxillary teeth cut & repositioned in the wax setup articulating them with the mandibular setup

USES

TSALD – directly visualised

Estimates if uprighting of the 2nd molars could solve the arch length discrepancy

Visualizes complex orthodontic treatment

Possibility of aligning incisors

USES

Borderline cases: Extraction / non extraction 1st premolar or 2nd premolar

Possible types of occlusal arrangement in abnormal occlusal problems

Patient can be motivated- simulating various corrective procedures

CONCLUSION

Diagnostic setup – very valuable diagnostic aid

Routine use - better treatment plan & patient motivation

BIBLIOGRAPHY

Textbook of Orthodontics- Gurkeerat Singh, 2nd edition

Orthodontics- The Art and Science- S.I. Bhalajhi, 4th edition

Textboook of Orthodontics- M.S. Rani, 3rd edition

Prep Manual for Undergraduates- Sridhar Premkumar

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