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Case Presentation
By:
Raza siddique.Roll No:03FINAL YEAR
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History
Medical history: Not significant.
Past dental history: None.
Family history: Not significant.
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History
Para functional habits: none
Social and behavioral status:
Affording.
Internally motivated
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Extra OralExamination
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Frontal View
Symmetrical face
Head Form: mesiocephalic
Face Form: mesioprosopic.
Lips are not compitent
Lips shape: normal
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Frontal View Smile
Gum visibilty: 0Symetrical smile
consonant smile
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Profile Viewlips are not
compitent at rest.
Facial profile:
convex
Nasiolabial angle:Normal
Mentolabial angle:obtuse.
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Oblique View
Zygomatic prominence is normalLips are not competent at rest.
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Intra- OralExamination
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Dentition status:
Dentition status: permanent.
7 6 5 4 3 2 1 1 2 3 4 5 6
6 5 4 3 2 1 1 2 3 4 5 6
8 7 7 8
7 88
P t M
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Per o onta MucosaStatus
Frenum: normal and attached
Periodontal status: good
No soft tissue lesion
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Frontal View
Upper to Lowermidline: normal.
Frenum attached.
Good oral hygiene.
Overbite = 55%.
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Right Intraoral View
Molar Class:class II
Canine Class:Class II
Overjet: 5mm
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Left Intraoral View
Molar Class: Class II
Canine Class: Class II
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Maxillary Occlusal View
Midline: NormalPalatal vault: Normal
Arch shape: U shaped
Line of occlusion:normal.
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Mandibular Occlusal View
Midline: normal.
Arch shape: U
shaped.
Line of occlusion:disturbed.
Infraversion 35,45
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TMJ Analysis
Mouth opening: 30 mmNo significant finding.
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Investigations
Cephalogram
OPG
Study models
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Cephalogram
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Sagittal analysis
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Sagittal AnalysisNORMAL
VALUE
PATIENTS
READINGSSNA 82 2o 77o
SNB 782o 75o
ANB 1-4 2o
WITS ANALYSIS 0 2mm 0.5 mm
FACIAL ANGLE 87-90o 88o
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Sagittal Analysis
NORMALVALUES
PATIENTSVALUES
Mcnamara to pt A 01mm 0 mm
Mcnamara to upperIncisor
4mm 8.5mm
Mcnamara to Pog -34mm 4 mm
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Vertical analysis
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Dental Analysis
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Dental analysisNORMAL VALUES PATIENTS
VALUESUI-SN 102o 115
UI-FH 110o 125o
UI-PAL 108o 123
IMPA 90o 94o
UI-LI 125-135o 111o
NA/UI 22o 38o
NB/LI 25o 38o
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Dental analysis
NORMAL VALUE PATIENTSREADINGS
UI-NA Distance 4mm 13mm
LI-NB Distance 4mm 7mm
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Soft Tissue Analysis
Upper lip - E line = 0 mm
Lower lip - E line = +1 mm
Nasiolabial Angle = 61
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OPG
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OPG
No bone loss.No hard tissue abnormality.
According to Nollas stage:
VI,VIII,IX,IX,IX,IX,X,X
X,X,IX,IX,IX,IX,VIII,VI
V,VIII,IX,IX,IX,IX,X,X X,X,IX,IX,IX,IX,VIII,V
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Cast Apart
Maxilla arch:MIDLINE: Normal
PALATAL VAULT:Deep
ARCH SHAPED: Ushaped.
LINE OF OCCLUSION:normal
Diastema:2mm.
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Cast Apart
Mandibular arch:MIDLINE: normal.
ARCH SHAPE: USHAPED.
LINE OFOCCLUSION:disturbed.
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Cast In Occlusion
OVER JET: 7mmOVERBITE: 55%
MOLARRELATION:
RIGHT: Class II
LEFT: Class II
CUSPIDRELATION:
RIGHT: Class II
LEFT: Class II
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Space Analysis
UPPER ARCH:Space available: 86mm
Space required: 81mm
Discrepancy: 5mm
LOWER ARCHSpace available= 73.5mm
Space required= 70.5mm
Discrepancy= 3mm
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Bolton Analysis
WHOLE ARCH:Whole Arch = 90.5%
Discrepancy=1.2mm
ANTERIOR ARCH:Anterior Arch = 82.82%
Discrepancy =3.74.
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bl i
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Problem ListMolars are in class 2.
Canines are in class 2.
Overjet 7mm.
Distema.
Deepbite 55%
bimaxPrtusion.
i f
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Aim of Treatment
To achieve class I molar relationship.
To achieve class I canine relationship.
To reduce distema.
Manage bimaxilary protusion.
Reduce deepbite and overjet.
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Treatment Plan
Plan A
Fixed orthodontic appliance.
Distalization of molars in maxilla.
Extraction of all 4s.
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Plan B Extraction of upper 4s with
distalization of upper anteriorsegment.and molars ends in full cuspclass 2.
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Thank You!