EUROPEAN SOCIETY OF LINGUAL ORTHODONTICS CANDIDATE NUMBER: KDr. KP. kanarelis CASE NUMBER: 1 Year: 2010 WBLO 01
RESUME OF CASE 1 CASE CATEGORY: ADULT MALOCCLUSION NAME : IOANNIS.G BORN: 03.01.1989 SEX: M PRETREATMENT RECORDS: AGE:18 DATE:09.02.2007 CLASSIFICATION: Adult malocclusion - Class III TEETH MISSING BEFORE TREATMENT: 0 TREATMENT PLAN: APPLIANCE: Upper & lower lingual fixed orthodontic appliance TREATMENT STARTED: AGE: 18 DATE: 11-04-2007 TREATMENT ENDED: AGE: 20 DATE: 17-01-2009 ACTIVE TREATMENT TIME: 21 months POSTTREATMENT RECORDS: AGE: 20 DATE: 17-01-2009 RETAINERS: a)upper: a)lower: DATE: 17-01-2009 RETENTION ENDED: a)upper: not ended a)lower: not ended DATE: not ended RETENTION TIME: unlimited (POST-) RETENTION RECORDS: AGE:21 DATE:18-06-2010 TIME OUT OF RETENTION: still in retention WBLO 02
DIAGNOSTIC DESCRIPTION OF THE MALOCCLUSION A. SUMMARY Young man 18 years old, with previous orthodontic treatment (10-12 years). B. EXAMINATION OF HEAD AND FACE Facial asymmetry, deviation right of the mandible and high angle face. C. FUNCTIONAL EXAMINATION Patient s mastication shows no particular problem to mention D. INTRAORAL EXAMINATION 1.Very bad hygiene, many amalgams of the posterior upper and lower teeth. III molar and canine. 2. Overjet 0 mm and overbite -2 mm 3. Crowding on the lower arch 4. Lingual-version of the mandibular incisors 5. Mesial in rotation of the upper canines E. DENTAL CASTS Mandibular arch: crowding of the anteriors Maxillary arch: moderate rotation of the 13; 23; Occlusion Sagittal: 0 mm Class III Occlusion Vertical: -2 m m Occlusion Transversal: ok CANDIDATE NUMBER: CASE NUMBER: 1 DATE: 09.02.2007 AGE: 18 WBLO 03
FRONTAL SMILING PROFILE FACIAL PHOTOGRAPHS BEFORE TREATMENT CANDIDATE NUMBER: CASE NUMBER: 1 DATE: 09.02.2007 AGE: 18 WBLO 04
Right Buccal Left Buccal Center Upper Occlusal Lower Occlusal INTRA-ORAL COLOUR PHOTOGRAPHS START OF THE TREATMENT CANDIDATE NUMBER: CASE NUMBER: 1 DATE: 09.02.2007 AGE: 18 WBLO 05
LATERAL SKULL RADIOGRAPH BEFORE TREATMENT CANDIDATE NUMBER: CASE NUMBER: 1 DATE: 09.02.2007 AGE: 18 WBLO 06
TRACING OF LATERAL SKULL RADIOGRAPH BEFORE TREATMENT CANDIDATE NUMBER: CASE NUMBER: 1 DATE: 09.02.2007 AGE: 18 WBLO 06-1
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CEPHALOMETRIE ANALYSE TWEED MERRYFIELD Start Tt SNA 82 ± 2 78.7 SNB 80 ± 2 80.6 ANB 2 ± 2-1.9 FMA IMPA OP/F 25 ± 3 87 ± 3 10 39 76.4 14.1 CANDIDATE NUMBER: CASE NUMBER: 1 DATE: 09.02.2007 AGE: 18 WBLO 07-1
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 78.7 82º ± 3.5º 80.6 80º ± 3.5º -1.9 2º ± 2.5º 6.6 8º ± 3.0º 38.6 33º ± 2.5º Vertical Jaw Relation ANS-PNS / Go-Gn 30.5 25º ± 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) 116.4 110º ± 6.0º 76.4 94º ± 7.0º 2.3mm 0 m m 2± 2.0 3.5± 2.5 Overbite (mm) -2 m m 2± 2.5 Interincisal Angle 1 / 1 135.1 132º ± 6.0º CANDIDATE NUMBER: CASE NUMBER: 1 DATE: 09.02.2007 AGE: 18 WBLO 07-2
PERIAPICAL OR PANORAMIC RADIOGRAPHS BEFORE TREATMENT CANDIDATE NUMBER: CASE NUMBER: 1 DATE: 09.02.2007 AGE: 18 WBLO 08
NO NEED FOR OTHER X-RAY ANY OTHER RADIOGRAPHS BEFORE TREATMENT If needed WBLO 09
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RADIOGRAPHIC ANALYSIS BEFORE TREATMENT A. INTRAORAL / PANORAMIC RADIOGRAPH PANORAMIC RADIOGRAPH: periodontic desease grade 1. B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT 1. Sagittal Skeletal Relations: Sagittal Skeletal Class III; Jjaw relation ANB -1.9 2. 3. 4. Vertical Skeletal Relations: vertical face height beyond the range of normal, long lowe r anterior face height ; Dento- Basal Relations: Maxillary incisor in an acceptable position; mandibular incisor in a retrusive position; Dental relations: excessive lingual position of the lower incisor s, Classe III molar and canine; 5. Esthetic Profil: Hight concavity. CANDIDATE NUMBER: CASE NUMBER: 1 DATE: 09.02.2007 AGE: 18 WBLO12-01
TREATMENT PLAN AND THE REASON FOR IT PLANNING & STEPS 1) Banding both arches with lingual appliances; 2) Teeth alignement; 3) Coodrination of both arches before surgery; 4) Indirect labial bonding before surgery; 5) Surgical treatment (maxilla and mandible) 6) Detailing; 7) Retaining. The reason for this treatment is to improve smile (patient expectation) and masticatory function on professionnal point of view. CANDIDATE NUMBER: CASE NUMBER: 1 DATE: 09.02.2007 AGE: 18 WBLO12-2
Right Buccal Left Buccal Center Upper Occlusal Lower Occlusal TREATMENT STEPS INTRA-ORAL OCCLUSAL VIEW COLOUR PHOTOGRAPHS CANDIDATE NUMBER: CASE NUMBER: 1 DATE: 11.04.2007 AGE:18 WBLO13
BONDING LABIAL BUTTONS TO DEROTEDED THE CANINES 8 02-11-2007 WBLO13-1
23/11/2007.0175 x.0175 TMA 02/11/2007.01 6 x.016 Thermo NiTi and circumferencial ligatures 33,43 Center Upper Occlusal Lower Occlusal TREATMENT STEPS INTRA-ORAL OCCLUSAL VIEW COLOUR PHOTOGRAPHS CANDIDATE NUMBER: CASE NUMBER: 1 DATE: 02.11.2007 AGE: 18 WBLO13-2
Upper Occlusal.016 x.016 SS Lower Occlusal TREATMENT STEPS INTRA-ORAL OCCLUSAL VIEW COLOUR PHOTOGRAPHS CANDIDATE NUMBER: CASE NUMBER: 1 DATE: 10.12.2007 AGE: 18 WBLO13-3
Right Buccal Left Buccal Center Repositioning of the lower anteriors and augmentation of the sagittal relationship TREATMENT STEPS INTRA-ORAL VIEW COLOUR PHOTOGRAPHS CANDIDATE NUMBER: CASE NUMBER: 1 DATE: 21.03.2008 AGE: 19 WBLO13-4
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09/06/2008 Indirect bonding of labial brackets and.017 x.025 SS WBLO13-8
Lateral radiography before surgery 22/05/2008 WBLO14
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PANORAMIC AT THE END OF THE TREATMENT WBLO22
END OF THE TREATMENT 1/2009 WBLO22
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BEFORE TREATMENT AFTER ORTHODONTIC ALIGNEMENT AFTER SURGERY WBLO28
RESUME OF THE TREATMENT CARRIED OUT INCLUDING ANY DIFFICULTIES ENCOUNTERED TREATMENT GOUVERNANCE 1) Banding both arches with lingual appliances 2) Leveling of both dental arches 3) Coordination of maxilla and mandible before surgery 4) 5) Indirect bonding of labial brackets to stabilise the surgical splints Detailing 6) Retaining CANDIDATE NUMBER: CASE NUMBER: 1 DATE: 17.01.2009 AGE: 20 WBLO29
CEPHALOMETRIE ANALYSE TWEED MERRYFIELD Start Tt End Tt SNA 82 ± 2 78.7 78.8 SNB 80 ± 2 80.6 78.1 ANB 2 ± 2-1.9 0.7 FMA IMPA OP/F 25 ± 3 87 ± 3 10 39 38.9 76.4 81.3 14.1 5.9 CANDIDATE NUMBER: CASE NUMBER: 1 DATE: 01-2009 AGE: 20 WBLO29-1
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 78.7 78.8 82º ± 3.5º 80.6 78.1 80º ± 3.5º -1.9 0.7 2º ± 2.5º 6.6 14.5 8º ± 3.0º 38.6 42.2 33º ± 2.5º Vertical Jaw Relation ANS-PNS / Go-Gn 30.5 24.8 25º ± 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) 116.4 120.7 110º ± 6.0º 76.4 81.3 94º ± 7.0º 2.3mm 0mm 2.8mm 3mm 2± 2.0 3.5± 2.5 Overbite (mm) -2mm 2mm 2± 2.5 Interincisal Angle 1 / 1 135.1 131.1 132º ± 6.0º CANDIDATE NUMBER: CASE NUMBER: 1 DATE: 01.2009 AGE: 20 WBLO29-2
RADIOGRAPHIC ANALYSIS AT COMPLETION OF TREATMENT A. INTRAORAL / PANORAMIC RADIOGRAPH - Roots on the upper and lower arches are parallele - Resorptions of the anterior teeth B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT 1. Sagittal Skeletal Relations : ANB 0.7 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: 1 DATE: 01.2009 AGE: 20 WBLO30
DESCRIPTION OF THE TREATMENT RESULT TREATMENT RESULT ORIENTATION 1) Patient s profile is nice and harmonious 2) Class I cuspid relationship 3) Retaining goal: lifelong CANDIDATE NUMBER: CASE NUMBER: 1 DATE: 01.2009 AGE: 20 WBLO31
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: 1 DATE: 06.2010 AGE: 21 WBLO32