DEPARTMENT OF ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS

GURUNANAK INSTITUTE OF DENTAL SCIENCE AND RESEARCH

157/F Nilgunj Road, Sodepur, Kolkata – 700114

CASE RECORDS

NAME :-_________________________________________________________________________________________________

OPD NO.:-_______________________________________________________________________________________________

ORTHO NO.:-________________________________________________________________________________________

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DEPARTMENT OF ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS

GURUNANAK INSTITUTE OF DENTAL SCIENCE AND RESEARCH

157/F Nilgunj Road, Sodepur, Kolkata – 700114

CASE RECORDS

Name :- ___________________________________________________________________________________

Age/ Sex :- ___________________________________________________________________________________

OPD No. :- ___________________________________________________________________________________

Ortho No. :- ___________________________________________________________________________________

Address :- ___________________________________________________________________________________

Malocclusion :- ___________________________________________________________________________________

Mode of Treatment :- ___________________________________________________________________________________

(Removable/ Fixed :- ___________________________________________________________________________________

Myofunctional/ Surgical) :- ___________________________________________________________________________________

Treatment Commence on :- ___________________________________________________________________________________

Treatment completed on :- ___________________________________________________________________________________

Retention completed on :- ___________________________________________________________________________________

Retention completed on :- ___________________________________________________________________________________

Operator’s Name :- 1. __________________________________________________________________________

2. __________________________________________________________________________

3. __________________________________________________________________________

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Supervisor :- ___________________________________________________________________________________

DEPARTMENT OF ORTHODONTICS &DENTOFACIAL ORTHOPEDICSORTHODONTIC TREATMENT CONSENT FORM

I, _______________________________________________________________________________ fully understand that my ward

_______________________________________________________________________________________needs Orthodontic treatment.

I have also understood the need for extraction of_________________ teeth as imperative before starting the

orthodontic treatment of my ward.

I have understood that although orthodontic treatment has a high degree of success, it is still a

biomechanical procedure, so it cannot be guaranteed & that the unfavorable consequence of this

treatment :: may include the following

1. Post extraction discomfort ft swelling may occur, for which medication will be prescribed, if deemed

necessary, by the doctor.

2. Pain & discomfort of teeth & adjacent soft tissue may occur due to placement of bracket,

band % wire.

3. The treatment time will be increased if the patient doesn’t co —operate with all the instructions given

by the treating doctor

4. The treatment may be a total failure if the patient doesn’t wear elastic head gear/other appliances as

prescribed.

5. There may be a total relapse of finished treatment. if the retainers are not worn for the

required duration of time.

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6. There may be a total relapse of the treatment, if deleterious oral habits such as tongue thrusting,

mouth breathing lip sucking etc. persist after completion of treatment.

7. Relapse of the treatment may occur later due to eruption of the third molar.

8. Extraction, if not deemed necessary at the initial examination may be needed later & carried out with

due consent.

9. Accidental breakage of the wires or brackets will not be the responsibility of the doctors.

10. Tooth mobility and gum swelling may occur due to orthodontic treatment, if proper oral if proper oral

hygiene is not maintained during the treatment.

11. Poor oral hygiene may also result in permanent stains or cavities in the teeth.

12. On completion of treatment, aesthetic judgment of the treating doctor will be considered final and

unquestionable.

13. Some patients the length of the roots of the teeth may be shortened during orthodontic treatment.

Some patients are prone to this happening, some are not.

14. Occasionally problems may occur in jaw joints (T.M.J.) such as joint pain, clicking headaches or ear

problems etc.

15. Sometimes a root may have been traumatized by a previous accident or tooth may have large

fillings which can cause damage to the nerve of tooth.

16. Sometimes orthodontic appliances may be accidentally swallowed or aspirated or may initiate

damage to the oral tissue.

17. If improperly handled headgear may cause injury to the face or or eyes.

18. The treatment will be carried out by the Resident doctors.

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19. Facial photographs at regular intervals will be taken for evaluation of treatment progress.

I have also understood the prognosis and the estimated duration of the treatment will be about

2-3 years or more and retention time also varies from 1-3 years.

Signature of the patient / Guardian-

Relationship to the patient

Address

CASE RECORD

OPD NO._______________________________________ ORTHO NO.____________________________________________

NAME :- _______________________________________________________________________________________________________

DATE OF BIRTH :- ____________________________ AGE / SEX _____________________________________________

EDUCATIONAL QUALIFICATION:- ___________________________________________________________________________

OCCUPATION _______________________________________________________________________________________________

NAME AND OCCUPATION OF FATHER _______________________________________________________________________

NAME AND OCCUPATION OF MOTHER______________________________________________________________________

HOME ADDRESS :- __________________________________________________________________________________________

CONTACT NO ____________________________________

Diagnostic aid Pretreatment (date )

Stage – I Stage – II Post Treatment

(Date )a) Study Models

b) Lateral Cephalogram

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c) PA Cephalogram

d) Orthopantomogram

e) IOPA X – Rays

f) Occlusal/ Bite Wing X-rays

g) Photographs

h) Hand wrist Radiographs

i) Dental scan

j) Other

HISTORY

CHIEF COMPLAINT : ___________________________________________________________________Sibling : Male _______________________Female _______________________

Parent’s Dental conditions & Malocclusion :

___________________________________________________________________

Siblings Dental conditions & Malocclusion : ________________________________________________________________

Familial diseases : ________________________________________________________________

History of previous orthodontics treatment :

___________________________________________________________________

Type of Home oral hygiene care : Brush/ Other aids

Patient’s concern for Treatment : Very Concerned / Indifferent/ Opposed

Parent’s concern for Treatment : Very Concerned / Indifferent/ Opposed

PRE-NATAL HISTORYInformer : Patient / Parent/ Other

Health of mother during pregnancy : ___________________________________________________________

Drug taken during pregnancy : __________________________________________________________

Delivery : Full Term/ Pre Mature

Type of Delivery : Normal/ Forceps/ Cesarean

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POST- NATAL-HISTORYFeeding : Brest/ Bottle/ Combined

History of childhood diseases : ___________________________________________________________

Injuries. : ________________________________________________________

HABITSDURATION INTENSITY FREQUENCY

Thumb/ Finger Sucking

Nail/ Lip BitingMouth Breathing

Tongue ThrustingBruxism

Snoring

REASON FOR SEEKING ORTHODONTIC TREATMENTEsthetic

Functional

Speech

Hygiene

ANY OTHER INFORMATION

CLINICAL EXAMINATION

PHYSICAL STATUS

Height: cm.

Weight: Kg.

EXTRA ORAL EXAMINATION:

Shape of Head : Dolicocephalic/ Mesocephalic/ Brachycephalic

Facial Form : Mesoprosopic/ Leptoprosopic/ Europrosopic

Facial Profile : Convex/ Straight/ Concave

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Facial Divergence : Straight/ Anterior Divergence / PosteriorDivergence

Facial Symmetry : ___________________________________________________________

Lip Competency : Incompetent / Potentially Competent/ Competent

Inter Labial gap : ___________________________________________________________

Incisor Display at rest : ___________________________________________________________

Incisor Display during full smile : ___________________________________________________________

Congenital anomaly : Cleft lip/ Palate /any other

Gingival display at rest : ___________________________________________________________

Gingival display during full smile : ___________________________________________________________

FUNCTIONAL EXAMINATION

RESPIRATION : Nasal/ Oral/ Oro-nasal

Lip Tonicity Upper Lip : Normal/ Hypotonic/ Hypertonic

Lower Lip : Normal/ Hypotonic/ Hypertonic

Mentalis : Normal/ Hypotonic/ Hypertonic

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Masseter : Normal/ Hypotonic/ Hypertonic

Pattern of swallowing/ deglutition : Somatic/ Visceral

Speech analysis : Normal/ AbnormalArticulated/ Non Articulated

Path of Closure : Normal/ Deviated

TMJ : Pain/Clicking/ Crepitus

Freeway Space : ___________________________________________________________

Clinical Examination

Pre- Treatment Stage Post treatmentI II

TendernessOver Joint

RightLeft

Clicking Sounds Right

Left

Muscle tenderness Right

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Temporalis Left

Masseter RightLeft

MedialPterygoid

Right

Left

Lateral Pterygoid Right

Left

Any OtherRight

Left

Lateralexcursions (mm)

Right

Left

Maximum incisal opening (mm)

Protrusion(mm)

INTRAORAL EXAMINATION

SOFT TISSUESOral Hygiene Status : Good/ Satisfactory/Poor

Gingiva : Normal/ Oedematous / Fibrous

Brushing Habits : Good/ Satisfactory/Poor

Position of Mucogingival Junction : Normal/ Abnormal

Frenal Attachment-Upper : Normal/ Abnormal

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-Lower : Normal/ Abnormal

Tongue : 1. Size

2. Shape

3. Movement

4. Posture

Oral Mucosa : ..……………………………………………………………….

Tonsils / Adenoids : ..……………………………………………………………….

HARD TISSUESNUMBER OF TEETH PRESENT : 51 52 53 54 55 61 62 63 64 65

71 72 73 74 75 81 82 83 84 85: 11 12 13 14 15 16 17 18 21 22 23 24 25 26 27 28

31 32 33 34 35 36 37 38 41 42 43 44 45 46 47 48

Number of unerupted teeth : ..……………………………………………………………….

Supernumerary /Missing teeth : ………………………………………………………...………

Size and form of teeth : ..……………………………………………………………….

Texture : Normal/ Hypoplastic (localized/ generalized)

Carious teeth : ………………………………...………………………………

Endodontically Treated : ……………………………..……………….…………………

Occlusal Wear Facets : ………………………………..……………………………….

Traumatic fractured teeth : ………………………………..……………………………….

MAXILLARY ARCHShape : ‘V’ Shaped/ ‘U’ Shaped/ SquareArch Symmetry : Symmetrical/Asymmetrical Arch Alignment : Crowding/Spacing / AlignmentPalatal Contour/ Depth : Deep/Average/ Shallow

MANDIBULAR ARCH

Shape : ‘V’ Shaped/ ‘U’ Shaped/ Square

Arch Symmetry : Symmetrical/Asymmetrical

Arch Alignment : Crowding/ Spacing/ Alignment11

ANTERO-POSTERIOR RELATIONSHIP

Molar Relation (Angle’s) :…………………………………………………………………………………..

Premolar Relation (Katz’s) :…………………………………………………………………………………..

Canine Relation (Rickett’s) :…………………………………………………………………………………..

Incisor Relation (Ballard &Weinmann) :…………………………………………………………………………………..

Overjet :……………………………………mm

VERTICAL RELATIONSHIP

Overbite :…………………………………..mm/percentage

Openbite : Anterior/ Posterior/ No

Curve of Spee :……………………………………………………………………………………

TRANSVERSE RELATIONSHIP

Crossbite :………………………………………………………………………………….

Scissors bite :………………………………………………………………………………….

Mid Line : Normal/Shifted to Left/ Right

STUDY MODEL ANALYSIS

TOOTH MEASUREMENT

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Right Left6 5 4 3 2 1 1 2 3 4 5 6

U

L

6 5 4 3 2 1 1 2 3 4 5 6

Right Left

CAREY’S ARCH PERIMETER ANALYSISUpper Lower

Total tooth material

Arch perimeter

Discrepancy

LINDER- HARTH’S & PONT’S ANALYSESLINDER- HARTH’S ANALYSIS PONT’S ANALYSIS

Premolar Index

Measured Arch Width

Calculated Arch Width

Discrepancy

Molar Index

Measured Arch Width

Calculated Arch Width

Discrepancy

ASHLEY HOWE’S ANALYSISMaxillary Mandibular

Total tooth material

Premolar Diameter

Basal Arch Width

Percentage

INFERENCES

BOLTON’S TOOTH RATIO

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Anterior Ratio: Mandibular(3-3)X 100 / Maxillary(3-3)

NORMAL OBSERVED VALUE DISCREPANCY

77.2%

Overall Ratio: Mandibular(6-6)X 100 / Maxillary(6-6) 91.3%

BOLTON’S TOOTH RATIO

Ideal proportion of tooth material of maxillary and mandibular teeth.

Anterior Ratio Overall Ratio

Max. Mand. Max. Mand. Max. Mand. Max. Mand.

40.0 30.9 48.0 37.1 85 77.6 103 94.0

40.5 31.3 48.5 37.4 86 78.5 104 95.0

41.0 31.7 49.0 37.8 87 79.4 105 95.9

41.5 32.0 49.5 38.2 88 80.3 106 96.8

42.0 32.4 50.0 38.6 89 81.3 107 97.8

42.5 32.8 50.5 39.0 90 82.1 108 98.6

43.0 33.2 51.0 39.4 91 83.1 109 99.5

43.5 33.6 51.5 39.8 92 84.0 110 100.4

44.0 34.0 52.0 40.1 93 84.9

44.5 34.4 52.5 40.5 94 85.8

45.0 34.7 53.0 40.9 95 86.7

45.5 35.1 53.5 41.3 96 87.6

46.0 35.5 54.0 41.7 97 88.6

47.0 36.3 55.0 42.5 99 90.4

47.5 36.7 100 91.3

INFERENCES

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RADIOGRAPHIC EXAMINATION

PANORAMIC RADIOGRAPH

1. Teeth Present :…………………………………………………………………………………….

2. Teeth Absent :…………………………………………………………………………………….

3. Root Resorption of Deciduous Teeth : Normal/ Abnormal

4. Root Formation of Permanent Teeth : Normal/ Abnormal

5. Character of Restoration :…………………………………………………………………………………….

6. Lamina Dura : Normal/Abnormal

7. Height of Interdental crest : Normal / Abnormal

8. Supernumerary teeth :……………………………………………………………………………………

9. Third Molar Status :…………………………………………………………………………………..

10. Pathological Condition (if any) :…………………………………………………………………………………..

Any other special observation regarding

a. DNS :…………………………………………………………………………………

b. Maxillary Sinus :………………………………………………………………………………..

c. TMJ/ Condyles :………………………………………………………………………………..

d. Any other :………………………………………………………………………………..

INTRA ORAL RADIOGRAPH

P A CEPHALOGRAM

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HAND WRIST RADIOGRAPHS

SKELETAL MATURITY INDICATORS Hand Wrist Radiograph stage for the patient

Inference

Width-of epiphysis as wide as diaphysis SMI 1 - Third finger - proximal phalanx SMI 2 - Third finger – middle phalanx SMI 3 - Fifth finger – middle phalanx

SMI 4 - Adductor sesamoid of thumb

SMI 5 - Third finger - distal phalanx SMI 6 - Third finger – middle phalanx SMI 7 - Fifth finger – middle phalanx

SMI 8 - Third finger - distal phalanxSMI 9 - Third finger - proximal phalanx

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SMI 10 - Third finger – middle phalanxSMI 11 - Radius.

LATERAL CEPHALOGRAM

CERVICAL VERTEBRAE STAGE FOR THE PATIENT

INTERFACE :-

1INITIATION Corresponds to SMI 1 and 2. Adolescent growth just beginning. 80% to 00% of

growth expected. Inferior borders of C2, C3.and C4 are flat. The vertebrae are

wedge shaped. Superior vertebral borders tapered from posterior to anterior.

2ACCELERATION Corresponds to SMI 3 and 4. Growth acceleration beginning. 65% to 85% or

acceleration adolescent growth expected. Concavities developing in the inferior borders of C2 and C3. The inferior border of C4 is flat. The bodies Os C3 and C4 are nearly rectangular in shape.

3TRANSITION Corresponds to SMI 5 and 6. Adolescent growth still accelerating towards

peak height velocity 25% to 65 % of adolescent growth expected. Distinct

concavities seen in the inferior borders of C2 and C3.A concavity beginning to

develop inferior border of C4. The bodies of C3 and C4 are rectangular in shape.

4DECLARATION Corresponds to SMI 7 and 8. Adolescent growth begins to decelerate

dramatically. 10% to 25% of adolescent growth expected. Distinct concavities seen in the inferior borders of C2, C3,and C4. The vertebral bodies of C3 and C4 are becoming more square in shape.

5MATURATION Corresponds to SMI 9 and 10. Final maturation of the vertebrae takes place

during this stage. 5% to 10% of adolescent growth expected. More accentuated

concavities seen in the inferior borders of C2, C3 and C4. The bodies of C3 and C4

are nearly square in shape. 17

C3

C3

C3

C3

C3

C3

6COMPLETION Corresponds to SMI 11 Growth considered to be complete. Little or no

adolescent growth is expected. Deep concavities seen in the inferior borders of C2, C3 and C4. The bodies of C3 and C4 are square or greater in vertical dimension than in horizontal dimension.

CEPHALOMETRIC EVALUATION

DOWN’S ANALYSIS

Sl no.

Parameters Normal Value Treatment

Down’s Mean

Indian Mean

Pre Stage – I Stage – II Post

Skeletal1 Facial angle (N-Pog : FH) 87.8 3.6 86.5 4.0

2 Angle of Convexity (N-A : A -Pog) 0 5.1 1.5 5.8

3 AB Plane Angle (AB : N-Pog) -4.6 3.7 -3.3 4.2

4 Mand Plane Angle (FH:MP) 21.9 3.2 22.5 4.4

5 Y-Axis (S-Gn : FH) 59.4 3.8 59.8 3.0

Dental6 Cant of Occlusal Plane +9.3 3.8 8.1 5.1

7 Interincisal Plane 135.4 5.8 125 7.4

8 Lower Incisor to Occlusal Plane 14.5 3.5 23.1 5.8

9 Lower Incisor to Mand Plane 1.43 3.8 3.0 6.8

10 Upper Incisor to APog line 2.7 1.8 5.7 2.2

INFERENCE

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STEINER’S ANALYSIS

Measurement Mean India Pre Stage - I Post

1 SNA 82 0

2 SNB 80 0

3 SND 76 0

4 ANB 2 0

5 FHP to SN 6-7 0

6 Go Gn to SN 32 0

7 Occl. To S-N (Angle)

14 0

8 S -E (Linear) 22 mm

9 S - L (Linear) 51 mm

10 1 to N-A (mm) 4 mm

11 1 to N –A (angle) 22 0

12 1 to N –B (mm) 4 mm

13 1to N –B (Angle) 25 0

14 Pog to NB (mm) Not Established

15 1 to 1 (angle) 131 0

16 1 – Go Gn (angle) 93 0

17 6 –NA (Linear) 27 mm

18 6 –NB (Linear) 23 mm

‘S’ Line to Upper Lip‘S’ Line to Lower Lip

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Acceptable Compromise

-20 00 20 40 60 80

8mm 260 6mm 240 4mm 220 2mm 200 0mm 180 2mm 160

3mm 210 3.5mm 230 4mm 250 4.5mm 270 5mm 290 5.5mm 310

INFERENCE

TWEED’S ANALYSIS

Sl No.

Parameter Norms (Degree)

Pre Stage –I Stage – II Post

1 FMA (Angle) 25

2 IMPA (Angle) 90

3 FMIA (Angle) 65

HEAD PLATE CORRECTIONFMA FMIA

30 0 Above 650

210 - 290 680

200 720

Less than 200 IMPA should not exceed 940

FMIA will range from 660 800 / more

For the patient’s FMA, an objective line is traced from the required FMIA. The distance between this objective line and the line passing through the actual axial inclination of the mandibular incisors is measured at the occlusal plane. This figure is multiplied by 2 to include right and left

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side and is added to the difference between space required and space available to yield total discrepancy.

INFERENCE

RICKETTS ANALYSISMean at 9 Yrs Age change Pre Stage –

IStage –

IIPost

Facial Axis (BaN – Ptm Gn) 900± 3.50 None

Facial Angle (FH – N Pog) 870± 30 +10 /3 Years

Mandibular Plane (FH – Go Gn)

260± 40 - 10 /3 Years

Facial Taper (N Pog – Go Gn) 680± 40 None

Lower face Height (ANS Xi – Xi PM)

470± 40 None

Mandibular Arc (DC Xi – Xi PM)

260± 40 +10 /2 Years

Convexity of Point A to N Pog 2 mm ± 2mm -1mm / 3 Years

Lower incisor to A Pog (mm) 1mm ± 2 None

Lower incisor Inclination (1 – to N Pog)

22 ±4 None

6 Distal to Pterygoid VerticalAge + 3 Add1 mm/ Year

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Lower Lip - E Line -2mm ± 2 Decreases

INFERENCE:

McNAMARA’S ANALYSIS

Mean Pre-Treatment

Stage-I Stage -II Post treatment

Na Perpendicular to Point A 0-1 mm

Na Perpendicular to Pog Small-8 to- 6mmMedium -4 to 0Large - 2to +2

Facial axis angle(Ba-N) to (Ptm-Gn)

0±3.5°

Mand Plane angle 22°±4°

Max. Length (Co-Pt.A) ------

Mand Length (Co-Gn) ------

Maxillomandibular Difference

Small 20 - 23mmMedium 27 -30mmLarge 30-33mm

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Lower Ant Facial Height (ANS-ME)

Small 60-62mmMedium 65-67mmLarge 70-73mm

1 to Point A 4-6 mm

Lower Incisor to A-Po Line 1-3 mm

Naso Labial Angle 90-110°

AIRWAY ANALYSISPre Stage-I Stage-II Post

UPPER PHARYNX: 15-20mm(<5mm impairment) Posterior outline of soft palate to closest point on posterior pharyngeal wall LOWER PHARYNX: 10-12mmIntersection of posterior border of tongue & the inferior border of mandible to the closest point on the posterior pharyngeal wall

INFERENCE

BJORK’S ANALYSIS

Mean Pre Treatment

Stage-I Stage II Post Treatment

Saddle Angle (N-S-Ar) 123±5°

Angle(S-Ar-Go) 143±6°

Gonial Angle (Ar-Go-Gn) 130±7°

Upper Gonial 50-55°

Lower Gonial 70-75°

Sum 396°

Anterior Cranial Base(S-N) 71±3mm

Posterior Cranial Base(S-Ar) 32±3mm

Ramus Height (Ar-Go) 44±5mm

Body Length (Go-Me) 71±5mm

SN-MP 32.5°

1 to MP 90±3°

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1 to SN 102±2°

FH (S-Go) ----

FH (N-Me) ----

FH/AFH% ----

INFERENCE

JARABAK’S ROTATIONAL INDEX

Pre Stage-I Stage-II Post

Posterior Facial height (S-Go)

Anterior Facial height (N-Me)

Ratio =(PFH/AFH) X 100

Ratio less than 62% expresses a vertical growth pattern,Ratio more than 65% expresses horizontal growth pattern

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WITS APPRAISAL

(Measuring the extent of jaw disharmony in anteroposterior plane)

AO to the left of BO- Negative valueAO to the right of BO- positive value

Pre Stage-I Stage-II post

INFERENCE:

SOFT TISSUE ANALYSIS

HOLDAWAY’S ANALYSIS

Mean Pre-Treatment

Stage-I Stage-II Post Treatment

Facial Angel 91±7°

Upper Lip Curvature 2.5 mm

Skeletal Convexity at Pt.A -2 to +2 mm

H- Line Angel 7°-15°

Nose Tip – H Line 14-24mm (max)

Upper Sulcus Depth 5mm

Upper Lip Thickness 15mm

Upper Lip Strain 13-14 mm

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Lower Lip to H-Line -1 to +2 mm

Lower Sulcus Depth 5mm

Soft tissue Chin Thickness 10-12mm

RICKETT’S E Line

Pre Stage-I Stage-II Post

Upper lip to E line (Normal: 4 mm behind)

Lower lip to E line (Normal: 2mm behind)

ANGLE OF MERRIFIELD

INFERENCE:

PHOTOGRAPHIC ANALYSIS

1. Bilateral Symmetry: A vertical tine passing through glabella, nasal tip, mid point of upper lip and

midpoint of chin bisects the face into two halves

_________________________________________________________________________________________________________________

2. Alar base width should equal intercanthal distance___________________________________________________________

3. Width of the mouth should equal distance between medial limbs (irises) of the eye

_________________________________________________________________________________________________________________

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4. Vertical, height of midface from glabella to subnasale should be equal to vertical height of lower face

from subnasale to soft tissue menton

_______________________________________________________________________________________________________

5. Upper lip length (Sn-StmS) is 1/3rd of the tower third facial height

(Sn - Me’)[ Sn-StmS) : (Stm1 - Me’) = 1:2 ______________________________________________________________________

PROFILE VIEW

1. Profile Convexity / Concavity : ______________________________________________________________________________

2. Divergence of face : ___________________________________________________________________________________________

[Facial. angle, between true horizontal (visual axis) and N-Pog-[if less than 90 posteriorly

divergent, if more - anteriorly divergent]

3. Nasolabial angle_____________________________________________________________________________________________

Nasolabial angle, Cm - Sn Ls, is 1020 ± 8

Cm= Columella point - most anterior point on the Columella of the nose (Columella is the terminal fleshy

portion of the nasal septum)

Sn = Subnasale - the point at which nasal septum merges with the upper cutaneous lip.

Ls = Labrale superioris -anterior most point of upper lip indicating mucocutaneous border of upper lip.

DISCUSSION

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TREATMENT FOLLOW – UP

DATE TREATMENT DONE SIGNATURE

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COMPREHENSIVE DIAGNOSTIC ASSESSMENT

MAXILLA_______________________________________________________________________________________________

_______________________________________________________________________________________________

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MANDIBLE_______________________________________________________________________________________________

_______________________________________________________________________________________________

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GROWTH PATTERN_______________________________________________________________________________________________

_______________________________________________________________________________________________

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DENTITION/ OCCLUSION_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________29

SOFT TISSUE_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

TREATMENT PLAN_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

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APPLIANCE DESIGN/ TYPE OF MECHANOTHERAPY_______________________________________________________________________________________________

_______________________________________________________________________________________________

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PROGNOSTIC ASSESSMENT_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

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RETENTION CONSIDERATIONS_______________________________________________________________________________________________

_______________________________________________________________________________________________

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_______________________________________________________________________________________________

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