Title of the Case:

Chief Complaint:

Medical History:

Dental History:

Family History:

Physical Growth:

1. Interviews / Questionnaire

3rd Aozora Seminar, Minoh, December, 2007.

Presenter: Dr. Aaaa Bbbb, Cccc Orthodontic Clinic

Patient Initial: A. B., Age at 1st visit: y m, Sex: , Birth Date: mm/dd/19yy

2

Pre-Treatment: y m

2. Clinical Examination

Facial Photograph

Smile

Facial Photograph

Frontal

Facial Photograph

Right side Profile

Evaluation:

3

Intra-oral Photograph

Right Side

Intra-oral Photograph

Frontal

Intra-oral Photograph

Left Side

Intra-oral Photograph

Upper Arch

Intra-oral Photograph

Lower Arch

Intra-oral Photograph

Overjet & Overbite

Evaluation (OJ, OB, Molar Relation, Canine Relation, Cross-bite, Functional Evaluation, etc):

4

Pre-treatment Orthopantomogram

Orthopantomogram

Evaluation:

5

Cast Analysis

Evaluation (Arch Length Discrepancy, Bolton Index, etc):

6

Pre - Treatment

Age 　 　 y　 　 m

SNA

SNB

ANB

Facial Angle

Y - axis

FMA

SN-MP

Gonial Angle

NB - Pog (mm)

Occ. Plane to SN

U1 to FH or SN

IMPA

FMIA

U1 to A-Pog (mm)

L1 to A-Pog (mm)

Cephalometric Analysis

Evaluation:

Pre-treatment Cephalometric Radiograph

7

4. Diagnosis

5. Problem Lists

6. Treatment Objectives

7. Treatment Plan

8.Treatment Progress (Intra-oral Photographs)

Intra-oral Photograph

Right Side

Intra-oral Photograph

Frontal

Intra-oral Photograph

Left Side

Intra-oral Photograph

Upper Arch

Intra-oral Photograph

Lower Arch

Intra-oral Photograph

Overjet & Overbite

Comments:

Key Stages in Treatment Progress

10

Facial Photograph

Smile

Facial Photograph

Frontal

Facial Photograph

Right-side

9. Post-treatment: y m

Orthopantomogram

Intra-oral Photograph

Right Side

Intra-oral Photograph

Frontal

Intra-oral Photograph

Left Side

Intra-oral Photograph

Upper Arch

Intra-oral Photograph

Lower Arch

Intra-oral Photograph

Overjet & Oberbite

12

Cephalogram

13

Superimposition on SN Plane at S

10. Superimposition (Pre-treatment: black, Post-treatment: red, Final: green, 2nd Stage: blue)

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Superimposition on Palatal Plane at ANS

Superimposition on Mandibular Plane at Me

15

11. Cephalometric MeasurementsPre - Treatment Progress Post - Treatment Final

Age y m y m y m y m

SNA

SNB

ANB

Facial Angle

Y - axis

FMA

SN-MP

Gonial Angle

NB - Pog (mm)

Occ. Plane to SN

U1 to FH or SN

IMPA

FMIA

U1 to A-Pog (mm)

L1 to A-Pog (mm)

12. Treatment Results

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13. Discussion and Conclusion