EUROPEAN SOCIETY
OF LINGUAL
ORTHODONTISTS
CANDIDATE NUMBER: 13 Dr. Masatoshi Sana
CASE NUMBER: 3
Year: 2010
ESLO 01
NAME:
BORN:
SEX:
PRETREATMENT RECORDS:
CLASSIFICATION:
TEETH MISSING BEFORE TREATMENT:
APPLIANCE:
TREATMENT STARTED:
TREATMENT ENDED:
ACTIVE TREATMENT TIME:
POSTTREATMENT RECORDS:
RETAINERS:
RETENTION ENDED:
AGE:43.4years
RETENTION TIME:
(POST-) RETENTION RECORDS:
TIME OUT OF RETENTION:
DATE16/4/2005
AGE:43.7years DATE:09/07/2005
AGE:46.1years DATE09/01/2008
a)Upper : Begg type retainer
a)upper:
b)lower:
DATE:29/01/2010
AGE:48.1years DATE: 29/01/2010
ESLO 02
03.12.1961
DATE09/01/2008
b)Lower : Begg type retainer
AGE:46.1years
RÉSUMÉ OF CASE 6
CLASS Ⅲ MALOCCLUSION CASE CATEGORY:
Chieko.I
F
0.6years
Adult malocclusion – Skeletal Cl Ⅲ malocclusion
18,28,38,48
Upper and lower lingual fixed orthodontic appliance( Kurz 7th)
2.6years
2.0years
DIAGNOSTIC DESCRIPTION
OF THE MALOCCLUSION
A. SUMMARY
B. EXAMINATION OF HEAD AND FACE
C. FUNCTIONAL EXAMINATION
D. INTRAORAL EXAMINATION
E. DENTAL CASTS
Maxillary arch: Arch length discrepancy: +2.6mm
Mandibular arch: Arch length discrepancy: +14.1mm
Occlusion Sagittal: Angle Class R)Ⅰ L) Ⅱ , Overjet -1.9mm
Occlusion Vertical: Overbite 3.6mm
Occlusion Transversal : Unilateral crossbite,menton was shifted to left 2.0mm
CANDIDATE NUMBER:13 DATE: 16/04/2005 AGE: 43.4years
ESLO 03
From latelal view,lower lip was protruded.
From frontal view,mandibular position was shifted to left.
Smile view was asymmetry.
TMJ mobility was no problem.
Patient’s mastication was dysfunction.
Speech was not clear.
CASE NUMBER: 3
Patient’s chief complaint is dysfunction of mastication.
Patient’s smile was disharmony.
1. Angle class R: ClⅠ, L: ClⅡ
2. Overjet -1.9mm , Overbite 3.6mm
3. Crossbite (11,21,22,26 / 31,32,33,36,41)
4. Spacing on the upper and lower arch (upper +2.6mm, lower +14.1mm )
5. 14,15,21,22,31,32,41 was supraversion
FRONTAL
45° PROFILE
ESLO 04
FACIAL PHOTOGRAPHS BEFORE TREATMENT
SMILE
CANDIDATE NUMBER:13 DATE: 16/04/2005 AGE: 43.4yearsCASE NUMBER: 3
vvvv
vvv
Right Buccal Left Buccal
Center
Upper Occlusal Lower Occlusal
ESLO 05
INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BEFORE TREATMENT
CANDIDATE NUMBER:13 DATE: 16/04/2005 AGE: 43.4yearsCASE NUMBER: 3
ESLO 06
LATERAL SKULL RADIOGRAPH BEFORE TREATMENT
CANDIDATE NUMBER:13 DATE: 16/04/2005 AGE: 43.4yearsCASE NUMBER: 3
ESLO 07
TRACING OF LATERAL SKULL RADIOGRAPH BEFORE TREATMENT
CANDIDATE NUMBER:13 DATE: 16/04/2005 AGE: 43.4yearsCASE NUMBER: 3
CEPHALOMETRIE
ANALYSE TWEED MERRYFIELD
ESLO 08!1
SNA 82°±2 80.5°
SNB 80°±2 83.0°
ANB 2°±2 -2.5°
FMA 25°±3 18.1°
IMPA 87°±3 86.5°
OP/F 10° 4.4°
Debut Tt
CANDIDATE NUMBER:13 DATE: 16/04/2005 AGE: 43.4yearsCASE NUMBER: 3
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 1
Pretreatment Mean SD Sagittal Skeletal Relations
Maxillary Position S-N-A
80.5° 82º ± 3.5º
Mandibular Position S-N-Pg 83.9° 80º ± 3.5º
Sagittal Jaw Relation A-N-Pg -3.4° 2º ± 2.5º
Vertical Skeletal Relations Maxillary Inclination S-N / ANS-PNS
10.2° 8º ± 3.0º
Mandibular Inclination S-N / Go-Gn 27.8° 33º ± 2.5º
Vertical Jaw Relation ANS-PNS / Go-Gn 18.3° 25º ± 6.0º
Dento-Basal Relations Maxillary Incisor Inclination 1 - ANS-PNS
117.3° 110º ± 6.0º
Mandibular Incisor Inclination 1 - Go-Gn 86.6° 94º ± 7.0º
Mandibular Incisor Compensation 1 - A-Pg (mm) 5.6mm 2 ± 2.0
Dental Relations Overjet (mm) -1.9mm 3.5 ± 2.5
Overbite (mm) 3.6mm 2 ± 2.5
Interincisal Angle 1 / 1 137.8° 132º ± 6.0º
ESLO 08-2
CANDIDATE NUMBER:13 DATE: 16/04/2005 AGE: 43.4yearsCASE NUMBER: 3
PERIAPICAL OR PANORAMIC RADIOGRAPHS
BEFORE TREATMENT
ESLO 09
CANDIDATE NUMBER:13 DATE: 16/04/2005 AGE: 43.4yearsCASE NUMBER: 3
ANY OTHER RADIOGRAPHS BEFORE TREATMENT
ESLO 10
CANDIDATE NUMBER:13 DATE: 16/04/2005 AGE: 43.4yearsCASE NUMBER: 3
RADIOGRAPHIC ANALYSIS
BEFORE TREATMENT
A. INTRAORAL / PANORAMIC RADIOGRAPH
B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT
ESLO 11
Upper and lower alveolar bone was resorbed.
36,37,46,47, were mesial tipping
18,28,38,48 were absence
CANDIDATE NUMBER:13 DATE: 16/04/2005 AGE: 43.4yearsCASE NUMBER: 3
1. Sagittal Skeletal Relations:
Maxillary position was in the normal range, but retrognathic tendency.
Mandibular position was protrusive.
( SNA 80.5°, SNB 83.9° ANB -2.5°)
2. Vertical Skeletal Relations:
Vertical jaw relation at ANS-PNS / Go-Gn was close.
3. Dento- Basal Relations:
Maxillary incisor was slightly, inclined to labial related ANS-PNS line.
( 1-ANS-PNS 17.3°)
Mandibular incisor was protrusive position related A-Pg line and inclined to
lingual related Go-Gn line.
( 1-Go-Gn: 86.6°, 1-A-Pg : 5.6mm)
4. Dental relations:
Anterior crossbite (11,21,22,26 / 31,32,33,36,41).
Overbite 3.6mm, Overjet -1.9mm.
At the end of jaw closing movement, premature contact was founded at
upper and lower incisors.
Mandibular was functional shifted to left.
5. Esthetic Profile:
Patient’s profile was concave.
Lower lip was protrusive.
TREATMENT PLAN
AND THE REASON FOR IT
ESLO 12-0
CANDIDATE NUMBER:13 DATE: 16/04/2005 AGE: 43.4yearsCASE NUMBER: 3
1, Indirect bonding both arches with lingual appliance.
(Kurz 7th brace)
2, Bite rising
3, Leveling
4, Expand upper arch and contract lower arch
5, Torqing
6, Detailing
This case was skeletal ClassⅢ, and patient’s chief complaint was
dysfunction of mastication.
The mesurement of sagittal skeletal relation ( ANB-2.5°) was mandibular
set back surgery indication.
On the other hand, dysfunction was caused from anterior cross bite with
functional jaw shift.
This treatment plan (without surgery) that contraction mandibular arch
and expand maxillary arch considered lead to improve patient’s dysfunction.
On the set up model before treatment space was remained on lower
arch, because of stable interdigitation and ideal incisal relation.
Treatment plan
The reason
INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BETWEEN TREATMENT
ESLO 12-1
Right Buccal Left Buccal
Center
Upper Occlusal Lower Occlusal
Upper : Ni-Ti (.014)
Lower : Ni-Ti (.012)
CANDIDATE NUMBER:13 DATE: 03/09/2005 AGE: 43.9yearsCASE NUMBER: 3
INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BETWEEN TREATMENT
ESLO 12-2
Right Buccal Left Buccal
Center
Upper Occlusal Lower Occlusal
Upper : TMA (.016!.022)
Lower : Ni-Ti (.016)
CANDIDATE NUMBER:13 DATE: 21/04/2007 AGE: 45.4yearsCASE NUMBER: 3
RÉSUMÉ OF THE TREATMENT CARRIED OUT
INCLUDING
ANY DIFFICULTIES ENCOUNTERED
ESLO 13
28.05.2005 Diagnosis
07.09.2005 Indirect binding to maxillary arch
(Kurz 7th brace / Ni-Ti.012 )
03.09.2005 Indirect bonding to mandibular arch
(Kurz 7th brace / Ni-Ti.012)
25.02.2006 Alignment maxillary and mandibular arch
(Ni-Ti.012~TMA.0175!.0175)
11.11.2006 Expand of maxillary arch
(Ni-Ti .016 !.022)
Contraction of mandibular arch
(TMA.0175!.0175~TMA.016!.022)
20.12.2006 Torqing (TMA.016!.022)
03.02.2007 Detailing (Ni-Ti .016~S.S.016!.016)
09.01.2008 Remove the appliances
Started retention
CANDIDATE NUMBER:13 DATE: 09/01/2008 AGE: 46.1yearsCASE NUMBER: 3
ESLO 14
FACIAL PHOTOGRAPHS AT COMPLETION OF TREATMENT
FRONTAL
45° PROFILE
SMILE
CANDIDATE NUMBER:13 DATE: 09/01/2008 AGE: 46.1yearsCASE NUMBER: 3
vvvv
vvv
INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION AT COMPLETION OF TREATMENT
ESLO 15
Right Buccal Left Buccal
Center
Upper Occlusal Lower Occlusal
CANDIDATE NUMBER:13 DATE: 09/01/2008 AGE: 46.1yearsCASE NUMBER: 3
ESLO 16
LATERAL SKULL RADIOGRAPH
AT COMPLETION OF TREATMENT CANDIDATE NUMBER:13 DATE: 09/01/2008 AGE: 46.1yearsCASE NUMBER: 3
TRACING OF LATERAL SKULL RADIOGRAPH
AT COMPLETION OF TREATMENT
ESLO 17-1
CANDIDATE NUMBER:13 DATE: 09/01/2008 AGE: 46.1yearsCASE NUMBER: 3
SUPERIMPOSITION AT SN-S
ESLO 17-2
CANDIDATE NUMBER:13 DATE: 09/01/2008 AGE: 46.1yearsCASE NUMBER: 3
ESLO 17-3
SUPERIMPOSITIONS of MAXILLA , MANDIBULE , PROFILE
CANDIDATE NUMBER:13 DATE: 09/01/2008 AGE: 46.1yearsCASE NUMBER: 3
Palatal Plane at ANS
Mandibular Plane at Me
S-N at S
ESLO 18!1
CEPHALOMETRIE
ANALYSE TWEED MERRYFIELD
Debut Tt Fin Tt
SNA 82°±2 80.5° 80.7°
SNB 80°±2 83.0° 82.9°
ANB 2°±2 -2.5° -2.2°
FMA 25°±3 18.1° 19.0°
IMPA 87°±3 86.5° 83.1°
OP/F 10° 4.4° 4.8°
CANDIDATE NUMBER:13 DATE: 09/01/2008 AGE: 46.1yearsCASE NUMBER: 3
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 2
ESLO 18-2
Pretreatment Posttreatment Mean SD Sagittal Skeletal Relations
Maxillary Position S-N-A
80.5° 80.7° 82º ± 3.5º
Mandibular Position S-N-Pg 83.9° 84.3° 80º ± 3.5º
Sagittal Jaw Relation A-N-Pg -3.4° -3.6° 2º ± 2.5º
Vertical Skeletal Relations Maxillary Inclination S-N / ANS-PNS
10.2° 10.0° 8º ± 3.0º
Mandibular Inclination S-N / Go-Gn 27.8° 28.5° 33º ± 2.5º
Vertical Jaw Relation ANS-PNS / Go-Gn 18.3° 19.1° 25º ± 6.0º
Dento-Basal Relations Maxillary Incisor Inclination 1 - ANS-PNS
117.3° 119.8° 110º ± 6.0º
Mandibular Incisor Inclination 1 - Go-Gn 86.6° 83.3° 94º ± 7.0º
Mandibular Incisor Compensation 1 - A-Pg (mm) 5.6mm 3.0mm 2 ± 2.0
Dental Relations Overjet (mm) -1.9mm 1.6mm 3.5 ± 2.5
Overbite (mm) 3.6mm 1.9mm 2 ± 2.5
Interincisal Angle 1 / 1 137.8° 137.7° 132º ± 6.0º
CANDIDATE NUMBER:13 DATE: 09/01/2008 AGE: 46.1yearsCASE NUMBER: 3
PERIAPICAL OR PANORAMIC RADIOGRAPHS
AT COMPLETION OF TREATMENT
ESLO 19
CANDIDATE NUMBER:13 DATE: 09/01/2008 AGE: 46.1yearsCASE NUMBER: 3
ESLO 19-1
CANDIDATE NUMBER:13 DATE: 09/01/2008 AGE: 46.1yearsCASE NUMBER: 3
ANY OTHER RADIOGRAPHS AT COMPLETION OF TREATMENT
RADIOGRAPHIC ANALYSIS AT
COMPLETION OF TREATMENT
A. INTRAORAL / PANORAMIC RADIOGRAPH
B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT
ESLO 20
CANDIDATE NUMBER:13 DATE: 09/01/2008 AGE: 46.1yearsCASE NUMBER: 3
・ Teeth were consolidated on the maxillary and mandibular arch.
・ Maxillary arch was expanded (16~26 :42.6mm" 43.7mm )
・ Mandibular arch was contracted (36~46 :42.9mm" 39.2mm)
・ Alveolar bone level was no change.
・ No root resorption
1. Sagittal Skeletal Relations:
No significant change compared with before treatment.
( SNA 80.5°"80.7°, SNB 83.0°"84.3°, ANB -2.5 °" -2.2°)
2. Vertical Skeletal Relations:
Vertical relation related ANS-PNS / Go-Gn was slightly increased.
(18.3°"19.1°)
3. Dento-Basal Relations:
Maxillary incisor inclined to labial.
Mandibular incisor inclined to lingual.
( 1-ANS-PNS 117.3°"119.8°, 1-Go-Gn 86.6°"83.3°)
4. Dental relations:
Overbite 3.6mm"1.9mm, Overjet -1.9mm"1.6mm,
Midline discrepancy was improved.
5. Esthetic Profile:
Patient’s profile was changed to straight.
DESCRIPTION OF THE
TREATMENT RESULT
ESLO 21-1
1) Patient’s smile is harmonious.
2) ClassⅠ relationship
3) Midline discrepancy was improved
4) Crossbite was corrected
5) Retention: Upper : Begg type retainer
Lower : Begg type retainer with artificial tooth for
space retain
CANDIDATE NUMBER:13 DATE: 09/01/2008 AGE: 46.1yearsCASE NUMBER: 3
TREATMENT RESULT ORIENTATION
DESCRIPTION OF THE
POST-TREATMENT EVALUATION
OF RETENTION
ESLO 21-2
1) Retaining goal : Begg type retainer was two years totally.
( upper and lower)
After 6 months retention , prosthetic restoration
to the mandibular arch.
2) Occlusoin is stable
3) Teeth positions are stable
CANDIDATE NUMBER:13 DATE: 09/01/2008 AGE: 46.1yearsCASE NUMBER: 3
RETENTION RESULT ORIENTATION
ESLO 22
FACIAL PHOTOGRAPHS AT RETENTION / POST RETENTION
FRONTAL
45° PROFILE
SMILE
CANDIDATE NUMBER:13 DATE: 29/01/2010 AGE: 48.1yearsCASE NUMBER: 3
vvvv
vvv
INTRA-ORAL COLOUR PHOTOGRAPHS AT RETENTION / POST-RETENTION
ESLO 23
Right Buccal Left Buccal
Center
Upper Occlusal Lower Occlusal
CANDIDATE NUMBER:13 DATE: 29/01/2010 AGE: 48.1yearsCASE NUMBER: 3
PERIAPICAL OR PANORAMIC RADIOGRAPHS
AT RETENTION / POSTRETENTION
ESLO 24-1
CANDIDATE NUMBER:13 DATE: 29/01/2010 AGE: 48.1yearsCASE NUMBER: 3
ESLO 24-2
CANDIDATE NUMBER:13 DATE: 29/01/2010 AGE: 48.1yearsCASE NUMBER: 3
ANY OTHER RADIOGRAPHS AT RETENTION / POSTRETENTION
RADIOGRAPHIC ANALYSIS
AT RETENTION/POSTRETENTION
A. INTRAORAL / PANORAMIC RADIOGRAPH
B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT
ESLO 24-3
CANDIDATE NUMBER:13 DATE: 29/01/2010 AGE: 48.1yearsCASE NUMBER: 3
Teeth positions and roots stay parallel.
Alveolar bone level was stable.
1. Sagittal Skeletal Relations:
ldem page 20 = stable
2. Vertical Skeletal Relations:
ldem page 20 = stable
3. Dento- Basal Relations:
ldem page 20 = stable
4. Dental relations:
ldem page 20 = normal and stable overjet & overbite
5. Esthetic Profile:
ldem page 20 = stable
ESLO 24-4
CANDIDATE NUMBER:13 DATE: 29/01/2010 AGE: 48.1yearsCASE NUMBER: 3
LATERAL SKULL RADIOGRAPH AT RETENTION / POSTRETENTION
ESLO 25-1
CANDIDATE NUMBER:13 DATE: 29/01/2010 AGE: 48.1yearsCASE NUMBER: 3
TRACING OF LATERAL SKULL RADIOGRAPH
AT RETENTION / POST-RETENTION
SUPERIMPOSITION AT SN-S
ESLO 25-2
CANDIDATE NUMBER:13 DATE: 29/01/2010 AGE: 48.1yearsCASE NUMBER: 3
SUPERIMPOSITIONS of MAXILLA,MANDIBULE,PROFILE
Palatal Plane at ANS
Mandibular Plane at Me
S-N at S
ESLO 25-3
CANDIDATE NUMBER:13 DATE: 29/01/2010 AGE: 48.1yearsCASE NUMBER: 3
ESLO 26-1
CEPHALOMETRIE
ANALYSE TWEED MERRYFIELD
Debut Tt Fin Tt
SNA 82°±2 80.5° 80.7° 80.8°SNB 80°±2 83.0° 82.9° 82.7°ANB 2°±2 -2.5° -2.2° -1.9°FMA 25°±3 18.1° 19.0° 18.6°IMPA 87°±3 86.5° 83.1° 84.0°OP/F 10° 4.4° 4.8° 5.4°
Fin Cont
CANDIDATE NUMBER:13 DATE: 29/01/2010 AGE: 48.1yearsCASE NUMBER: 3
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 3
ESLO 26-2
Pretreatment Posttreatment Retention/ Postretention
Mean SD
Sagittal Skeletal Relations Maxillary Position S-N-A
80.5° 80.7° 80.8° 82º ± 3.5º
Mandibular Position S-N-Pg 83.9° 84.3° 84.0° 80º ± 3.5º
Sagittal Jaw Relation A-N-Pg -3.4 -3.6 -3.2 2º ± 2.5º
Vertical Skeletal Relations Maxillary Inclination S-N / ANS-PNS
10.2° 10.0° 10.1° 8º ± 3.0º
Mandibular Inclination S-N / Go-Gn 27.8° 28.5° 28.1° 33º ± 2.5º
Vertical Jaw Relation ANS-PNS / Go-Gn 18.3° 19.1° 18.3° 25º ± 6.0º
Dento-Basal Relations Maxillary Incisor Inclination 1 - ANS-PNS
117.3° 119.8° 119.5° 110º ± 6.0º
Mandibular Incisor Inclination 1 - Go-Gn 86.6° 83.3° 83.9° 94º ± 7.0º
Mandibular Incisor Compensation 1 - A-Pg (mm) 5.6mm 3.0mm 2.6mm 2 ± 2.0
Dental Relations Overjet (mm) -1.9mm 1.6mm 2.0mm 3.5 ± 2.5
Overbite (mm) 3.6mm 1.9mm 2.0mm 2 ± 2.5
Interincisal Angle 1 / 1 137.8° 137.7° 138.3° 132º ± 6.0º
CANDIDATE NUMBER:13 DATE: 29/01/2010 AGE: 48.1yearsCASE NUMBER: 3
DESCRIPTION OF RETENTION /
POST-RETENTION FINDINGS
ESLO 27
1) Occlusion is stable
2) Teeth positions are stable
3) Patient dysfunction of mastication and speech were improved
CANDIDATE NUMBER:13 DATE: 29/01/2010 AGE: 48.1yearsCASE NUMBER: 3
LONG TREM RETENTION RESULT ORIENTATION