EUROPEAN SOCIETY OF LINGUAL ORTHODONTISTS

Transcription

1 EUROPEAN SOCIETY OF LINGUAL ORTHODONTISTS CANDIDATE NUMBER:44 CASE NUMBER: 2 Year: 2010 ESLO 01

2 RÉSUMÉ OF CASE 5 CASE CATEGORY: CLASS II DIVISION 1 MALOCCLUSION A MALOCCLUSION WITH SIGNIFICANT MANDIBULAR ARCH LENGTH DEFICIENCY In at least one of the two Class II 1 cases the treatment must involve extractions in both dental arches NAME: M.K BORN: 03/10/1975 SEX:Female PRE-TREATMENT RECORDS: CLASSIFICATION: AGE: 27.7years Angle Cl II division I DATE:09/11/2002 TEETH MISSING BEFORE TREATMENT: Nothing TREATMENT PLAN: APPLIANCE: Quad helix and 14,24,35,45 extraction Lingual appliance(kurtz 7 th ) TREATMENT STARTED: AGE: 27.11years DATE: 01/02/2003 TREATMENT FINISHED: ACTIVE TREATMENT TIME: AGE: 30.5years DATE: 09/03/ years POST-TREATMENT RECORDS: AGE: 30.5years DATE: 09/03/2005 RETAINERS: a)upper:begg type retainer a)lower: Fixed type retainer DATE: 09/03/2005 RETENTION ENDED: a)upper: Begg type retainer a)lower: : Fixed type retainer DATE: 16/06/2009 RETENTION TIME: 3.10 years (POST-) RETENTION RECORDS: AGE: 34.3 years DATE: 16/06/2009 TIME OUT OF RETENTION: ESLO 02

3 DIAGNOSTIC DESCRIPTION OF THE MALOCCLUSION A. SUMMARY M.S, 27y7m Japanese female The chief complain was the maxillary crowding. Angle Class division crowding case bimaxillary protrusion Treatment involved upper 1 st bicuspid and lower 2 nd bicuspid removal. Expand of upper dental arch with quad helix. Multilingual system with palatal bar and Cl elastic. Active treatment time was 2.6 years and good occlusion was stable. B. EXAMINATION OF HEAD AND FACE 1.From lateral view, patient s profile was mesio facial type. 2.This patient has protrusive lips 3.From frontal view, facial asymmetry was not recognized C. FUNCTIONAL EXAMINATION TMJ was no problem D. INTRAORAL EXAMINATION 1. Angle Class 2. Overjet mm Overbite 2.0mm 3. Cross bite (24,25,26/34,35,36) 4. Crowding in the upper and lower anterior teeth. 5. Midline discrepancy (Lower midline shifted to left 1.2mm) E. DENTAL CASTS Maxillary arch: Arch length discrepancy -7.2mm Mandibular arch: Arch length discrepancy -5.3mm Occlusion Sagittal: Angle Cl II, overjet 7.4 mm Occlusion Vertical: overbite 2.0mm Occlusion Transversal: Cross bite (24,25,26/34,35,36) CASE NUMBER: 2 DATE: 09/11/2002 AGE: 27.7years ESLO 03

4 FRONTAL SMILE PROFILE 45 FACIAL PHOTOGRAPHS BEFORE TREATMENT CASE NUMBER: 2 DATE: 09/11/2002 AGE: 27.7years ESLO 04

5 Right Buccal Left Buccal Upper Occlusal Center Lower Occlusal INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BEFORE TREATMENT CASE NUMBER: 2 DATE: 09/11/2002 AGE: 27.7years ESLO 05

6 Print on transparent support LATERAL SKULL RADIOGRAPH BEFORE TREATMENT DATE: 09/11/2002 AGE:27.7years ESLO 06

7 Print on transparent support TRACING OF LATERAL SKULL RADIOGRAPH BEFORE TREATMENT DATE: 09/11/2002 AGE:27.7years ESLO 07

8 CEPHALOMETRIE ANALYSE TWEED MERRYFIELD Debut Tt SNA 82 ± 87.1 SNB 80 ± 76.6 ANB 2 ± 10.5 FMA 25 ± IMPA 87 ± OP/F CANDIDATE NUMBER: CASE NUMBER: 2 DATE: 09/11/2002 AGE: 27.7years ESLO 08!1

9 CEPHALOMETRIC MORPHOLOGICAL ASSESSMENT 1 Sagittal Skeletal Relations Maxillary Position S-N-A Pretreatment Mean SD º ± 3.5º Mandibular Position S-N-Pg º ± 3.5º Sagittal Jaw Relation A-N-Pg º ± 2.5º Vertical Skeletal Relations Maxillary Inclination S-N / ANS-PNS º ± 3.0º Mandibular Inclination S-N / Go-Gn º ± 2.5º Vertical Jaw Relation ANS-PNS / Go-Gn º ± 6.0º Dento-Basal Relations Maxillary Incisor Inclination 1 - ANS-PNS º ± 6.0º Mandibular Incisor Inclination 1 - Go-Gn º ± 7.0º Mandibular Incisor Compensation 1 - A-Pg (mm) 7.1mm 2 ± 2.0 Dental Relations Overjet (mm) 7.4mm 3.5 ± 2.5 Overbite (mm) 2.0mm 2 ± 2.5 Interincisal Angle 1 / º ± 6.0º DATE: 09/11/2002 AGE:27.7years ESLO 08

10 PERIAPICAL OR PANORAMIC RADIOGRAPHS BEFORE TREATMENT DATE: 09/11/2002 AGE:27.7years ESLO 09

11 ANY OTHER RADIOGRAPHS BEFORE TREATMENT DATE: 09/11/2002 AGE:27.7years ESLO 10

12 RADIOGRAPHIC ANALYSIS BEFORE TREATMENT A. INTRAORAL / PANORAMIC RADIOGRAPH Lower second premolars treated endodontically. The bilateral lower third molars were impacted horizontally. B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT 1.Sagittal Skeltal Relations: Maxillary position in a protruded position. Mandibular position was in a retruded position. increasd ANB( 10.5 Class II division 1 malocclusion 2.Vertical Skeltal Relations: Mandibular Inclination was beyond the range of normal. Lower anterior face height was normal. 3. Dento-Basal Relations: Maxillary incisors and mandibular incisors was flaring and in a protruded position; 4. Dental relations: The upper and lower incisors were excessive labial tipping. Midline discrepancy (Lower midline shifted to left 1.2mm) Cross bite (24,25,26/34,35,36) 5.Esthetic Profile; Lip protrusion DATE: 09/11/2002 AGE:27.7years ESLO 11

13 TREATMENT PLAN AND THE REASON FOR IT Treatment plan 1. Expand of upper dental arch by quad helix 2. Placement a transpalatal bar for reinforcement of the source of anchorage 3. Upper 1 st premolar extraction and lower 2 nd premolar extraction 4. Align the upper and lower arch with multilingual brackets 5. Class elastics The reason is.upper dental arch width is narrow and left premolars cross bite. 2.Angle class relationships. 3.Measurements of upper and lower incisors indicated flaring and upper and lower incisors were crowding. 4. Lower anterior face height was normal, so the moderate anchorage was enogh by using palatal bar. DATE: 09/11/2002 AGE:27.7years ESLO 12

14 Right Buccal Left Buccal Upper Occlusal Center Lower Occlusal INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BETWEEN TREATMENT Upper respond.0175 CANDIDATE NUMBER:44 DATE:28/06/2003 AGE: 28.4 years ESLO 12-1

15 Right Buccal Left Buccal Upper Occlusal Center Lower Occlusal INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BETWEEN TREATMENT Upper Co-NiTi 017! 017 Lower Respond 0175 DATE:10/11//2003 AGE:28.8years ESLO 12-2

16 Right Buccal Left Buccal Center Upper Occlusal Lower Occlusal Upper SS 016! Lower SS 016! DATE:02/03/2004 AGE:29.2years ESLO 12-2

17 RÉSUMÉ OF THE TREATMENT CARRIED OUT INCLUDING ANY DIFFICULTIES ENCOUNTERED The upper bilateral third molar extraction and the lower right third molar extraction were performed after Diagnosis. 01/02/2003 The quad helix was placed on upper arch molars (entire 6 months to improve the buccal crossbite) 31/05/2003 Extraction of 24 21/06/2003 Extraction of 14 06/28/2003 The palatal bar was applied on the upper arch. Placement upper lingual appliance and starting to leveling with Respond 0175 (Levering was continued with TMA 016 and Copper-niti 017! 017 ) 10/11/2003 Placement lower lingual appliance with Respond /11/2003 Extraction of 45 21/11/2003 Extraction of 35 01/12/2003 Levering was continued with TMA 016 and Copper-niti 017! 017 for 3 month 02/03/2004 Placement 016! 022 SS wire on upper and lower arch and start to class elastics. Starting of the upper and lower anterior retraction by elastic chain.(entire 10 months) 08/01/2005 Starting of detailing withtma 0175! 0175 wire (entire 8 months) 03/09/2005 Removed The period of active treatment was 2.6years. CANDIDATE NUMBER:44 DATE:03/09/2003 AGE:30.5years ESLO 13

18 FRONTAL SMILE PROFILE FACIAL PHOTOGRAPHS AT COMPLETION OF TREATMENT DATE:03/09/2003 AGE:30.5years ESLO 14

19 Right Buccal Left Buccal Upper Occlusal Center Lower Occlusal INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION AT COMPLETION OF TREATMENT DATE:03/09/2003 AGE:30.5years ESLO 15

20 Print on transparent support LATERAL SKULL RADIOGRAPH AT COMPLETION OF TREATMENT DATE:03/09/2003 AGE:30.5years ESLO 1

21 Print on transparent support LATERAL SKULL RADIOGRAPH AT COMPLETION OF TREATMENT DATE:03/09/2003 AGE:30.5years ESLO 1

22 SUPERIMPOSITION AT SN-S DATE:03/09/2003 AGE:30.5years ESLO 17-1

23 Palatal Plane at ANS Mandibular Plane at Me SN at S SUPERIMPOSITIONS of MAXILLA,MANDIBULE,PROFILE DATE:03/09/2003 AGE:30.5years ESLO 17-2

24 CEPHALOMETRIE ANALYSE TWEED MERRYFIELD Debut Tt Fin Tt SNA 82 ± SNB 80 ± ANB 2 ± FMA 25 ± IMPA 87 ± OP/F CANDIDATE NUMBER:44 DATE: 03/09/2003 AGE:30.5years ESLO 18!

25 CEPHALOMETRIC MORPHOLOGICAL ASSESSMENT 2 Sagittal Skeletal Relations Maxillary Position S-N-A Pretreatment Posttreatment Mean SD º ± 3.5º Mandibular Position S-N-Pg º ± 3.5º Sagittal Jaw Relation A-N-Pg º ± 2.5º Vertical Skeletal Relations Maxillary Inclination S-N / ANS-PNS º ± 3.0º Mandibular Inclination S-N / Go-Gn º ± 2.5º Vertical Jaw Relation ANS-PNS / Go-Gn º ± 6.0º Dento-Basal Relations Maxillary Incisor Inclination 1 - ANS-PNS º ± 6.0º Mandibular Incisor Inclination 1 - Go-Gn º ± 7.0º Mandibular Incisor Compensation 1 - A-Pg (mm) 7.1mm 3.1mm 2 ± 2.0 Dental Relations Overjet (mm) 7.4mm 3.0mm 3.5 ± 2.5 Overbite (mm) 2.0mm 3.0mm 2 ± 2.5 Interincisal Angle 1 / º ± 6.0º DATE:03/09/2003 AGE:30.5years ESLO 18

26 PERIAPICAL OR PANORAMIC RADIOGRAPHS AT COMPLETION OF TREATMENT DATE:03/09/2003 AGE:30.5years ESLO 19

27 ANY OTHER RADIOGRAPHS AT COMPLETION OF TREATMENT DATE:03/09/2003 AGE:30.5years ESLO 20

28 RADIOGRAPHIC ANALYSIS AT COMPLETION OF TREATMENT A. INTRAORAL / PANORAMIC RADIOGRAPH The roots of 34,35 were tipped mesial. Upper and lower incisors slightly root resorpted. B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT 1.Sagittal Skeltal Relations: Maxillary position and Mandible position was no change. ANB was no change. 2.Vertical Skeltal Relations: Lower anterior face height was no change. 3. Dento-Basal Relations: The flaring of Maxillary incisors and mandibular incisors was improved. 4. Dental relations: Overbite and overjet was in the range of normal. The midline discrepancy and the cross bite (24,25,26/34,35,36) was improved. 5.Esthetic Profiel; The lip protrusion was slightly improved. DATE:03/09/2003 AGE:30.5years ESLO 20

29 DESCRIPTION OF THE TREATMENT RESULT The active treatment was completed according to the treatment plan. Active treatment time was 2.6years. The anterior crowding was improved. The posterior cross bite was corrected by quad helix and a favorable occlusal relationship was obtained. The post treatment molar relation showed Angle Cl molar relationship. Maxillary Incisor Inclination (1-ANS-PNS) changed to Over jet was improved from +7.4mm to +3.0 mm,so the lip protrusion was improved. DATE:03/09/2003 AGE:30.5years ESLO 21

30 FRONTAL SMILE PROFILE 45 FACIAL PHOTOGRAPHS AT RETENTION / POST RETENTION CANDIDATE NUMBER:44 DATE:16/06/2009 AGE:34.3years ESLO 22

31 Right Buccal Left Buccal Upper Occlusal Center Lower Occlusal INTRA-ORAL COLOUR PHOTOGRAPHS AT RETENTION / POST-RETENTION CANDIDATE NUMBER:44 DATE:16/06/2009 AGE:34.3years ESLO 23

32 Print on transparent support LATERAL SKULL RADIOGRAPH AT RETENTION / POSTRETENTION CANDIDATE NUMBER:44 DATE:16/06/2009 AGE:34.3years ESLO 24

33 ESLO 26 PERIAPICAL OR PANORAMIC RADIOGRAPHS AT RETENTION / POST-RETENTION CANDIDATE NUMBER:44 DATE:16/06/2009 AGE:34.3years ESLO 27

34 ANY OTHER RADIOGRAPHSAT RETENTION / POST-RETENTION CANDIDATE NUMBER:44 DATE:16/06/2009 AGE:34.3years ESLO 28

35 DESCRIPTION OF RETENTION / POST-RETENTION FINDINGS The lower left third molar was extracted. The relationship of maxillary and mandibular showed stable condition. Occlusion of Cl is stable after 3.10 years of retention. CANDIDATE NUMBER:44 DATE:16/06/2009 AGE:34.3years ESLO 29