Case Presentation

By: Click to edit Master subtitle style Raza siddique. Roll No:03 FINAL YEAR

Personal Data
Name: Razia Gender: Female. Age: 12 years. Occupation: Student. Address: Gulshan-e-iqbal. Marital status: Single.

Chief Complain
Patient complained of poor facial looks.

History
Medical history: Not significant. Past dental history: None. Family history: Not significant.

History
Para functional habits: none Social and behavioral status: Affording. Internally motivated

Extra Oral Examination

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Frontal View
Symmetrical face Head Form: mesiocephalic Face Form: mesioprosopic. Lips are not compitent Lips shape: normal

Frontal View Smile

Gum visibilty: 0 Symetrical smile consonant smile

Profile View
lips are not compitent at rest. Facial profile: convex Nasiolabial angle: Normal Mentolabial angle: obtuse.

Oblique View
Zygomatic prominence is normal Lips are not competent at rest.

Intra- Oral Examination

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Dentition status:
Dentition status: permanent.

8 7654321 654321 87

78 123456 123456 78

Periodontal & Mucosal Status

Frenum: normal and attached Periodontal status: good No soft tissue lesion

Frontal View
Upper to Lower midline: normal. Frenum attached. Good oral hygiene. Overbite = 55%.

Right Intraoral View

Molar Class: class II Canine Class: Class II Overjet: 5mm

Left Intraoral View

Molar Class: Class II Canine Class: Class II

Maxillary Occlusal View

Midline: Normal Palatal vault: Normal Arch shape: U shaped Line of occlusion: normal.

Mandibular Occlusal View

Midline: normal. Arch shape: U shaped. Line of occlusion: disturbed. Infraversion 35,45

TMJ Analysis
Mouth opening: 30 mm No significant finding.

Investigations
Cephalogram OPG Study models

Cephalogram

Sagittal analysis

Sagittal Analysis
SNA SNB ANB WITS ANALYSIS FACIAL ANGLE NORMAL VALUE 82 2o 782o 1-4 0 2mm 87-90o PATIENTS READINGS 77o 75o 2o 0.5 mm 88o

Sagittal Analysis
NORMAL VALUES Mcnamara to pt A 01mm Mcnamara to upper 4mm Incisor Mcnamara to Pog -34mm PATIENTS VALUES 0 mm 8.5mm 4 mm

Vertical analysis

Vertical Analysis
SNMP FHMP LFH PFH Y axis Facial axis NORMAL VALUES PATIENTS VALUES 32-33o 39o 22-25o 55% 65% 57-61o 90o 22o 57% 62.8% 61o 87o

Dental Analysis

Dental analysis
UI-SN UI-FH UI-PAL IMPA UI-LI NA/UI NB/LI NORMAL VALUES PATIENTS VALUES 102o 115 110o 108o 90o 125-135o 22o 25o 125o 123 94o 111o 38o 38o

Dental analysis
NORMAL VALUE PATIENTS READINGS 4mm 13mm 4mm 7mm

UI-NA Distance LI-NB Distance

Soft Tissue Analysis

Upper lip - E line = 0 mm Lower lip - E line = +1 mm Nasiolabial Angle = 61

OPG

OPG
No bone loss. No hard tissue abnormality. According to Nollas stage:
VI,VIII,IX,IX,IX,IX,X, X,X,IX,IX,IX,IX,VIII,VI X V,VIII,IX,IX,IX,IX,X,X X,X,IX,IX,IX,IX,VIII,V

Cast Apart
Maxilla arch:
MIDLINE: Normal PALATAL VAULT: Deep ARCH SHAPED: U shaped. LINE OF OCCLUSION: normal Diastema:2mm

Cast Apart
Mandibular arch:
MIDLINE: normal. ARCH SHAPE: U SHAPED. LINE OF OCCLUSION: disturbed.

Cast In Occlusion
OVER JET: 7mm OVERBITE: 55% MOLAR RELATION:
RIGHT: Class II LEFT: Class II

CUSPID RELATION:
RIGHT: Class II LEFT: Class II

Space Analysis
UPPER ARCH:
Space available: 86mm Space required: 81mm Discrepancy: 5mm

LOWER ARCH
Space available= 73.5mm Space required= 70.5mm Discrepancy= 3mm

Bolton Analysis
WHOLE ARCH:
Whole Arch = 90.5% Discrepancy=1.2mm

ANTERIOR ARCH:
Anterior Arch = 82.82% Discrepancy =3.74.

Diagnosis
Skeletal class 1. Dental class 2. diastema.

Problem List
Molars are in class 2. Canines are in class 2. Overjet 7mm. Distema. Deepbite 55% bimaxPrtusion.

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.

Treatment Plan
Plan A Fixed orthodontic appliance. Distalization of molars in maxilla. Extraction of all 4s.

Plan B Extraction of upper 4s with distalization of upper anterior segment.and molars ends in full cusp class 2.

Thank You!

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