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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!!!!!