european society of lingual orthodontists...sagittal jaw relation a-n-pg -2.6 1.7 2º ± 2.5º...

EUROPEAN SOCIETY

OF LINGUAL

ORTHODONTISTS

CANDIDATE NUMBER: 13 Dr. Masatoshi Sana

CASE NUMBER: 4

Year:　２０１０

ESLO 01

NAME: Mia H.

BORN: 03/09/1974

SEX: F

PRETREATMENT RECORDS:

CLASSIFICATION: 　

TEETH MISSING BEFORE TREATMENT: 28,38,48

APPLIANCE: Upper & lower lingual fixed orthodontic appliance (Kurz 7th)

TREATMENT STARTED:

TREATMENT ENDED:

ACTIVE TREATMENT TIME: 2.2years

POSTTREATMENT RECORDS:

RETAINERS:

RETENTION ENDED:

AGE:27.4years

RETENTION TIME: 3.4years

(POST-) RETENTION RECORDS:

TIME OUT OF RETENTION: 2.2years

DATE:02/02/2002

AGE:27.7years DATE:06/04/2002


a) Dynamic Positioner

DATE: 28/04/2008

ESLO 02

RÉSUMÉ OF CASE 7

A SEVERE SKELETAL DISCREPANCY CASE CATEGORY:

DATE:27/10/2007 AGE:33.1years


Adult malocclusion - Angle ClassⅢ, skeletal Cl Ⅲ

DIAGNOSTIC DESCRIPTION

OF THE MALOCCLUSION

A. SUMMARY

B. EXAMINATION OF HEAD AND FACE

C. FUNCTIONAL EXAMINATION

D. INTRAORAL EXAMINATION

E. DENTAL CASTS

CANDIDATE NUMBER:13

ESLO 03

Patient’s chief complaint was mandibular prognathism.

Patient’s mastication was dysfunctioned at incisal area.

TMJ was no- problem.

Speech was not clear, caused by tongue thrust habit.

1.Angle class Ⅲ

2. Overjet -1.3mm , Overbite ＋0.5mm

3. Crossbite (16/44,13~22/44~33)

4. Crowding

5. Midline discrepancy (Lower midline shifted to right 1.4mm)

6. Narrow dental arch

Maxillary arch: Arch length discrepancy was -2.3mm

Mandibular arch: Arch length discrepancy was -1.4mm

Occlusion Sagittal: Angle classⅢ，overjet -1.3mm

Occlusion Vertical: overbite ＋0.5mm

Occlusion Transversal: crossbite (16/44,13~22/44~33)

DATE: 02/02/2002 AGE: 27.4years

From lateral view, patient’s profile was concave.

From frontal view , mandibular position was shifted to right.

From smile view, upper incisor was not exposure.

CASE NUMBER:4

FRONTAL

45° PROFILE

ESLO 04

FACIAL PHOTOGRAPHS BEFORE TREATMENT

SMILE

CANDIDATE NUMBER:13 DATE: 02/02/2002 AGE: 27.4years CASE NUMBER:4

vv vv

vvv

Right Buccal Left Buccal

Center

Upper Occlusal Lower Occlusal

ESLO 05

INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BEFORE TREATMENT


ESLO 06

LATERAL SKULL RADIOGRAPH BEFORE TREATMENT CANDIDATE NUMBER:13 DATE: 02/02/2002 AGE: 27.4years CASE NUMBER:4

ESLO 07

TRACING OF LATERAL SKULL RADIOGRAPH BEFORE TREATMENT


CEPHALOMETRIE

ANALYSE TWEED MERRYFIELD

ESLO 08!1

SNA 82°±２ 86.0°

SNB 80°±２ 87.7°

ANB 2°±２ -1.7°

FMA 25°±3 26.5°

IMPA 87°±3 81.5°

OP/F 10° 6.9°

Debut Tt


CEPHALOMETRIC MORPHOLOGICAL

ASSESSMENT 1

Pretreatment Mean SD Sagittal Skeletal Relations

Maxillary Position S-N-A

86.0° 82º ± 3.5º

Mandibular Position S-N-Pg 88.6° 80º ± 3.5º

Sagittal Jaw Relation A-N-Pg -2.6° 2º ± 2.5º

Vertical Skeletal Relations Maxillary Inclination S-N / ANS-PNS

8.8° 8º ± 3.0º

Mandibular Inclination S-N / Go-Gn 31.8° 33º ± 2.5º

Vertical Jaw Relation ANS-PNS / Go-Gn 23.0° 25º ± 6.0º

Dento-Basal Relations Maxillary Incisor Inclination 1 - ANS-PNS

121.7° 110º ± 6.0º

Mandibular Incisor Inclination 1 - Go-Gn 82.8° 94º ± 7.0º

Mandibular Incisor Compensation 1 - A-Pg (mm) 5.8mm 2 ± 2.0

Dental Relations Overjet (mm) -1.3mm 3.5 ± 2.5

Overbite (mm) 0.5mm 2 ± 2.5

Interincisal Angle 1 / 1 132.6° 132º ± 6.0º

ESLO 08-2


PERIAPICAL OR PANORAMIC RADIOGRAPHS

BEFORE TREATMENT

ESLO 09


ANY OTHER RADIOGRAPHS BEFORE TREATMENT

ESLO 10


RADIOGRAPHIC ANALYSIS

BEFORE TREATMENT

A. INTRAORAL / PANORAMIC RADIOGRAPH

B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT

ESLO 11

18 was erupted.

28,38,48, were absence.

Roots of 15,25 were short.

No root resorption.

Root parallelism is good.


1. Sagittal Skeletal Relations:

Maxillary position was almost normal.

Mandibular position was protrusive position.

( SNA86.0°, SNB87.7°, ANB -1.7°)

2.  Vertical Skeletal Relations:

All measurements were in the range of normal.

3.  Dento- Basal Relations:

Maxillary incisor was inclined to labial.

( 1-ANS-PNS : 121.7°)

　　Mandibular incisor was inclined to lingual.

( 1-Go-Gn : 82.8°)

4.  Dental relations:

Overbite 0.5mm, Overjet -1.3mm

　　Molar relation was ClassⅢ

　　Lower midline shifted to right 1.4mm

5.  Esthetic Profile:

Patient’s profile was concave.

　 Lower lip was protruded.

TREATMENT PLAN

AND THE REASON FOR IT

ESLO 12-0

Treatment plan

Mandibular position was severe protruded (ANB:-1.0°).

Mandibular set back osteotomy was indicated for this correction.

Before surgery, maxillary expansion and deconpensate inclination of

upper and lower incisors was needed.

During active orthodontic treatment , MFT (Myofunctional Therapy) was

needed for functional improvement and stability.


1, Extraction (18)

2, Bonding both arches with lingual appliances.

(Kurz 7th brace)

3, Myofunctional therapy (MFT)

4, Leveling

5, Expanding maxillary arch.

6, Arch coordination

7, IVRO (Intraoral Vertical Ramus Osteotomy)

8, Detailing

The reason

INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BETWEEN TREATMENT

ESLO 12-1


Center


Upper : Ni-Ti (.012)


FACIAL PHOTOGRAPHS PRE-OPERATION

FRONTAL

45° PROFILE

SMILE

ESLO 12-2


vvvv

vvv

INTRA-ORAL COLOUR PHOTOGRAPHS PRE-OPERATION

ESLO 12-2


Center


Upper : S.S (.016!.022)

Lower : TMA (.016!.022)


INTRA-ORAL COLOUR PHOTOGRAPHS DURING HOSPITALIZATION

ESLO 12-3


Center

Upper : S.S (.016!.022)

Lower : TMA (.016!.022)


INTRA-ORAL COLOUR PHOTOGRAPHS POST-OPERATION

ESLO 12-4


Center


Upper : S.S (.016!.022)

Lower : TMA (.016!.022)


INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BETWEEN TREATMENT

ESLO 12-5


Center


Upper : S.S (.016!.022)

Lower : TMA (.016!.022)


RÉSUMÉ OF THE TREATMENT CARRIED OUT

INCLUDING

ANY DIFFICULTIES ENCOUNTERED

ESLO 13

01.03.2002　 Diagnosis

18 extraction

06.04.2002 Started pre-surgical orthodontic treatment

　 Indirect bonding to maxillary arch

(Kurz 7th brace / Ni-Ti .012)

19.05.2002 Indirect bonding to mandibular arch

(Kurz 7th brace / Ni-Ti .012)

Started Myofunctional theraphy

14.06.2002 Alignment maxillary and mandibular arch

(Ni-Ti.014~ low friction TMA .016!.022)

26.07.2003 Taken pre-operation examination

06.08.2003 Operation

(Intraoral vertical ramous osteotomy /

R : 3.5mm, L : 5.8mm set back)

30.08.2003 Taken post-operation examination

Started post-surgical orthodontic treatment

21.11.2003 Detailing (TMA .0175!.0175)

26.06.2004 Removed the appliances

Started retention


ESLO 14

FACIAL PHOTOGRAPHS AT COMPLETION OF TREATMENT

FRONTAL

45° PROFILE

SMILE


vvvv

vvv

INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION AT COMPLETION OF TREATMENT

ESLO 15


Center



ESLO 1６

LATERAL SKULL RADIOGRAPH

AT COMPLETION OF TREATMENT CANDIDATE NUMBER:13 DATE: 26/06/2004 AGE: 29.9years CASE NUMBER:4

TRACING OF LATERAL SKULL RADIOGRAPH

AT COMPLETION OF TREATMENT

ESLO 17-1




ESLO 17-1


SUPERIMPOSITION AT SN-S

ESLO 17-2



ESLO 17-2


ESLO 17-3

SUPERIMPOSITIONS of MAXILLA , MANDIBULE , PROFILE


Palatal Plane at ANS

Mandibular Plane at Me

S-N at S

ESLO 18!1

CEPHALOMETRIE


Debut Tt Fin Tt

SNA 82°±２ 86.0° 85.3°

SNB 80°±２ 87.7° 82.5°

ANB 2°±２ -1.7° 2.8°

FMA 25°±3 26.5° 30.5°

IMPA 87°±3 81.5° 91.6°

OP/F 10° 6.9° 11.5°



ASSESSMENT 2

ESLO 18-2

Pretreatment Posttreatment Mean SD Sagittal Skeletal Relations

Maxillary Position S-N-A

86.0° 85.3° 82º ± 3.5º

Mandibular Position S-N-Pg 88.6° 83.6° 80º ± 3.5º

Sagittal Jaw Relation A-N-Pg -2.6° 1.7° 2º ± 2.5º


8.8° 7.5° 8º ± 3.0º

Mandibular Inclination S-N / Go-Gn 31.8° 35.1° 33º ± 2.5º

Vertical Jaw Relation ANS-PNS / Go-Gn 23.0° 27.6° 25º ± 6.0º


121.7° 114.5° 110º ± 6.0º

Mandibular Incisor Inclination 1 - Go-Gn 82.8° 93.7° 94º ± 7.0º

Mandibular Incisor Compensation 1 - A-Pg (mm) 5.8mm 4.3mm 2 ± 2.0

Dental Relations Overjet (mm) -1.3mm 3.5mm 3.5 ± 2.5

Overbite (mm) 0.5mm 2.1mm 2 ± 2.5

Interincisal Angle 1 / 1 132.6° 124.2° 132º ± 6.0º




ESLO 19


ESLO 19-1


ANY OTHER RADIOGRAPHS AT COMPLETION OF TREATMENT

RADIOGRAPHIC ANALYSIS AT

COMPLETION OF TREATMENT



ESLO 20

1.  Sagital Skeletal Relations:

Maxillary position was no change.

Mandibular position was change to the range of normal.

　　(SNA 86.0°" 85.3°, SNB 87.7°" 82.5°, ANB -1.7°" 2.8°)

2.  Vertical Skeletal Relations:

All measurements were in the range of normal.

3.  Dento-Basal Relations:

Maxillary incisor well positioned relative to line ANS-PNS .

Mandibular incisor well positioned relative to Go-Gn.

4.  Dental relations:

Normal overjet and overbite.

　　( overjet -1.3mm"3.5mm , overbite 0.5mm"2.1mm)

Midline discrepancy was improved.

ClassⅠ molar relation was established.

5.  Esthetic Profile:

Patient’s profile changed to straight.

　　 (Upper : -2.2mm " -0.2mm / Lower: 1.9mm " 1.6mm)

18 was extracted.

33 root tipped to distal.

Lower incisor roots were slightly resorbed.


DESCRIPTION OF THE

TREATMENT RESULT

ESLO 21-1


1)  Patient’s profile changed from concave to straight.

2)  ClassⅠrelationship was established.

3)  Mastication and speech dysfunction were improved.

TREATMENT RESULT ORIENTATION

DESCRIPTION OF THE

POST-TREATMENT EVALUATION

OF RETENTION

ESLO 21-2

1) Retaining goal : lifelong

2) Occlusion is stable

3) Teeth positions are stable


RETENTION RESULT ORIENTATION

ESLO 22

FACIAL PHOTOGRAPHS POST RETENTION

FRONTAL

45° PROFILE

SMILE


vvvv

vvv

INTRA-ORAL COLOUR PHOTOGRAPHS AT RETENTION / POST-RETENTION

ESLO 23


Center



ESLO 24-1



AT RETENTION / POSTRETENTION

ESLO 24-2


ANY OTHER RADIOGRAPHS AT RETENTION / POSTRETENTION

RADIOGRAPHIC ANALYSIS

AT RETENTION/POSTRETENTION



ESLO 24-3


Roots position were improved to parallel compared with

post active treatment.

Alveolar bone was stable.

1. Sagittal Skeletal Relations:

Idem page 20 =stable

2. Vertical Skeletal Relations:

ANS-PNS / Go-Gn 27.6° " 30.2°

Other measurements were stable

3. Dento-Basal Relations:

1-Go-Gn 93.7°" 91.3°


4. Dental Relations:

Overbite was increased from 2.1mm to 2.4mm


5. Esthetic Profile:

　 Idem page 20 = stable

LATERAL SKULL RADIOGRAPH AT RETENTION / POSTRETENTION

ESLO 24-4


ESLO 25-1


AT RETENTION / POST-RETENTION



ESLO 25-2


SUPERIMPOSITIONS of MAXILLA,MANDIBULE,PROFILE

Palatal Plane at ANS

Mandibular Plane at MeS-N at S

ESLO 25-3


ESLO 26-1

CEPHALOMETRIE


Debut Tt Fin Tt

SNA 82°±２ 86.0° 85.3° 85.6°SNB 80°±２ 87.7° 82.5° 82.1°ANB 2°±２ -1.7° 2.8° 3.5°FMA 25°±3 26.5° 30.5° 31.5°IMPA 87°±3 81.5° 91.6° 89.6°OP/F 10° 6.9° 11.5° 11.6°

Fin Cont



ASSESSMENT 3

ESLO 26-2

Pretreatment Posttreatment Retention/ Postretention

Mean SD

Sagittal Skeletal Relations Maxillary Position S-N-A

86.0° 85.3° 85.6° 82º ± 3.5º

Mandibular Position S-N-Pg 88.6° 83.6° 83.4° 80º ± 3.5º

Sagittal Jaw Relation A-N-Pg -2.6° 1.7° 2.2° 2º ± 2.5º


8.8° 7.5° 6.3° 8º ± 3.0º

Mandibular Inclination S-N / Go-Gn 31.8° 35.1° 36.6° 33º ± 2.5º

Vertical Jaw Relation ANS-PNS / Go-Gn 23.0° 27.6° 30.2° 25º ± 6.0º


121.7° 114.5° 114.9° 110º ± 6.0º

Mandibular Incisor Inclination 1 - Go-Gn 82.8° 93.7° 91.3° 94º ± 7.0º

Mandibular Incisor Compensation 1 - A-Pg (mm) 5.8mm 4.3mm 4.6mm 2 ± 2.0

Dental Relations Overjet (mm) -1.3mm 3.5mm 2.9mm 3.5 ± 2.5

Overbite (mm) 0.5mm 2.1mm 2.4mm 2 ± 2.5

Interincisal Angle 1 / 1 132.6° 124.2° 123.6° 132º ± 6.0º


DESCRIPTION OF RETENTION /

POST-RETENTION FINDINGS

ESLO 27


1) Maxillar and mandibular relation are stable.

2) Occlusion is stable.

3) Teeth position are stable.

4) Retaining goal : life long

LONG TERM RETENTION RESULT ORIENTATION

european society of lingual orthodontists...sagittal jaw relation a-n-pg -2.6 1.7 2º ± 2.5º...

Documents