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1/23

NAME NAZEER MOHAMMED

Ortho No. 20130329

OPD NO 16797

Date of birth 8/12/1985

Age / Sex 28/M

Address VASALPUR

,NARAINGARH,AMBALA

Phone No. 09813583319

PATIENT CASE HISTORY


2/23

28/M,FARMER R/O VASALPUR,NARA

INGARH/

C/C PATIENT COMPLAINS OF

FORWARDLY PLACED ANERIOR TEETH

Family history

N.R

Medical historyN.R

Dental history N.R

Pretreatment 28/1/13


3/23

EXTRA ORAL FACIAL VIEW

Apprantly bilaterally

Symmetrical

leptoprosopic face

Convex profile

Potentially competent

lips

Interlabial gap 5 mm

Incisor show at rest

4mm

acute nasolabial angle

deep mentolabial


4/23

Molar relation ;END ON ON

RT,CLASS II

Canine relation :END ON,CLASS

I

Incisor ;CLASS II

Faciomaxillary midline

concordant

Maxilo-mandibular midlines are

concordant

Overjet 9mmOverbite 4 mm

Intra oral examination


5/23


Max arch:

Arch form: U shape

HIGH arched palate

Mand arch:

Arch form: U SHAPE


6/23

Pretreatment OPG 24/12/12

P t t t C h l 28/01/13


7/23

Pretreatment Cephalogram 28/01/13

Skeletal Class II jaw bases

l


8/23

SNA82

SNB80

ANB3.12+/-1.8

Wits-0.01mm

App-Bpp+5mm

MM bisector-1.5mm

AB Plane angle (-4.6 3.67)

SKELETAL ANALYSIS

Pt is skeletal Class

Discrepancy in Sagital plane


9/23

SN length(72mm) mm

Maxillary length(ANS

toPNS)(49mm)mm

Mandibular length (GoTO

PoG)(76mm)mm

Maxillary and mand length is increased

N perpendicular to

A point (-4.46mm) mm

B point (-11.03mm) mm

Pog (-10.5mm) mm

Both the mand and

max are proportionally

Enlarge.

A and B point are

placed normal to

N perpendicular.


10/23

FMA

(24)

SN-MP (32)

Y-axis (59)

Gonial angle (123)

Lower gonialangle

(70)

J-ratio (62 %)

UFH / LFH (45 : 55)

Discrepancy in Vertical dimensions

Indicating normal growth pattern


11/23

LI- A-Pg ( -2mm to2mm)

+7mm

LI-NB (61.7mm) 6mm

LI-NB (274.3 ) 25

IMPA (90) 95-

UI -A-Pg:

6.741.3mm

+6mm

UI-NA:

4.922.05mm +7mm

UI-NA:

24.025.82

27

UI-Palatal Plane (

110) 118

UI-SN 112


Upper incisors are proclined and protruded

Lower incisors are proclined


12/23

E line (mm) Upper lip

(-4mm)

mm

Lower lip(-2 mm)

mm

S line (mm) Upper lip

(0 mm)

mm

Lower lip(0 mm)

mm

Soft tissue analysis

Nasolabial angle

Inter labial gap 0 mm

Lip strain 2mm

Upper and lower lip are protruded w.r.t E & S line


13/23

Model Analysis


14/23

Boltons Analysis

Indicates mandibular tooth material excess

maxillary anteriorexcess


15/23

S.I. = 25.5 M.P.V. = 35 M.M.V = 46

C.P.V = 42.5 indicating no need for expansion.C.M.V = 39.84 indicating no need for expansion.

Ponts Analysis


16/23

T.T.M=83 P.M.D=41 P.M.B.A.W=43.37

P.M.B.A.W.% = 43.37 %indicating borderlinecase

Ashley Howes Analysis


17/23

UPPER LOWER

a) Arch perimeter 79mm 67mm

space availableb) Tooth material 83mm 55.5mm

Discrepancy b/w 4 mm 11.5mm

arch length andtooth material

Carey Indicating

Arch perimeter indicating

Careys Analysis


18/23

CASE SUMMARY

A 20 yrs old female patient shows Skeletal Class I jaw bases ..

Dentoalveolar: Malocclusion irregularly placed teeth.

Soft tissue: convex profile,acute nasolabial angle, average

mentolabial sulcus,potentialy competent lips, crossbitepresent.


19/23

PROBLEM LIST

Skeletal Class I jaw bases

ANGLES CLASS II DIV I malocclusion missing lower firs canine

class I and Class I incisor relationship.

acute nasolabial angle

competent lips

DEEP mentolabial sulcus


20/23

DIAGNOSIS

SKELETAL CLASS I Normodivergent GROWTHPATTERN .

INCRESED OVERJET

ANGLES CLASS II DIV IMALOCCLUSION


21/23

DISCREPANCY CALCULATION

Mandibular Arch

FMA 24

IMPA(95)

IMPA correction =5

intraarch correction =4

Maxillary Arch

Overjet due to IMPA correction= 2mm

Total overjet=2+2=4mm

Space required for correction of total overjet= 4x2=8mm

(maxillary arch)


22/23

TREATMENT OBJECTIVE

Correction of molar and incisor relationship

Correction of crowding ,spacing.

Correction of crossbite

CORRECTION of overjet and overbite


23/23

TREATMENT PLAN

FIXED MECHANOTHERAPY

No EXTRACTION

ANCHORAGE-GROUP C

TYPE OF APPLIANCE-PREADJUSTED

APPLIANCE

MECHANICS-ROTH .022 SLOT

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