EUROPEAN SOCIETY OF LINGUAL ORTHODONTICS

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1 EUROPEAN SOCIETY OF LINGUAL ORTHODONTICS

2 EUROPEAN SOCIETY OF LINGUAL ORTHODONTICS KANARELIS PANAGIOTIS (TAKIS) CASE NUMBER: 1 Year: 2012 WBLO 1

3 RÉSUMÉ OF CASE 1 CASE CATEGORY: ADULT MALOCCLUSION NAME: BOURELAKI SOFIA BORN: 07/12/1990 SEX: F PRETREATMENT RECORDS: AGE: 18 DATE: 26/01/2009 CLASSIFICATION: CLASS I EXTRACTIONS OF 4 BICUSPIDS TEETH MISSING BEFORE TREATMENT: APPLIANCE: Upper & lower lingual fixed orthodontic appliance TREATMENT STARTED: AGE: 18 DATE: 14/03/2009 TREATMENT ENDED: AGE:20 DATE: 14/02/2011 ACTIVE TREATMENT TIME: 23 MONTHS POSTTREATMENT RECORDS: 14/02/2011 RETAINERS: a)upper: removable splint a)lower: removable splint DATE: 14/02/2011 RETENTION ENDED: a)upper: a)lower: DATE: RETENTION TIME: 15 months (POST-) RETENTION RECORDS: AGE: 22 DATE: 30/05/2012 TIME OUT OF RETENTION: WBLO 2

4 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 frontal view. C. FUNCTIONAL EXAMINATION Patient s mastication don t show particular problems. D. INTRAORAL EXAMINATION 1. Classe I molar right; Classe I molar left. 2. Overjet 2,5 mm and overbite 0 mm. 3. Severe crowding on the upper and lower arch,. 4. Ectopic Mandibular teeth deviation to the right. E. DENTAL CASTS Mandibular arch: anterior severe crowding Maxillary arch: anterior severe crowding Occlusion Sagittal: 2,5mm Occlusion Vertical: 0 mm Occlusion Transversal: ectopic position of 13, 23, 43 PANAGIOTIS KANARELIS CASE NUMBER: 1 DATE:21/01/2009 AGE: 18 WBLO 3

5 FRONTAL 45 PROFILE FACIAL PHOTOGRAPHS BEFORE TREATMENT KANARELIS PANAGIOTIS CASE NUMBER: 1 DATE: 26/01/2009 AGE: 18 WBLO 4

6 Right Buccal Left Buccal Upper Occlusal Center Lower Occlusal INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BEFORE TREATMENT KANARELIS PANAGIOTIS CASE NUMBER:1 DATE:26/01/2009 AGE:18 WBLO 5

7 Mandibular teeth deviation to the right KANARELIS PANAGIOTIS CASE NUMBER:1 DATE:26/01/2009 AGE:18 WBLO 05-1

8 LATERAL SKULL RADIOGRAPH BEFORE TREATMENT KANARELIS PANAGIOTIS CASE NUMBER:1 DATE:26/01/2009 AGE:18 WBLO 6

9 TRACING OF LATERAL SKULL RADIOGRAPH BEFORE TREATMENT KANARELIS PANAGIOTIS CASE NUMBER:1 DATE:26/01/2009 AGE:18 WBLO 7

10 5,5 28,1 112,4 34 1,6 29,5 54,l 96,4 KANARELIS PANAGIOTIS CASE NUMBER1 DATE AGE 18 WBLOO l-1

11 CEPHALOMETRIC MORPHOLOGICAL Pretreatment Mean SD Sagittal Skeletal Maxillary Position S-N-A Mandibular Position S-N-Pg Sagittal Jaw Relation A-N-Pg 84,4º 82º ±3.5º 79,7º 80º ± 3.5º 4,7º 2º ± 2.5º Vertical Skeletal Relations Maxillary Inclination S-N/ANS- PNS Mandibular Inclination S-N/Go-Gn 9,2º 8º ± 3.0º 39º 33º ± 2.5º KANARELIS PANAGIOTIS CASE NUMBER:1 DATE:26/01/2009 AGE:18 WBLO 08

12 CEPHALOMETRIC MORPHOLOGICAL Pretreatment Mean SD Vertical Jaw Relation ANS- PNS/Go-Gn 25,3º 25º ± 6.0º Dento- Basal Relations Maxillary Incisor Inclination 1-ANS-PNS 121,7º 110º ± 6.0º Mandibular Incisor Inclination 1-Go-Gn 96,4º 94º ± 7.0º KANARELIS PANAGIOTIS CASE NUMBER:1 DATE:26/01/2009 AGE:18 WBLO 08-1

13 CEPHALOMETRIC MORPHOLOGICAL Mandibular Incisor Compensati on 1 A-Pg (mm) 6,6mm 2 ± 2.0 Dental Relations Overjet (mm) 2,5mm 2 ± 2.0 Overbite (mm) 0mm 2 ± 2.5 Interincisal Angle 1/1 112,4º 132º ± 6.0º KANARELIS PANAGIOTIS CASE NUMBER:1 DATE:26/01/2009 AGE:18 WBLO 08-2

14 INTERPRETATION OF CEPHALOMETRIC ASSESSMENT 1. Sagittal Skeletal Relations: ANB 5.6 º skeletal classe II malocclusion; 2. Vertical Skeletal Relations: Mandibular Inclination S-N/Go-Gn 39º; 3. Dento- Basal Relations: Excesive labial position of the upper incisors (121.7 º); 4. Dental relations: overjet 2,5mm,overbite 0mm ; increased interincisall Angle (112,4 º) caused by the postion of the maxillary incisors; 5. Esthetic Profil: normal. KANARELIS PANAGIOTIS CASE NUMBER:1 DATE:26/01/2009 AGE:18 WBLO 09

15 A) PANORAMIC RADIOGRAPH BEFORE TREATMENT B. INTERPRETATION OF PANORAMIC ASSESSMENT Severe crowding of the anterior maxilla and mandibular teeth Existence of Periodontal diseases' of the anterior maxilla teeth KANARELIS PANAGIOTIS CASE NUMBER:1 DATE:26/01/2009 AGE:18 WBLO 10

16 TREATMENT STEPS INTRA-ORAL VIEW COLOUR PHOTOGRAPHS KANARELIS PANAGIOTIS CASE NUMBER:1 DATE: 14/03/2009 AGE:18 WBLO 11-1

17 TREATMENT STEPS INTRA-ORAL VIEW COLOUR PHOTOGRAPHS KANARELIS PANAGIOTIS CASE NUMBER:1 DATE: 11/04/2009 AGE:18 WBLO 11-2

18 TREATMENT STEPS INTRA-ORAL COLOUR PHOTOGRAPHS KANARELIS PANAGIOTIS CASE NUMBER:1 DATE:22/06/2009 AGE:19 WBLO 11-3

19 TREATMENT STEPS INTRA-ORAL COLOUR PHOTOGRAPHS KANARELIS PANAGIOTIS CASE NUMBER:1 DATE:25/01/2010 AGE:19 WBLO 11-4

20 TREATMENT STEPS INTRA-ORAL COLOUR PHOTOGRAPHS KANARELIS PANAGIOTIS CASE NUMBER: 1 DATE:28/07/2010 AGE:20 WBLO 11-5

21 KANARELIS PANAGIOTIS CASE NUMBER 1 DATE 28/07/2010 AGE 20 WBLO 11-6

22 TREATMENT STEPS INTRA-ORAL COLOUR PHOTOGRAPHS KANARELIS PANAGIOTIS CASE NUMBER: 1 DATE:20/12/2010 AGE:20 WBLO 11-7

23 FRONTAL SMILING PROFILE FACIAL PHOTOGRAPHS AT COMPLETION OF TREATMENT KANARELIS PANAGIOTIS CASE NUMBER: 1 DATE:14/02/2011 AGE:20 WBLO 12-1

24 INTRA-ORAL PHOTOGRAPHS AT COMPLETION OF TREATMENT KANARELIS PANAGIOTIS CASE NUMBER: 1 DATE:14/02/2011 AGE:20 WBLO 12-2

25 TREATMENT STEPS INTRA-ORAL OCCLUSAL VIEW COLOUR PHOTOGRAPHS FRONTAL VIEW WBLO 13-1

26 TREATMENT STEPS INTRA-ORAL COLOUR PHOTOGRAPHS LATERAL RIGHT VIEW WBLO 13-2

27 TREATMENT STEPS INTRA-ORAL COLOUR PHOTOGRAPHS LATERAL LEFT VIEW WBLO 13-3

28 TREATMENT STEPS INTRA-ORAL UPPER OCCLUSAL VIEW COLOUR PHOTOGRAPHS WBLO 13-4

29 TREATMENT STEPS INTRA-ORAL LOWER OCCLUSAL VIEW COLOUR PHOTOGRAPHS WBLO 13-5

30 LATERAL SKULL RADIOGRAPH AT COMPLETION OF TREATMENT KANARELIS PANAGIOTIS CASE NUMBER:1 DATE: 14/02/2011 AGE:20 WBLO 14

31 SNA: 84,5 Lande angle (FH- SNB: 78,6 Facial angl (FH-NP---0 SNPog: 80,2 NSBa: 134,9 ANB: 5,9 \Vits ABO (m 1 SN-PP: 9,6 GoGn-SN: 34,B MP-PP: 22,8 Y-axis: 58,5 Gonial angle: UFH \ TFH: LFH \ TFH: Ul-FH: 10 Ul-SN: 95 Ul-PP: 10 Ul-APog: Ul to AP PP-FOP: AB-FOP Ll-FOP: L l-apog. Ll to APo SOFT-TISSUE MEASUR. Labionasal angle: 116,6 Up. lip to E-Plane: -2,6 Low. lip to E-Plane: -2,3 Z-angle (Merrifield): 75,2 H- angle: 12,5 KANARELIS PANAGIOTIS CASE NUMBER:1 DATE: 14/02/2011 AGE:20 WBLO 14-1

32 5,9 132,9 2,9 28,1 57,1 94,8 KANAR ELIS PANAG IOTIS CASE NUMBER:1 DATE: 14/ AGE:20 WBLO 14-2

33 CEPHALOMETRIC MORPHOLOGICAL Pretreatment Aftertreatment Mean SD Sagittal Skeleatal Maxillary Position S-N-A Mandibular Position S-N-Pg Sagittal Jaw Relation A-N-Pg 84,4º 84.5º 82º ±3.5º 79,7º 80.2º 80º ± 3.5º 4,7º 4.3º 2º ± 2.5º Vertical Skeletal Relations Maxillary Inclination S-N/ANS- PNS Mandibular Inclination S-N/Go-Gn 9,2º 9.6º 8º ± 3.0º 39º 34.3º 33º ± 2.5º KANARELIS PANAGIOTIS CASE NUMBER:1 DATE: 14/02/2011 AGE:20 WBLO 15

34 CEPHALOMETRIC MORPHOLOGICAL Pretreatment After treatment Mean SD Vertical Jaw Relation ANS- PNS/Go-Gn 25,3º 22.8º 25º ± 6.0º Dento- Basal Relations Maxillary Incisor Inclination 1-ANS-PNS 121,7º 104.7º 110º ± 6.0º Mandibular Incisor Inclination 1-Go-Gn 96,4º 94.8º 94º ± 7.0º KANARELIS PANAGIOTIS CASE NUMBER:1 DATE: 14/02/2011 AGE:20 WBLO 15-1

35 CEPHALOMETRIC MORPHOLOGICAL Mandibular Incisor Compensati on 1 A-Pg (mm) 6,6mm 3.5mm 2 ± 2.0 Dental Relations Overjet (mm) 2,5mm 2.5mm 2º ± 2.0 Overbite (mm) Interincisal Angle 1/1 0mm 2 mm 2 ± ,4º 132.9º 132º ± 6.0º KANARELIS PANAGIOTIS CASE NUMBER:1 DATE: 14/02/2011 AGE:20 WBLO 15-2

36 RADIOGRAPHIC ANALYSIS AT COMPLETION OF TREATMENT A. INTRAORAL / PANORAMIC RADIOGRAPH B. INTERPRETATION OF PANORAMIC ASSESSMENT Good parallelism of the anterior maxilla and mandibular teeth must be extracted Moderate apex resorption of the anterior maxilla teeth Need for extraction of 18,28,38,48. KANARELIS PANAGIOTIS CASE NUMBER:1 DATE: 14/02/2011 AGE:20 WBLO 16

37 RADIOGRAPHIC ANALYSIS AT COMPLETION OF TREATMENT B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT 1) Normalization of Mandibular Inclination S-N/Go-Gn (34.3º) 2) Normalization of Maxillary Incisor Inclination 1-ANS-PNS (104.7 º) 3) Normalization of Mandibular Incisor Compensation 1-A-Pg (3.5mm) 4) Normalization of Interincisal Angle 1/1 (132.9º) KANARELIS PANAGIOTIS CASE NUMBER:1 DATE: 14/02/2011 AGE:20 WBLO 17

38 GENERAL SUPERIMPOSITION Superimposition on stable structures in the anterior cranial base KANARELIS PANAGIOTIS CASE NUMBER:1 DATE: 14/02/2011 AGE:20 WBLO 17-1

39 SUPERIMPOSITION OF THE MAXILLA KANARELIS PANAGIOTIS CASE NUMBER:1 DATE: 14/02/2011 AGE:20 WBLO 17-2

40 SUPERIMPOSITION OF THE MANDIBLE KANARELIS PANAGIOTIS CASE NUMBER:1 DATE: 14/02/2011 AGE:20 WBLO 17-3

41 FRONTAL SMILING PROFILE FACIAL PHOTOGRAPHS 6 MONTHS AFTER THE TREATMENT KANARELIS PANAGIOTIS CASE NUMBER:1 DATE: 01/09/2011 AGE:21 WBLO 18

42 TREATMENT STEPS INTRA-ORAL COLOUR PHOTOGRAPHS KANARELIS PANAGIOTIS CASE NUMBER:2 DATE:01/09/2011 AGE:21 WBLO 18-1

43 FRONTAL 45 PROFILE FACIAL PHOTOGRAPHS 15 MONTHS AT RETENTION / POST RETENTION KANARELIS PANAGIOTIS CASE NUMBER:1 DATE: 30/05/2012 AGE:22 WBLO 19

44 Right Buccal Left Buccal Upper Occlusal Center Lower Occlusal INTRA-ORAL COLOUR PHOTOGRAPHS AT 15 MONTHS RETENTION KANARELIS PANAGIOTIS CASE NUMBER:1 DATE: 30/05/2012 AGE:22 WBLO 19-1

45 RADIOGRAPHIC ANALYSIS AT COMPLETION OF TREATMENT A. INTRAORAL / PANORAMIC RADIOGRAPH 1. Good parallelism of the anterior maxilla and mandibular teeth must be extracted 3. Moderate apex resorption of the anterior maxilla teeth B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT 1. Correction of the mandibular inclination (S-N/Go-Gn) 39º before treatment, 34.3º at the end of the treatment; 2. Correction of the Maxillary Incisor Inclination (121.7º before treatment,104.7 after treatment); 3. Correction of the Mandibular Incisor Compensation 1-A-Pg ( 6.6mm before treatment, 3.5mm after treatment); 4. Correction of the Interincisal Angle (112.4º before treatment, 132.9º after treatment). KANARELIS PANAGIOTIS CASE NUMBER:1 DATE: 30/05/2012 AGE:22 WBLO 20

46 DESCRIPTION OF THE TREATMENT RESULT 1. Very good alignment of the anterior upper and lower teeth; 2. Classe I molar and cuspid; 3. Normalization of the maxillary incisor inclination; 4. Correction of the Interincisal Angle; 5. 4 months of triangular lateral intermaxillary elastics; months of active treatment. KANARELIS PANAGIOTIS CASE NUMBER:1 DATE: 30/05/2012 AGE:22 WBLO 21

47 CONCLUSION Before After

48 Before After

49 Before After

50 Before After

51 Before After

52

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