OF LINGUAL ORTHODONTICS

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1 EUROPEAN SOCIETY OF LINGUAL ORTHODONTICS CANDIDATE NUMBER: KDr. KP. kanarelis CASE NUMBER: 2 Year: 2010 WBLO 01

2 RESUME OF CASE 2 CASE CATEGORY: ADULT MALOCCLUSION NAME : MARIA A. BORN: SEX: F PRETREATMENT RECORDS: AGE:23 DATE: CLASSIFICATION: Adult malocclusion - Class II1 TEETH MISSING BEFORE TREATMENT: 0 TREATMENT PLAN: APPLIANCE: Upper & lower lingual fixed orthodontic appliance TREATMENT STARTED: AGE: 23 DATE: TREATMENT ENDED: AGE: 25 DATE: ACTIVE TREATMENT TIME: 23 months POSTTREATMENT RECORDS: AGE: 25 DATE: RETAINERS: a)upper: a)lower: DATE: RETENTION ENDED: a)upper: not ended a)lower: not ended DATE: not ended RETENTION TIME: unlimited (POST-) RETENTION RECORDS: AGE: DATE: TIME OUT OF RETENTION: still in retention WBLO 02

3 DIAGNOSTIC DESCRIPTION OF THE MALOCCLUSION A. SUMMARY Patient s chief complaint is smile dysharmony. She is motivated to get a perfect smile B. EXAMINATION OF HEAD AND FACE Patient s face is symetric and in harmony C. FUNCTIONAL EXAMINATION Patient s mastication shows no particular problem to mention D. INTRAORAL EXAMINATION INTRAORAL: 1. Classe II molar and canine: 2. Overjet 7.5 mm and overbite 4,5 mm 3. Crowding on the upper and lower arch, 4. No Crossbite 5. Mesial in rotation of the upper molar with protrusion of the mandibular incisors E. DENTAL CASTS Mandibular arch: crowding of the incisors Maxillary arch: malposition 13; 23; Occlusion Sagittal: 7.5mm Class II1 Occlusion Vertical: 4,5mm Occlusion Transversal: ok CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE: 23 WBLO 03

4 FRONTAL SMILING PROFILE FACIAL PHOTOGRAPHS BEFORE TREATMENT CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE: 23 WBLO 04

5 Right Buccal Left Buccal Center Upper Occlusal Lower Occlusal INTRA-ORAL COLOUR PHOTOGRAPHS START OF THE TREATMENT CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE: 24 WBLO 05

6 WBLO6

7 LATERAL SKULL RADIOGRAPH BEFORE TREATMENT CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE: 23 WBLO 07

8 TRACING OF LATERAL SKULL RADIOGRAPH BEFORE TREATMENT CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE: 23 WBLO 07-1

9 WBLO07-02

10 CEPHALOMETRIE ANALYSE TWEED MERRYFIELD Start Tt SNA 82 ± SNB 80 ± ANB 2 ± FMA IMPA OP/F 25 ± 3 87 ± CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE: 23 WBLO 08-1

11 CEPHALOMETRIC MORPHOLOGICAL ASSESSMENT 1 Sagittal Skeletal Relations Maxillary Position S-N-A Mandibular Position S-N-B Sagittal Jaw Relation A-N-B Vertical Skeletal Relations Maxillary Inclination S-N / ANS-PNS Mandibular Inclination S-N / Go-Gn Pretreatment Mean SD º ± 3.5º º ± 3.5º 6.8 2º ± 2.5º 8.8 8º ± 3.0º º ± 2.5º Vertical Jaw Relation ANS-PNS / Go-Gn º ± 6.0º Dento-Basal Relations Maxillary Incisor Inclination 1 - ANS-PNS Mandibular Incisor Inclination 1 - Go-Gn Mandibular Incisor Compensation 1 - A-Pg (mm) Dental Relations Overjet (mm) º ± 6.0º º ± 7.0º 2.5mm 7.5mm 2± ± 2.5 Overbite (mm) 4.5mm 2± 2.5 Interincisal Angle 1 / º ± 6.0º CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE: 23 WBLO 08-2

12 PERIAPICAL OR PANORAMIC RADIOGRAPHS BEFORE TREATMENT CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE: 23 WBLO 09

13 RADIOGRAPHIC ANALYSIS BEFORE TREATMENT A. INTRAORAL / PANORAMIC RADIOGRAPH PANORAMIC RADIOGRAPH: periodontic desease grade 1. B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT 1. Sagittal Skeletal Relations: Sagittal Jjaw Relation ANB Skeletal Classe II malocclusion; Vertical Skeletal Relations: vertical face height beyond the range of normal, lower anterior face height normal; Dento- Basal Relations: Maxillary incisor in an acceptable position; mandibular incisor in a protusive position; Dental relations: excessive buccal position of the lower incisor s, Classe II molar and canine; 5. Esthetic Profil: Hight convexity. CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE: 23 WBLO 10

14 Right Buccal Left Buccal Center Upper Occlusal Lower Occlusal TREATMENT STEPS INTRA-ORAL OCCLUSAL VIEW COLOUR PHOTOGRAPHS CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE:24 WBLO11

15 8 partial retraction of the upper canines WBLO11-1

16 Right Buccal Left Buccal Center Upper Occlusal Lower Occlusal TREATMENT STEPS INTRA-ORAL OCCLUSAL VIEW COLOUR PHOTOGRAPHS CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE: 24 WBLO11-2

17 Right Buccal Left Buccal Center Upper Occlusal Lower Occlusal TREATMENT STEPS INTRA-ORAL OCCLUSAL VIEW COLOUR PHOTOGRAPHS CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE: 25 WBLO11-3

18 Right Buccal Left Buccal Center Upper Occlusal Lower Occlusal TREATMENT STEPS INTRA-ORAL OCCLUSAL VIEW COLOUR PHOTOGRAPHS CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE: 25 WBLO11-4

19 WBLO11-5

20 WBLO11-6

21 RESUME OF THE TREATMENT CARRIED OUT INCLUDING ANY DIFFICULTIES ENCOUNTERED TREATMENT GOUVERNANCE 1) Banding both arches with lingual appliances 2) Extraction 14; 24 + stripping lower arch 3) 2 «facettes»leveling both arches 4) Partial retraction of the upper cuspids and en mass retraction of upper cuspids and incisors (bowing effect occured & repairs) 5) Class II elastics 6) Detailing 7) Retaining 8) Due the short lingual surfaces of the lower bicuspids we have bonded the anteriors with InOvation-L and the premolars with STb. CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE: 25 WBLO12

22 LATERAL SKULL RADIOGRAPH AT COMPLETION OF TREATMENT CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE: 25 WBLO13

23 TRACING OF LATERAL SKULL RADIOGRAPH AT COMPLETION OF TREATMENT CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE: 25 WBLO13-1

24 WBLO13-2

25 WBLO13-3

26 CEPHALOMETRIE ANALYSE TWEED MERRYFIELD Start Tt End Tt SNA 82 ± SNB 80 ± ANB 2 ± FMA IMPA OP/F 25 ± 3 87 ± CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE: 25 WBLO14-1

27 CEPHALOMETRIC MORPHOLOGICAL ASSESSMENT 2 Sagittal Skeletal Relations Maxillary Position S-N-A Mandibular Position S-N-B Sagittal Jaw Relation A-N-B Vertical Skeletal Relations Maxillary Inclination S-N / ANS-PNS Mandibular Inclination S-N / Go-Gn Pretreatment Posttreatment Mean SD º ± 3.5º º ± 3.5º º ± 2.5º º ± 3.0º º ± 2.5º Vertical Jaw Relation ANS-PNS / Go-Gn º ± 6.0º Dento-Basal Relations Maxillary Incisor Inclination 1 - ANS-PNS Mandibular Incisor Inclination 1 - Go-Gn Mandibular Incisor Compensation 1 - A-Pg (mm) Dental Relations Overjet (mm) º ± 6.0º º ± 7.0º 2.5mm 7.5mm 4.2mm 2mm 2± ± 2.5 Overbite (mm) 4.5mm 2mm 2± 2.5 Interincisal Angle 1 / º ± 6.0º CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE: 25 WBLO14-2

28 PERIAPICAL OR PANORAMIC RADIOGRAPHS AT COMPLETION OF TREATMENT CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE: 25 WBLO15

29 RADIOGRAPHIC ANALYSIS AT COMPLETION OF TREATMENT A. INTRAORAL / PANORAMIC RADIOGRAPH - Roots on the upper and lower arches are parallele - T ipping of the lower incisors B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT 1. Sagittal Skeletal Relations: maxillary position beyond the range of normal; mandible retruded relative to the maxilla; increased ANB 2. Vertical Skeletal Relations: normal vertical face height beyond the range of 3. Dento- Basal Relations: Maxillary incisor well positionned relative to line SN/ANS-PNS; mandibular incisor well positionned relative to line Go-Gn 4. Dental relations: normal overjet and overbite CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE: 25 WBLO16

30 DESCRIPTION OF THE TREATMENT RESULT TREATMENT RESULT ORIENTATION 1) Patient s profile is nice and harmonious 2) Class I cuspid relationship 3) Class II molar relationship, because of upper 1st bicuspid extractions 4) Retaining goal: lifelong CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE: 25 WBLO17

31 WBLO18

32 WBLO19

33 WBLO20

34 DESCRIPTION OF THE POST-TREATMENT EVALUATION OF RETENTION RETENTION RESULT ORIENTATION 1) Retaining goal: lifelong 2) Occlusion is stable 3) Teeth positions are stable CANDIDATE NUMBER: CASE NUMBER: 2 DATE: AGE: 27 WBLO21

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