Souminicpc /certified fixed orthodontic courses by Indian dental academy

INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com


NAME: Soumini
AGE : 27 YEARS
SEX

: FEMALE

CHIEF COMPLAINT : Forwardly placed teeth,
patient is not satisfied with her appearance

CLINICAL EXAMINATION RECORDS
•

ATHLETIC BUILD , MESOMORPHIC BODY TYPE,NORMAL GAIT AND
ERECT POSTURE
EXTRAORAL EXAMINATIONS:

•
•
•
•
•
•
•
•
•
•

SHAPE OF THE HEAD
FACIAL FORM
FACIAL PROFILE
FACIAL DIVERGENCE
FMA
MAXILLA
MANDIBLE
INCISOR VISIBILITY
LIPS
MENTALIS

- MESOCEPHALIC
- MESOFACIAL
- CONVEX
- POSTERIOR DIVERGENCE
- HIGH
- PROTRUSIVE
- RETRUSIVE
- 7 mm
- INCOMPETENT
- HYPERACTIVE


EXTRA ORAL PHOTOGRAPHS


INTRAORAL EXAMINATION
•
•
•

No. of teeth present -28
Periodontal status –normal
Tongue size-normal

Maxillary Arch • mild crowding
• U- shaped symmerical arch,

MandibularArch • mild crowding
• flat Curve of Spee
• U- shaped symmerical arch,

Antero-Posterior Relationship
Molar relationship - Angles’s Class I

Incisor relationship:
Overjet - 0
Overbite - 0 mm

(Edge to edge bite)

Canine relationship: Class I

LATERAL CEPHALOGRAM


OPG


STEINER’S ANALYSIS
ANGLES

PRE
TREATMENT

SNA

82°

86 °

SNB

80°

77°

ANB

2°

9°

Go Gn to SN

32°

39°

Occl. Pl to SN

SKELETAL

NORMAL
(RANGE)

14°

U1 to N-A(mm)

4mm

11mm

U1 to N-A (Angle)

22°

35 °

L1 to N-B (mm)

4mm

21mm

L1 to N-B (Angle)

25°

53°

Int. Inc. Angle

134°

84°

DENTAL


FEMALES
MEAN
S.D

LANDMARKS
CRANIAL BASE
Ar PTM (HP)
PTM-N (HP)

32.8 ±
50.9 ±

1.9
3.0

PATIENT VALUE

36mm
54mm

HORIZONTAL (Sk.)
2.6
-2.0
-6.9
-6.5

±
±
±
±

5.4
+2
4.3
5.1

18º
+1.5mm
-13mm
-14mm

±
±
±
±
±
±
±
±

2.4
3.3
2.2
5.0
1.7
1.8
1.3
1.9

52mm
69mm
47mm
32º
31mm
47mm
27mm
35mm

52.6 ±
3.5
46.8 ±
2.5
74.3 ±
5.8
7.2
±
1.9
122.0 ±
www.indiandentalacademy.com 6.9

58mm
39mm
78mm
6mm
135º

N-A-Pg angle
N-A (HP)
N-B (HP)
N-Pg (HP)
VERTICAL (Sk. and DENTAL)
N-ANS (HP)
ANS-Gn (HP)
PNS-N (HP)
MP-HP angle
Upper incisor –NF
Lower incisor-MP
Upper molar-NF
Lower molar-MP

50.0
61.3
50.6
24.2
27.5
40.8
23.3
32.1

MAXILLA –MANDIBLE
PNS-ANS (HP)
Ar-Go (linear)
Go-Pg(linear)
B-Pg (MP)
Ar-Go-Gn angle

WITT’S APPRAISAL:

Pretreatment:: AO ahead of BO by 5mm
Inference : Sk. Cl II

Female: BO ahead of AO by 0.10mm

Nasolabial angle- 92°

SOFT TISSUE ANALYSIS (HOLDAWAY)
MEAN
VALUE

PRE
TREATMENT

90°

82°

2.5 mm

4mm

-2 to+2mm

10 mm

7 - 15°

25°

12mm (max)

4mm

Upper sulcus depth

5mm

14mm

Upper lip thickness

15mm

12mm

Upper lip strain

14 – 16 mm

6mm

lower lip – H line

-2 1 ± 2mm

8mm

ANGLES

Facial angle
Upper lip curvature
Skeletal convexity to point A
H – line angle
Nose tip to H line

Lower sulcus depth

5mm

1mm

Diagnosis :
•

Angle’s Cl I molar relationship with bidentoalveolar protrusion on a Cl II
Skeletal base with normally positioned maxilla and retruded mandible

•

Edge to edge bite

•

Mild crowding in the upper and lower anteriors

•

Convex facial profile

•

High FMA

Treatment Objectives:
•

Alignment of upper/lower arches

•

Correction of dentoaleolar protrusiom

•

Enhancement of facial esthetics


Treatment Plan:
• Alignment using 0.22 Roth prescription bracket system.
• Surgical correction of upper and lower dentoalveolar
protrusion by
– Anterior maxillary segmental osteotomy
– Lower anterior subapical osteotomy

• Post surgical Orthodontics for finishing and detailing


Thank you
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Souminicpc /certified fixed orthodontic courses by Indian dental academy

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Souminicpc /certified fixed orthodontic courses by Indian dental academy