orthodontic case presentation
DESCRIPTION
Orthodontic Case PresentationTRANSCRIPT
ORTHODONTIC CASE PRESENTATION
Marwa Ibrahim Halalmeh Eman Khalid Nazzal
Rahaf Hasan Ibrahim
Malak Ali Abu-aquleh
PATIENT’S BIOGRAPHY
- Name : Rula Yaseen Wardat
- Age : 22
- Gender : Female
HISTORY
Chief Complaint :
-She doesn’t like her teeth shape
-crowding anteriorly
-facial asymmetry
History of Chief Complaint :
-With eruption of permanent teeth
Medical History :- Patient denied any medical problems
Dental History :- She wear a removable appliance 4 years ago for 1 year to expand her upper jaw - Uncomplicated previous extraction 3 years ago- Previous restoration 3 months ago
Social History & Habits :-None
Extra Oral Examination
Frontal view-Symmetrical:
Asymmetrical face
- LFH ratio:
increased
Profile View
Profile angle: ConvexSkeletal Class: Class IIFMPA: average
Soft Tissue Analysis
Lip: incompetentNasolabial angle: averageUpper lip: average Lower lips: prominent
¾ View
Intra Oral ExaminationOral Hygiene: Fair
Intra-arch:Teeth number : Upper: 14 lower: 12Crowding :Upper: severe crowdingLower: mild crowdingIncisor inclination :Upper: proclined Lower: averageOther :Buccally erupted upper canines
Inter-arch/occlusion:
Anterior-posterior relation:Overjet: increased 4mmIncicor relation: II division 1Canine relation:
Right: II by ¾ unit
Left: II by ½ unitMolare relation:
Right: II by ¼ unit
Left: II by ½ unit
Vertical relation:Anterior Open bite
Transverse relation:Unilateral Cross bite without displacementCentral line :
Lower non-coincident with the upper to the right by 2 mm
Upper occlusal
Lower occlusal
Study Cast
Study CastLowerLower UpperUpper
Space analysis on upper cast• Space available : 68 mm• Space required : 79.5 mm• There is deficiency 10.5 → sever crowding
Space analysis on lower cast• Space available : 63 mm• Space required : 65.5 mm• There is deficiency 2.5 → mild crowding
Total Bolton ratio : 86.51% ( normal 91% )
Anterior Bolton ratio : 80.5% ( normal 77.3% )
Space analysis
Panaromic Radiograph
Cephalometric Cephalometric
RadiographRadiograph
Cephalometric AnalysisMeasurements Normal Pts result
Antero-Postero Skeletal Relations
SNA 82±3 86 Prognathic maxilla
SNB 79±3 75 Retrognathic mandible
ANB 3±1 8 Increased
Wits measurement
0 female 3 Increased
A-B FOP 90±5 93 normal
Vertical Skeletal Relationship
MM Angle 27±5 24 Normal
LFH/TFH 50-55% 60 % Increased
Gonial angle 126±5 134 Increased
Dento-skeletal Relation
UI/MX PLANE 108±5 120 Increased
LI/MN PLANE 92±5 110 Increased Intericisal angle 133±10 112 Decreased
Diagnosis
Patient has Class II Division I incisors relation based on skeletal class II relationship.
Complicated by :•Class II canine relationships•Class II molar relationships•Convex profile angle•Anterior open bite•increased overjet•Midline of lower teeth is not coincident with the upper to the right by 2 mm•Unilateral cross bite (right)
Treatment Plan
Aims of treatment:
1- achieve Class I incisors relationship
2- relief crowding
3- achieve Class I molar and canine relationships
4- correct the cross bite
5- increase overbite
6- overjet reduction
Means of achieving aims:-fixed appliance (upper and lower) : - anchorage control by: Nance for upper arch Fixed for lower arch
- with extraction of: 4 4 7 5- retention by : Vaccum-formed Essix Retainer
5 and 7 are badly destructed teeth
Thank you