EUROPEAN SOCIETY OF LINGUAL ORTHODONTISTS · - decided not to extract #34, to prevent over-retraction of lower incisors and make the mechanics easier [leave solid molar relations

CANDIDATE NAME: Joel Blustein

CASE NUMBER:

Year:2010

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EUROPEAN SOCIETYOF LINGUAL

ORTHODONTISTS

NAME:Talia Nisim

BORN: 23/4/78

SEX: F

PRETREATMENT RECORDS:

CLASSIFICATION: Angle class 2/1 subdivision

TEETH MISSING BEFORE TREATMENT:

APPLIANCE: incognito upper and lower

TREATMENT STARTED:

TREATMENT ENDED:

ACTIVE TREATMENT TIME: 24 months

POSTTREATMENT RECORDS:

RETAINERS:

RETENTION ENDED:

AGE:28-5

RETENTION TIME:

(POST-) RETENTION RECORDS:

TIME OUT OF RETENTION:

DATE: sept 2006

AGE: 28-5 DATE: oct. 2006

AGE: 30-6 DATE:october 2008

a)upper: hawley

a)lower: fixed

a)Upper continue:

a)Lower fixed:

DATE: nov. 2008

DATE:

AGE: DATE:

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RÉSUMÉ OF CASE 4RÉSUMÉ OF CASE 4

CLASS II DIVISION 1 MALOCCLUSIONCASE CATEGORY:

HIGH FRANKFORT MANDIBULAR PLANE ANGLE, MINIMUM

FM ANGLE OF 30° AND/OR SN TO Go-Gn ANGLE OF 37°

s.rys

Tampon

DIAGNOSTIC DESCRIPTION

OF THE MALOCCLUSION

DIAGNOSTIC DESCRIPTION

OF THE MALOCCLUSION

A. SUMMARY

28 y old female, Angle class 2/1 subdivision left, lower incisor crowding

Tooth 22 after apicectomy, crown on #24, decalcification spot on #31.

narrow and elongated dental arches, incomplete overbite

B. EXAMINATION OF HEAD AND FACE

C. FUNCTIONAL EXAMINATION

D. INTRAORAL EXAMINATION

E. DENTAL CASTS

Mandibular arch: moderate incisor crowding

Maxillary arch: mild incisor crowding

Occlusion Sagittal: Angle class 1 right side, Angle class 2 left side

Occlusion Vertical: incomplete overbite

Occlusion Transversal: lingual and palatal inclination of posterior segments i

in both arches

Dolichofacial face

Convex, small nasolabial angle

Good pogonion

-No functional shift, solid buccal occlusion

- no TMJ symptoms

Overjet: 8 mm, Overbite: 3 mm

Lower midline shifted to the left

Large amount of restorations

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CANDIDATE NUMBER: DATE: AGE:CASE NUMBER:

FRONTAL 45°

PROFILE

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FACIAL PHOTOGRAPHS BEFORE TREATMENTCANDIDATE NUMBER: CASE NUMBER: DATE: sept 2006 AGE: 28-5

FRONTAL smile

DATE: sept 2006 AGE: 28-5CANDIDATE NUMBER: CASE NUMBER:

Right Buccal Left Buccal

CenterUpper Occlusal Lower Occlusal

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INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BEFORE TREATMENT

CANDIDATE NUMBER: CASE NUMBER: DATE: sept 2006 AGE: 28-5

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LATERAL SKULL RADIOGRAPH BEFORE TREATMENT

Print on transparent support

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TRACING OF LATERAL SKULL RADIOGRAPHBEFORE TREATMENT


Pre-treatment

Mean SD

Sagittal Skeletal

Maxillary PositionS-N-A

76 82º ±3.5º

Mandibular PositionS-N-Pg

73 80º ± 3.5º

Sagittal Jaw RelationA-N-Pg

5 2º ± 2.5º

Vertical Skeletal

Relations

Maxillary InclinationS-N/ANS-

PNS

10 8º ± 3.0º

Mandibular Inlination

S-N/Go-Gn

40 33º ± 2.5º

CEPHALOMETRIC MORPHOLOGICAL

ASSESSMENT 1


ASSESSMENT 1

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Pre-treatment

Mean SD

Vertical Jaw Relation

ANS-PNS/Go-Gn

30

25º ± 6.0º

Dento-Basal

Relations

Maxillary Incisor

Inclination1-ANS-PNS

116

110º ± 6.0º

Mandibular Incisor

Inclination1-Go-Gn

9194º ± 7.0º


ASSESSMENT 1


ASSESSMENT 1

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Mandibular Incisor

Compensation1 –A-Pg (mm) 0

2 ± 2.0

Dental Relations

Overjet (mm) 8 2º ± 2.0

Overbite (mm) 3 2 ± 2.5

Interincisal Angle

1/1

121132º ± 6.0º


ASSESSMENT 1


ASSESSMENT 1

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PERIAPICAL OR PANORAMIC RADIOGRAPHS

BEFORE TREATMENT

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RADIOGRAPHIC ANALYSIS

BEFORE TREATMENT

RADIOGRAPHIC ANALYSIS

BEFORE TREATMENT

A. INTRAORAL / PANORAMIC RADIOGRAPH

- Missing #38, all other 3rd molars erupted

- #24: root canal tx

#22 : root canal tx & apicectomy

No pathologies in TMJ

B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT

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Good skeletal relations in sagittal plane

Hyperdivergent skeletal pattern, high mandibular plane angle

Good position of lower incisor, proclination of upper incisor

Good soft-tissue and hard-tissue pogonion

CANDIDATE NUMBER: DATE: sept 2006 AGE:28-5CASE NUMBER:

TREATMENT PLAN

AND THE REASON FOR IT

TREATMENT PLAN

AND THE REASON FOR IT

Plan:

-Extraction of teeth 14,24,44 to correct overjet and lower midline shift.

- decided not to extract #34, to prevent over-retraction of lower incisors

and make the mechanics easier [leave solid molar relations in left side][.

Occlusal goals:

-Leave molar relations on left side, and reach Angle class 1 relations

on right side

-Acheive canine Angle class 1 relations on both sides.

-Get ovoid shape on both arches.

- correct lower midline, reach good overbite and overjet.

Mechanics:

-Class 1 mechanics on right side, class 2 mechanics on left side

- control upper incisor torque as possible.

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CANDIDATE NUMBER: CASE NUMBER: DATE: sept 2006 AGE:28-5



INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION -bonding

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CANDIDATE NUMBER: CASE NUMBER: DATE: oct 2006 AGE:28-6



INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION -9 months in treatment

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CANDIDATE NUMBER: CASE NUMBER: DATE:july 2007 AGE:29-3

Right Buccal

CenterLower Occlusal

Left Buccal

Upper Occlusal

INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION – 18 months in treatment

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CANDIDATE NUMBER: CASE NUMBER: DATE:april 2008 AGE:30-0



INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION – 24 months in treatment

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CANDIDATE NUMBER: CASE NUMBER: DATE: oct 2008 AGE: 30-6

RÉSUMÉ OF THE TREATMENT CARRIED OUT

INCLUDING

ANY DIFFICULTIES ENCOUNTERED

RÉSUMÉ OF THE TREATMENT CARRIED OUT

INCLUDING

ANY DIFFICULTIES ENCOUNTERED

9.2006: Bonding of upper arch, niti 016

10.2006: Bonding of lower arch, niti 016

11.2006: upper arch niti 016x022,

2.2007: upper arch s.s. 016x022, lower arch niti 016x022

3.2007: lower arch s.s. 016x022

5.2007: start class 2 elastics, chain on lower-right

to shift the midline

10.2007: chains both arches. problem : torque spring on #31

[labial crown torque]

1.2008: problem: need to burn anchorage on left side- class 3 elastics on left side

class 2 elastics on right side.

4.2008- 8.2008: problems: 1. opening of the bite in posterior segments.

buttons on buccal aspects and vertical elastics to settle the bite.

2. incisal edge alignment of #31 occurs with over-torque of #31-

took out torque spring.

6.2008: problems: 1. loss of anterior torque- upper arch TMA 017x025

2. crossbite 1st and 2nd molars right side- cross elastics.

10.2008: debonding, 2 essix aplliances. Sent to restore #22 and #25.

2.2009: fixed lower retainer.

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CANDIDATE NUMBER: DATE: AGE:CASE NUMBER:

FRONTAL 45°

PROFILE

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FACIAL PHOTOGRAPHS AT COMPLETION OF TREATMENT

CANDIDATE NUMBER: CASE NUMBER: DATE: feb 2009 AGE: 30-10

FRONTAL smile after treatment FRONTAL smile after restoring 22, 25

CANDIDATE NUMBER: DATE: feb 2009 AGE: 30-10CASE NUMBER:



INTRA-ORAL COLOUR PHOTOGRAPHS OF THEOCCLUSION AT COMPLETION OF TREATMENT

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CANDIDATE NUMBER: DATE: feb 2009 AGE: 30-10CASE NUMBER:



INTRA-ORAL COLOUR PHOTOGRAPHS OF THEOCCLUSION after restoring 22, 25

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CANDIDATE NUMBER: CASE NUMBER: DATE: june 2009 AGE: 31-2

LATERAL SKULL RADIOGRAPH

AT COMPLETION OF TREATMENT

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TRACING OF LATERAL SKULL RADIOGRAPH


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Pre-treatment

Post-treatment

73

69

2

10

Mean SD

Sagittal Skeleatal

Maxillary PositionS-N-A

76 82º ±3.5º

Mandibular PositionS-N-Pg

73 80º ± 3.5º

Sagittal Jaw RelationA-N-Pg

5 2º ± 2.5º

Vertical Skeletal

Relations

Maxillary InclinationS-N/ANS-

PNS

10 8º ± 3.0º

Mandibular Inlination

S-N/Go-Gn

40 45 33º ± 2.5º


ASSESSMENT 2


ASSESSMENT 2

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Pre-treatment

Post -treatment

Mean SD

Vertical Jaw Relation

ANS-PNS/Go-Gn

30 35

25º ± 6.0º

Dento-Basal

Relations

Maxillary Incisor

Inclination1-ANS-PNS

116 102

110º ± 6.0º

Mandibular Incisor

Inclination1-Go-Gn

91 9294º ± 7.0º


ASSESSMENT 2


ASSESSMENT 2

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Mandibular Incisor

Compensation1 –A-Pg (mm)

Pre-treatment

0

Post –treatment

22 ± 2.0

Dental Relations

Overjet (mm) 8 3 2º ± 2.0

Overbite (mm) 3 3 2 ± 2.5

Interincisal Angle

1/1

121 132132º ± 6.0º


ASSESSMENT 2


ASSESSMENT 2

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PERIAPICAL OR PANORAMIC RADIOGRAPHS


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RADIOGRAPHIC ANALYSIS AT

COMPLETION OF TREATMENT

RADIOGRAPHIC ANALYSIS AT

COMPLETION OF TREATMENT

A. INTRAORAL / PANORAMIC RADIOGRAPH

Good root parallelism of teeth near extraction sites

Normal blunting of root apices, no change around apex of #22

Shortening of distal root #36.

B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT

Posterior rotation of mandible

Retroclination of upper incisors

Good control of lower incisors

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DESCRIPTION OF THE

TREATMENT RESULT

DESCRIPTION OF THE

TREATMENT RESULT

Dental :

- Coordinated arches, ovoid shape

-Angle class 2 molar relations on left side, Angle class 1

on right side. Angle class 1 on canines both sides

-Dental midlines coincide, good overbite and overjet.

- upper incisor torque is similar to the set-up.

- Difference in crown torque of #31 and others- probably

crown-root dilaceration [shown and explained in during-treatment-

photos].

Facial:

-Smile line and width improved, profile is more straight

-Remarks:

-Loss of some upper lip support

- upper incisors did not get enough torque despite full-size

archwire. May be related to occlusal plane

rotation during treatment.

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Documents

EUROPEAN SOCIETY OF LINGUAL ORTHODONTISTS · - decided not to extract #34, to prevent over-retraction of lower incisors and make the mechanics easier [leave solid molar relations