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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
THANK YOU!!!!!

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Kesling dagnostic setup

  • 1.
  • 3. CONTENTS  Introduction  Requirements  Procedure  Uses  Conclusion  Bibliography
  • 4. INTRODUCTION  Diagnosis Correct determination, discrimination, estimation & logical appraisal of conditions found during examination as evidenced by distinctive signs, marks & symptoms
  • 5. INTRODUCTION  Comprehensive database: Case history Clinical examination Study casts Radiographs Photographs  Diagnostic aids: Essential & Supplemental
  • 6. DIAGNOSTIC SETUP  H.D. Kesling (1956)  Supplemental diagnostic aid  Practical aid in treatment planning  Derive maximum clinical information  A set of trimmed & polished casts
  • 7. 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
  • 8. REQUIREMENTS  Well trimmed casts  Fret saw with blades  Modelling wax  Wax knife  Alcohol torch/ Spirit lamp
  • 9. 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
  • 10.
  • 11. 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
  • 12.
  • 13. 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
  • 14.
  • 15. 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
  • 16.
  • 17.
  • 18. 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
  • 19. 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
  • 20. CONCLUSION  Diagnostic setup – very valuable diagnostic aid  Routine use - better treatment plan & patient motivation
  • 21. 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