PATIENT CASE HISTORY

NAME NAZEER MOHAMMED

Ortho No. OPD NO

20130329 16797

Date of birth 8/12/1985 Age / Sex 28/M

Address VASALPUR ,NARAINGARH,AMBALA

Phone No. 09813583319

Pretreatment 28/1/13

28/M,FARMER R/O VASALPUR,NARA INGARH/

C/C PATIENT COMPLAINS OF FORWARDLY PLACED ANERIOR TEETH

Family history N.R Medical history N.R Dental history N.R

EXTRA ORAL FACIAL VIEW

Apprantly bilaterally Symmetrical leptoprosopic face Convex profile Potentially competent lips Interlabial gap 5 mm Incisor show at rest 4mm

acute nasolabial angle deep mentolabial

Intra oral examination

Molar relation ;END ON ON RT,CLASS II

Canine relation :END ON,CLASS I Incisor ;CLASS II Faciomaxillary midline concordant Maxilo-mandibular midlines are concordant

Overjet Overbite

9mm 4 mm

Pretreatment 28/01/13

Max arch:
Arch form: U shape HIGH arched palate

Mand arch:
Arch form: U SHAPE

Pretreatment OPG 24/12/12

Pretreatment Cephalogram 28/01/13

Skeletal Class II jaw bases l

SKELETAL ANALYSIS Discrepancy in Sagital plane

SNA SNB

82 80 3.12+/-1.8 -0.01mm +5mm -1.5mm

ANB
Wits App-Bpp MM bisector

AB Plane angle
Pt is skeletal Class

(-4.6 3.67)

SN length(72mm) Maxillary length(ANS toPNS)(49mm) Mandibular length (GoTO PoG)(76mm)

mm mm mm
Both the mand and max are proportionally Enlarge.

Maxillary and mand length is increased

N perpendicular to A point (-4.46mm) B point (-11.03mm) Pog (-10.5mm)

mm mm mm

A and B point are placed normal to N perpendicular.

Discrepancy in Vertical dimensions

FMA
(24) SN-MP Y-axis (32) (59)

Gonial angle
Lower gonial angle J-ratio UFH / LFH

(123)
(70) (62 %) (45 : 55)

Indicating normal growth pattern

Pretreatment 24/12/12 Upper incisors are proclined and protruded UI -A-Pg: +6mm 6.741.3mm UI-NA: 4.922.05mm

+7mm

UI-NA: 24.025.82
UI-Palatal Plane ( 110)

27

118

UI-SN

112

Lower incisors are proclined

LI- A-Pg ( -2mm to 2mm) LI-NB (61.7mm) LI-NB (274.3 ) IMPA (90)

+7mm 6mm
25 95

Soft tissue analysis

E line (mm)

Upper lip (-4mm)

Lower lip (-2 mm)

mm
mm mm mm

S line (mm)

Upper lip (0 mm) Lower lip (0 mm)

Upper and lower lip are protruded w.r.t E & S line Nasolabial angle Inter labial gap Lip strain 0 mm 2mm

Model Analysis

Boltons Analysis
Indicates mandibular tooth material excess maxillary anterior excess

Ponts Analysis

S.I. = 25.5 M.P.V. = 35

M.M.V = 46

C.P.V = 42.5 indicating no need for expansion. C.M.V = 39.84 indicating no need for expansion.

Ashley Howes Analysis

T.T.M=83

P.M.D=41 P.M.B.A.W=43.37

P.M.B.A.W.% = 43.37 %indicating borderline case

Careys Analysis
a) Arch perimeter space available b) Tooth material UPPER 79mm LOWER 67mm

83mm

55.5mm

Discrepancy b/w arch length and tooth material

4 mm

11.5mm

Carey Indicating Arch perimeter indicating

CASE SUMMARY A 20 yrs old female patient shows Skeletal Class I jaw bases .. Dentoalveolar: Malocclusion irregularly placed teeth.

Soft tissue: convex profile,acute nasolabial angle, average mentolabial sulcus,potentialy competent lips, crossbite present.

PROBLEM LIST
Skeletal Class I jaw bases ANGLES CLASS II DIV I malocclusion missing lower firs canine class I and Class I incisor relationship. acute nasolabial angle competent lips DEEP mentolabial sulcus

DIAGNOSIS
SKELETAL CLASS I Normodivergent GROWTH PATTERN .

INCRESED OVERJET
ANGLES CLASS II DIV IMALOCCLUSION

DISCREPANCY CALCULATION

Mandibular Arch
FMA 24

IMPA(95) IMPA correction =5 intraarch correction =4

Maxillary Arch
Overjet due to IMPA correction= 2mm Total overjet=2+2=4mm Space required for correction of total overjet= 4x2=8mm (maxillary arch)

TREATMENT OBJECTIVE
Correction of molar and incisor relationship Correction of crowding ,spacing. Correction of crossbite CORRECTION of overjet and overbite

TREATMENT PLAN
FIXED MECHANOTHERAPY No EXTRACTION ANCHORAGE-GROUP C TYPE OF APPLIANCE-PREADJUSTED APPLIANCE MECHANICS-ROTH .022 SLOT