First of all, the chief complaint:

Second, the current medical history:

Third, the past history:

Fourth, the family history:

Verb (abbreviation for verb) Clinical examination:

1. General situation: height _ _ _ _ cm weight _ _ _ _ kg CVS-one □ two □ three □ four □ growth period.

Sexual characteristics: obviously unclear but not obvious □

2. Oral profile:

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Dental caries: premature tooth loss: retention of deciduous teeth: others:

3. Type: deciduous teeth □ permanent teeth with undefined dentition □

4. Molar relation: neutral □ proximal □ distal □

5. Anterior overbite: normal Ⅰ Ⅱ Ⅲ occlusal gingiva:+-

6. Anterior tooth coverage: normal I Ⅱ Ⅲ _ _ _ _ mm.

7. Anterior tooth opening: No Ⅰ Ⅱ Ⅲ _ _ _ _ mm.

8. dentition crowding: the upper dental arch is I ⅱ ⅲ _ _ _ _ _ mm.

Lower dental arch Ⅰ Ⅱ Ⅲ _ _ _ _ mm

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9. Burton index: anterior tooth ratio _ _ _ _% and total tooth ratio _ _ _ _%

10. Wrong tooth:

1 1. midline: normal maxilla □ left deviation _ _ mm right deviation _ _ mm normal mandible □ left deviation _ _ mm right deviation _ _ _ mm

12. Maxillary body: normal maxilla → protrusion → retraction → normal mandible → protrusion with undefined retraction □

13. Alveolar bone: full maxilla □ not full □ depressed mandible □ full □ not full □ depressed unknown □

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14. Transverse curve: maxillary normal □ flat □ reverse □ mandibular normal □ flat undefined reverse □

Informed consent of invisible correction

Dear patient (or patient's guardian):

Your orthodontist will try his best to provide you with the best transparent and invisible orthodontic service. In order to ensure the smooth application of invisible appliance as expected, it is necessary for you to have a correct understanding and understanding of orthodontic related matters.

First of all, good cooperation is the key to successful treatment. You need to know:

1, worn normally, except for eating, brushing teeth and using teeth.

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The stitches must be removed and the appliance must be worn for more than 22 hours every day. because

Only when you wear the invisible appliance will it play a corrective role. must

2. Because the invisible appliance moves the teeth step by step in a certain order, it is necessary to wear and replace the appliance according to the doctor's advice and the number of the appliance. Usually, the wearing time of each appliance is 12 weeks. Please follow the doctor's advice. If the wearing time is less than 22 hours a day, the wearing time of each pair of appliances needs to be extended for several days, reaching 1 week. Never wear braces indiscriminately.

Please keep at least 3 pairs of recently used electrical appliances and store the corresponding numbers in the box.

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In order to prevent the currently used appliances from being accidentally lost, damaged or unable to be put back in place. In these cases, your orthodontist may find and reuse a pair of severely worn appliances in reverse order to maintain the current orthodontic results.

4. If you can't wear the appliance according to the wearing time, the orthodontic cycle will be prolonged and the orthodontic effect will be difficult to guarantee. The consequences are borne by the patient.

Please follow up regularly according to the doctor's advice. If you don't keep the agreement, the doctor can't guarantee the correction effect. Rescheduling or postponing treatment due to this incident should obtain the doctor's consent. Those who fail to return for more than 6 months without reason are regarded as giving up treatment automatically, and the consequences arising therefrom are borne by the patients themselves.

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6. When wearing the appliance for the first time, there will be slight foreign body sensation, increased saliva secretion and uncomfortable pronunciation. Generally, it will ease or disappear in a few days.

7. After wearing the appliance for the first time or wearing a new appliance, the teeth may have slight pain, looseness, decreased chewing power, etc. It is a normal corrective reaction and will generally be relieved or disappeared within 3 or 4 days. If you have other serious discomfort, please contact your doctor as soon as possible.

8. Maintaining oral hygiene is of great significance to the success of orthodontic treatment. Therefore, in the process of orthodontic treatment, please keep good oral hygiene habits and keep the appliance clean. If the appliance is not cleaned well, its transparency and aesthetics will be reduced.

9, according to the needs of correction, often on some of your teeth.

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Some small accessories with the same or similar color to the teeth are bonded to the teeth, which is beneficial to the retention of the appliance and the effective movement of the teeth These attachments are almost invisible. If you refuse to paste the attachment, the modification effect may be affected.

10. Try to gently bite the upper and lower teeth together at ordinary times (but don't bite your teeth), especially in the first 3-4 days after each replacement of a new invisible appliance. This can make the appliance better in place and give full play to its correction efficiency.

1 1. Please read the instructions of the contact tools carefully before use, so as to fully understand the disassembly, cleaning and storage of the contact tools.

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12. In some cases, it may be necessary to modify the design of existing devices or add several more devices. If necessary, doctors do not rule out the use of conventional fixed appliances to end the follow-up treatment of patients.

Informed consent for early correction

Dear patient (or patient's guardian):

As your child's doctor, we will treat your child with the most appropriate corrective methods and quality medical services. However, orthodontic treatment is a process with complex technology and long course of treatment, and the curative effect is closely related to the cooperation of children. In order to obtain good and stable curative effect, you need to understand and pay attention to the following problems in orthodontic treatment:

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1. Early correction and treatment of malocclusion in children is to correct malocclusion as soon as possible and make children's teeth and jaws develop in a normal direction. The formation of malocclusion in children is complicated, in which skeletal and hereditary malocclusion children are prone to relapse with their growth and development, and systematic orthodontic treatment should be received after tooth replacement to improve the quality of life of patients to the greatest extent.

To the beauty of teeth and face.

2. The movement of teeth in the jaw is a slow process. The length of treatment is closely related to the degree of malocclusion, cooperation and the age of the child. Children need to adhere to the appliance according to the doctor's advice in order to achieve the desired effect. If bad habits are corrected at the same time, they will be worn for a long time: after correcting bad habits, parents should supervise their children at any time to prevent recurrence.

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3. Early correction of malocclusion in children may not be completely cured, but it can reduce the degree of malocclusion, and at the same time help to alleviate or eliminate the persistent influence of bad habits on dentition, which is conducive to later orthodontic treatment.

4. Continuous and reasonable orthodontic force can make teeth move in the right direction and speed. Children should see a doctor in time according to the doctor's appointment time to ensure the treatment effect.

5, just wearing the appliance will have a certain impact on chewing pronunciation, there will be discomfort or slight pain, children should insist on wearing.

6. Symptoms such as slight loosening of teeth and discomfort of temporomandibular joint may occur during orthodontic treatment, and most of them belong to this genus.

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For the temporary reaction during the treatment, the child needs to see a doctor in time and adjust the correction device, and can gradually recover after the correction is completed. If the loosening is abnormal or the symptoms of temporomandibular joint discomfort are obvious, the child can terminate the treatment.

7. During the treatment, the doctor will monitor the various conditions of the child's deformity at any time, modify the treatment design as appropriate, and the treatment expenses that have occurred will not be refunded.

8. Pay attention to oral hygiene when wearing the appliance to prevent dental caries and gingivitis. In addition to brushing your teeth after meals, you should also remove the movable appliance and brush it carefully with a toothbrush.

9. When movable appliances cannot be worn for some reason, they should be soaked in cold water and cannot be dried to prevent deformation and scrapping.

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10, the above items do not include unpredictable situations that may occur.

1 1, case data The patient's medical records, dental casts, photos and X-rays are the important basis for the hospital to diagnose, design, control the treatment process and observe the recurrence, all of which are kept by the hospital according to national regulations.

Name _ _ _ _ _ _ _ Sex _ _ _ _ _ Date of birth (year/month/day) _ _ _ _ _ _ _ _ _ _ _ _

The doctor has told me that my child's dental condition is _ _ _ _ _ _ _ _ _.

The doctor has explained to me various treatment options, including no treatment.

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I have no difficulty in reading and understanding Chinese, nor in language communication. The doctor has explained the above contents to me in detail, and I fully understand the method, time, cost, precautions, possible complications and all the contents of the whole treatment process. I am willing to bear the possible risks when the doctor treats my child, follow the doctor's advice, cooperate with the doctor to complete all the treatments, and agree to pay all the necessary expenses. I agree with the doctor to use my medical records and photos for non-commercial medical research and academic exchanges.

Children can't sign the informed consent form, please ask their authorized agent (parents must sign here).

Signature of client/legal guardian: _ _ _ _ _ Relationship with patient: _ _ _ _ _ _ _

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ID number: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

As an attending doctor, I promise: I will treat patients with good medical ethics, strictly abide by medical operation norms, do my best to avoid and prevent complications, and strive to minimize risks.

Doctor's signature: _ _ _ _ _ _ _ Date: MM DD YY.

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How to write the medical record of orthodontic spring