CASE: H, Z DRS. D/B M (CA) Caucasian AGE: 10.7 SKEL: 12.2 RMO VISUAL NORMS X: 12/10/ R: 04/26/2011 MISSING PERMANENT TEETH RMO 2011
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1 CASE: H, Z DS. D/B M (CA) Caucasian AGE:. SKE:. X: // - : // MISSING PEMANENT TEETH VISUA NOMS MO O C MO
2 CASE: H, Z DS. D/B M (CA) Caucasian AGE:. SKE:. X: // - : // MISSING PEMANENT TEETH VISUA NOMS MO O C MO
3 MO Diagnostic Services MO, Inc. ()- PO BOX Denver, Colorado H, Z MO Case Number: X-ay date: // Age:. Wrist:. eference: C C D Drs. D/B MO un date: // Birthdate: // Sex: Male C C D - O T H O D O N T I C C O N D I T I O N S ATEA BEFOE TEATMENT FONTA BEFOE TEATMENT FACTO MEASUED CINICA CINICA FACTO MEASUED CINICA CINICA VAUE NOM DEVIATIONS VAUE NOM DEVIATIONS # - Appears on tracing FOM NOM # - Appears on tracing FOM NOM ======================= DENTA EATIONS ======================= ======================= DENTA EATIONS ======================= Molar elation. mm -. mm. * Molar elation eft (A-B). mm. mm -. Canine elation -. mm -. mm. Molar elation ight (A-B) -. mm. mm -. Incisor Overjet. mm. mm. # Intermolar Width (B-B). mm. mm. * Incisor Overbite. mm. mm. ** Intercanine Width (B-B). mm. mm -. ** Mand Incisor Extrusion. mm. mm. * # Denture Midline. mm. mm. # Interincisal Angle. dg. dg. *** ====================== DENTA TO SKEETON ====================== ====================== DENTA TO SKEETON ====================== # A Molar Position to PTV. mm. mm -. * B to J-Ag eft. mm. mm -. * # B to A-Po Plane -. mm. mm -. * B to J-Ag ight. mm. mm -. * A to A-Po Plane. mm. mm -. # Denture to Jaw Midlines -. mm. mm -. # B Inclination to A-Po. dg. dg -. ** Occlusal Plane Tilt. mm. mm. * A Inclination to A-Po. dg. dg -. *** Occlusal Plane to Xi. mm. mm. * Inclination of Occl Plane. dg. dg -. B Inclination to FH. dg. dg. =========================== ESTHETICS ========================== ower ip to Esthetic Plane -. mm -. mm -. * Upper ip ength. mm. mm -. ip Embrasure to Occl Plane -. mm -. mm -. * Nasoabial Angle. dg. dg. ===================== NASOPHAYNGEA AIWAY ==================== N-S-Ba. dg. dg -. Ba-S-PNS. dg. dg -. *** Airway Percent. %. % -. inder-aronson AD. mm. mm -. inder-aronson AD. mm. mm -. * Distance PTV to Adenoid. mm. mm -. Prepared for the doctor and subject to the terms and conditions appearing on our current orderform
4 MO Diagnostic Services MO, Inc. ()- PO BOX Denver, Colorado H, Z MO Case Number: X-ay date: // Age:. Wrist:. eference: C C D Drs. D/B MO un date: // Birthdate: // Sex: Male C C D - S K E E T A C O N D I T I O N S ATEA BEFOE TEATMENT FONTA BEFOE TEATMENT FACTO MEASUED CINICA CINICA FACTO MEASUED CINICA CINICA VAUE NOM DEVIATIONS VAUE NOM DEVIATIONS # - Appears on tracing FOM NOM # - Appears on tracing FOM NOM ====================== SKEETA EATIONS ====================== ====================== SKEETA EATIONS ====================== # Convexity. mm. mm. ** # Max-Mand Width eft -. mm -. mm -. # ower Facial Height. dg. dg. # Max-Mand Width ight -. mm -. mm -. ** Present Patient Height. in. in Max-Mand Midline -. dg. dg -. * Posterior face height. mm Anterior face height. mm Posterior/Anterior ratio. % Saddle Angle. dg. dg -. * Condylion-A point. mm. mm -. Condylion-Gnathion. mm. mm -. Max-Mand Differential. mm. mm -. Menton-ANS. mm. mm. * ======================== JAW TO CANIUM ======================== ======================== JAW TO CANIUM ======================== # Facial Depth. dg. dg -. Postural Symmetry -. dg. dg -. # Facial Axis. dg. dg -. *** # Maxillary Width (J-J). mm. mm -. ** # Maxillary Depth. dg. dg. # Mandibular Width (AG-GA). mm. mm -. Maxillary Height. dg. dg. ** Palatal Plane to FH -. dg. dg -. # Mandibular Plane to FH. dg. dg. Ba-N-A. dg. dg -. * S-N-A. dg. dg -. S-N-B. dg. dg -. ** A-N-B Difference. dg. dg. * Total Facial Height. dg. dg. ** ====================== INTENA STUCTUE ====================== ====================== INTENA STUCTUE ====================== Cranial Deflection. dg. dg. ** # Nasal Width. mm. mm -. Cranial ength Anterior. mm. mm. Nasal Height. mm. mm. * amus Height (CF-Go). mm. mm. Facial Width. mm. mm -. ** amus Xi Position. dg. dg -. * Porion ocation (Por to PTV) -. mm -. mm. # Mandibular Arc. dg. dg. * Corpus ength. mm. mm -. * Prepared for the doctor and subject to the terms and conditions appearing on our current orderform
5 MO Diagnostic Services MO, Inc. ()- PO BOX Denver, Colorado H, Z MO Case Number: X-ay date: // Age:. Wrist:. eference: I N F O Drs. D/B MO un date: // Birthdate: // Sex: Male P A T I E N T I N F O M A T I O N S I G N I F I C A N T C O N S I D E A T I O N S ============================= NAME ============================= CONDITION CCD FACTOS Patient name: H, Z ========================== HOIZONTA ========================== Doctor name: D/B Age:. Class II malocclusion X-ay date: // due to the lower molar MO Case Number: Severe Skeletal Class II MO un date: // due to the mandible & maxilla,,,, ==================== MISSING PEMANENT TEETH =================== =========================== VETICA =========================== Severe Deep Bite ======================= HEIGHT PEDICTION ====================== ========================== TANSVESE ========================== Wrist film age:. Current height:. inches Skel ingual Crossbite pattern,,, Amount of adult growth achieved:. % due to the maxilla, Expected adult height:. inches Md arch wide compared to jaw,, ======================== AIWAY ANAYSIS ======================= If the patient is clinically diagnosed =========================== SYMMETY =========================== as a mouthbreather, observed mouthbreathing is probably not caused by adenoid blockage Positional Max-Mand asymmetry of the airway. ======================== BOTON ANAYSIS ======================= ==================== SPECIA CONSIDEATIONS ==================== Bolton ratio:. Bolton ratio:. =========================== COMMENTS =========================== Skeletal age:. years Prepared for the doctor and subject to the terms and conditions appearing on our current orderform
6 CASE: H, Z DS. D/B M (CA) Caucasian AGE:. SKE:. X: // - : // MISSING PEMANENT TEETH TACING BEFOE TEATMENT MO / / / / / / / -/ / / SHOTAGE EEWAY. MM. MM / MEASUED VAUE/NOM SIGNIFICANT CONSIDEATIONS CONDITION EASON Class II malocclusion due to the lower molar Severe Skeletal Class II due to the mandible & maxilla Severe Deep Bite Adenoid blockage of the airway? Probably not SHOTAGE. MM EEWAY. MM FACIA PATTEN: MID VETICA # FACTOS MEASUED VAUE NOM CINICA DEVIATION Interincisal Angle. dg. dg. *** Convexity. mm. mm. ** ower Facial Height. dg. dg. A Molar Position to PTV. mm. mm -. * B to A-Po Plane -. mm. mm -. * B Inclination to A-Po. dg. dg -. ** Facial Depth. dg. dg -. Facial Axis. dg. dg -. *** Maxillary Depth. dg. dg. Mandibular Plane to FH. dg. dg. Mandibular Arc. dg. dg. * O C MO
7 CASE: H, Z DS. D/B M (CA) Caucasian AGE:. SKE:. X: // - : // MISSING PEMANENT TEETH TACING BEFOE TEATMENT MO / / / / / / / MEASUED VAUE/NOM SIGNIFICANT CONSIDEATIONS CONDITION EASON Skel ingual Crossbite pattern due to the maxilla Md arch wide compared to jaw Positional Max-Mand asymmetry FACIA PATTEN: MID VETICA # FACTOS MEASUED VAUE NOM CINICA DEVIATION Intermolar Width (B-B). mm. mm. * Denture Midline. mm. mm. Max-Mand Width eft -. mm -. mm -. Max-Mand Width ight -. mm -. mm -. ** Denture to Jaw Midlines -. mm. mm -. Nasal Width. mm. mm -. Maxillary Width (J-J). mm. mm -. ** Mandibular Width (AG-GA). mm. mm -. O C MO
8 MO Diagnostic Services MO, Inc. H, Z MO Case Number: X-ay date: // Age:. Wrist:. eference: G T N Drs. D/B MO un date: // Birthdate: // Sex: Male ()- PO BOX Denver, Colorado ========== G U I D E T O A T E N A T I V E T E A T M E N T P A N N I N G ========== Probability of ower Third Molar Facial Pattern -. C.D. (based on space available) Vertical Description MID VETICA Impaction Eruption Eruption Questionable Functional Auxiliary Appliances Function Headgear HIGH PU HEAVY FOCES.%.%.% Activator NOT INDICATED Palate Separation INDICATED Convexity Objective educe. mm ower Arch ength Discrepancy (original arch). mm Shortage Including useable leeway (E) space equired Tooth Effect on esulting * * * O W E A C H * * * Movement Arch ength Discrepancy t:. mm Fwd. ower Incisor to Ideal t:. mm Fwd.. mm Increase. mm Shortage Buccal Expansion to Ideal Arch Form. mm Increase. mm Shortage Incisors & Convexity to Cephalometric imit. mm Fwd.. mm Increase. mm Excess ower Molar Distal Movement. mm. mm Increase Not eqd * * * U P P E A C H * * * Movement of First Molar (non-ext.) equired for Class I. mm Distal esulting Expected Space for nd & rd Molars at Maturity (non-ext.). mm equired Space for nd Molars. mm to. mm equired Space for nd & rd Molars. mm to. mm *** Indicated Treatment using Dr's Personalized Decision Program *** Upper Arch NON-EXTACTION ower Arch NON-EXTACTION ower Incisor Forward. mm Buccal Expansion Gain. mm ower Molar Movement Backward. mm Teeth Sizes: TOTA SUM OF INCISO NOM Upper Arch : MM N/A ower Arch : MM. Prepared for the doctor and subject to the terms and conditions appearing on our current orderform
9 MO Diagnostic Services MO, Inc. H, Z MO Case Number: X-ay date: // Age:. Wrist:. eference: W N Drs. D/B MO un date: // Birthdate: // Sex: Male ()- PO BOX Denver, Colorado W O K U P A T I O N A E ====================== OIGINA CONDITION ====================== ================ EASONS FO OWE ACH DECISION =============== Facial pattern: -. CD - Mild Vertical Mandibular Arch ength Analysis ower arch form: Normal. Initial Conditions A. Original Arch ength. mm shortage Missing permanent teeth: B. Useable eeway Space. mm C. Total Initial Discrepancy(A+B). mm shortage ower arch length discrepancy (AD). mm SHOTAGE. Maximum Permissible Arch ength eeway space. mm --- Increase(Within Doctor imits) Maximum use of leeway space. mm Due To: Total arch length discrepancy. mm SHOTAGE D. ower Incisor epositioning. mm increase E. Buccal Expansion. mm ======================= COMPUTE DECISION ====================== F. ower Molar Distal Movement. mm based on Drs. Doyle/Baker's individualized standards G. Total Possible Increase (D+E+F). mm increase UPPE ACH: NON-EXTACTION. esultant Arch ength Discrepancy. mm excess Considering All Possible Arch Convexity change EDUCE. mm ength Increases (C+G). esultant Computer Decision Non-Extraction OWE ACH: NON-EXTACTION. Work-Up Presented Is NON-EXTACTION ower incisor FOWAD. mm Extracted teeth Buccal Expansion NONE ================ EASONS FO UPPE ACH DECISION =============== ower molar STATIONAY. Convexity change. mm reduce ===================== AUXIIAY APPIANCES =====================. Upper incisor tip movement for. mm forward overbite/overjet ideal to lower Activator: NOT INDICATED. First molar movement required. mm backward Palate separation: INDICATED Headgear: HIGH PU. First molar movement clinical limit. mm backward HEAVY FOCES. Work-Up Presented Is NON-EXTACTION ======================== POST TEATMENT ======================== =========================== COMMENTS =========================== Pentamorphic arch form: Normal Arch length relapse:. mm Skeletal age:. years ower third molar probabilities (based on space available) Impaction: % Marginal: % Functional: % Prepared for the doctor and subject to the terms and conditions appearing on our current orderform
10 H, Z M. /. SEQUENCES WOKSHEET // PHASE I TEATMENT NON-EXTACTION MO U P P E A C H ACTIVITY DESCIPTION MONTHS NOTES POGESS ECODS POGESS ECODS POST TX ECODS PAATA EXPANSION ADVANCE INCISOS INTUDE COECT CONVEXITY DISTAIZE ETACT INCISOS O W E A C H ACTIVITY DESCIPTION MONTHS NOTES POGESS ECODS POGESS ECODS POST TX ECODS INTUDE ADVANCE INCISOS O C MO
11 H, Z M. /. SEQUENCES WOKSHEET // PHASE II TEATMENT NON-EXTACTION MO U P P E A C H ACTIVITY DESCIPTION MONTHS NOTES POGESS ECODS POST TX ECODS ETACT AND/O AIGN/EVE BUCCA SEGS IDEA ACH FINA ACH O W E A C H ACTIVITY DESCIPTION MONTHS NOTES POGESS ECODS POST TX ECODS AIGN/EVE BUCCA SEGS IDEA ACH FINA ACH O C MO
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14 H, Z M. /. // NON-EXTACTION TEATMENT DESIGN MAXIAY CHANGE CHANGE IN MAXIAY TEETH MO EXTACT PT. A MOVEMENT BACKWAD. MM UPPE MOA CHANGE CHANGE IN MANDIBUA TEETH OWE INCISO OWE MOA FWD(T). FWD. MM MM WOKUP PESENTED Upper arch: NON-EXTACTION ower arch: NON-EXTACTION MISSING PEMANENT TEETH MANDIBUA GOWTH COMMENTS Skeletal age:. years OIGINA GOWTH W/O TEATMENT TEATMENT OBJECTIVE O C MO
15 H, Z M. /. // NON-EXTACTION MINI VTO SUGGEST NOMA MO PEFOMED PENTAMOPHIC ACHWIE MO KEY FACTOS TOTA ACH ENGTH DISCEPANCY. MM SHOTAGE VETICA DESCIPTION EXTACT DATE - D D ODEED EXTACT DATE D D ODEED MAXIAY CHANGE CHANGE IN MAXIAY TEETH TX NOTES MANDIBUA GOWTH CHANGE IN MANDIBUA TEETH O C MO
16 MO Diagnostic Services MO, Inc. April, MODS Case #: Non-extraction Patient: H, Z etter: ( ) Dear DS. D/B: After considering the patients facial pattern and projecting the expected reaction to treatment, the treatment design shows extensive incisor intrusion to be required. Please review the treatment design and determine, in your opinion, if conventional treatment methods would be adequate. Some less conventional approaches often considered as an alternative to our enclosed workup include: ) the use of bite opening mechanics ) a functional appliance phase of treatment ) treating the case to a deeper than normal overbite While there may be many approaches to such cases, we feel that it is our task to alert you that the movements called for were out of the ordinary limits. We appreciate the opportunity to be of service to you. If you have any questions, please contact one of our technical representatives. ocky Mountain Orthodontics PO BOX Denver, Colorado W. Colfax Ave. Denver, CO ()-
17 MO Diagnostic Services MO, Inc. April, TEMS AND CONDITIONS. This order is subject to acceptance by MO, Inc. Diagnostic Services ( MO ). Upon acceptance, this order becomes a binding contract on the terms and conditions set forth herein, which shall be governed by the laws of the State of Colorado. The Doctor/Buyer hereby submits to the jurisdiction of the courts of the State of Colorado to resolve any dispute related to this contract.. Exclusion of Warranties: The following statements are applicable to the products or services provided: a) Tracing of the cephalometric head films is subject to personal interpretation and is dependant upon the clarity of the head film furnished by the Doctor/Buyer; b) Growth forecasts are statements of expectation. Individuals may differ greatly from forecasted values; c) Cephalometrics is a tool which does not constitute a complete diagnosis; and d) The materials and information provided by MO constitute an aid to the qualified clinician, not a diagnosis or treatment plan. Only a qualified clinician can develop a complete diagnosis and treatment plan. MO HEEBY DISCAIMS ANY AND A WAANTIES AS TO THE ACCUACY OF ANY TACING, GOWTH FOECAST, O TEATMENT, AND MAKES NO OTHE WAANTY OF ANY KIND, EXPESSED O IMPIED, APPICABE TO THE PODUCTS O SEVICES COVEED BY THIS CONTACT. MO SPECIFICAY DISCAIMS ANY WAANTY OF MECHANTABIITY O OF FITNESS FO A PATICUA PUPOSE APPICABE TO THE PODUCTS O SEVICES COVEED BY THIS CONTACT. THEE AE NO WAANTIES WHICH EXTEND BEYOND THE DESCIPTION ON THE FACE HEEOF.. The Doctor/Buyer bears all responsibility for final diagnosis and the results of treatment.. Services are performed in compliance with applicable State and Federal laws; including the applicable provisions of the Fair abor Standards Act, as amended, and of regulations and orders issued thereunder.. No liability shall result from delay in performance, or nonperformance, caused by circumstances beyond the control of the party affected; including, but not limited to, an act of God, fire, flood, war, government action, labor trouble, and the like. MO furnishes the materials and information to the Doctor/Buyer based upon representations made to MO by the Doctor/Buyer that he/she is a qualified clinician, i.e. that he/she has the requisite knowledge and experience to utilize this aid properly in developing a complete diagnosis and treatment plan. ocky Mountain Orthodontics PO BOX Denver, Colorado W. Colfax Ave. Denver, CO ()-
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