EUROPEAN SOCIETY OF LINGUAL ORTHODONTICS CANDIDATE NUMBER: KDr. KP. kanarelis CASE NUMBER: 2 Year: 2010 WBLO 01
RESUME OF CASE 2 CASE CATEGORY: ADULT MALOCCLUSION NAME : MARIA A. BORN: 18.04.1983 SEX: F PRETREATMENT RECORDS: AGE:23 DATE:20.11.2006 CLASSIFICATION: Adult malocclusion - Class II1 TEETH MISSING BEFORE TREATMENT: 0 TREATMENT PLAN: APPLIANCE: Upper & lower lingual fixed orthodontic appliance TREATMENT STARTED: AGE: 23 DATE: 07-01-2007 TREATMENT ENDED: AGE: 25 DATE: 15-12-2008 ACTIVE TREATMENT TIME: 23 months POSTTREATMENT RECORDS: AGE: 25 DATE: 15-12-2008 RETAINERS: a)upper: a)lower: DATE: 15-12-2008 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
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: 20.11.2006 AGE: 23 WBLO 03
FRONTAL SMILING PROFILE FACIAL PHOTOGRAPHS BEFORE TREATMENT CANDIDATE NUMBER: CASE NUMBER: 2 DATE: 20.11.2006 AGE: 23 WBLO 04
Right Buccal Left Buccal Center Upper Occlusal Lower Occlusal INTRA-ORAL COLOUR PHOTOGRAPHS START OF THE TREATMENT CANDIDATE NUMBER: CASE NUMBER: 2 DATE: 07.01.2007 AGE: 24 WBLO 05
WBLO6
LATERAL SKULL RADIOGRAPH BEFORE TREATMENT CANDIDATE NUMBER: CASE NUMBER: 2 DATE: 20.11.2006 AGE: 23 WBLO 07
TRACING OF LATERAL SKULL RADIOGRAPH BEFORE TREATMENT CANDIDATE NUMBER: CASE NUMBER: 2 DATE: 20.11.2006 AGE: 23 WBLO 07-1
WBLO07-02
CEPHALOMETRIE ANALYSE TWEED MERRYFIELD Start Tt SNA 82 ± 2 83.4 SNB 80 ± 2 76.6 ANB 2 ± 2 6.8 FMA IMPA OP/F 25 ± 3 87 ± 3 10 26.1 104.3 2.6 CANDIDATE NUMBER: CASE NUMBER: 2 DATE: 20.11.2006 AGE: 23 WBLO 08-1
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 83.4 82º ± 3.5º 76.6 80º ± 3.5º 6.8 2º ± 2.5º 8.8 8º ± 3.0º 33.7 33º ± 2.5º Vertical Jaw Relation ANS-PNS / Go-Gn 26.1 25º ± 6.0º Dento-Basal Relations Maxillary Incisor Inclination 1 - ANS-PNS Mandibular Incisor Inclination 1 - Go-Gn Mandibular Incisor Compensation 1 - A-Pg (mm) Dental Relations Overjet (mm) 113.5 110º ± 6.0º 104.3 94º ± 7.0º 2.5mm 7.5mm 2± 2.0 3.5± 2.5 Overbite (mm) 4.5mm 2± 2.5 Interincisal Angle 1 / 1 119 132º ± 6.0º CANDIDATE NUMBER: CASE NUMBER: 2 DATE: 20.11.2006 AGE: 23 WBLO 08-2
PERIAPICAL OR PANORAMIC RADIOGRAPHS BEFORE TREATMENT CANDIDATE NUMBER: CASE NUMBER: 2 DATE: 20.11.2006 AGE: 23 WBLO 09
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 6.8 2. 3. 4. 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: 20.11.2006 AGE: 23 WBLO 10
Right Buccal Left Buccal Center Upper Occlusal Lower Occlusal TREATMENT STEPS INTRA-ORAL OCCLUSAL VIEW COLOUR PHOTOGRAPHS CANDIDATE NUMBER: CASE NUMBER: 2 DATE: 07.01.2007 AGE:24 WBLO11
8 partial retraction of the upper canines WBLO11-1
Right Buccal Left Buccal Center Upper Occlusal Lower Occlusal TREATMENT STEPS INTRA-ORAL OCCLUSAL VIEW COLOUR PHOTOGRAPHS CANDIDATE NUMBER: CASE NUMBER: 2 DATE: 08.10.2007 AGE: 24 WBLO11-2
Right Buccal Left Buccal Center Upper Occlusal Lower Occlusal TREATMENT STEPS INTRA-ORAL OCCLUSAL VIEW COLOUR PHOTOGRAPHS CANDIDATE NUMBER: CASE NUMBER: 2 DATE: 03.10.2008 AGE: 25 WBLO11-3
Right Buccal Left Buccal Center Upper Occlusal Lower Occlusal TREATMENT STEPS INTRA-ORAL OCCLUSAL VIEW COLOUR PHOTOGRAPHS CANDIDATE NUMBER: CASE NUMBER: 2 DATE: 15.12.2008 AGE: 25 WBLO11-4
WBLO11-5
WBLO11-6
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: 15.12.2008 AGE: 25 WBLO12
LATERAL SKULL RADIOGRAPH AT COMPLETION OF TREATMENT CANDIDATE NUMBER: CASE NUMBER: 2 DATE: 15.12.2008 AGE: 25 WBLO13
TRACING OF LATERAL SKULL RADIOGRAPH AT COMPLETION OF TREATMENT CANDIDATE NUMBER: CASE NUMBER: 2 DATE: 15.12.2008 AGE: 25 WBLO13-1
WBLO13-2
WBLO13-3
CEPHALOMETRIE ANALYSE TWEED MERRYFIELD Start Tt End Tt SNA 82 ± 2 83.4 83 SNB 80 ± 2 76.6 75.4 ANB 2 ± 2 6.8 7.6 FMA IMPA OP/F 25 ± 3 87 ± 3 10 26.1 27.8 104.3 109.3 2.6 1.8 CANDIDATE NUMBER: CASE NUMBER: 2 DATE: 15-12-2008 AGE: 25 WBLO14-1
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 83.4 83 82º ± 3.5º 76.6 75.4 80º ± 3.5º 6.8 7.6 2º ± 2.5º 8.8 7.6 8º ± 3.0º 33.7 35.3 33º ± 2.5º Vertical Jaw Relation ANS-PNS / Go-Gn 26.1 24.9 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) 113.5 99.9 110º ± 6.0º 104.3 109.3 94º ± 7.0º 2.5mm 7.5mm 4.2mm 2mm 2± 2.0 3.5± 2.5 Overbite (mm) 4.5mm 2mm 2± 2.5 Interincisal Angle 1 / 1 119 124.7 132º ± 6.0º CANDIDATE NUMBER: CASE NUMBER: 2 DATE: 15.12.2008 AGE: 25 WBLO14-2
PERIAPICAL OR PANORAMIC RADIOGRAPHS AT COMPLETION OF TREATMENT CANDIDATE NUMBER: CASE NUMBER: 2 DATE: 15.12.2008 AGE: 25 WBLO15
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: 15.12.2008 AGE: 25 WBLO16
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: 15.12.2008 AGE: 25 WBLO17
WBLO18
WBLO19
WBLO20
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: 06.2010 AGE: 27 WBLO21