Figure9. Seviss of ccs photos of patent during he reatment prOEeSS The figute inthe upper lef ofthe picture indicates the numberof months following the start of weatment. 1462, Occlusal Reconsrvtion ofthe Skeletal Reversed Occlusion Figure 10. Series of imzaoeal pictures of patient 1 during the weatment process ‘The figures inthe upper lef corner represent the months after the sat of he treatment year and a half post treatment, the molars, even the occlusal plane, has vertically changed due to the alignment of the roots of the teeth, and climination of the anterior component of the occlusal force was attained, The facial profile also improved (Figure 11), and the occlusal condition was very stable even after the retention period implying that relapse was not possible. Figure 11 Facial profile of patient 1 post orthodontic treatment 147Patient 2 Figure 12, Facial profile of patient 2 pre-treatment This 19.7-year old female patient was subjected to treatment with chief complaints of mandibular protrusion and anterior teeth crowding. 1 Facial profile: Pace is round and almost symmetrical. Severe mandibular protrusion was observed (Figure 12). 2, Intra-oral Examination: Occlusal relationship of the molars is Angle class III and crowding of the maxillary anterior teeth were observed Overjet is -4.1 mm, overbite is 3.2 mm. 2 Cephalometric radiograph: SNA 80°, SNB 85° showing a clear mandibular protrusion, FH- MPis 30°. (Figure 13). OP-MP is 18°, OP-MP/ PP-MP IS 0.63, showing a flattening of the occlusal plane. Moreover, AB-MP 49°, ODI 50.5°, APDI 103.5°, considering skeletal ‘mandibular protrusion associated with an openbite tendency (chart 2). Labial tipping of the maxillary anterior teeth is observed 3 Panoramic radiograph: The lower right 3° molar was extracted about a year ago. The upper 148 DENTURE FRAME ANALYSIS. Mean(S.0) Pre-Tx _PosteTx FHP FECrey 300-340 PPMP 248239 25 310 op-uP 192857 180 280 OP-MPIPPMP 054 083081 AB-MP hath 490 530 ae 5002s 470470 ag 230125 ws 195 ASIAP 0.48 038 041 ABE) 3740 m0 348 -AB(mn) ose15 aot as: +AB) 254e44 340 17.0 {eaBimnm) B24 go | 53. Intermola®) 1746837 1700 1752 ‘Tooth material _94343.5, 977 ‘Opi 71.955 28) 505 980 APO! 1043s) 1035. «97.0 Table. and lower molars teeth show a slight mesial tipping Diagnosis and Treatment Plan This patient was diagnosed to have posterior discrepancy in the maxilla and mandible due t© the flattening of the occlusal plane, and skeletal reversed occlusion related to the excessive growth of the mandible. With that, the treatment objectives in orthodontic occlusal reconstruction were 1) elimination of posterior discrepancy. 2) restoration of the harmony of the occlusion and maxillofacial skeleton, 3) alignment of the molars with mesial tipping 4) improvement of anterior guidance by improving the anterior teeth overlap and elimination of crowding and functional