ORTHODONTIC CASE

PRESENTATION
Presentor : Dr Midhat Shaikh
INTRODUCTION

• Name: M. Jamshed Imtiaz

• Age:15 years old
• Gender: male
• Marital status: Single
• Address:Muslim Abad society Karachi.
• Occupation: student
• Socioeconomical Status: Afordable
• DOB: 23/may/2007
CHIEF COMPLAINT
“my front tooth is twisted “
MEDICAL HISTORY
Medical condition ; none
family medical history: Diabetes in father & mother
Previous treatment ; none
Medication: None
Allergies: nil
Parafunctional Habits: nil
DENTAL HISTORY
• EXTRACTIONS/MISSING/IMPACTED : all 8s

• CAVITIES/RESTORATIONS: none

• ROOT CANAL TREATMENTS: None

• DENTAL SURGERIES: None

• TRAUMA: None
 EXTRA ORAL EXAMINATION
• HEADFORM; mesencephalic
• FACEFORM; leptoprosopic
• FRONTAL VIEW: symmetrical
FRONTAL VIEW (AT REST)

• Symmetry : symmetrical
• Lip posture :Normal
• Competency of lips : competent
• upper lip : average
• lower lip : average
• Position: Normal
• Interlabial Gap: none
• Nose: mesorrhine, symmetrical, medium
FRONTAL VIEW (AT
SMILE)
• Smile Symmetry: Symmetric
• Smile line: average
• Smile arc: composed
• Buccal corridor: narrow
• Smile type : posed
 FACE PROFILE

• Straight
• Orthognathic
• Normodivergent
CHIN
• SIZE: medium
• Symmetry: symmetrical
OBLIQUE
VIEW
 TMJ EXAMINATION
• Pain /tenderness: No

• Noises/crepitus: No

• Deviation on opening/closing: No

• Max mouth opening: 43 mm

INTRA ORAL EXAMINATION

MANDIBLE MAXILLA
• U shaped • U shaped
• Symmetric
• Symmetric • Normally attached frenum
• Normally attach frenum • Malformed teeth: upper right
• midline is toward left :1mm central incisor
 R L

Molar class I Class I Molar class 1

Canine class I over jet: 4% Canine class I
over bite: 0%

IN OCCLUSION
CAST IN OCCLUSION
overjet: 4mm
overbite; 0%
skeletal base class I
normal angle
Bimax Proclination
 CAST APART
MANDIBLE MAXILLA
Spacing 2mm Spacing 6mm
No Bolton discrepancy
CEPHALOMETRIC ANALYSIS
 SAGITTAL ANALYSIS
ANALYSIS NORMAL VALUES PRE TREATMENT VALUES
SNA 80-84 84
SNB 78-82 83
ANB 0-4 +1
WITTS AO/BO 0+2mm +1
Point A to Nasion perpendicular 0-4 4
Pog to Nasion perpendicular 1-(-7) -8
Facial angle 83-91 87
 VERTICAL ANALYSIS
VERTICAL ANALYSIS NORMAL VALUES PRE TREATMENT VALUES
SNMP 28-36 22
FHMP 21-29 20
MMA 21-29 25
Y- axis 56-64 59
Facial axis 90 93
PFH/TAFH ratio 65% 69%
LFH/TAFH ratio 55% 54%
 DENTAL ANALYSIS
DENTAL ANALYSIS NORMAL VALUES PRE TREATMENT VALUES
UI-SN 97-107 122
IMPA 86-94 105
I-I angle 125+/- 135 110
UI-NA (angle) 22 36
UI-NA(distance) 2-6mm 9mm
LI-NB (angle) 25 33
LI-NB(distance) 2-6mm 5mm
Holdway ratio 1:1 6:1
SOFT TISSUE ANALYSIS
SOFT TISSUE ANALYSIS NORMAL VALUES PRE TREATMENT VALUES
E- plane Upper Lip -3 +/- 2mm -1mm
Lower Lip -2+/- 2mm +1mm
S-plane Upper lip 0+/- 2mm +2mm
Lower lip 0+/- 2mm +2mm
Z angle 78 +/-5 75
Nasolabial angle 90-110 75
PROBLEM LIST
• Skeletal base class 1 , normal angle with Bimax proclination
• Acute nasolabial angle
• Dental Base class 1, Molar class I on both R & L.
• ALD ; Max=6mm spacing, Mand= 2mm spacing
• over jet = 4mm
• overbite=0mm
Treatment Plan
• Appliance : fixed orthodontic appliance
• Anchorage : Banding followed by bonding
• Plan: correction of 1 by couple mechanism
• Additional treatment : space consolidation ( then evaluation)
THANK YOU!