EUROPEAN SOCIETY OF LINGUAL ORTHODONTISTS CANDIDATE NUMBER: 44 CASE NUMBER: 1 Year: ESLO 01
RÉSUMÉ OF CASE 1 CASE CATEGORY: ADULT MALOCCLUSION NAME: K.N BORN: 03/03/1980 SEX: Male PRE-TREATMENT RECORDS: CLASSIFICATION: AGE: 21.7 years CLASS II DIVISION 1 DATE: 27/10/2001 TEETH MISSING BEFORE TREATMENT: None TREATMENT PLAN: APPLIANCE: TREATMENT STARTED: Dental arch expansion by guad helix appliance 14.24 extraction Lingual appliance (Kurz 7th) AGE: 21.8 years DATE: 29/11/2001 TREATMENT FINISHED: ACTIVE TREATMENT TIME: AGE: 23.9 years DATE: 03/12/2003 2.1 years POST-TREATMENT RECORDS: RETAINERS: RETENTION ENDED: AGE: 23.9 years DATE: 03/12/2003 a)upper: Begg type retainer &Dynamic positioner a)lower: : Fixed type retainer &Dynamic positioner DATE:: 03/12/2003 a)upper: DATE: a)lower: RETENTION TIME: 4.6 years (POST-) RETENTION RECORDS: AGE: 28.3 years DATE: 21/06/2008 TIME OUT OF RETENTION: ESLO 02
DIAGNOSTIC DESCRIPTION OF THE MALOCCLUSION A. SUMMARY K.N. Japanese male,21y7m, The chief complain was flaring of upper incisors. Angle Class division with upper anterior crowding. Over jet +7.3mm, Over bite+5.5mm,deep over bite Treatment involved upper 1st bicuspid removal Multilingual system with Palatal bar and Cl elastic. Active treatment length was 2.1years 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 3mm, Overbite 5.5mm 3. Deep bite 4. Crowding in the upper anterior teeth. E. DENTAL CASTS Maxillary arch: Arch length discrepancy -3.0mm Mandibular arch: Arch length discrepancy -2.1 mm Occlusion Sagittal: Angle class, Overjet 7.3mm Occlusion Vertical: overbite 5.5mm Occlusion Transversal: None CANDIDATE NUMBER: 44 CASE NUMBER: DATE:27/10/2001 AGE:21.7years ESLO 03
FRONTAL SMILE PROFILE 45 FACIAL PHOTOGRAPHS BEFORE TREATMENT CANDIDATE NUMBER: 44 CASE NUMBER: DATE:27/10/2001 AGE:21.7years ESLO 04
Right Buccal Left Buccal Upper Occlusal Center Lower Occlusal INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BEFORE TREATMENT CANDIDATE NUMBER: 44 CASE NUMBER: DATE:27/10/2001 AGE:21.7years ESLO 05
Print on transparent support LATERAL SKULL RADIOGRAPH BEFORE TREATMENT CANDIDATE NUMBER: 44 CASE NUMBER: DATE:27/10/2001 AGE:21.7years ESLO 06
Print on transparent support TRACING OF LATERAL SKULL RADIOGRAPH BEFORE TREATMENT CANDIDATE NUMBER: 44 CASE NUMBER: DATE:27/10/2001 AGE:21.7years ESLO 07
CEPHALOMETRIC MORPHOLOGICAL ASSESSMENT 1 Sagittal Skeletal Relations Maxillary Position S-N-A Pretreatment Mean SD 79.4 82º ± 3.5º Mandibular Position S-N-Pg 76.5 80º ± 3.5º Sagittal Jaw Relation A-N-Pg 2.9 2º ± 2.5º Vertical Skeletal Relations Maxillary Inclination S-N / ANS-PNS 10.6 8º ± 3.0º Mandibular Inclination S-N / Go-Gn 36.7 33º ± 2.5º Vertical Jaw Relation ANS-PNS / Go-Gn 26.1 25º ± 6.0º Dento-Basal Relations Maxillary Incisor Inclination 1 - ANS-PNS 119.5 110º ± 6.0º Mandibular Incisor Inclination 1 - Go-Gn 98.1 94º ± 7.0º Mandibular Incisor Compensation 1 - A-Pg (mm) 5.5mm 2mm ± 2.0 Dental Relations Overjet (mm) 7.3mm 3.5mm ± 2.5 Overbite (mm) 5.5mm 2mm ± 2.5 Interincisal Angle 1 / 1 115.8 132º ± 6.0º CANDIDATE NUMBER: 44 CASE NUMBER: DATE:27/10/2001 AGE:21.7years ESLO 08
Print on transparent support PERIAPICAL OR PANORAMIC RADIOGRAPHS BEFORE TREATMENT CANDIDATE NUMBER: 44 CASE NUMBER: DATE:27/10/2001 AGE:21.7years ESLO 09
Print on transparent support ANY OTHER RADIOGRAPHS BEFORE TREATMENT CANDIDATE NUMBER: 44 CASE NUMBER: DATE:27/10/2001 AGE:21.7years ESLO 10
RADIOGRAPHIC ANALYSIS BEFORE TREATMENT A. INTRAORAL / PANORAMIC RADIOGRAPH The bilateral lower third molors were impacted. B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT.Sagittal Skeltal Relations: Maxillary position was normal. Mandible position was normal. ANB( 3.8 was normal. Skeletal Class 2.Vertical Skeltal Relations: Vertical face height was slightly beyond the range of normal. Lower anterior face height was normal. 3. Dento-Basal Relations: Maxillary incisors were flaring. Mandibular incisors were in a protruded position. 4. Dental relations: The incisors were excessive buccal position. Deep bite, Angle Class molocclusion 5.Esthetic Profile Lip protrusion CANDIDATE NUMBER: 44 CASE NUMBER: DATE:27/10/2001 AGE:21.7years ESLO 11
TREATMENT PLAN AND THE REASON FOR IT Treatment plan 1. Upper dental arch expansion by quad helix 2. Extraction 14;24 3. Placement of multilingual brackets and alignment the upper and lower arch 4. En masse retraction of upper incisors. 5. Class elastic 6. Detailing 7. Retaining The reason is 1.Upper dental arch width is narrow 2.The molar relation was Angle class. 3,The patient had protrusive lips. 4.Upper incisors were crowded and measurements of upper incisors indicated flaring. 5.Lower incisors were slightly crowded but measurements of lower incisors didn t indicated flaring. CANDIDATE NUMBER: 44 CASE NUMBER: DATE:27/10/2001 AGE:21.7years ESLO 12
Right Buccal Left Buccal Upper Occlusal Center Lower Occlusal INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BETWEEN TREATMENT Upper Quad helix set CANDIDATE NUMBER:44 CASE NUMBER: 1 DATE:29/11/2001 AGE: 21.8years ESLO 12-1
Right Buccal Left Buccal Upper Occlusal Center Lower Occlusal INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BETWEEN TREATMENT Upper respond.0175 Lower TMA.016 CANDIDATE NUMBER:44 CASE NUMBER: 1 DATE:05/03/2002 AGE: 22.0years ESLO 12-1
Right Buccal Left Buccal Upper Occlusal Center Lower Occlusal INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BETWEEN TREATMENT Upper SS.016!.022 Lower Co-NiTi.017!.017 CANDIDATE NUMBER: 44 CASE NUMBER: 1 DATE:07/10/2002 AGE: 22.7years ESLO 12-1
Right Buccal Left Buccal Upper Occlusal Center Lower Occlusal INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BETWEEN TREATMENT Upper TMA.0175!.0175 Lower TMA.0175!.0175 CANDIDATE NUMBER: 44 CASE NUMBER: 1 DATE:08/10/2003 AGE: 23.7years ESLO 12-1
RÉSUMÉ OF THE TREATMENT CARRIED OUT INCLUDING ANY DIFFICULTIES ENCOUNTERED Extractions of lower third molars were postponed for patient s inconvenience. 29/11/2001 The quad helix was placed on upper arch molars. 26/12/2001 Placement lower lingual appliance and start to leveling with 0175 Respond. 25/02/2002 Extraction the upper 1st premolars 05/03/2002 Placement upper lingual appliance with respond 0175. 01/04/2002 Levering was continued with TMA 016 and Copper-niti 017! 017 for 4 month 05/08/2002 Placement of 016! 022 SS wire on upper and lower arch and starting in using of class elastics. Starting in the upper and lower anterior retraction by elastic chain. (entire 11 months) 08/07/2003 Starting of detailing with TMA 0175! 0175 wire (entire 5 months) The period of active treatment was 2.1years. CANDIDATE NUMBER: CASE NUMBER: 1 DATE:29.9.2003 AGE: ESLO 13
FRONTAL SMILE PROFILE 45 FACIAL PHOTOGRAPHS AT COMPLETION OF TREATMENT CANDIDATE NUMBER:44 CASE NUMBER:1 DATE:03/12/2003 AGE:23.9years ESLO 14
Right Buccal Left Buccal Upper Occlusal Center Lower Occlusal INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION AT COMPLETION OF TREATMENT CANDIDATE NUMBER:44 CASE NUMBER:1 DATE:03/12/2003 AGE:23.9years ESLO 15
Print on transparent support LATERAL SKULL RADIOGRAPH AT COMPLETION OF TREATMENT CANDIDATE NUMBER:44 CASE NUMBER:1 DATE:03/12/2003 AGE:23.9years ESLO 1
Print on transparent support TRACING OF LATERAL SKULL RADIOGRAPH AT COMPLETION OF TREATMENT CANDIDATE NUMBER:44 CASE NUMBER:1 DATE:03/12/2003 AGE:23.9years ESLO 17
SUPERIMPOSITION AT SN-S CANDIDATE NUMBER:44 CASE NUMBER:1 DATE:03/12/2003 AGE:23.9years ESLO 17-1
Palatal Plane at ANS Mandibular Plane at Me SN at S SUPERIMPOSITIONS of MAXILLA,MANDIBULE,PROFILE CANDIDATE NUMBER: 44 CASE NUMBER: 1 DATE:03/12/2003 AGE: 23.9years ESLO 17-1
CEPHALOMETRIE ANALYSE TWEED MERRYFIELD Debut Tt Fin Tt SNA 82 ± 79.4 79.0 SNB 80 ± 75.6 75.0 ANB 2 ± 3. 4.0 FMA 25 ±3 23.3 24.0 IMPA 87 ±3 98.4 97.6 OP/F 10 5.6 6.9 CANDIDATE NUMBER:44 CASE NUMBER:1 DATE: 03/12/2003 AGE:23.9years ESLO 18!
CEPHALOMETRIC MORPHOLOGICAL ASSESSMENT 2 Sagittal Skeletal Relations Maxillary Position S-N-A Pretreatment Posttreatment Mean SD 79.4 79.0 82º ± 3.5º Mandibular Position S-N-Pg 76.5 75.9 80º ± 3.5º Sagittal Jaw Relation A-N-Pg 2.9 3.1 2º ± 2.5º Vertical Skeletal Relations Maxillary Inclination S-N / ANS-PNS 10.6 10.4 8º ± 3.0º Mandibular Inclination S-N / Go-Gn 36.7 37.2 33º ± 2.5º Vertical Jaw Relation ANS-PNS / Go-Gn 26.1 26.8 25º ± 6.0º Dento-Basal Relations Maxillary Incisor Inclination 1 - ANS-PNS 119.5 110.4 110º ± 6.0º Mandibular Incisor Inclination 1 - Go-Gn 98.1 99.2 94º ± 7.0º Mandibular Incisor Compensation 1 - A-Pg (mm) 5.5mm 5.3mm 2 ± 2.0 Dental Relations Overjet (mm) 7.3mm 2.0mm 3.5 ± 2.5 Overbite (mm) 5.5mm 2.1mm 2 ± 2.5 Interincisal Angle 1 / 1 115.8 125.2 132º ± 6.0º CANDIDATE NUMBER:44 CASE NUMBER:1 DATE:03/12/2003 AGE:23.9years ESLO 18
Print on transparent support PERIAPICAL OR PANORAMIC RADIOGRAPHS AT COMPLETION OF TREATMENT CANDIDATE NUMBER:44 CASE NUMBER:1 DATE:03/12/2003 AGE:23.9years ESLO 19
ANY OTHER RADIOGRAPHS AT COMPLETION OF TREATMENT CANDIDATE NUMBER:44 CASE NUMBER:1 DATE:03/12/2003 AGE:23.9years ESLO 19-1
RADIOGRAPHIC ANALYSIS AT COMPLETION OF TREATMENT A. INTRAORAL / PANORAMIC RADIOGRAPH Upper and Lower incisors slightly root resorped.. B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT.Sagittal Skeltal Relations: Maxillary position was normal Mandible position was normal ANB( 3.8 was normal 2.Vertical Skeltal Relations: Lower anterior face was slightly open. 3. Dento-Basal Relations: The flaring of Maxillary incisors was improved. Maxillary Incisor Inclination( 1 - ANS-PNS) was changed from 119.5 to 110.4 4. Dental Relations: Overbite and overjet was in the range of normal 5.Esthetic Profile: The protrusive lips was improved. CANDIDATE NUMBER:44 CASE NUMBER:1 DATE:03/12/2003 AGE:23.9years ESLO 20
DESCRIPTION OF THE TREATMENT RESULT Active treatment was 2.0years. The deep bite was improved at the first stage by the bite plane effect, and the over bite was improved from +5.5mm to 1.5mm. Maxillary Incisor Inclination (1 - ANS-PNS) was changed from 119.5 to 110.4,so the protrusive lips were improved. Sagittal Jaw relation ( A-N-Pg) slightly increased 0.3. The patient was so co-operation that the molar relationship was stable Cl and favorable occlusal relationship was obtained by using Cl elastics. It took 6 months for detailing of upper incisors. The upper and lower incisors was fixed by fixed type retainer and the patient used the Dynamic positioner during night time. CANDIDATE NUMBER:44 CASE NUMBER:1 DATE:03/12/2003 AGE:23.9years ESLO 21
FRONTAL SMILE PROFILE 45 FACIAL PHOTOGRAPHS AT RETENTION / POST RETENTION CANDIDATE NUMBER:44 CASE NUMBER: 1 DATE21/06/2008 AGE: 28.3yars ESLO 22
Right Buccal Left Buccal Upper Occlusal Center Lower Occlusal INTRA-ORAL COLOUR PHOTOGRAPHS AT RETENTION / POST-RETENTION CANDIDATE NUMBER:44 CASE NUMBER: 1 DATE21/06/2008 AGE: 28.3yars ESLO 23
Print on transparent support LATERAL SKULL RADIOGRAPH AT RETENTION / POSTRETENTION CANDIDATE NUMBER:44 CASE NUMBER: 1 DATE21/06/2008 AGE: 28.3yars ESLO 24
PERIAPICAL OR PANORAMIC RADIOGRAPHS AT RETENTION / POST-RETENTION CANDIDATE NUMBER: CASE NUMBER: DATE: 21/06/2008 AGE:28.3years ESLO 27-1
ANY OTHER RADIOGRAPHS ATAT RETENTION / POST-RETENTION CANDIDATE NUMBER: CASE NUMBER: DATE: 21/06/2008 AGE:28.3years ESLO 28-2
DESCRIPTION OF RETENTION / POST-RETENTION FINDINGS The upper third molars was controled by using Dymanic positioner after treatment. The good occlusion is stable after years of retention. CANDIDATE NUMBER: CASE NUMBER: DATE:18.3.2005 AGE:28.2years ESLO 27