DR.

THANADOL
OLL
PRESENTATION
Orthodontic life learning
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Pt.1 Panida
EXTRA ORAL PHOTOS 3
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PATIENT 1 : Panida
Age 24 General health Healthy

Crooked teeth , Crossbite , Don’t like her

Chief Complaint smile
Dental formula Permanent dentition

Attitude Keen for all options Oral Hygiene Fair

1/2/2
Periodontal status
1/2/1

Dental health Good

Jaw functions Healthy

Traumatic occlusion 31 41
Records needed 13 Rotation
Incompetent lip
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Study Model
 MODEL ANALYSIS 6

Transverse
Normal
Relationship

Upper Lower Sagittal relationship

Class 3

Yes Symmetry Yes

Vertical relationship Normal
Arch
U V
Form
Midlines Lower midline to left 1 mm
Moderate Crowding Moderate

Frenulum insertion Normal

Dental
18 - 28 38 - 48
Formula
Occlusal curve Lower slightly curve
15 13 25 27 Rotations 35 32 42 45

Upper Proclined
Teeth inclination
Lower Retroclined
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CEPHALOMETRIC ANALYSIS 8

Pre-Tx
SNA (82°) 94.69 (protrude maxilla)
SNB (80°) 99.63 (Prognathic mandible)
ANB (2°) - 4.94 (Class 3 relationship)
Wits (0 mm) - 8.64 (Skeletal class 3)
U1 to SN (104°) 132.66 (Proclined upper incisor)
IMPA (95°) 78.97 (Retroclined lower incisor)
Inter incisal angle (128°) 130 (Normal inter-incisor angle)
E-line UL (0 mm) - 5.71 (Retruded upper lip)
E-line LL (0 mm) - 0.79 (Normal lower lip position)
Overjet - 2.03 (Anterior crossbite)
Overbite 2.41(Normal overbite)
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Teeth Present 18 - 48
Impactions/Agenesis/
-
Supernumerary teeth
Root Inclinations 42 43 divergence

Condyles Normal and symmetry

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Pt.1 Panida

Symmetry Yes Sagittal Class 3

Aesthetic Profile Concave Skeletal Vertical Normal

diagnosis diagnosis
U : Proclined
Smile Exposure 4-4 Incisors
L : Retrocline
Sagittal Class 3

Vertical Normal
Dental
Transversal Normal
diagnosis
Space Discrepancy
Other
Discrepancies -
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DIAGNOSTIC SUMMARY

“Skeletal class 3 - dental class 3 malocclusion with moderate crowding”

Upper anterior proclination and lower anterior retroclination

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Panida

De-crowding and De-rotation

P1. Try non extraction
Crossbite correction
Treatment
Goals Balance occlusal load
Options P2. Orthodontic treatment +
Control lower anterior inclination
orthognathic surgery

Good alignment
Anticipated No traumatic occlusion
Treatment Plan Class 1 relationship
Good anterior inclination
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Leveling /Open space at 22

Passive coil spring

 FURTHER OBSERVATIONS 14

1. Caries under bracket

2. White spot lesion area
3. Plaque and calculus (Oral hygiene)
4. Pits and fissures caries
5. Stain
6. Toothmovement and Complication
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Open space
and
piggy back

Main archwire = 17*25 ss

Aux archwire 12 Heat activated NiTi
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12 Closed to
alignment

Re – Leveling 12 NiTi
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Pt.2 Chakris
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PATIENT 2 : Chakris
Age 14 General health Healthy

Chief Complaint Buck teeth / Spacing Dental formula Permanent dentition

Attitude negligence Oral Hygiene Fair

Periodontal status Good

Dental health Good

Jaw functions Healthy

Lip potentially incompetent

Records needed
Check unusual habit
 Dental arch ANALYSIS 25

Transverse
Normal
Relationship

Upper Lower Sagittal relationship

Class 2

Yes Symmetry Yes

Vertical relationship Normal
Arch
U U
Form
Midlines Lower midline to left 1.5 mm
None Crowding None

Frenulum insertion Normal

Dental
17-27 37-47
Formula
Occlusal curve Lower slightly curve
15 13 25 27 Rotations 35 45

Upper Proclined
Teeth inclination
Lower normal
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Pre-Tx
SNA (82°) 81.05 Normal AP position of maxilla
SNB (80°) 79.30 Normal AP position of mandible
ANB (2°) 1.76 (Class 1 relationship)
Wits (0 mm) - 2.91 (Skeletal class 2)
U1 to SN (104°) 136.66 (Proclined upper incisor)
IMPA (95°) 94.76 (Normal lower incisor)
Inter incisal angle (128°) 95 (Proclined incisor angle)
E-line UL (0 mm) + 2.24 (Protrude upper lip)
E-line LL (0 mm) + 1.88 (Normal lower lip position)
Overjet 10 (Large overjet)
Overbite 2.46 (Normal overbite)
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Teeth Present 17-47

Impactions/Agenesis/
18/28/38/48
Supernumerary teeth
Root Inclinations normal

Condyles Normal and symmetry

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Pt.2 Chakris

Yes (but chin

Symmetry Sagittal Class 1
deviate to left)
Aesthetic Skeletal
Profile Straight Vertical Normal
diagnosis diagnosis
U : Proclined
Smile Exposure 3-3 Incisors
L : Normal
Sagittal Class 2

Vertical Normal

Transversal Normal
Dental diagnosis
Space Excess
Lower midline shift to
left 1.5 mm
Other Discrepancies
Q1/Q4 lingual
crossbite
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DIAGNOSTIC SUMMARY

“Skeletal class 1 - dental class 2 malocclusion with generalize spacing”

Upper anterior proclination and 14/44 scissorbite with functional shift (Mandible shift to left side)
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Chakris

Good function P1. Try non extraction

Treatment
Goals Esthetic
Options
Better smile and lip competent P2. Extraction 14/24/35/45

Overjet correction
Good occlusion
Anticipated
Class 1 molar and canine
Treatment Plan
Finished without space
Midline correction
 FURTHER OBSERVATIONS 32

1. Caries under bracket

2. White spot lesion area
3. Plaque and calculus (Oral hygiene)
4. Pits and fissures caries
5. Stain
6. Tooth movement and Complication
 Pt.2 Chakris
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Extra oral Photo

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Class II Corrector
ML Over correction
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Pt.2 Final
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 Pt.3 Hatayrat
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Extra oral Photo

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This overjet
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PATIENT 3 : Hatayrat
Age 16 General health Healthy

Chief Complaint Buck teeth / Gummy smile / Protrusive lip Dental formula Permanent dentition

Attitude Negligence but trainable Oral Hygiene Good

Periodontal status Good

Dental health Good

Jaw functions Healthy

Records needed Lip incompetent

 Dental arch ANALYSIS 55

Transverse
Normal
Relationship

Upper Lower Sagittal relationship

Class 2

Yes Symmetry Yes

Vertical relationship Deep bite
Arch
U U
Form
Midlines OK
None Crowding Mild

Frenulum insertion Normal

Dental
17-27 37-47
Formula
Occlusal curve Lower slightly curve
15 13 25 27 Rotations 31 41 35 45

Upper Retrocline
Teeth inclination
Lower normal
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Teeth Present 17-47

Impactions/Agenesis/
-
Supernumerary teeth
Root Inclinations normal

Condyles Normal and symmetry

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Protrusive Lip
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Pre-Tx
SNA (82°) 89.34 Normal AP position of maxilla
SNB (80°) 78.66 Normal AP position of mandible
ANB (2°) 10.6 (Class 2 relationship)
Wits (0 mm) 0.72 (Skeletal class 2)
U1 to SN (104°) 98.46 (Retrocline upper incisor)
IMPA (95°) 91.90 (normal lower incisor)
Inter incisal angle (128°) 129.27 (normal incisor angle)
E-line UL (0 mm) + 1.41 (normal upper lip)
E-line LL (1-2mm) + 6.91 (Protruded lower lip)
Overjet 7.46 (Large overjet)
Overbite 5.11 (Deep overbite)
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Pt.3 Hatayrat

Symmetry Yes Sagittal Class 2

Aesthetic Profile convex Skeletal Vertical Normal

diagnosis diagnosis
U : Retroclined
Smile Exposure 13-24 Incisors
L : Normal
Sagittal Class 2

Vertical Deepbite

Maxilla
Transversal
Dental diagnosis contriction
Space proper
Lower midline shift to
left 1.5 mm
Other Discrepancies
Q1/Q4 lingual
crossbite
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DIAGNOSTIC SUMMARY

“Skeletal class 2 - dental class 2 malocclusion deepbite”

Upper anterior over eruption (Gummy smile)

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Hatayrat

P1. Extraction 14/24/35/45

Good function
Treatment
Goals Esthetic P2. Extraction 14/24/35/45 with
Options
Better smile TADs

Overjet correction
Deepbite correction
Anticipated Good occlusion
Treatment Plan Class 1 molar and canine
Gummy smile correction
Midline correction
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Dental is good
But Gummy smile

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Intrusion anterior teeth

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Why forsus ?
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Pt3. Final No more gummy smile

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