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Ortho Case Pres PDF
Ortho Case Pres PDF
CASE PRESENTATION
EILEEN EIKA M. DELA CRUZ, DMD
PATIENTS INFORMATION
Patients Name:
EDRYL ERVIN M. DELA CRUZ
Age: 20
Chief Complaint:
Ang panget ng position ng mga ipin ko
sa gilid.
Medical History:Medically fit
Significant Dental History:
-brushes 2x a day
-no caries found
CLINICAL EXAMINATION
Patient has
symmetrical face
FACIAL EXAMINATION
B. VERTICAL PROPORTIONS
4mm deficiency
FACIAL EXAMINATION
C. HORIZONTAL PROPORTIONS
HEAD: Mesocephalic
or Mesofacial
PROFILE
Convex Profile
DIVERGENCE
Slight Posterior
Divergence because
chin is slightly
posterior than the
forehead
EXAMINATION OF THE SOFT TISSUES OF THE
FACE
LIPS AT REST
- normal color and texture
-Lips are competent.
EXAMINATION OF THE SOFT TISSUES OF THE
FACE
LIPS ON A SMILE
LIPS ON FUNCTION
-Normal breathing
and swallow was
observed.
EXAMINATION OF THE SOFT TISSUES OF THE
FACE
NASOLABIAL ANGLE
MENTOLABIAL
SULCUS
EXAMINATION OF THE SOFT TISSUES OF THE
FACE
FACIAL AND
DENTAL MIDLINE:
Coincides
INTRAORAL EXAMINATION
Normal Frenal
Attachment
Presence of
Healthy
Gingiva
INTRAORAL EXAMINATION
No Caries &
Composite found
tooth #16
lingually
inclined
INTRAORAL EXAMINATION
Impacted tooth
#48
Composite on
tooth #36
INTRAORAL EXAMINATION
(RIGHT SIDE)
RIGHT
MOLAR CLASS III
-Class III
PREMOLAR CLASS III
LEFT
CLASS III
PREMOLAR CLASS III
OVERJET:
-2mm on CI
Normal
-1mm on LI
OVERBITE: 2mm
Normal
Transverse Symmetry
Right 28mm
Left 27mm
Minimal Deviation
ARCH FORM
-no exostoses
-no exostoses
ARCH LENGTH
LOWER: 25mm
UPPER: 31mm
ARCH PERIMETER (ALVEOLAR ARCH
LENGTH)
LOWER: 69mm
UPPER: 81mm
Summary: no crowding on upper and lower
arch
6mm 7mm 8mm 6mm 8mm 8mm 6mm 8mm 7mm 6mm
2nd 1st Canine Lateral Central Central Lateral Canine 1st 2nd
7mm 7mm 7mm 6mm 5mm 5mm 6mm 7mm 7mm 7mm
Upper Lower
Tooth size 70mm 64mm
Alveolar Arch Length 81mm 69mm
LOWER: 47mm
UPPER: 48mm
RADIOGRAPHIC ANALYSIS
PANORAMIC XRAY
in relation to the
cranial base
77.2~84.8 A
78
Maxillary bone is
NORMAL in relation to
the cranial base
SNB(78 3.0)
determines the
protrusiveness
of mandibular Na
S
bone or
mandibular
denture base in
relation to the
cranial base
75~81
81
Mandibular bone is
NORMAL in relation
to the cranial base
ANB(2.5 2.5)
determines the position
of the maxillary
denture base in relation Na
0~5 A
2.5
position of maxillary
denture base is NORMAL B
in relation to mandibular
base
FH/NP
FACIAL ANGLE
(85 2.5)
determines the Na
protrusiveness of Po
compared to the
cranial base
82.5~87.5
93.5
Chin is PROTRUSIVE in
Pog
relation to cranial base.
1/SN (103.0 5.0)
describes the axis of
the most protrusive
Na
upper central incisor S
in relation to the
cranial base
98~108
103.5
122.7~137.3
125
85~95
91
Go
Mandibular incisor is
NORMAL in relation to
mandibular plane. Gn
FMIA
(65.0 5.0)
determines the position
of the most protrusive
mandibular central
incisor in relation to Po
the Frankfort Or
Horizontal Plane
60~70
62
Mandibular central
incisor is NORMAL in
relation to FHP
FMA
(25 3.0)
determines the
stiffness of the
mandibular plane
Po
when compared to the
cranial base
Or
22~28
22.5
Go
Growth of
Gn
mandible is NORMAL
Y axis
(59 3.7)
determines the
direction of growth
potential of the S
mandible Po
Or
55.3~62.7
60
NORMAL growth of
mandible.
Gn
S-LINE
NORMAL: Should
Touch the S-Line
PATIENT
Upper: Touching the S-
Line (Normal)
Lower: 1mm Anterior to
S-Line (Protrusive)
A-POG
NORMAL
Upper Incisor:
4-6mm Anterior
to A-pog
Lower Incisor:
2mm Anterior to
A-pog
A
PATIENT
Upper Incisor: 9mm
Anterior to A-pog
(Protrusive)
Lower Incisor: 8mm
Anterior to A-pog pog
(Protrusive)
SUMMARY OF 10 ANGLE ANALYSIS
Oral Prophylaxis
Placement of Separator
elastics and brass wire
STAGES OF
TREATMENT
STAGE I ALIGNMENT AND LEVELING OF ANT TEETH
2. AFTER
PROTRUSION: CLOSE FIG 8 CHAIN
SPACE TO MIDLINE
3. BRACKET 11-12
11-21
REMAINING TEETH 21-22
4. Correction of Narrow
Archwidth by:
PROTRACTION OF UPPER
POSTERIORS using :
- Bayonet bend
- Auxilliary Expansion
Archwire
- bite elastics
STAGE II ALIGNMENT AND LEVELING OF
POST TEETH
1. Preserve the
corrections done FIG 8 CHAIN
in stage I by using:
FIG 8 molar to
molar
13-14
2. Close all posterior 13-23
spaces 23-24
3. Correct molar
relationship 14-15
14-24 24-25
- stable molar
occlusion
FIG 8 CHAIN
15-16
15-25
25-26
16-26
STAGE III ROOT PHASE
.021 x .025
STAGE IV FINISHING STAGE
Objectives:
1. Idealize the
alignment
2. Arch Coordination
3. Settling of occlusion
(1 month before
bracket removal)
Hawleys Retainer
on the upper for
3 years
Direct Bond
fixed lingual
Retainer on the
lower for 3
years
END